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

<2>
Accession Number
2038328919
Title
Design of a randomised, placebo-controlled, double-blind multicentre study
assessing the effect of colchicine on the incidence of knee or hip
replacements in symptomatic knee or hip osteoarthritis: the ECHO trial.
Source
BMJ Open. 15(4) (no pagination), 2025. Article Number: e098096. Date of
Publication: 14 Apr 2025.
Author
Heijman M.W.J.; Van Den Ende C.H.M.; Cornel J.H.; Smolders J.M.H.; Schers
H.J.; Kievit W.; Koeter S.; Van Den Bemt B.J.F.; Popa C.D.
Institution
(Heijman, Van Den Ende) Department of Research, Sint Maartenskliniek,
Nijmegen, Netherlands
(Heijman, Van Den Ende, Popa) Department of Rheumatology, Radboud
University Medical Center, Nijmegen, Netherlands
(Cornel) Department of Cardiology, Radboud University Medical Center,
Nijmegen, Netherlands
(Cornel) Department of Cardiology, Northwest Clinics, Alkmaar, Netherlands
(Cornel) Dutch Network for Cardiovascular Research (WCN), Utrecht,
Netherlands
(Smolders) Department of Orthopedics, Sint Maartenskliniek, Nijmegen,
Netherlands
(Schers) Department of Primary and Community Care, Radboud University
Medical Center, Nijmegen, Netherlands
(Kievit) Department of Health Evidence, Radboud University Medical Center,
Nijmegen, Netherlands
(Koeter) Department of Orthopedics, Canisius Wilhelmina Hospital,
Nijmegen, Netherlands
(Van Den Bemt) Department of Pharmacy, Sint Maartenskliniek, Nijmegen,
Netherlands
(Van Den Bemt) Department of Pharmacy, Radboud University Medical Center,
Nijmegen, Netherlands
(Popa) Department of Rheumatology, Sint Maartenskliniek, Nijmegen,
Netherlands
Publisher
BMJ Publishing Group
Abstract
Introduction Osteoarthritis (OA) is a multifactorial disease in which
low-grade inflammation is considered to play a pivotal role. Although
colchicine is a widely used anti-inflammatory drug in the treatment of
gout, its effect in OA is still disputed due to inconsistent results of
short-term clinical trials. Therefore, we aim to evaluate the effect of
long-term colchicine 0.5 mg once daily on the incidence of knee or hip
replacements in patients with knee or hip OA. Methods and analysis The
ECHO trial is a prospective, multicentre, randomised, double-blind,
placebo-controlled, phase III trial in which 1200 participants with knee
or hip OA tolerant to colchicine during a 30-day run-in period will be 1:1
randomised to colchicine 0.5 mg once daily or matching placebo using
concealed allocation. The primary endpoint is the time from randomisation
to the first knee or hip replacement assessed up to 4.5 years. Secondary
endpoints include course of pain, physical function, joint space
narrowing, low-grade inflammation, quality of life, clinical or
radiological onset of OA in a new joint group other than present at
baseline, number of participants using pain medication during the study,
onset of new cardiovascular events (ie, myocardial infarction,
ischaemia-driven coronary revascularisation, ischaemic stroke, peripheral
artery disease or cardiovascular death) and direct and indirect costs
related to treatment and disease burden due to OA. Harm-related endpoints
include the number of (serious) adverse events, the number of withdrawals
due to (serious) adverse events and changes in laboratory data (ie, serum
creatinine, estimated glomerular filtration rate and alanine transferase)
throughout the study. The primary analysis will be performed according to
the intention-to-treat principle. Ethics and dissemination This trial has
been approved by the Medical Ethics Review Committee East-Netherlands.
Findings will be presented at scientific meetings and published in a
peer-reviewed scientific journal. Trial registration number
NCT06578182.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2025.
Re-use permitted under CC BY. Published by BMJ Group.

<3>
Accession Number
2038262487
Title
Sevoflurane vs. Propofol Anaesthesia and the Risk of Perioperative Acute
Kidney Injury.
Source
Journal of the College of Physicians and Surgeons Pakistan. 35(4) (pp
480-485), 2025. Date of Publication: 01 Apr 2025.
Author
Li M.; You W.; Chi X.; Nie M.; Xie A.
Institution
(Li) Department of Anaesthesiology, The Affiliated Hospital of Qingdao
University, Qingdao, China
(You) Department of Proctology, The Affiliated Hospital of Qingdao
University, Qingdao, China
(Chi) Department of Geriatrics, The Affiliated Hospital of Qingdao
University, Qingdao, China
(Nie) Department of Anaesthesiology, Qingdao University Medical College
Affiliated Yantai Yuhuangding Hospital, Yantai, China
(Xie) Department of Neurology, The Affiliated Hospital of Qingdao
University, Qingdao, China
Publisher
College of Physicians and Surgeons Pakistan
Abstract
Sevoflurane has been suggested to lower the incidence of acute kidney
injury (AKI) after heart surgery compared to intravenous anaesthetics.
However, recent studies indicated opposite results. Therefore, this
meta-analysis was conducted on randomised controlled trials (RCTs) to
determine if sevoflurane decreases the risk of AKI compared to propofol.
Relevant RCTs were identified from PubMed, EMBASE databases, and reference
lists of reviews and related articles till June 6, 2023. Review Manager
was used for statistical analysis. In this study, 10 RCTs were included.
Compared with propofol, sevoflurane increased the incidence of AKI (odds
ratio [OR], 2.74; 95% confidence interval [CI], 1.62-4.65; p = 0.0002;
I² = 13%) and prolonged the length of intensive care unit
(standard mean difference [SMD], 0.29; 95% CI, 0.06-0.53; p = 0.01;
I² = 0%) and hospital stays (mean difference [MD], 1.62; 95%
CI, 0.59-2.64; p = 0.002; I² = 0%). Based on current evidence,
sevoflurane was linked to an increased risk of perioperative AKI compared
to propofol. To verify the results, more high-quality RCTs are
necessary.<br/>Copyright &#xa9; 2025 College of Physicians and Surgeons
Pakistan. All rights reserved.

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

<5>
Accession Number
2036169336
Title
A Randomised Test Comparing Serum hs-CRP and hs-Troponin Concentration
when Prilocaine 2% and Hyperbaric Lidocaine 5% are Used in Cystoscopy.
Source
Research Journal of Pharmacy and Technology. 18(2) (pp 632-638), 2025.
Date of Publication: 2025.
Author
Purwoko; Putro B.N.; Sunjoyo A.; Permana S.A.
Institution
(Purwoko, Putro, Sunjoyo, Permana) Department of of Anaesthesiology and
Intensive Therapy, Faculty of Medicine Universitas Sebelas Maret, Dr.
Moewardi Hospital, Surakarta, Indonesia
Publisher
Research Journal of Pharmacy and Technology
Abstract
Background: Anaesthesia use has a depressant effect on the cardiovascular
system during surgery. The decreasing blood pressure as the heart and
blood vessels through sodium channel activity reduces cardiac output and
induces vasodilation. The analgesic sympathetic blockade effect is
associated with hypotension, characterised by a decline in glomerular
filtration rate (eGFR), which, in turn, escalates two biomarkers: troponin
and high-sensitivity C-reactive protein (hs-CRP) concentration. Serum
troponin signals ischemia while hs-CRP indicates systemic inflammation. In
this study, the cardiac and inflammatory responses associated with using
Lidocaine and Prilocaine as subarachnoid blocks for spinal surgery is
investigated. The authors intend to compare newcomer drug (Prilocaine) as
to be considered for alternative local anaesthesia use instead of
Lidocaine 5% that has been widely used for a long time in the nation.
<br/>Method(s): In this parallel randomised, controlled, double-blind
trial design, two groups (identified as P and L), each comprising 45
participants were elected for Hyperbaric Lidocaine 5% and Prilocaine 2%
treatment. The subjects' blood was drawn twice (within 24 hours
preoperatively and 4 hours postoperatively) for cardiac and inflammatory
response assessment based on Troponin and serum hs-CRP concentrations
respectively. <br/>Result(s): Group P had a lower incidence of
hypotension, bradycardia, and nausea. In group P, hs-CRP (1.58+/-1.58mg/dL
vs 4.09+/-1.60mg/dL with p<0.001(alpha<.05 two tailed) and postoperative
hs-Troponin (3.47+/-2.0ng/L vs 5.64+/-2.61ng/L with p<0.001(alpha<.05 two
tailed). The concentration of troponin and Serum hs-CRP were lower
compared with group L. <br/>Conclusion(s): Cardiac and inflammatory
response were higher in prilocaine than lidocaine group as indicated by
the lower serum hs-CRP and troponin concentration level in the former
group, implying that prilocaine 2% induces lower cardiovascular
dysfunction effect as shown by a lower increment of hs-Troponin level, and
fewer side effects like bradycardia, and nausea.<br/>Copyright &#xa9; RJPT
All right reserved.

<6>
Accession Number
2038353992
Title
A Prospective double-blind, randomised controlled trial comparing
angiotensin II to norepinephrine to reduce length of hospital stay in
cardiac surgery patients (the PORTHOS study protocol).
Source
BMJ Open. 15(4) (no pagination), 2025. Article Number: e095099. Date of
Publication: 15 Apr 2025.
Author
Coulson T.G.; Paul E.; Miles L.F.; Pilcher D.; Marasco S.F.; Frei D.;
Bellomo R.
Institution
(Coulson) Department of Anaesthesiology and Perioperative Medicine, Alfred
Health, Melbourne, VIC, Australia
(Coulson) Department of Anaesthesiology and Perioperative Medicine, Monash
University, Melbourne, VIC, Australia
(Coulson, Miles) Centre for Integrated Critical Care, The University of
Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne,
VIC, Australia
(Paul, Pilcher) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, VIC, Australia
(Miles) Department of Anaesthesia and Pain Medicine, Austin Health,
Heidelberg, VIC, Australia
(Pilcher) Alfred Health, Melbourne, VIC, Australia
(Marasco) Department of Cardiothoracic Surgery, Alfred Health, Melbourne,
VIC, Australia
(Frei) Wellington Regional Hospital, Wellington, Newtown, New Zealand
(Frei) Medical Research Institute of New Zealand, Wellington, New Zealand
(Frei) University of Otago, Dunedin, New Zealand
(Bellomo) Department of Critical Care, University of Melbourne, Melbourne,
VIC, Australia
(Bellomo) Department of Intensive Care, Royal Melbourne Hospital,
Melbourne, VIC, Australia
(Bellomo) Department of Intensive Care, Austin Hospital, Heidelberg, VIC,
Australia
Publisher
BMJ Publishing Group
Abstract
Introduction Cardiac surgery is frequently associated with vasoplegia and
vasopressor treatment. Both may be associated with postoperative
complications and prolonged length of stay. The most frequently used
vasopressor is norepinephrine. However, in a pilot, double-blind,
randomised controlled trial (RCT) in cardiac surgery patients, angiotensin
II was effective in maintaining blood pressure and was associated with a
shorter duration of hospital stay than norepinephrine. Furthermore,
hyperreninaemic patients were more sensitive to angiotensin II. These
findings support the need for a larger RCT to determine whether
angiotensin II is superior to norepinephrine as a first-line treatment for
low blood pressure after cardiac surgery. Methods and analysis We will
conduct a double-blind RCT comparing an infusion of either angiotensin II
or norepinephrine intraoperatively and for up to 48 hours after the start
of surgery. We will randomly allocate 400 cardiac surgery patients at
multiple centres in two countries to either an equipotent angiotensin II
or norepinephrine infusion, titrated to a mean arterial pressure of 70-80
mm Hg. The primary outcome will be length of hospital stay. Secondary
outcomes will include a composite of renal, cardiovascular and
neurological events. A subgroup analysis of patients with elevated
baseline renin levels will be undertaken. Ethics and dissemination Ethical
approval has been granted by the Alfred Human Research Ethics Committee on
14 July 2023 (HREC/97814/Alfred-2023). Results will be published on
completion of the trial.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2025.

<7>
Accession Number
2036155414
Title
Comparison of TIVA and sevoflurane: ensuring hemodynamic and respiratory
stability in prone position spinal surgeries: a randomized controlled
trial.
Source
Signa Vitae. 21(4) (pp 50-61), 2025. Date of Publication: 01 Apr 2025.
Author
Yuce Y.; Onal C.; Karakus S.A.; Sezen O.; Cevik B.; Guclu B.; Aydogmus E.
Institution
(Yuce, Sezen, Cevik) Anesthesiology and Reanimation Department, Kartal Dr.
Lutfi Kirdar City Hospital, Hamidiye International Faculty of Medicine,
University of Health Sciences, Istanbul, Turkey
(Onal) Anesthesiology and Reanimation Department, Agri Education and
Research Hospital, Agri, Turkey
(Karakus) Anesthesiology and Reanimation Department, Basaksehir Cam and
Sakura City Hospital, Hamidiye Faculty of Medicine, University of Health
Sciences, Istanbul, Turkey
(Guclu, Aydogmus) Neurosurgery Department, Kartal Dr. Lutfi Kirdar City
Hospital, Hamidiye International Faculty of Medicine, University of Health
Sciences, Istanbul, Turkey
Publisher
Pharmamed Mado Ltd
Abstract
Background: This study evaluates the impact of total intravenous
anesthesia (TIVA) versus sevoflurane anesthesia on respiratory mechanics
and hemodynamic parameters during spinal surgery in the prone position.
<br/>Method(s): A randomized controlled trial was conducted on 52 patients
(26 in the TIVA group and 26 in the sevoflurane group). Respiratory
mechanics, such as peak airway pressure (Ppeak), mean airway pressure
(Pmean), positive end-expiratory pressure (PEEP), end-tidal carbon dioxide
(ETCO<inf>2</inf>), and dynamic compliance (Cdyn) were measured at various
intervals. Hemodynamic parameters including systolic blood pressure,
diastolic blood pressure, and heart rate were monitored. <br/>Result(s):
There were no significant differences between the TIVA and sevoflurane
groups in any of the measured respiratory and hemodynamic parameters.
Ppeak at 30 minutes was 20 cmH<inf>2</inf>O in the TIVA group and 19
cmH<inf>2</inf>O in the sevoflurane group (p = 0.550). Mean Cdyn was 35.0
mL/cmH<inf>2</inf>O for TIVA and 34.3 mL/cmH<inf>2</inf>O for sevoflurane
(p = 0.796). Both groups maintained stable hemodynamic parameters
throughout surgery, with heart rate and mean arterial pressure within the
normal range. <br/>Conclusion(s): TIVA and sevoflurane are equally
effective in maintaining respiratory and hemodynamic stability during
prone spinal surgeries. These findings provide flexibility for
anesthesiologists in selecting the appropriate anesthesia technique based
on patient and surgical factors. Clinical Trial Registration:
ClinicalTrials.gov: NCT06558695. Date: 14 August 2024 Retrospectively
registered.<br/>Copyright &#xa9; 2025 The Author(s). Published by MRE
Press.

<8>
Accession Number
2037395891
Title
Cardiovascular Disease-Specific Responses to Autonomic Denervation.
Source
JACC: Clinical Electrophysiology. 11(4) (pp 776-788), 2025. Date of
Publication: 01 Apr 2025.
Author
Zhang Y.; Po S.S.; Xin F.; Zhao J.; Zhao K.; Tao D.; Chakraborty P.; Yin
Z.; Liu G.; Wang H.
Institution
(Zhang, Xin, Zhao, Zhao, Tao, Yin, Liu, Wang) Department of Cardiovascular
Surgery, General Hospital of Northern Theater Command, Liaoning, Shenyang,
China
(Po, Chakraborty) Section of Cardiovascular Diseases and Heart Rhythm
Institute, University of Oklahoma Health Sciences Center, Oklahoma City,
OK, United States
Publisher
Elsevier Inc.
Abstract
Background: Calcium-mediated autonomic denervation has been shown to
suppress postoperative atrial fibrillation (POAF) after coronary artery
bypass grafting. <br/>Objective(s): This study sought to evaluate whether
similar autonomic denervation can prevent POAF after mitral or aortic
valve surgeries. <br/>Method(s): This research consisted of 2
single-center, randomized, double-blind, sham-controlled trials: CAP-AF2
(Calcium Autonomic Denervation Prevents Postoperative Atrial Fibrillation
in Patients Undergoing Isolated Mitral Valve Surgery for Mitral
Regurgitation) for mitral valve (MV) surgery and CAP-AF3 (Calcium
Autonomic Denervation Prevents Postoperative Atrial Fibrillation in
Patients Undergoing Isolated Aortic Valve Surgery) for aortic valve
surgery. Patients were randomized to receive injections of either 5%
CaCl<inf>2</inf> or 0.9% NaCl (control) into the atrial ganglionated plexi
during surgery. The primary outcome was the incidence of POAF >=30 seconds
within 7 days after surgery. Secondary outcomes included hospital stay, AF
burden, actionable antiarrhythmic therapy for POAF, and inflammatory
marker. <br/>Result(s): After 160 patients were enrolled into the CAP-AF2
trial, mid-term analysis revealed a significant increase in POAF incidence
in the CaCl<inf>2</inf> group (55.13%, CaCl<inf>2</inf> vs 37.80%, NaCl; P
= 0.028). The CAP-AF2 trial was terminated by the safety committee. In the
CAP-AF3 trial, 239 patients were randomized; final analysis showed no
significant difference in the POAF incidence between the CaCl<inf>2</inf>
and NaCl groups (35.59% vs 39.67%, P = 0.516). Postoperative hospital
stay, AF burden, antiarrhythmic therapy for POAF, and plasma levels of
inflammatory markers were not different between the 2 groups in both
trials. Immunohistochemical analyses showed parasympathetic predominance
at the tissue level in patients receiving MV surgery. <br/>Conclusion(s):
Calcium-mediated autonomic denervation did not uniformly prevent POAF
across all cardiac surgeries, with an increased incidence observed in the
MV surgery group, highlighting the need for disease-specific strategies to
prevent POAF. (Calcium Autonomic Denervation Prevents Postoperative Atrial
Fibrillation in Patients Undergoing Isolated Mitral Valve Surgery for
Mitral Regurgitation [CAP-AF2]; ChiCTR2000029314; Calcium Autonomic
Denervation Prevents Postoperative Atrial Fibrillation in Patients
Undergoing Isolated Aortic Valve Surgery [CAP-AF3];
ChiCTR2000029313).<br/>Copyright &#xa9; 2025 American College of
Cardiology Foundation

<9>
Accession Number
2034220147
Title
Sex-related outcomes during short-term mechanical circulatory support: A
systematic review and meta-analysis of propensity-score matched studies.
Source
Perfusion (United Kingdom). (no pagination), 2025. Date of Publication:
2025.
Author
Luiz L.; Mesadri Gewehr D.; Picado-Loaiza S.; Ohashi L.; Goebel N.; Rylski
B.; Ayala R.
Institution
(Luiz) Department of Medicine, University of the Region of Joinville,
Joinville, Brazil
(Mesadri Gewehr) Curitiba Heart Institute, Curitiba, Brazil
(Picado-Loaiza) Department of Cardiovascular Surgery, Hospital Mexico, San
Jose, Costa Rica
(Ohashi) Department of Cardiovascular Surgery, Federal University Sao
Paulo, Sao Paulo, Brazil
(Goebel, Rylski, Ayala) Department of Cardiovascular Surgery, Robert Bosch
Hospital, Stuttgart, Germany
Publisher
SAGE Publications Ltd
Abstract
Background: The association between sex and cardiovascular risk and
different responses to heart failure therapies is well established.
However, sex related outcomes of different types of short-term mechanical
circulatory support (MCS) therapy remains controversial. <br/>Method(s):
We performed a systematic review and meta-analysis of studies comparing
outcomes of MCS between sexes. We restricted inclusion to propensity score
matched studies to minimize the risk of confounding. We pooled binary and
continuous outcomes with odds ratio (OR) and mean differences (MD),
respectively, under a random effects model. <br/>Result(s): We pooled 6
propensity score matched studies evaluating sex related outcomes during
short-term MCS, with 18,720 patients, of whom 9442 (50.5%) were male and
9278 (49.5%) were female. Subgroup analysis showed higher 30-day mortality
during ECMO (OR 1.11; 95% CI 1.01-1.22; p =.038; I² = 0%) in
males, but lower 30-day mortality during Impella therapy than females (OR
0.87; 95% CI 0.80-0.94; p =.001; I² = 0%). Males had a higher
need of myocardial revascularization (OR 3.09; 95% CI 1.56-5.99; p =.001;
I² = 0%), but a higher risk of acute kidney injury (OR 1.20;
95% CI 1.09-1.31; p <.001; I² = 18%). <br/>Conclusion(s):
In-hospital and 30-day mortality were similar between females and
males.<br/>Copyright &#xa9; The Author(s) 2025.

<10>
Accession Number
2036149675
Title
Thoracic Aortic Aneurysm Growth Rates and Predicting Factors: A Systematic
Review and Meta-Analysis.
Source
Journal of the American Heart Association. 14(7) (no pagination), 2025.
Article Number: e038821. Date of Publication: 01 Apr 2025.
Author
Henry M.; Campello Jorge C.A.; van Bakel P.A.J.; Knauer H.A.; Maceachern
M.; van Herwaarden J.A.; Teixido-Tura G.; Evangelista A.; Jeremy R.W.;
Figueroa C.A.; Patel H.J.; Bowman M.H.; Eagle K.; Burris N.S.
Institution
(Henry, Campello Jorge, Knauer, Burris) Department of Radiology,
University of Michigan, Ann Arbor, MI, United States
(van Bakel, Patel) Department of Cardiac Surgery, University of Michigan,
Ann Arbor, MI, United States
(van Bakel, van Herwaarden) Department of Vascular Surgery, University
Medical Center Utrecht, Utrecht, Netherlands
(Maceachern) Taubman Health Sciences Library, University of Michigan, Ann
Arbor, MI, United States
(Teixido-Tura, Evangelista) Department of Cardiology, Hospital Vall
d'Hebron, CIBERCV, Universitat Autonoma de Barcelona, Barcelona, Spain
(Jeremy) Sydney Medical School, University of Sydney, Sydney, Australia
(Figueroa) Department of Vascular Surgery, University of Michigan, Ann
Arbor, MI, United States
(Figueroa) Department of Biomedical Engineering, University of Michigan,
Ann Arbor, MI, United States
(Bowman, Eagle) Division of Cardiovascular Medicine, Department of
Internal Medicine, University of Michigan, Ann Arbor, MI, United States
(Burris) Department of Radiology, University of Wisconsin-Madison,
Madison, WI, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Thoracic aortic aneurysm (TAA) is an indolent, potentially
fatal disease, which progresses at variable rates that are influenced by
pathogenesis and patient characteristics. We conducted a systematic review
and meta-analysis to synthesize the current evidence on growth rate (GR)
and predictive factors among patients with syndromic and nonsyndromic
heritable thoracic aortic disease, bicuspid aortic valve, and sporadic
TAA. METHODS AND RESULTS: Online databases were searched for studies that
reported aortic growth on adult patients with asymptomatic TAA. Pooled GRs
were calculated for 3 different TAA groups: syndromic heritable thoracic
aortic disease, bicuspid aortic valve, and sporadic TAA. The search
yielded 6297 studies, of which 85 were included in the systematic review,
and 55 in the meta-analysis of growth rate (10 syndromic heritable
thoracic aortic disease, 31 bicuspid aortic valve, and 34 sporadic
subgroups). Mean observed TAA GR was 0.25 mm/y (95% CI, -0.18 to 0.68) in
Turner syndrome, 0.45 mm/y (95% CI, 0.00-0.90) in Marfan syndrome, and
0.81 mm/y (95% CI, -0.46 to 2.08) in Loeys-Dietz syndrome. The mean
observed GR in patients with bicuspid aortic valve before aortic valve
surgery was 0.37 mm/y (95% CI, 0.29-0.46), compared with 0.18 mm/y (95%
CI, 0.14-0.33) in postsurgical studies. Mean observed GR in sporadic
ascending TAA was 0.33 mm/y (95% CI, 0.13-0.52) and 2.71 mm/y (95% CI,
0.53-4.88) in descending TAA. <br/>CONCLUSION(S): Considering all
pathogeneses, ascending TAAs typically grow at 0.25 to 1 mm/y, and thus
annual surveillance is likely too frequent to detect growth in most
patients. Studies vary widely in populations, methodology, and outcomes,
with few high-quality longitudinal studies and no predictors of aortic
GR.<br/>Copyright &#xa9; 2025 The Author(s). Published on behalf of the
American Heart Association, Inc., by Wiley.

<11>
Accession Number
2036149679
Title
Rationale and Design of the CREATE Trial: A Multicenter, Randomized
Comparison of Continuation or Cessation of Single Antithrombotic Therapy
at 1 Year After Transcatheter Aortic Valve Replacement.
Source
Journal of the American Heart Association. 14(7) (no pagination), 2025.
Article Number: e039350. Date of Publication: 01 Apr 2025.
Author
Liu R.; Li Y.; Zhang L.; Lu Z.; Fu Z.; Modine T.; Jilahawi H.; Pocock S.;
Wu Y.; Song G.
Institution
(Liu, Li, Lu, Fu, Song) Interventional Center of Valvular Heart Disease,
Beijing Anzhen Hospital, Capital Medical University, Beijing, China
(Zhang, Wu) Cardiovascular Disease, Fuwai Hospital, National Center for
Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking
Union Medical College, Beijing, China
(Modine) Department of Cardiology and Cardio-Vascular Surgery, Hopital
Cardiologique de Haut-Leveque, Bordeaux University Hospital, Bordeaux,
France
(Jilahawi) Cedars-Sinai Medical Center, Smidt Heart Institute, Los
Angeles, CA, United States
(Pocock) London School of Hygiene and Tropical Medicine, London, United
Kingdom
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Current guidelines and expert consensus recommend lifelong
single antiplatelet therapy for patients undergoing transcatheter aortic
valve replacement who have no indication for anticoagulation or dual
antiplatelet therapy. However, there is no direct evidence from randomized
controlled trials supporting this practice. Furthermore, the optimal
duration of antiplatelet therapy in this population has not been
adequately investigated. METHODS AND RESULTS: CREATE (A Multicenter
Randomized Controlled Study to Evaluate Cessation of Antithrombotic
Therapy at 1 Year in TAVR Patients-The CREATE Study) is a prospective,
multicenter, open-label, randomized controlled trial for patients who have
undergone successful transcatheter aortic valve replacement and have no
indication for long-term oral anticoagulation or antiplatelet therapy.
Eligible patients are free from major bleeding and ischemic events for 1
year postprocedure before being randomized 1:1 to single antiplatelet
therapy (control group) or no antiplatelet therapy (experimental group).
The primary efficacy end point is the incidence of bleeding events,
defined by the VARC-3 (Valve Academic Research Consortium-3) criteria, at
1-year postrandomization. The primary safety end point is a composite of
cardiac death, myocardial infarction, and ischemic stroke at 1 year. The
trial is powered for both superiority in efficiency and noninferiority in
safety. Accordingly, a total of 3380 patients will be enrolled.
<br/>CONCLUSION(S): The CREATE trial aims to assess if stopping
antiplatelet therapy at 1-year after transcatheter aortic valve
replacement reduces bleeding risk without increasing ischemic events in
patients not requiring chronic antithrombotic therapy. REGISTRATION: URL:
https://www.chictr.org.cn; Unique identifier:
ChiCTR2400087454.<br/>Copyright &#xa9; 2025 The Author(s). Published on
behalf of the American Heart Association, Inc., by Wiley.

<12>
Accession Number
2038417261
Title
Letter to the Editor, "The effects of sodium-glucose transporter 2
inhibition on cardiac surgery-associated acute kidney injury: An
open-label randomized pilot study".
Source
Journal of Clinical Anesthesia. 104 (no pagination), 2025. Article Number:
111838. Date of Publication: 01 Jun 2025.
Author
Jiang L.; Peng Z.
Institution
(Peng) Foshan Women and Children Hospital, China
(Jiang) The Seventh Affiliated Hospital of Southern Medical University,
China
Publisher
Elsevier Inc.

<13>
Accession Number
2034224256
Title
3D virtual surgical planning of fractures in hip arthrodesis: a systematic
review, case series and recommendations for treatment.
Source
European Journal of Orthopaedic Surgery and Traumatology. 35(1) (no
pagination), 2025. Article Number: 157. Date of Publication: 01 Dec 2025.
Author
Plomp R.G.; Ten Duis K.; Meesters A.M.L.; IJpma F.F.A.
Institution
(Plomp, Ten Duis, IJpma) Department of Trauma Surgery, University Medical
Center Groningen, Groningen, Netherlands
(Meesters) 3D Lab, University Medical Center Groningen, Groningen,
Netherlands
Publisher
Springer Nature
Abstract
Purpose: Fractures through an arthrodesed hip are rare and challenging.
The aim of the study is (1) to explore whether 3D-planned percutaneous
screw fixation of fractures in hip arthrodesis is a viable minimally
invasive surgical option for geriatric patients and (2) to standardize
surgical treatment by providing a comprehensive overview of the literature
and propose a treatment algorithm. <br/>Method(s): We presented a case
series of patients with an acute fracture in a previous hip arthrodesis
treated in a level 1 trauma centre in 2024. Furthermore, we conducted a
systematic review on fractures in hip arthrodesis from 1970 to 2023.
<br/>Result(s): We presented three cases treated for a fracture in an
arthrodesed hip. Two patients with a proximal/medial fracture to the
acetabulum were operated with 3D-planned percutaneous cannulated screws,
and one patient with an intertrochanteric fracture was operated with a DHS
system. The systematic review resulted in an overview of 16 case series on
fractures in hip arthrodesis treated with various surgical techniques,
each with its pros and cons; cannulated screws, DHS system, intramedullary
nailing and plate osteosynthesis. <br/>Conclusion(s): Acute fractures in
arthrodesed hips in fragile geriatric patients can be treated minimally
invasively with 3D-planned percutaneous screw fixation. This technique is
most suitable for femoral neck fracture types. Alternative surgical
techniques include DHS, intramedullary nailing, plate osteosynthesis or
conversion to total hip arthroplasty, for which a treatment algorithm is
provided.<br/>Copyright &#xa9; The Author(s) 2025.

<14>
Accession Number
2034196582
Title
Impact of cardiopulmonary bypass flow on the lower limit of cerebral
autoregulation during cardiac surgery: a randomized cross-over pilot
study.
Source
Journal of Clinical Monitoring and Computing. (no pagination), 2025. Date
of Publication: 2025.
Author
Desebbe O.; Berna A.; Joosten A.; Raphael D.; Malapert G.; Rolo D.;
Taccone F.S.; Gergele L.
Institution
(Desebbe, Berna, Rolo) Department of Anesthesiology and perioperative
care, Ramsay Sante, Sauvegarde Clinic, Lyon, France
(Joosten) Department of Anesthesiology & Perioperative Care, University of
California Los Angeles, Los Angeles, CA, United States
(Raphael) Department of Anesthesiology & Perioperative Care, University of
California Irvine, Irvine, CA, United States
(Malapert) Department of Cardiac Surgery, Ramsay Sante, Sauvegarde Clinic,
Lyon, France
(Taccone) Department of Intensive Care, Hopital Universitaire de Bruxelles
(HUB), Universite Libre de Bruxelles, Brussels, Belgium
(Gergele) Department of Anesthesiology and Perioperative Care, Ramsay
Sante, Hopital Prive de la Loire, Saint-Etienne, France
(Desebbe) Department of Anesthesiology & Perioperative Medicine, Clinique
de la Sauvegarde, 480 avenue Ben Gourion, Lyon, France
Publisher
Springer Science and Business Media B.V.
Abstract
Assessment of cerebral autoregulation is challenging under different
hemodynamic conditions during cardiac surgery and must be rapidly
calculated in order to optimize mean arterial pressure (MAP). Whether
systemic flow during cardiopulmonary bypass impacts the lower limit of
cerebral autoregulation (LLA) remains unclear. Forty patients requiring
cardiac surgery were included in this randomized crossover study. Patients
assigned to the conventional/high blood flow arm received 20 min of
conventional cardiopulmonary bypass (CPB) blood flow (2.2
L/min.m^-2) followed by 20 min of high blood flow (2.8
L/min.m^-2), both during aortic cross clamping. Patients
assigned to the high/conventional arm received the same flows but in
reverse order. During each 20-minute period, MAP was gradually increased
from 40 to 90 mmHg, while PaCO<inf>2</inf>, hematocrit, depth of
anesthesia, central temperature and arterial oxygen tension were kept
constant. Continuous cerebral blood flow velocities of the middle cerebral
artery (Fv) were monitored using transcranial doppler. Cerebral
autoregulation was calculated using a Pearson's correlation coefficient
(Mean flow index, Mxa) between the MAP and Fv. Mxa values were then
plotted across MAP ranges. The LLA was defined as the corresponding MAP
value when Mxa initially decreased and crossed the threshold value of 0.4.
A mixed model, including the LLA as the dependent variable, the CPB flow
and period as fixed effects and patients as a random effect was used to
compare conventional and high CPB flows. Thirty-seven patients were
analyzed. The LLA mean difference between groups, adjusted on the period,
was - 2.8 (SE 2.4) mmHg with 95% CI [-7.8, + 2.1 mmHg], p = 0.2538). 24%
of patients presented an LLA < 65 mmHg during the conventional CPB flow
phase versus 35% during the high CPB flow phase. Increasing the
cardiopulmonary pump flow did not decrease the LLA during cardiac
surgery.<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer Nature B.V. 2025.

<15>
Accession Number
2038341930
Title
Early aortic valve replacement versus conservative management in
asymptomatic severe aortic stenosis: Meta-analysis of time-to-event data
of randomized controlled trials.
Source
International Journal of Cardiology. 432 (no pagination), 2025. Article
Number: 133269. Date of Publication: 01 Aug 2025.
Author
Jacquemyn X.; Sa M.P.; Marin-Cuartas M.; Bax J.J.; Borger M.A.; Clavel
M.-A.; Pibarot P.; Genereux P.; Sultan I.
Institution
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Sa) Division of Cardiac Surgery Massachusetts General Hospital, Harvard
Medical School Boston, MA, United States
(Marin-Cuartas, Borger) University Department of Cardiac Surgery, Heart
Center Leipzig, Leipzig, Germany
(Bax) Department of Cardiology, Leiden University Medical Center, Leiden,
Netherlands
(Clavel, Pibarot) Department of Medicine, Quebec Heart & Lung Institute,
Laval University, Quebec, Canada
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Sultan) Department of Cardiothoracic Surgery, University of Pittsburgh,
United States
(Sultan) UPMC Heart and Vascular Institute, Pittsburgh, PA, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Current guidelines recommend aortic valve replacement (AVR)
for symptomatic patients with severe aortic stenosis (AS), but the optimal
timing for intervention in asymptomatic patients is still debated. Recent
randomized controlled trials (RCTs) have offered new insights, prompting a
reevaluation of the potential benefits of early AVR. <br/>Method(s): A
systematic review and pooled meta-analysis of Kaplan-Meier-derived
reconstructed time-to-event data of RCTs published by November 2024 was
conducted in compliance with the Preferred Reporting Items for Systematic
Reviews and Meta-analyses (PRISMA) guideline. Outcomes were derived from
the primary endpoints of the included studies, with the main analysis
focusing on all-cause mortality, cardiovascular mortality, and heart
failure hospitalization. <br/>Result(s): Four randomized controlled
trials, involving 1427 patients, were included. The early AVR group
demonstrated a significant reduction in all-cause mortality (hazard ratio
[HR] = 0.72, 95 % confidence interval [CI] 0.53-0.97, p = 0.031),
cardiovascular mortality (HR = 0.56, 95 % CI 0.36-0.89, p = 0.014), and
heart failure hospitalization (HR = 0.31, 95 % CI 0.18-0.53, p < 0.001).
No significant interaction effects between surgical AVR and transcatheter
AVR were observed. Additionally, in the conservative management group, the
conversion to AVR was substantial, with a median time to conversion of
13.4 months. The cumulative conversion rates were 42.8 % (95 % CI 38.6
%-46.7 %) at 1 year, 82.3 % (95 % CI 78.6 %-85.3 %) at 3 years, and 94.9 %
(95 % CI 91.4 %-96.9 %) at 5 years. <br/>Conclusion(s): Early AVR in
asymptomatic patients with severe AS is associated with a significant
reduction in all-cause mortality, cardiovascular mortality, and heart
failure hospitalization compared to conservative management.<br/>Copyright
&#xa9; 2024

<16>
Accession Number
2034207378
Title
Opioid-Sparing Effects of Erector Spinae Plane Block in Off-Pump Coronary
Artery Bypass Grafting with Median Sternotomy: A Randomized Controlled
Trial.
Source
Cardiovascular Drugs and Therapy. (no pagination), 2025. Date of
Publication: 2025.
Author
Zhang Y.; Liu J.; Lv K.; Wang F.; Shi Y.; You P.; Wang W.
Institution
(Zhang, Lv, Wang, You, Wang) Department of Anesthesiology, Jining No. 1
People's Hospital, Shandong, Jining, China
(Liu) Department of Emergency Surgery, Jining No. 1 People's Hospital,
Shandong, Jining, China
(Shi) Department of Cardiac and Vascular Surgery, Jining No. 1 People's
Hospital, Shandong, Jining, China
Publisher
Springer
Abstract
Purpose: This study assessed the efficacy of preoperative erector spinae
plane block (ESPB) in reducing intraoperative opioid use and enhancing
recovery in off-pump coronary artery bypass grafting (OPCABG) patients,
who typically require high-dose opioids with associated postoperative
risks. <br/>Method(s): A prospective, double-blind randomized controlled
trial was conducted on 37 patients. Patients were randomized to receive
either bilateral ESPB with 0.375% ropivacaine or a sham block with normal
saline. Primary outcomes included intraoperative sufentanil consumption,
while secondary outcomes encompassed hemodynamic stability, postoperative
pain scores, mechanical ventilation (MV) duration, and hospital stay.
<br/>Result(s): The ESPB group demonstrated a significant reduction in
intraoperative sufentanil consumption compared to the sham group (150.3
+/- 36.1 microg vs. 194.4 +/- 38.3 microg, p = 0.001). Postoperatively,
ESPB patients exhibited lower pain scores at rest and during coughing
within the first 6 h post-extubation (p < 0.001) and required less rescue
analgesia (5.3% vs. 50.0%, p = 0.003). Additionally, ESPB shortened MV
duration (5.43 +/- 1.65 h vs. 6.88 +/- 1.68 h, p = 0.013). No significant
differences were observed in cardiac care unit or hospital stay lengths.
<br/>Conclusion(s): Preoperative ESPB effectively reduces intraoperative
opioid requirements and provides sustained analgesia in the early
postoperative period, facilitating earlier extubation. These findings
support ESPB as a valuable component of multimodal analgesia in OPCABG,
though further large-scale studies are needed to validate these results
and optimize its application. Clinical Trial Registration: The trial was
registered with the China Clinical Trials Center
(http://www.chictr.org.cn, ChiCTR2200066902) on December 21,
2022.<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2025.

<17>
Accession Number
2034205104
Title
Year in Review 2024: Noteworthy Literature in Cardiothoracic Critical
Care.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination),
2025. Date of Publication: 2025.
Author
Gilliland S.; Kim K.K.; Li X.; Tanabe K.; Hennigan A.; Alber S.
Institution
(Gilliland, Kim, Li, Tanabe, Hennigan, Alber) Department of
Anesthesiology, University of Colorado, Aurora, CO, United States
Publisher
SAGE Publications Inc.
Abstract
This article reviews noteworthy additions to the literature for the
management of critically ill cardiothoracic surgical patients published in
2024. We reviewed 8100 articles to identify 10 publications that provided
new or updated information across a diverse range of topics including
extracorporeal membrane oxygenation (ECMO), sepsis and shock, and acute
hypoxemic respiratory failure (AHRF). Additional topics within these
publications included prophylaxis guidelines and evidence for prevention
of common complications in the intensive care unit, such as bleeding,
thrombosis, and acute kidney injury (AKI).<br/>Copyright &#xa9; The
Author(s) 2025.

<18>
Accession Number
2034205200
Title
Etomidate vs Ketamine-Propofol for Induction of Anesthesia in Coronary
Artery Bypass Grafting: An Updated Systematic Review and Meta-Analysis.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination),
2025. Date of Publication: 2025.
Author
Kumar N.; Bardia A.; Fitzsimons M.G.; Essandoh M.; Mitchell J.; Falkson
S.R.; Dalia A.; Tang J.; Sawyer T.R.; Iyer M.H.
Institution
(Kumar, Bardia, Fitzsimons, Falkson, Dalia) Department of Anesthesia,
Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard
Medical School, Boston, MA, United States
(Essandoh, Tang, Iyer) Department of Anesthesiology, The Ohio State
University Wexner Medical Center, Columbus, OH, United States
(Mitchell) Department of Anesthesiology and Perioperative Medicine,
University of California Los Angeles, Los Angeles, CA, United States
(Sawyer) Central Michigan University College of Medicine, Mt. Pleasant,
MI, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Etomidate has minimal cardiovascular depressant effects at the
cost of endogenous cortisol production suppression, whereas propofol has
vasodilatory and myocardial depressant properties, which may be poorly
tolerated in the cardiac surgical population. To offset the undesirable
effects of propofol, ketamine can be co-administered to harness its
cardiac stimulatory properties. Though etomidate is a more cardio-stable
induction agent than propofol, its superiority over the combination of
propofol and ketamine-colloquially known as "ketofol"-remains
controversial. <br/>Method(s): United States National Library of Medicine
Database (MEDLINE) and Excerpta Medica Database (EMBASE) were searched for
randomized controlled trials published since 2010 comparing etomidate and
ketofol relative to propofol alone for induction of general anesthesia for
coronary artery bypass grafting (CABG). Key data collected included
post-induction nadir mean arterial pressure (MAP), heart rate, cardiac
index, systemic vascular resistance (SVR), and serum cortisol levels at 24
hours postoperatively. Variables were compared by calculating a weighted
mean difference (WMD) [95% confidence interval (CI)]. <br/>Result(s): This
analysis included 15 studies (1125 patients). Anesthetic induction with
etomidate was associated with a higher nadir MAP and SVR compared to
ketofol during the peri-induction period by WMD 4.77 mmHg [95% CI 0.31,
9.23, P = 0.04] and 42.22 dynes/cm⁵ [95% CI 0.49-83.94, P =
0.05]. However, there was no difference in the frequency of needed boluses
of vasopressors or fluids for peri-induction hypotension.
<br/>Conclusion(s): Though etomidate appears to provide a superior
hemodynamic profile compared to ketofol, both agents require similar
degrees of clinical response to hypotension during the induction of CABG
surgery patients.<br/>Copyright &#xa9; The Author(s) 2025.

<19>
Accession Number
2037202344
Title
Safety and Efficacy of Tranexamic Acid in General Surgery.
Source
JAMA Surgery. 160(3) (pp 267-274), 2025. Date of Publication: 12 Mar 2025.
Author
Park L.J.; Marcucci M.; Ofori S.N.; Borges F.K.; Nenshi R.; Kanstrup
C.T.B.; Rosen M.; Landoni G.; Lomivorotov V.; Painter T.W.; Xavier D.;
Martinez-Zapata M.J.; Szczeklik W.; Meyhoff C.S.; Chan M.T.V.; Simunovic
M.; Bogach J.; Serrano P.E.; Balasubramanian K.; Cadeddu M.; Yang I.; Kim
W.H.; Devereaux P.J.
Institution
(Park, Marcucci, Ofori, Borges, Nenshi, Balasubramanian, Devereaux)
Population Health Research Institute, Hamilton, ON, Canada
(Park, Nenshi, Simunovic, Bogach, Serrano, Cadeddu, Yang) Department of
Surgery, Division of General Surgery, McMaster University, Hamilton, ON,
Canada
(Park, Marcucci, Ofori, Borges, Serrano, Balasubramanian, Devereaux)
Department of Health Research Methods,Evidence & Impact,, McMaster
University, Hamilton, ON, Canada
(Marcucci) Clinical Epidemiology and Research Centre (CERC), Humanitas
University and IRCCS Humanitas Research Hospital, Milan, Italy
(Ofori, Borges) Department of Medicine, McMaster University, Hamilton, ON,
Canada
(Kanstrup) Department of Surgery, Copenhagen University Hospital, North
Zealand, Hillerod, Denmark
(Rosen) Digestive Disease Institute, Cleveland Clinic Foundation,
Cleveland, OH, United States
(Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Lomivorotov) Department of Anesthesiology and Intensive Care, E.
Meshalkin National Medical Research Center, Novosibirsk, Russian
Federation
(Painter) Royal Adelaide Hospital, Adelaide, SA, Australia
(Xavier) Division of Clinical Research & Training, St John's Research
Institute, Bengaluru, India
(Martinez-Zapata) Iberoamerican Cochrane Center, Institut de Recerca Sant
Pau, CIBER Epidemiologia y Salud Publica, Barcelona, Spain
(Szczeklik) Centre for Intensive Care and Perioperative Medicine,
Jagiellonian University Medical College, Krakow, Poland
(Meyhoff) Department of Anaesthesia and Intensive Care, Copenhagen
University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
(Chan) The Chinese University of Hong Kong, Hong Kong
(Kim) Department of Anesthesiology and Pain Medicine, Seoul National
University College of Medicine, Seoul, South Korea
(Devereaux) Department of Medicine, Division of Cardiology, McMaster
University, Hamilton, ON, Canada
(Devereaux) World Health Research Trust, Hamilton, ON, Canada
Publisher
American Medical Association
Abstract
Importance: Perioperative bleeding is common in general surgery. The
POISE-3 (Perioperative Ischemic Evaluation-3) trial demonstrated efficacy
of prophylactic tranexamic acid (TXA) compared with placebo in preventing
major bleeding without increasing vascular outcomes in noncardiac surgery.
<br/>Objective(s): To determine the safety and efficacy of prophylactic
TXA, specifically in general surgery. <br/>Design, Setting, and
Participant(s): Subgroup analyses were conducted that compared randomized
treatment with TXA vs placebo according to whether patients underwent
general surgery or nongeneral surgery in the POISE-3 blinded,
international, multicenter randomized clinical trial. Participants were 45
years or older, were undergoing noncardiac surgery, had increased
cardiovascular risk, and were expected to require at least an overnight
hospital admission after surgery. Among 26581 eligible patients
identified, 17046 were excluded, resulting in 9535 patients randomized to
the POISE-3 trial. Participants were enrolled from June 2018 through July
2021. The data were analyzed during December 2023. <br/>Intervention(s):
Prophylactic, 1-g bolus of intravenous TXA or placebo at the start and end
of surgery. <br/>Main Outcomes and Measures: The primary efficacy outcome
was a composite of life-threatening bleeding, major bleeding, or bleeding
into a critical organ. The primary safety outcome was a composite of
myocardial injury after noncardiac surgery, nonhemorrhagic stroke,
peripheral arterial thrombosis, or symptomatic proximal venous
thromboembolism at 30 days. Cox proportional hazards models were
conducted, incorporating tests of interaction. <br/>Result(s): Among 9535
POISE-3 participants, 3260 underwent a general surgery procedure. Mean age
was 68.6 (SD, 9.6) years, 1740 were male (53.4%), and 1520 were female
(46.6%). Among general surgery patients, 8.0% and 10.5% in the TXA and
placebo groups, respectively, had the primary efficacy outcome (hazard
ratio [HR], 0.74; 95% CI, 0.59-0.93; P =.01) and 11.9% and 12.5% in the
TXA and placebo groups, respectively, had the primary safety outcome (HR,
0.95; 95% CI, 0.78-1.16; P =.63). There was no significant interaction by
type of surgery (general surgery vs nongeneral surgery) on the primary
efficacy (P for interaction =.81) and safety (P for interaction =.37)
outcomes. Across subtypes of general surgery, TXA decreased the composite
bleeding outcome in hepatopancreaticobiliary surgery (HR, 0.55; 95% CI,
0.34-0.91 [n = 332]) and colorectal surgery (HR, 0.67; 95% CI, 0.45-0.98
[n = 940]). There was no significant interaction across subtypes of
general surgery (P for interaction =.68). <br/>Conclusions and Relevance:
In this study, TXA significantly reduced the risk of perioperative
bleeding without increasing cardiovascular risk in patients undergoing
general surgery procedures.<br/>Copyright &#xa9; 2025 American Medical
Association. All rights reserved.

<20>
Accession Number
2032505210
Title
Speckle-tracking echocardiography of left and right ventricle and acute
cellular rejection in orthotropic heart transplantation: a systematic
review and meta-analysis.
Source
International Journal of Cardiovascular Imaging. 41(4) (pp 669-679), 2025.
Date of Publication: 01 Apr 2025.
Author
Xourgia E.; Brignoli K.; Linder O.; Neagoe A.-M.; Capek L.; Bruno J.;
Strickler E.; Bakula A.; Pavlicek-Bahlo M.; Furholz M.; Muster C.;
Malagutti P.; Martinelli M.; Hunziker L.; Schnegg B.
Institution
(Xourgia, Neagoe, Capek, Bruno, Strickler, Bakula, Pavlicek-Bahlo,
Furholz, Muster, Malagutti, Martinelli, Hunziker, Schnegg) Department of
Cardiology, Inselspital, Bern University Hospital, University of Bern,
Bern, Switzerland
(Xourgia, Brignoli, Linder) Department of Internal Medicine, Burgerspital
Solothurn, Solothurn, Switzerland
Publisher
Springer Science and Business Media B.V.
Abstract
After a cardiac transplantation, the steering of immunosuppression
requires an active search for acute cellular rejection (ACR). Surveillance
with endomyocardial biopsy (EMB) is the gold standard. Given the costs and
potential complications, there is growing interest in the use of
non-invasive screening methods. Thus, we have conducted a systematic
review and meta-analysis to evaluate the role of speckle-tracking
echocardiography as a screening method for ACR. We searched PubMed
(CENTRAL) and gray literature for studies presenting data on speckle
tracking echocardiography in heart-transplant patients experiencing acute
cellular rejection. The primary outcomes of the meta-analysis were left
and right ventricular global longitudinal strain. We used random effects
models for all our calculations. We pre-registered our meta-analysis with
PROSPERO (CRD42024508654). By incorporating data from over 2000 biopsies
included in 18 studies, we found that both left (LVGLS, MD -1.96, 95% CI
-2.85 to -1.07, p < 0.0001), and right (RVGLS, MD -2.90, 95% CI -4.03 to
-1.76, p < 0.00001) ventricular longitudinal strain were lower among
patients without ACR. The change of LVGLS from baseline over time was also
greater among patients experiencing ACR (MD -2.43, 95% CI -4.82 to -0.05,
p = 0.045). Current data suggest that myocardial strain measured by
speckle tracking echocardiography is affected in ACR and could potentially
be used for early rejection detection as a rule-out strategy, leading to
reduction of routine EMB in heart transplant follow-up.<br/>Copyright
&#xa9; The Author(s) 2024.

<21>
Accession Number
2032696733
Title
Randomized Trial of Pulsatile and Nonpulsatile Flow in Cyanotic and
Acyanotic Congenital Heart Surgery.
Source
World Journal for Pediatric and Congenital Heart Surgery. 16(3) (pp
329-337), 2025. Date of Publication: 01 May 2025.
Author
Patel K.; Lin T.K.; Clark J.B.; Ceneviva G.D.; Imundo J.R.; Spear D.;
Kunselman A.R.; Thomas N.J.; Myers J.L.; Undar A.
Institution
(Patel, Lin, Clark, Ceneviva, Imundo, Spear, Kunselman, Thomas, Myers,
Undar) Penn State Hershey Pediatric Cardiovascular Research Center, Penn
State College of Medicine, Hershey, PA, United States
(Patel, Clark, Imundo, Myers, Undar) Division of Pediatric Cardiology,
Department of Pediatrics, Penn State College of Medicine, Hershey, PA,
United States
(Patel, Clark, Myers, Undar) Department of Surgery, Penn State College of
Medicine, Hershey, PA, United States
(Lin) Division of Pediatric Critical Care Medicine, Department of
Pediatrics, University of Virginia Children's Hospital, Charlottesville,
VA, United States
(Ceneviva, Spear, Thomas) Division of Pediatric Critical Care Medicine,
Department of Pediatrics, Penn State College of Medicine, Hershey, PA,
United States
(Kunselman, Thomas) Department of Public Health Sciences, Penn State
College of Medicine, Hershey, PA, United States
(Undar) Department of Biomedical Engineering, College of Engineering, The
Pennsylvania State University, University Park, PA, United States
Publisher
SAGE Publications Inc.
Abstract
Background: The study objective was to determine the impact of
cardiopulmonary bypass perfusion modalities on cerebral hemodynamics and
clinical outcomes in congenital cardiac surgery patients stratified by
acyanotic versus cyanotic heart disease. <br/>Method(s): A total of 159
pediatric (age <18 years) cardiac surgery patients were prospectively
randomized to pulsatile or nonpulsatile cardiopulmonary bypass and
stratified by type of congenital heart disease: acyanotic versus cyanotic.
Intraoperative cerebral gaseous microemboli counts and middle cerebral
artery pulsatility index were assessed. Organ injury was quantified by
Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score at 24, 48, and 72 h
postoperatively. Additional outcomes included Pediatric Risk of
Mortality-3 score, vasoactive-inotropic score, duration of mechanical
ventilation, intensive care and hospital length of stay, and 180-day
mortality. Heterogenous variance linear models (ie, ANOVA and mixed
models) and chi² tests were used to compare groups for
continuous and categorical variables, respectively. <br/>Result(s): Within
congenital heart disease subgroups, patients randomized to nonpulsatile
versus pulsatile bypass had similar preoperative and operative
characteristics. While the intraoperative pulsatility index was higher in
the pulsatile subset of both acyanotic and cyanotic groups (P <.05),
regional cerebral oxygen saturation, mean arterial pressure, and gaseous
microemboli counts were similar. Postoperative PELOD-2 scores decreased at
similar rates in the acyanotic and cyanotic subgroups regardless of the
perfusion modality utilized. There were also no significant between-group
differences in the additional postoperative outcomes by perfusion modality
in either acyanotic or cyanotic groups. <br/>Conclusion(s): Despite
patients undergoing pulsatile cardiopulmonary bypass experiencing a more
physiologic pulsatility index in both acyanotic and cyanotic groups, no
significant differences in cerebral hemodynamics or clinical outcomes were
appreciated.<br/>Copyright &#xa9; The Author(s) 2024.

<22>
Accession Number
2036653034
Title
Editor's Choice - Outcomes of Endovascular Repair Confined to the
Ascending Thoracic Aorta: A Systematic Review and Meta-Analysis.
Source
European Journal of Vascular and Endovascular Surgery. 69(4) (pp 531-544),
2025. Date of Publication: 01 Apr 2025.
Author
de Kort J.F.; Mandigers T.J.; Bissacco D.; Domanin M.; Piffaretti G.;
Twine C.P.; Wanhainen A.; van Herwaarden J.A.; Trimarchi S.; de Vincentiis
C.
Institution
(de Kort, Mandigers, Domanin, Trimarchi) Cardio Thoracic Vascular
Department, Section of Vascular Surgery, Fondazione IRCCS Ca Granda
Ospedale Maggiore Policlinico, Milan, Italy
(de Kort, Mandigers, van Herwaarden) Department of Vascular Surgery,
University Medical Centre Utrecht, Utrecht, Netherlands
(Bissacco, Domanin, Trimarchi) Department of Clinical Sciences and
Community Health, Universita degli Studi di Milano, Milan, Italy
(Piffaretti) Department of Medicine and Surgery, Vascular Surgery,
University of Insubria School of Medicine, Varese University Hospital,
Varese, Italy
(Twine) Southmead Hospital, North Bristol NHS Trust, and University of
Bristol Medical School, Bristol, United Kingdom
(Wanhainen) Section of Vascular Surgery, Department of Surgical Sciences,
Uppsala University, Uppsala, Sweden
(Wanhainen) Department of Surgical and Peri-operative Sciences, Surgery,
Umea University, Umea, Sweden
(de Vincentiis) Cardiac Surgery Unit, Cardiac Surgery Division, Department
of Cardiovascular Disease E. Malan, IRCCS Policlinico S. Donato, Milan,
Italy
Publisher
W.B. Saunders Ltd
Abstract
Objective: High risk, inoperable patients with ascending aortic disease
are increasingly managed with thoracic endovascular aortic repair (TEVAR).
The aim of this study was to assess the available literature on TEVAR
confined to the ascending aorta (a-TEVAR), describing study and patient
characteristics, procedural and stent graft details, and outcomes. Data
sources: This was a systematic review and meta-analysis. MEDLINE, Web of
Science, and Scopus were systematically searched for eligible studies
reporting on outcomes after a-TEVAR (PROSPERO ID: CRD42023440826).
Eligible studies reported outcomes after a-TEVAR without adjunctive
supra-aortic vessel treatment. Review Methods: The Preferred Reporting
Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was
followed. The ROBINS-I and Joanna Briggs Institute Critical Appraisal
Checklist were used as quality assessment tools. A Grading of
Recommendations Assessment, Development, and Evaluation (GRADE) evidence
certainty analysis was performed for the main outcomes. The main outcome
was death. A proportional meta-analysis was performed with a mean and 95%
confidence interval (CI) for the main outcomes. All articles were included
up to 1 January 2024. <br/>Result(s): Ninety four studies were included
(19 cohort studies, 75 case reports or series), reporting on 259 patients
(57.8% male). The mean age was 69.1 (95% CI 65.0 - 73.1) years and mean
follow up 19.6 (95% CI 14.5 - 24.6) months. The most common comorbidity
was prior cardiac or thoracic surgery (n = 191). The most frequent
indications for a-TEVAR (52.1% urgent a-TEVAR) were type A aortic
dissection (43.6%) and pseudoaneurysm (38.6%). The most commonly deployed
stent grafts were Gore (44.5%), Cook (23.5%), and Medtronic (17.0%). The
in hospital mortality rate was 7.3% (95% CI 4.7 - 11.2%), 30 day mortality
rate 7.7% (95% CI 5.1 - 11.6%), and overall mortality rate 17.0% (95% CI
12.9 - 22.0%) during follow up. GRADE showed very low evidence certainty
for all outcomes. Eighty eight complications were reported and there was a
re-operation rate of 13.1% (95% CI 9.5 - 17.8%). In hospital and 30 day
mortality rates for type A dissection were 12.4% (95% CI 7.5 - 19.7%) (n =
14) and 13.3% (95% CI 8.2 - 20.8%) (n = 15), respectively, and for
pseudoaneurysm 4.0% (95% CI 1.6 - 9.8%) (n = 4) and 4.0% (95% CI 1.6 -
9.8) (n = 4), respectively. <br/>Conclusion(s): Despite heterogeneous
literature and very low GRADE evidence certainty, a-TEVAR seems
technically feasible in high risk patients. In addition, there is need for
a consensus on when and how to use a-TEVAR and a need for a specific
endograft for use in the ascending aorta.<br/>Copyright &#xa9; 2024
European Society for Vascular Surgery

<23>
Accession Number
2038204709
Title
Letter: the effect of virtual reality on postoperative anxiety and pain in
patients following cardiac surgery: a randomized controlled trial.
Source
European Journal of Cardio-thoracic Surgery. 67(4) (no pagination), 2025.
Article Number: ezaf090. Date of Publication: 01 Apr 2025.
Author
Xie H.; Gao F.; Zheng X.
Institution
(Xie, Gao, Zheng) Department of Anesthesiology, Fuzhou University
Affiliated Provincial Hospital, Fuzhou, China
(Xie, Gao, Zheng) Department of Anesthesiology, Shengli Clinical Medical
College of Fujian Medical University, Fuzhou, China
Publisher
European Association for Cardio-Thoracic Surgery

<24>
Accession Number
2034207377
Title
Geranylgeranylacetone as Prevention for Postoperative Atrial Fibrillation
(GENIALITY).
Source
Cardiovascular Drugs and Therapy. (no pagination), 2025. Date of
Publication: 2025.
Author
S. Ramos K.; Nassiri S.; Wijdeveld L.F.J.; van der Palen R.L.; Kuipers
M.F.; Hills M.T.; Slijkerman P.; van Raalte D.H.; Handoko M.L.; de Groot
N.M.S.; Grewal N.; Klautz R.J.M.; Eringa E.C.; Brundel B.J.J.M.
Institution
(S. Ramos, Wijdeveld, van der Palen, Eringa, Brundel) Amsterdam
Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam
University Medical Center, Location Vrije Universiteit Amsterdam, De
Boelelaan 1117, Amsterdam, Netherlands
(Nassiri, Handoko) Department of Cardiology, Amsterdam University Medical
Center, Amsterdam, Netherlands
(Kuipers) AFIP Foundation, Amsterdam, Netherlands
(Hills) Stopafib.Org, American Foundation for Women'S Health, Decatur, TX,
United States
(Slijkerman) Innovation Exchange Amsterdam, Amsterdam University Medical
Center, Amsterdam, Netherlands
(van Raalte) Diabetes Center, Department of Internal Medicine, Amsterdam
University Medical Center, Amsterdam, Netherlands
(de Groot) Department of Cardiology, Erasmus Medical Center, Rotterdam,
Netherlands
(Grewal, Klautz) Department of Cardiothoracic Surgery, Amsterdam
University Medical Center, Amsterdam, Netherlands
(Grewal, Klautz) Department of Cardiothoracic Surgery, Leiden University
Medical Center, Leiden, Netherlands
(Eringa) Department of Physiology, Cardiovascular Research Institute
Maastricht, Maastricht, Netherlands
Publisher
Springer
Abstract
Purpose: Abstract: Interestingly, 30-50% of patients undergoing elective
cardiothoracic surgery develop postoperative AF (PoAF). Unfortunately,
preventive PoAF therapy is still suboptimal. In our previous studies, we
showed that oral Geranylgeranylacetone (GGA) administration increased
cardioprotective heat shock protein (HSP) protecting against AF onset and
progression in clinically relevant animal model studies. <br/>Method(s):
The GENIALITY study is a phase II single-center, double-blind,
placebo-controlled randomized trial comparing the efficacy of GGA in
preventing PoAF. Participants (N = 146) are adult patients, without any
registered history of AF, undergoing elective open-heart surgery for
valvular disease, coronary artery bypass grafting, or concomitant, and are
allocated with ratio 1:1 in treatment or placebo groups. Daily
administration of 300 mg of GGA or placebo starts 5 days before until 3
days after surgery. Cardiac rhythm will be monitored using a Holter
monitoring post-surgery until hospital discharge. Additionally, blood
samples, right atrial appendage tissue, and epicardial adipose tissue will
be collected to assess proteostasis levels. <br/>Result(s): The primary
endpoint is the assessment of PoAF incidence in the GGA group compared to
the placebo group. Secondary endpoints include the evaluation of HSP
levels through biochemical analysis in both blood and atrial tissue.
<br/>Conclusion(s): The GENIALITY study aims to reduce PoAF incidence in
the GGA group compared to the placebo group. Herewith, we expect to obtain
proof of concept for a beneficial effect of GGA in preventing PoAF in
patients undergoing cardiothoracic surgery. Trial Registration: Clinical
Trial Information System (CTIS) registry: 2024-514743-28-00. Authorized on
September 30th 2024.<br/>Copyright &#xa9; The Author(s) 2025.

<25>
Accession Number
2038309880
Title
Favorable impact of FFR<inf>CT</inf> on myocardial revascularization
outcomes: Results from an observational real-world registry.
Source
International Journal of Cardiology. 431 (no pagination), 2025. Article
Number: 133245. Date of Publication: 15 Jul 2025.
Author
Lammens J.; Motoc A.; Tanaka K.; Belsack D.; Vandeloo B.; Lochy S.;
Schoors D.; Van Loo I.; De Potter T.; Michiels V.; Tsugu T.; Van Dalem A.;
Thorrez Y.; Magne J.; De Mey J.; Cosyns B.; Argacha J.-F.
Institution
(Lammens, Motoc, Vandeloo, Lochy, Schoors, De Potter, Michiels, Cosyns,
Argacha) Department of Cardiology, Universitair Ziekenhuis Brussel, Vrije
Universiteit Brussel, Brussels, Belgium
(Tanaka, Belsack, Tsugu, De Mey) Department of Radiology, Universitair
Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
(Van Loo) Department of Cardiac Surgery, Universitair Ziekenhuis Brussel,
Vrije Universiteit Brussel, Brussels, Belgium
(Van Dalem) Department of Clinical Biology, Universitair Ziekenhuis
Brussel, Vrije Universiteit Brussel, Brussels, Belgium
(Thorrez) Department of Information Technologies, Universitair Ziekenhuis
Brussel, Vrije Universiteit Brussel, Brussels, Belgium
(Magne) Department of Cardiology, Dupuytren University Hospital 2,
Limoges, France
(Magne) INSERM U1094 and IRD, Limoges University, Limoges, France
Publisher
Elsevier Ireland Ltd
Abstract
Background: Coronary computed tomography angiography (CCTA)-derived
fractional flow reserve (FFR<inf>CT</inf>) strategy significantly
decreases unnecessary invasive coronary angiography and refines the
appropriateness of revascularization decision. The present study aimed to
evaluate how FFR<inf>CT</inf> guided - strategy impacts outcomes
postrevascularization. <br/>Method(s): We included patients with suspected
obstructive coronary artery disease (OCAD in a registry from 2013 to 2021.
FFR<inf>CT</inf> entered Heart-Team decision from 2017. Propensity score
adjusted Cox - and logistic - regression analyzed FFR<inf>CT</inf>'s
impact on post- revascularization major adverse cardiovascular events
(MACE) and myocardial injury (PMI). <br/>Result(s): Among 7541 patients,
1601 had suspected OCAD. 559 patients underwent revascularization: 69.0 %
PCI, 29.7 % CABG and 1.2 % both. 252(45.1 %) patients underwent
FFR<inf>CT</inf>. Over 4.4 +/- 2.2 years, 137(24.5 %) patients experienced
MACE. FFR<inf>CT</inf> was associated with a trend toward reduced MACE (HR
0.736, 95 % CI 0.513-1.055, p = 0.095) and significantly reduced all-cause
mortality (HR 0.476, 95 % CI 0.230-0.985, p = 0.046). In the post-2017
cohort (413 patients, follow-up 3.7 +/- 1.5 years), FFR<inf>CT</inf>
significantly reduced MACE (HR 0.610, 95 % CI 0.390-0.954, P = 0.030) and
all-cause mortality (HR 0.285, 95 % CI 0.104-0.779, P = 0.014). In CABG
patients, FFR<inf>CT</inf> was associated with lower PMI incidence (5.3 %
vs. 15.6 %, p = 0.044). Multivariable analysis revealed no significant
association between FFR<inf>CT</inf> use and PMI. <br/>Conclusion(s):
Revascularization decision-making with FFR<inf>CT</inf> translates into
better post-revascularization outcomes, primarily by reducing MACE through
lower mortality. There was no clear impact on PMI. These findings suggests
that FFR<inf>CT</inf>'s value lies indeed in improving patient selection
for revascularization, but warrants further confirmation in randomized
clinical trials.<br/>Copyright &#xa9; 2025 Elsevier B.V.

<26>
Accession Number
2038261902
Title
Association between surgeon age and surgical complications: A systematic
review and meta-analysis.
Source
American Journal of Surgery. 244 (no pagination), 2025. Article Number:
116316. Date of Publication: 01 Jun 2025.
Author
Mussa B.; Defrancisco B.; Petracco P.
Institution
(Mussa, Petracco) Surgical Science Department, University of Turin, Italy
(Defrancisco) Alchemica Hospital, Turin, Italy
Publisher
Elsevier Inc.
Abstract
This meta-analysis synthesizes evidence on the relationship between
surgeon age and surgical complications, incorporating 2.3 million
procedures by 72,000 surgeons. Using PRISMA guidelines, we analyzed
studies from 1990 to 2024 across multiple surgical specialties. Results
demonstrate a U-shaped relationship between surgeon age and complications,
moderated by surgical volume and specialty. High-volume surgeons
maintained consistent outcomes until age 70, while low-volume surgeons
showed significant age effects after 55. Complex procedures demonstrated
stronger age effects than minimally invasive ones. Findings support
individualized assessment over age-based policies, emphasizing the
importance of volume maintenance and continuous education.<br/>Copyright
&#xa9; 2025 The Authors

<27>
Accession Number
2031765064
Title
Effects and mechanisms of supramaximal high-intensity interval training on
extrapulmonary manifestations in people with and without chronic
obstructive pulmonary disease (COPD-HIIT): study protocol for a
multi-centre, randomized controlled trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 664. Date of
Publication: 01 Dec 2024.
Author
Jakobsson J.; Burtin C.; Hedlund M.; Boraxbekk C.-J.; Westman J.; Karalija
N.; Stal P.; Sandstrom T.; Ruttens D.; Gosker H.R.; De Brandt J.; Nyberg
A.
Institution
(Jakobsson, Hedlund, Westman, De Brandt, Nyberg) Section of Physiotherapy,
Department of Community Medicine and Rehabilitation, Umea University,
Umea, Sweden
(Burtin) REVAL - Rehabilitation Research Center, BIOMED - Biomedical
Research Institute, Hasselt University, Diepenbeek, Belgium
(Boraxbekk, Karalija) Umea Centre for Functional Brain Imaging (UFBI),
Umea University, Umea, Sweden
(Boraxbekk) Diagnostic Radiology, Department of Radiation Sciences, Umea
University, Umea, Sweden
(Boraxbekk) Institute of Sports Medicine Copenhagen (ISMC) and Department
of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen,
Denmark
(Boraxbekk) Institute for Clinical Medicine, Faculty of Medical and Health
Sciences, University of Copenhagen, Copenhagen, Denmark
(Ruttens) Department of Respiratory Medicine, Ziekenhuis Oost-Limburg,
Genk, Belgium
(Ruttens) Faculty of Medicine and Life Sciences, Hasselt University,
Diepenbeek, Belgium
(Karalija, Stal) Department of Medical and Translational Biology, Umea
University, Umea, Sweden
(Sandstrom) Department of Public Health and Clinical Medicine, Umea
University, Umea, Sweden
(Gosker) Department of Respiratory Medicine, NUTRIM School of Nutrition
and Translational Research in Metabolism, Maastricht University Medical
Center+, Maastricht, Netherlands
Publisher
BioMed Central Ltd
Abstract
Background: Beyond being a pulmonary disease, chronic obstructive
pulmonary disease (COPD) presents with extrapulmonary manifestations
including reduced cognitive, cardiovascular, and muscle function. While
exercise training is the cornerstone in the non-pharmacological treatment
of COPD, there is a need for new exercise training methods due to
suboptimal adaptations when following traditional exercise guidelines,
often applying moderate-intensity continuous training (MICT). In people
with COPD, short-duration high-intensity interval training (HIIT) holds
the potential to induce a more optimal stimulus for training adaptations
while circumventing the ventilatory burden often associated with MICT in
people with COPD. We aim to determine the effects of supramaximal HIIT and
MICT on extrapulmonary manifestations in people with COPD compared to
matched healthy controls. <br/>Method(s): COPD-HIIT is a prospective,
multi-centre, randomized, controlled trial with blinded assessors and data
analysts, employing a parallel-group designed trial. In phase 1, we will
investigate the effects and mechanisms of a 12-week intervention of
supramaximal HIIT compared to MICT in people with COPD (n = 92) and
matched healthy controls (n = 70). Participants will perform watt-based
cycling two to three times weekly. In phase 2, we will determine how
exercise training and inflammation impact the trajectories of
neurodegeneration, in people with COPD, over 24 months. In addition to the
92 participants with COPD performing HIIT or MICT, a usual care group (n =
46) is included in phase 2. In both phases, the primary outcomes are a
change from baseline in cognitive function, cardiorespiratory fitness, and
muscle power. Key secondary outcomes include change from baseline exercise
tolerance, brain structure, and function measured by MRI,
neuroinflammation measured by PET/CT, systemic inflammation, and
intramuscular adaptations. Feasibility of the interventions will be
comprehensively investigated. <br/>Discussion(s): The COPD-HIIT trial will
determine the effects of supramaximal HIIT compared to MICT in people with
COPD and healthy controls. We will provide evidence for a novel exercise
modality that might overcome the barriers associated with MICT in people
with COPD. We will also shed light on the impact of exercise at different
intensities to reduce neurodegeneration. The goal of the COPD-HIIT trial
is to improve the treatment of extrapulmonary manifestations of the
disease. Trial registration: Clinicaltrials.gov: NCT06068322.
Prospectively registered on 2023-09-28.<br/>Copyright &#xa9; The Author(s)
2024.

<28>
Accession Number
2035712357
Title
Assessment of Antitachycardia Pacing in Primary Prevention Patients: The
APPRAISE ATP Randomized Clinical Trial.
Source
JAMA. 332(20) (no pagination), 2024. Date of Publication: 26 Nov 2024.
Author
Schuger C.; Joung B.; Ando K.; Mont L.; Lambiase P.D.; O'Hara G.E.;
Jennings J.M.; Yung D.; Boriani G.; Piccini J.P.; Wold N.; Stein K.M.;
Daubert J.P.
Institution
(Schuger) Clinical Cardiac Research Center, University of Rochester,
Rochester, NY, United States
(Joung) Yonsei University, Severance Hospital, Seoul, South Korea
(Ando) Department of Cardiology, Kokura Memorial Hospital, Kitakyushu,
Japan
(Mont) Universitat de Barcelona, Hospital Clinic, Barcelona, Spain
(Lambiase) Bart's Heart Centre, St Bartholomew's Hospital, London, United
Kingdom
(O'Hara) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Quebec, QC, Canada
(Jennings) Heart Center Research, Huntsville, AL, United States
(Yung) Scarborough Health Network, Scarborough, ON, Canada
(Boriani) Cardiology Division, Department of Biomedical, Metabolic and
Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
(Piccini, Daubert) Duke Clinical Research Institute, Division of
Cardiology, Duke University, Durham, NC, United States
(Wold, Stein) Boston Scientific Corporation, Saint Paul, MN, United States
Publisher
American Medical Association
Abstract
Importance: The emergence of novel programming guidelines that reduce
premature and inappropriate therapies along with the availability of new
implantable cardioverter-defibrillator (ICD) technologies lacking
traditional endocardial antitachycardia pacing (ATP) capabilities requires
the reevaluation of ATP as a first strategy in terminating fast
ventricular tachycardias (VTs) in primary prevention ICD recipients.
<br/>Objective(s): To assess the role of ATP in terminating fast VTs in
primary prevention ICD recipients with contemporary programming.
<br/>Design, Setting, and Participant(s): This global, prospective,
double-blind, randomized clinical trial had an equivalence design with a
relative margin of 35%. Superiority tests were performed at interim
analyses and the final analysis if equivalence was not proven. Patients
were enrolled between September 2016 and April 2021 at 134 sites in 8
countries, with the last date of follow-up on July 6, 2023. Patients were
required to have an indication for a primary prevention ICD, including
left ventricular ejection fraction less than or equal to 35%.
<br/>Intervention(s): Patients were randomized in a 1:1 ratio to receive
ATP plus shock vs shock only. <br/>Main Outcomes and Measures: The primary
end point was time to first all-cause shock. Secondary end points included
time to first appropriate shock, time to first inappropriate shock,
all-cause mortality, and the composite of time to first all-cause shock
plus all-cause mortality. <br/>Result(s): A total of 2595 patients were
randomized (mean age, 63.9 years; 22.4% were females). At a mean follow-up
of 38 months, first all-cause shock occurred in 129 participants in the
ATP plus shock group and 178 participants in the shock only group. The
hazard ratio (HR) for the primary end point was 0.72 (95.9% CI,
0.57-0.92), with P =.005 for superiority of the ATP plus shock group over
the shock only group. During follow-up in an intention-to-treat analysis,
the total shock burden per 100 patient-years was not statistically
different, at 12.3 and 14.9, respectively (P =.70). <br/>Conclusions and
Relevance: The use of a single burst of ATP prior to shock in primary
prevention ICD recipients with modern ICD detection programming prolonged
the time to first all-cause ICD shock. Trial Registration:
ClinicalTrials.gov Identifier: NCT02923726.<br/>Copyright &#xa9; 2024
American Medical Association. All rights reserved.

<29>
Accession Number
2031845553
Title
Uniform or Sex-Specific Cardiac Troponin Thresholds to Rule Out Myocardial
Infarction at Presentation.
Source
Journal of the American College of Cardiology. 83(19) (pp 1855-1866),
2024. Date of Publication: 14 May 2024.
Author
Lowry M.T.H.; Mills N.L.; Shah A.S.V.; Strachan F.E.; Tuck C.; Anand A.;
Akinlade O.M.; Barker S.; Blades J.; Boeddinghaus J.; Bularga A.; de
Bakker M.; Chapman A.R.; Doudesis D.; Ferry A.V.; Fujisawa T.; Georgiev
K.; Kimenai D.M.; Lee K.K.; Lyell I.; Li Z.; Lowry M.T.; McKinlay L.;
McDermott M.; McPherson J.; Mendusic F.; Sorbie A.; Souter G.; Schulberg
S.D.; Taggart C.; Thurston A.J.; Tew Y.Y.; Perez-Vicencio D.; Wang Y.;
Wereski R.; Williams K.; Newby D.E.; Fox K.A.; Berry C.; Walker S.; Weir
C.J.; Ford I.; Gray A.; Collinson P.O.; Apple F.S.; Reid A.; Cruikshank
A.; Findlay I.; Amoils S.; McAllister D.A.; Maguire D.; Stevens J.; Norrie
J.; Shah A.S.; Andrews J.P.; Adamson P.D.; Moss A.; Anwar M.S.; Hung J.;
Malo J.; Fischbacher C.M.; Croal B.L.; Leslie S.J.; Keerie C.; Parker
R.A.; Walker A.; Harkess R.; Wackett T.; Weir C.; Armstrong R.; Stirling
L.; MacDonald C.; Sadat I.; Finlay F.; Harrison K.
Institution
(Li, Wereski, Anand, Lowry, Doudesis, McDermott, Ferry, Tuck, Chapman,
Lee, Mills, Kimenai) BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, United Kingdom
(Chapman) Department of Cardiology, Auckland City Hospital, Auckland, New
Zealand
(Shah) Department of Non-Communicable Disease, London School of Hygiene
and Tropical Medicine, London, United Kingdom
(Mills) Usher Institute, University of Edinburgh, Edinburgh, United
Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Myocardial infarction can be ruled out in patients with a
single cardiac troponin measurement. Whether use of a uniform rule-out
threshold has resulted in sex differences in care remains unclear.
<br/>Objective(s): The purpose of this study was to evaluate
implementation of a uniform rule-out threshold in females and males with
possible myocardial infarction, and to derive and validate sex-specific
thresholds. <br/>Method(s): The implementation of a uniform rule-out
threshold (<5 ng/L) with a high-sensitivity cardiac troponin I assay was
evaluated in consecutive patients presenting with possible myocardial
infarction. The proportion of low-risk patients discharged from the
emergency department and incidence of myocardial infarction or cardiac
death at 30 days were determined. Sex-specific thresholds were derived and
validated, and proportion of female and male patients were stratified as
low-risk compared with uniform threshold. <br/>Result(s): In 16,792
patients (age 58 +/- 17 years; 46% female) care was guided using a uniform
threshold. This identified more female than male patients as low risk (73%
vs 62%), but a similar proportion of low-risk patients were discharged
from the emergency department (81% for both) with fewer than 5 (<0.1%)
patients having a subsequent myocardial infarction or cardiac death at 30
days. Compared with a uniform threshold of <5 ng/L, use of sex-specific
thresholds would increase the proportion of female (61.8% vs 65.9%) and
reduce the proportion of male (54.8% vs 47.8%) patients identified as low
risk. <br/>Conclusion(s): Implementation of a uniform rule-out threshold
for myocardial infarction was safe and effective in both sexes.
Sex-specific rule-out thresholds should be considered, but their impact on
effectiveness and safety may be limited.<br/>Copyright &#xa9; 2024

<30>
Accession Number
2034158947
Title
Comparison of multiple arterial grafts vs. single arterial graft in
coronary artery bypass surgery: a systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1555242. Date of Publication: 2025.
Author
Ding Q.; Zhu Q.; Lu L.; Cheng X.; Ge M.
Institution
(Ding, Zhu, Lu, Cheng, Ge) Department of Cardio-thoracic Surgery, Nanjing
Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical
School, Nanjing, China
(Cheng) Department of Cardio-Thoracic Surgery, Nanjing Drum Tower
Hospital, Clinical College of Nanjing University of Chinese Medicine,
Nanjing, China
Publisher
Frontiers Media SA
Abstract
Observational studies and randomised controlled trials (RCTs) have yielded
conflicting results regarding the outcomes of multiple arterial grafts
(MAG) vs. single arterial grafts (SAG) in coronary artery bypass graft
(CABG) surgery. We conducted a comprehensive search across multiple
databases for RCTs that directly compared MAG and SAG. The clinical
outcomes assessed included all-cause mortality, cardiac-specific
mortality, myocardial infarction (MI), repeat revascularization, stroke,
sternal wound complications, and major bleeding. Outcomes were measured
using hazard ratios (HR), relative risks (RR), and the corresponding 95%
confidence intervals (CI). Eighteen RCTs involving 10,143 patients were
included in the analysis. The follow-up period ranged from 6 months to
12.6 years, and the average age of the patients across the studies ranged
between 56.3 and 77.3 years. MAG and SAG did not differ significantly in
terms of the incidence of sternal wound complications, major bleeding, or
stroke following CABG. However, the MAG group demonstrated a lower risk of
all-cause mortality, cardiac mortality, MI, and repeat revascularization
compared with the SAG group. MAG was associated with higher survival,
lower risk of MI, and fewer repeat revascularization. Nonetheless, there
were no significant differences in the incidence of sternal wound
infections, major bleeding, and stroke between MAG and SAG.<br/>Copyright
2025 Ding, Zhu, Lu, Cheng and Ge.

<31>
Accession Number
2035193010
Title
Anesthetic Risk with Large Mediastinal Masses: A Management Framework
Based on a Systematic Review.
Source
Annals of Thoracic Surgery. 119(5) (pp 967-979), 2025. Date of
Publication: 01 May 2025.
Author
Saffarzadeh A.; Popescu W.M.; Detterbeck F.C.; Li A.X.; Blasberg J.D.
Institution
(Saffarzadeh) Division of Thoracic Surgery, Department of Surgery,
Providence Mission Hospital, Mission Viejo, CA, United States
(Popescu) Thoracic Anesthesia, Department of Anesthesiology, Yale School
of Medicine, New Haven, Connecticut, United States
(Detterbeck, Li, Blasberg) Division of Thoracic Surgery, Department of
Surgery, Yale School of Medicine, New Haven, Connecticut, United States
Publisher
Elsevier Inc.
Abstract
Background: Anesthesia administered to a patient with a large mediastinal
mass engenders concern that it may precipitate catastrophic acute
hemodynamic or respiratory decompensation. A review of the available
evidence is needed to define the degree of risk, mechanisms, and
preventative or reactive interventions to mitigate the risk.
<br/>Method(s): A systematic review of the PubMed database was conducted
of studies involving adults with large mediastinal masses undergoing a
procedure or anesthesia; all types of publications were included that
provided data regarding risks, mechanisms, or techniques to address
potential decompensation. This literature involves primarily case reports
and small retrospective series; no quality assessment was deemed
appropriate. Evidence was synthesized according to the consensus judgment
of the writing panel. <br/>Result(s): Categories of low-, moderate-,
high-, and very-high-risk emerged from review of the 72 included studies,
based on the degree of symptoms, mass/chest ratio, and degree of airway
and/or vascular compression. This streamlines the preparation
needed-minimal for low-risk and more extensive for higher-risk. Assessment
of the impact of physiologic derangement stemming from the anatomic
compression in individual patients provides a framework for anesthetic
management, and back-up plans should decompensation occur.
<br/>Conclusion(s): Despite limitations in the evidence inherent to a
topic involving an uncommon but serious event, a framework was developed
to streamline preparation for and management of patients with a large
mediastinal mass requiring anesthesia in a rational manner.<br/>Copyright
&#xa9; 2025 The Society of Thoracic Surgeons

<32>
Accession Number
2037915051
Title
Vasoplegia in Cardiac Surgery: A Systematic Review and Meta-analysis of
Current Definitions and Their Influence on Clinical Outcomes.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(6) (pp 1451-1463),
2025. Date of Publication: 01 Jun 2025.
Author
Papazisi O.; van der Schoot M.M.; Berendsen R.R.; Arbous S.M.; le Cessie
S.; Dekkers O.M.; Klautz R.J.M.; Marczin N.; Palmen M.; de Waal E.E.C.
Institution
(Papazisi, Klautz, Palmen, de Waal) Department of Cardiothoracic surgery,
Leiden University Medical Center, Leiden, Netherlands
(van der Schoot, Berendsen) Department of Anesthesiology, Leiden
University Medical Center, Leiden, Netherlands
(Arbous) Department of Intensive Care, Leiden University Medical Center,
Leiden, Netherlands
(le Cessie, Dekkers) Department of Clinical Epidemiology, Leiden
University Medical Center, Leiden, Netherlands
(le Cessie) Department of Biomedical Data Sciences, Leiden University
Medical Center, Leiden, Netherlands
(Klautz) Department of Cardiothoracic surgery, Amsterdam University
Medical Center, Amsterdam, Netherlands
(Marczin) Division of Anaesthesia, Pain Medicine and Intensive Care,
Imperial College London, Royal Brompton & Harefield Hospitals, Guy's & St.
Thomas' NHS, London, United Kingdom
(Marczin) Department of Anesthesia and Intensive Care, Semmelweis
University, Budapest, Hungary
(de Waal) Department of Anesthesiology, University Medical Center Utrecht,
Netherlands
Publisher
W.B. Saunders
Abstract
Objectives: To identify differences in the reported vasoplegia incidence,
intensive care unit (ICU) length of stay (LOS), and 30-day mortality rates
as influenced by different vasoplegia definitions used in cardiac surgery
studies. <br/>Design(s): A systematic review was performed covering the
period 1977 to 2023 using PubMed/MEDLINE, Embase, Web of Science, Cochrane
Library, and Emcare and a meta-analysis (PROSPERO: CRD42021258328) was
performed. Setting and Participants: One hundred studies defining
vasoplegia in cardiac surgery patients were systematically reviewed. Sixty
studies with 20 or more patients, irrespective of design, reporting
vasoplegia incidence, ICU LOS, or 30-day mortality were included for
meta-analysis. <br/>Intervention(s): Cardiac surgery on cardiopulmonary
bypass. <br/>Measurements and Main Results: Studies were categorized
depending on the used mean arterial pressure (MAP) thresholds. Random
intercept logistic regression models were used for meta-analysis of
incidence and mortality. Random effect meta-analysis was used for ICU LOS.
One hundred studies were reviewed systematically. MAP and cardiac index
thresholds varied considerably (<50-80 mmHg and 2.0-3.5
L.min^-1m^-2, respectively). Vasopressor dosages also
differed between definitions. The reported incidence (60 studies; mean
incidence, 19.9%; 95% confidence interval [CI], 16.1-24.4) varied largely
between studies (2.5%-66.3%; I² = 97%; p < 0.0001).
Meta-regression models, including the MAP-threshold, did not explain this
heterogeneity. Similarly, the effect of vasoplegia on ICU LOS, and 30-day
mortality was very heterogeneous among studies (I² = 99% and
I² = 73%, respectively). <br/>Conclusion(s): The large
variability in vasoplegia definitions is associated with significant
heterogeneity regarding incidence and clinical outcomes, which cannot be
explained by factors included in our models. Such variations in
definitions leads to inconsistent patient diagnosis and renders published
vasoplegia research incomparable.<br/>Copyright &#xa9; 2025 The Authors

<33>
Accession Number
2038026244
Title
Effect of Dexmedetomidine on Cerebrovascular Carbon Dioxide Reactivity
During Pediatric Cardiac Surgery With Cardiopulmonary Bypass.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(6) (pp 1482-1488),
2025. Date of Publication: 01 Jun 2025.
Author
Sun L.; Zhang K.; Wang H.; Ji W.; Huang Y.; Bai J.; Zheng J.
Institution
(Sun, Zhang, Ji, Huang, Bai, Zheng) Department of Anesthesiology, Shanghai
Children's Medical Center, Shanghai Jiao Tong University School of
Medicine, Shanghai, China
(Sun, Zhang, Ji, Huang, Bai, Zheng) Department of Anesthesiology, National
Children's Medical Center, Shanghai, China
(Wang) GE Healthcare, Shanghai, China
Publisher
W.B. Saunders
Abstract
Objective: To assess the effects of dexmedetomidine (DEX) on
cerebrovascular autoregulation in children with congenital heart disease
(CHD) using transcranial color-coded duplex sonography (TCCD).
<br/>Design(s): Randomized controlled trial. <br/>Setting(s): This
single-center study was conducted at a tertiary care center in Shanghai,
China. <br/>Patient(s): Fifty-nine children aged 0 to 6 years with CHD who
underwent cardiac surgery with cardiopulmonary bypass were enrolled.
<br/>Intervention(s): Children were randomly assigned to receive either
DEX (DEX group) or normal saline (control group) for 10 minutes following
anesthetic induction. Cerebrovascular carbon dioxide reactivity
(CVR-CO<inf>2</inf>) was assessed by adjustment of lung ventilation.
<br/>Measurements and Main Results: Patients underwent TCCD before and
after surgery. CVR-CO<inf>2</inf>, resistance index (RI), pulsatility
index (PI), mean blood flow velocity (V<inf>mean</inf>) of the right
middle cerebral artery, and regional cerebral oxygen saturation
(ScrO<inf>2</inf>) of the right frontal lobe were measured and analyzed at
three distinct time points, resulting in six measurements. Hemodynamic
parameters, including heart rate (HR) and mean arterial pressure (MAP),
were recorded at each time point. The parameters CVR-CO<inf>2</inf> (p =
0.402), PI (p = 0.203), RI (p = 0.290), V<inf>mean</inf> (p = 0.290),
ScrO<inf>2</inf> (p = 0.426), HR (p = 0.522), and MAP (p = 0.236) were
comparable between the two groups. In the control group, PI, RI, and HR
significantly differed before and after surgery. In the DEX group, RI,
V<inf>mean</inf>, ScrO<inf>2,</inf> and HR significantly differed before
and after surgery. <br/>Conclusion(s): A low loading dose of DEX did not
compromise CVR-CO<inf>2</inf> in children with CHD undergoing cardiac
surgery with cardiopulmonary bypass.<br/>Copyright &#xa9; 2025 Elsevier
Inc.

<34>
Accession Number
2032635295
Title
Association between body mass index and clinical outcomes in patients with
acute myocardial infarction and reduced systolic function: Analysis of
PARADISE-MI trial data.
Source
European Journal of Heart Failure. 27(3) (pp 558-565), 2025. Date of
Publication: 01 Mar 2025.
Author
Amir O.; Elbaz-Greener G.; Carasso S.; Claggett B.; Barbarash O.; Zaman
A.; Christersson C.; Kiatchoosakun S.; Anonuevo J.; Opolski G.;
Vaghaiwalla M.F.; van der Meer P.; Zhou Y.; Mann D.L.; Kober L.; Steg G.;
Jering K.; Kulac I.; De Pasquale C.G.; McMurray J.J.V.; Pfeffer M.A.
Institution
(Amir, Elbaz-Greener) Department of Cardiology, Hadassah Medical Center,
Jerusalem, Israel
(Amir, Elbaz-Greener, Carasso) Faculty of Medicine, Hebrew University of
Jerusalem, Jerusalem, Israel
(Carasso) Shaare Zedek Medical Center, Jerusalem, Israel
(Claggett, Jering, Kulac, Pfeffer) Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Barbarash) Federal State Budgetary Institution, Kemerovo, Russian
Federation
(Zaman) Freeman Hospital and Newcastle University, Newcastle upon Tyne,
United Kingdom
(Christersson) Department of Medical Science, Cardiology, Uppsala
University, Uppsala, Sweden
(Kiatchoosakun) Cardiology Unit, Department of Medicine, Faculty of
Medicine, Khon Kaen University, Khon Kaen, Thailand
(Anonuevo) Department of Medicine, University of the Philippines College
of Medicine, Philippine General Hospital, Manila, Philippines
(Opolski) Department of Cardiology, Medical University of Warsaw, Warsaw,
Poland
(Vaghaiwalla) Heart Failure and Preventive Cardiology Programs, Department
of Veterans Affairs Greater Los Angeles, University of California, Los
Angeles, CA, United States
(van der Meer) Department of Cardiology, University Medical Center
Groningen, Groningen, Netherlands
(Zhou) Novartis Inc., East Hanover, NJ, United States
(Mann) Cardiovascular Division, Washington University, School of Medicine,
St. Louis, MS, United States
(Kober) Rigshospitalet, Blegdamsvej, University of Copenhagen, Copenhagen,
Denmark
(Steg) University Paris-Cite Institute, University de France, Hospital
Bichat, Paris, France
(De Pasquale) Department of Cardiovascular Medicine, Flinders Medical
Centre, Bedford Park, SA, Australia
(McMurray) School of Cardiovascular & Metabolic Health, BHF Glasgow
Cardiovascular Research Centre, University of Glasgow, Glasgow, United
Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Aims: The relationship between body mass index (BMI) and clinical outcomes
in patients with cardiovascular disease, including acute heart failure
(AHF) and acute myocardial infarction (AMI), remains debated. This study
investigates the association between BMI and clinical outcomes within the
PARADISE-MI cohort, while also evaluating the impact of angiotensin
receptor-neprilysin inhibitor (ARNI) versus angiotensin-converting enzyme
inhibitor (ACE-I) treatment on this relationship. <br/>Methods and
Results: The analysis included 5589 patients from the PARADISE-MI study
with available baseline BMI data. The cohort comprised patients with AMI
and pulmonary congestion and/or left ventricular ejection fraction <=40%.
Patients were categorized into six World Health Organization BMI
subgroups. The primary outcome of interest was the composite endpoint of
cardiovascular death, heart failure (HF)-associated hospitalization, and
outpatient symptomatic HF episodes. The mean baseline BMI of the cohort
was 28.1 +/- 5.0 kg/m². The lowest rate of the primary
composite endpoint (6.2/100 patient-years) was observed in overweight
patients (BMI 25-29.9 kg/m²), while the highest rates were
found in the lowest and highest BMI subgroups (8.4/100 patient-years for
BMI <18.5 kg/m² and 9.7/100 patient-years for BMI >40
kg/m²). There was no significant interaction between BMI and
the treatment effect of ARNI versus ACE-I on the primary composite outcome
(p = 0.73). Additionally, no significant differences in the incidence of
adverse events or serious adverse events were noted across the BMI
subgroups. <br/>Conclusion(s): In AMI with AHF patients, the relationship
between BMI and the primary composite outcome is non-linear, with the
lowest event rates observed in overweight individuals. Outcomes and safety
profiles for ARNI and ACE-I treatments were similar across BMI
subgroups.<br/>Copyright &#xa9; 2024 The Author(s). European Journal of
Heart Failure published by John Wiley & Sons Ltd on behalf of European
Society of Cardiology.

<35>
Accession Number
2037738077
Title
Clinical impact of CCT-FFR as first-strategy in patients with symptomatic
stable coronary artery disease: A systematic review and meta-analysis.
Source
Journal of Cardiovascular Computed Tomography. 19(2) (pp 174-182), 2025.
Date of Publication: 01 Mar 2025.
Author
Di Pietro G.; Improta R.; De Filippo O.; Bruno F.; Birtolo L.I.; Bruno E.;
Galea N.; Francone M.; Dewey M.; D'Ascenzo F.; Mancone M.
Institution
(Di Pietro, Improta, Birtolo, Bruno, Mancone) Department of Clinical,
Internal, Anesthesiological and Cardiovascular Sciences, Umberto I
Hospital, La Sapienza University of Rome, Italy
(De Filippo, Bruno, D'Ascenzo) Division of Cardiology, Cardiovascular and
Thoracic Department, AOU Citta della Salute e della Scienza di Torino and
Department of Medical Sciences, University of Turin, Italy
(Galea) Department of Radiological, Oncological and Pathological Sciences,
Sapienza University of Rome, Viale Regina Elena 324, Rome, Italy
(Francone) IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano,
Milan, Italy
(Francone) Department of Biomedical Sciences, Humanitas University, Pieve
Emanuele, Milan, Italy
(Dewey) Department of Radiology, Charite - Universitatsmedizin Berlin,
corporate member of Freie Universitat Berlin and Humboldt-Universitat zu
Berlin, Berlin, Germany
Publisher
Elsevier Inc.
Abstract
Aims: Despite the promising results, the clinical implications of the
CCT-FFR is already debated. This metanalysis aimed to determine the
potential benefits of incorporating FFRCT into stable CAD management.
<br/>Method(s): After searching for studies comparing outcomes of patients
with suspected stable CAD who underwent CCT-FFR as a first strategy versus
non-urgent cardiovascular testing after a clinical judgment, we calculated
odds ratios (ORs) and 95 % confidence intervals (CIs) using a
random-effects or fixed-effects meta-analysis model depending on
heterogeneity significance. <br/>Result(s): 5 studies (3 RCTs and 2
observational studies) globally encompassing 5282 patients (CCT-FFR = 2604
patients, Control Group = 2678 patients) were included in the quantitative
analysis. The rates of ICA overall (OR 1.57, 95%CI 1.36-1.81, p value <
0.001) and those without obstructive CAD (OR 6.63, 95%CI 4.79-9.16, p
value < 0.001) were reduced in the CCTAFFR group, as compared to the
control group. Moreover, CCT-FFR patients underwent coronary
revascularization more frequently than patients in the control arm (OR
0.48,CI 0.38-0.62, p value < 0.001). There was no significance difference
between the two strategies in terms of 1 year MACE (OR 1.11,CI 0.86-1.44,
p value 0.42), nonfatal MI (OR 0.73, CI 0.41-1.33, p value 0.31),
all-cause mortality (OR 1.29,CI 0.47-3.54, p value 0.63) and unplanned
revascularization for angina (OR 0.99, 95%CI 0.65-1.49, p value 0.95).
<br/>Conclusion(s): In conclusion, in the management of stable CAD, the
use of CCT-FFR was associated with lower overall rates of ICA but higher
rates of coronary revascularization with comparable 1-year clinical
impact.<br/>Copyright &#xa9; 2025 The Authors

<36>
Accession Number
2035507555
Title
Culprit vessel revascularization prior to complete angiography as a
strategy to minimize delays in primary percutaneous coronary intervention
for patients with ST-elevation myocardial infarction: a systematic review
and meta-analysis.
Source
Coronary Artery Disease. 36(3) (pp 232-239), 2025. Date of Publication: 01
May 2025.
Author
Bulhoes E.; Antunes V.L.J.; Defante M.L.R.; Mazetto R.; Garcia A.C.;
Garcia T.C.C.; Guida C.
Institution
(Bulhoes) Medicine Department, College of Higher Education of the United
Amazon, Para, Redencao, Brazil
(Antunes) Medicine Department, Federal University of Health Sciences of
Porto Alegre, Porto Alegre, Brazil
(Defante) Medicine Department, Redentor University Center, Itaperuna,
Brazil
(Mazetto) Medicine Department, Amazonas State University, Manaus, Brazil
(Garcia) Division of Cardiology, Goias Military Police Hospital, Goias,
Brazil
(Garcia, Guida) Division of Cardiology, Dante Pazzanese Institute of
Cardiology, Sao Paulo, Brazil
Publisher
Lippincott Williams and Wilkins
Abstract
The rapid restoration of blood flow in patients with acute myocardial
infarction with ST elevation through percutaneous coronary intervention
(PCI) is crucial for the survival of this population. Attempts to decrease
the time from diagnosis of ST-segment elevation myocardial infarction
(STEMI) to arrival at the catheterization laboratory have been extensively
investigated. However, strategies during the procedure aiming to reduce
the time to reperfusion are lacking. We conducted a meta-analysis to
evaluate culprit vessel revascularization prior to complete angiography as
a strategy to minimize delays in primary PCI for patients with STEMI. We
searched PubMed, Embase, and Cochrane Central. <br/>Outcome(s): vascular
access-to-balloon, door-to-balloon, and first medical contact-to-balloon
times; death, reinfarction in 30 days, Bleeding Academic Research
Consortium >=3 type, coronary artery bypass grafting referral, and left
ventricular ejection fraction %. Statistical analysis was performed using
the R program (version 4.3.2). Heterogeneity was assessed with
I² statistics. We included 2050 patients from six studies, of
which two were randomized controlled trials and four were observational
studies. Culprit vessel revascularization prior to complete angiography
was associated with a statistically significant decrease of times:
vascular access-to-balloon time (mean difference -6.79 min; 95% CI: -8.00
to -5.58; P < 0.01; I² = 82%) and door-to-balloon time (mean
difference -9.02 min; 95% CI: -12.83 to -5.22; P < 0.01; I² =
93%). In this meta-analysis, performing PCI on the culprit lesion prior to
complete coronary angiography led to significantly shorter reperfusion
times, with no discernible differences in complication
rates.<br/>Copyright &#xa9; 2024 Wolters Kluwer Health, Inc. All rights
reserved.

<37>
Accession Number
2034072902
Title
The Composite Number Needed to Treat for Semaglutide in Populations with
Overweight or Obesity and Established Cardiovascular Disease Without
Diabetes.
Source
Advances in Therapy. 42(5) (pp 2513-2525), 2025. Article Number: 102782.
Date of Publication: 01 May 2025.
Author
Lubker C.; Bhavsar J.; Duque do Vale R.; Emerson S.S.; Nortoft E.; Plutzky
J.; Roberts G.; Tarp J.M.; Lincoff A.M.
Institution
(Lubker, Duque do Vale, Nortoft, Tarp) Novo Nordisk A/S, Soborg, Denmark
(Bhavsar) Novo Nordisk Inc., Plainsboro, NJ, United States
(Emerson) Department of Biostatistics, University of Washington, Seattle,
WA, United States
(Plutzky) Cardiovascular Division, Brigham and Women's Hospital, Harvard
Medical School, Boston, United States
(Roberts) Health Economics and Outcomes Research Ltd, Cardiff, United
Kingdom
(Lincoff) Department of Cardiovascular Medicine, Cleveland Clinic,
Cleveland Clinic Lerner College of Medicine of Case Western Reserve
University, Cleveland, OH, United States
Publisher
Adis
Abstract
Introduction: Number needed to treat (NNT), an outcome measure derived
from the estimated risk results of clinical trials, is widely used to
demonstrate value to stakeholders by identifying how many patients require
treatment to avoid one event of interest. However, NNTs calculated for
primary trial endpoints may underestimate a treatment's value by not
considering other outcomes. In this secondary analysis of data from the
SELECT cardiovascular (CV) outcomes trial, we aimed to determine the NNT
for semaglutide for major adverse cardiovascular events (MACE), in
addition to NNTs when other clinically and payer-relevant outcomes are
included. <br/>Method(s): This study is a secondary analysis of data from
the randomized, double-blind SELECT trial (ClinicalTrials.gov NCT03574597)
of once-weekly subcutaneous administration of semaglutide compared with
placebo in 17,604 patients with overweight or obesity and with established
cardiovascular disease (CVD) (39.8 months mean follow-up). The outcomes
were NNT<inf>3P-MACE</inf> (based upon the trial's composite primary
endpoint of death from cardiovascular causes, non-fatal myocardial
infarction, non-fatal stroke), NNT<inf>EXTENDED</inf> (inclusive of
NNT<inf>3P-MACE</inf>, hospitalization for any cause, coronary
revascularization, and non-CV death), and NNT<inf>CKM</inf> (inclusive of
NNT<inf>EXTENDED</inf>, glycated hemoglobin level [HbA<inf>1c</inf>] >=
6.5%, and a 5-point nephropathy composite). <br/>Result(s): The relative
risk reductions observed for the events comprising the NNTs were 20%
(NNT<inf>3P-MACE</inf>), 20% (NNT<inf>EXTENDED</inf>), and 41%
(NNT<inf>CKM</inf>). At 1 and 4 years post initiation of semaglutide,
NNT<inf>3P-MACE</inf> was 125 and 58, NNT<inf>EXTENDED</inf> was 49 and
25, and NNT<inf>CKM</inf> was 20 and 11, respectively. <br/>Conclusion(s):
When clinically and payer-relevant outcomes from the SELECT trial are
included in calculations of NNT, semaglutide was associated with greater
risk reductions and lower estimates of NNT than for the primary endpoint
alone. Our findings suggest that including the broader effects of
semaglutide beyond the primary trial endpoint recognizes additional value
to stakeholders.<br/>Copyright &#xa9; The Author(s) 2025.

<38>
Accession Number
2038271022
Title
Study protocol: diagnosis of atrial fibrillation in postoperative thoracic
surgery using a smartwatch, an open-label randomised controlled study
(THOFAWATCH trial).
Source
BMJ Open. 15(4) (no pagination), 2025. Article Number: e097765. Date of
Publication: 09 Apr 2025.
Author
Huette P.; Beyls C.; Diouf M.; Ibrahima A.; Haye G.; Guilbart M.; Lefebvre
T.; Bayart G.; Lhotellier F.; Radji M.; Walczak K.-A.; Caboche M.; De
Dominicis F.; Georges O.; Berna P.; Merlusca G.; Hermida A.; Traulle S.;
Dupont H.; Mahjoub Y.; Abou-Arab O.; Bernasinski M.; Coupez A.; Besserve
P.; Henry A.; Daumin C.; BenAmmar A.; Leviel F.; Macq P.-Y.; Labont B.A.;
David G.; Epailly J.; Esmard P.-E.; Vernier A.; Bartoli P.; Delmas J.;
Romby S.; Marx S.; Fikri M.; Benoit-Fallet H.; Nam E.; Zakine J.; Zaatar
A.; Flet T.
Institution
(Huette, Lhotellier, Radji, Walczak, Caboche) Anesthesiology and critical
care, Pauchet sante, Victor Pauchet Clinic, Amiens, France
(Huette, Beyls, Ibrahima, Haye, Guilbart, Lefebvre, Bayart, Dupont,
Mahjoub, Abou-Arab) Amiens University Hospital, Hauts-deFrance, Amiens,
France
(Diouf) Department of Statistics, Amiens Hospital University, Amiens,
France
(De Dominicis, Georges, Merlusca) Department of Thoracic surgery, Amiens
Hospital University, Amiens, France
(Berna, Merlusca) Department of Thoracic Surgery, Pauchet sante, Victor
Pauchet Clinic, Amiens, France
(Hermida) Department of Cardiology, Amiens University hospital, Amiens,
France
(Traulle) Department of Cardiology, Victor Pauchet Clinic, Amiens, France
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative atrial fibrillation (POAF) affects
approximately 20% of patients undergoing thoracic surgery and is
associated with severe complications such as stroke, myocardial
infarction, heart failure, and increased mortality. Early diagnosis is
critical to mitigate these risks, but conventional monitoring is limited
in detecting asymptomatic episodes. Smartwatches equipped with single-lead
ECG and atrial fibrillation (AF) detection algorithms offer a novel
approach for early POAF detection. This study aims to evaluate the
effectiveness of smartwatch-based monitoring compared with standard care
in identifying POAF following thoracic surgery. Methods and analysis The
THOFAWATCH trial is a randomised, bicentric open-label study enrolling 302
adult patients undergoing major thoracic surgery (pneumonectomy or
lobectomy) with one-lung ventilation. Eligible patients will be randomised
into two groups: (1) the 'Smartwatch Monitoring' group, where participants
will undergo rhythm monitoring using a smartwatch and (2) the
'Conventional Monitoring' group, receiving standard care without
smartwatch monitoring. In the intervention group, any smartwatch-detected
POAF episodes will be confirmed by 12-lead ECG. The primary outcome is the
incidence of POAF within 7-day postsurgery. Secondary outcomes include the
rate of asymptomatic POAF, cardiovascular prognosis evaluated at 2 and 6
months (composite major adverse cardiovascular events outcome),
feasibility of smartwatch usage (device usage time and success rate of
single-lead ECGs) and recurrence or management of AF at follow-up.
Inclusion criteria include adults (>18 years) undergoing scheduled
thoracic surgery and able to use the smartwatch device. Exclusion criteria
encompass patients with prior AF, those requiring telemetry, or undergoing
reoperations. Statistical analysis will assess the primary outcome using
chi² or Fisher's exact test (alpha=5%), while secondary
outcomes will include descriptive and inferential statistics, with
analysis conducted using SAS V.9.4. Ethics and dissemination Ethical
approval for this bicentric study has been granted by the institutional
review board (IRB) of the University Hospital of Amiens (Comite de
Protection des Personnes sud-ouest et outre-mer 1, 21050 Toulouse, France,
registration number ID RDB: 2022-A02028-27 in November 2024). The trial is
registered under ClinicalTrials. gov (ID: (NCT06724718)). Results will be
disseminated through peer-reviewed publications and scientific conferences
to inform clinical practice regarding POAF detection and management
following thoracic surgery.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2025.

<39>
Accession Number
2038026254
Title
Acute Pain Management with Ultrasound-Guided Erector Spinae Plane Block
and Serratus Anterior Plane Block in Patients Undergoing Coronary Artery
Bypass via Mini-thoracotomy: A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(6) (pp 1514-1521),
2025. Date of Publication: 01 Jun 2025.
Author
Xin L.; Wang L.; Feng Y.
Institution
(Xin, Feng) Department of Anesthesiology, Peking University People's
Hospital, Beijing, China
(Wang) Department of Anesthesiology, Fuwai Hospital, Chinese Academy of
Medical Science and Peking Union Medical College, Beijing, China
Publisher
W.B. Saunders
Abstract
Objective: This study was designed to examine the analgesic efficacy of
erector spinae plane (ESP) block or combined ESP and superficial serratus
anterior plane (SAP) block in patients undergoing elective coronary artery
bypass via mini-thoracotomy. <br/>Design(s): Randomized controlled study.
<br/>Setting(s): Operating room, intensive care unit, and ward.
<br/>Patient(s): Fifty-four patients undergoing elective coronary artery
bypass via mini-thoracotomy. <br/>Intervention(s): Eligible patients were
randomly allocated to single-ESP block (ESP group) or combined ESP and
superficial SAP block (ESP+SAP group). <br/>Measurements and Main Results:
The primary outcome was dynamic numerical rating scale (NRS) scores (on
coughing) for the surgical incision site 6 hours after skin closure.
Secondary outcomes included dynamic NRS scores for surgical incision at
12, 18, 24, and 48 hours postoperatively plus NRS scores for the chest
tube, hydromorphone consumption, quality of recovery, and adverse events
within 48 hours postoperatively. The ESP+SAP group had lower dynamic NRS
scores for surgical incision at postoperative 6 hours (mean difference:
-2.1, 95% CI -2.8 to -1.4, adjusted p < 0.001) and 12 hours (-1.3, 95% CI
-2.0 to -0.7, adjusted p < 0.001) compared to the ESP group. The ESP+SAP
group also showed lower dynamic NRS scores for the chest tube at 6 hours
(-1.4, 95% CI -2.0 to -0.9, adjusted p < 0.001) and 12 hours (-1.2, 95% CI
-1.7 to -0.6, adjusted p < 0.001) postoperatively. Linear mixed-model
analysis showed that NRS scores for the surgical incision and chest tube
were lower in the ESP+SAP group compared to the ESP group (both p < 0.05).
<br/>Conclusion(s): Compared with ESP block alone, ESP combined with
superficial SAP block reduced pain scores in patients undergoing coronary
artery bypass via mini-thoracotomy.<br/>Copyright &#xa9; 2025

<40>
Accession Number
2038026250
Title
Analgesic Efficacy of Bilateral Ultrasound-Guided Transversus Thoracic
Muscle Plane Block Versus Erector Spinae Plane Block in Pediatric Patients
Undergoing Corrective Cardiac Surgeries: A Randomized Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(6) (pp 1495-1505),
2025. Date of Publication: 01 Jun 2025.
Author
Madkour M.A.F.A.; Abueldahab E.I.B.; Elela A.H.A.; Youssef M.F.; Gado A.A.
Institution
(Madkour, Abueldahab, Elela, Youssef, Gado) Department of Anesthesiology
and Intensive Care Medicine, Cairo University, Cairo, Egypt, Egypt
Publisher
W.B. Saunders
Abstract
Objectives: Transversus thoracic plane block (TTPB) and erector spinae
plane block (ESPB) are gaining popularity in cardiac surgeries to avoid
excessive narcotic use and achieve fast-track extubation This study was
performed to compare the analgesic efficacy of TTPB to that of ESPB in
pediatric patients undergoing cardiac surgeries. The study was conducted
in a university pediatric hospital (ClinicalTrials.gov NCT05559684).
<br/>Design(s): Single-center prospective randomized controlled study.
<br/>Setting(s): Tertiary referring pediatric university hospital.
<br/>Participant(s): Sixty pediatric patients undergoing corrective
cardiac surgeries during the period from November 2022 to August 2023.
<br/>Intervention(s): Randomization was done using a sealed envelope
technique that contained 20 labels of (control), 20 labels of (ESPB), and
another 20 labels of (TTPB). Patients in the control group (n = 20) were
given fentanyl infusion at a dosage of 0.5 microg/kg/h throughout the
whole operation, in addition to 1 microg/kg during skin incision,
sternotomy, and aortic cannulation. Patients in the ESPB group (n = 20)
were given fentanyl infusion at a dose of 0.5 microg/kg/h all through the
whole operation plus ultrasound-guided ESPB done bilaterally by injecting
0.4 mL/kg (1:1 solution of Bupivacaine25 % and lidocaine 1%) on each side.
Patients in the TTPB group were given fentanyl infusion at a dose of 0.5
microg/kg/h throughout the operation plus ultrasound-guided TTPB done
bilaterally by injecting 0.4 mL/kg on each side (1:1 solution of
bupivacaine 0.25 % and lidocaine 1%). <br/>Measurements and Main Results:
Primary outcome was the total intraoperative fentanyl consumption;
secondary outcomes included hemodynamics and time to first analgesic
request (which is the elapsed time between giving the block and the
patient's FLACC score >=4), postoperative fentanyl consumption, extubation
time, and adverse events. Intraoperative fentanyl consumption was
significantly decreased in the TTPB group (3.4 +/- 2.9) compared with the
control group (6.7 +/- 4.2), mean difference = 3.35, 95% CI (0.84, 5.86),
p = 0.006. It was comparable between the ESPB group and the control group.
Also, the TTPB and ESPB groups were comparable regarding the primary
outcome, mean difference 1.2, 95% CI (-1.31, 3.71), p = 0.486. Total
fentanyl consumption in the intensive care unit was significantly
decreased in the TTPB group (1.1 +/- 1.54) than in the control group (4.6
+/- 4.25), mean difference 3.55, 95% CI (1.5, 5.6) with p = 0.001. Other
pairwise comparisons were comparable between the groups. The time to first
rescue analgesia was significantly longer in TTPB group (5.15 +/- 4.21)
compared to the control group (1.95 +/- 3.5), mean difference -3.2, 95% CI
(-5.68, -0.72), p = 0.04. Patients in ESPB needed first rescue analgesia
slightly earlier (4.9 +/- 4.4) than patients in TTPB group, mean
difference -0.25, 95% CI (-3.01, 2.51), p = 0.979 and non-significantly
longer than control group, mean difference -2.95, 95% CI (-5.5, -0.4), p =
0.064. Fast-track extubation was significantly increased in patients who
received TTPB (85%) than in those who received ESPB (50%), relative risk =
0.58, 95% CI (0.36, 0.94), p = 0.018 and those in the control group (30%),
relative risk = 0.35, 95% CI (0.17, 0.706), p < 0.001). Also,
ultrafast-track extubation was significantly increased in patients who
received TTPB (60%) than those in the control group 15%), relative risk =
0.25, 95% CI (0.08, 0.75), p = 0.007. <br/>Conclusion(s): Both TTPB and
ESPB reduced nociception and appeared comparable in providing
perioperative analgesia as they reduced pain scores and intraoperative and
postoperative narcotic dosage, which facilitated early extubation. TTPB
was superior to ESPB regarding fast-track extubation and provided a double
incidence for the ultrafast-track extubation, but this was related to the
hyper incidence of adverse events not thought related to
analgesia.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<41>
[Use Link to view the full text]
Accession Number
2038177837
Title
Effects of Nicorandil, Isosorbide Mononitrate, or Diltiazem on Radial
Artery Grafts After CABG: The Randomized ASRAB-Pilot Trial.
Source
Circulation: Cardiovascular Interventions. 18(4) (pp e014542), 2025. Date
of Publication: 01 Apr 2025.
Author
Zhu Y.; Zhang W.; Qin K.; Liu Y.; Yao H.; Wang Z.; Ye X.; Zhou M.; Li H.;
Qiu J.; Xu H.; Sun Y.; Gaudino M.; Zhao Q.
Institution
(Zhu, Qin, Liu, Yao, Wang, Ye, Zhou, Li, Qiu, Xu, Sun, Zhao) Department of
Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiao Tong University,
School of Medicine, China
(Zhang) School of Public Health, Fudan University, Shanghai, China
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The optimal antispastic treatment after coronary artery bypass
grafting using radial artery (RA) grafts is controversial. This clinical
trial aimed to generate pilot comparative data on the effects of
nicorandil, isosorbide mononitrate, or diltiazem on RA grafts.
<br/>METHOD(S): This was a single-center, randomized, open-label,
parallel-group pilot trial. Eligible patients who underwent coronary
artery bypass grafting using RA grafts were randomized in a 1:1:1 ratio to
receive oral nicorandil (15 mg daily), isosorbide mononitrate (50 mg
daily), or diltiazem (180 mg daily) for 24 weeks post-coronary artery
bypass grafting. The primary outcome was RA graft failure (modified
Fitzgibbon grade B, S, or O) at 1 and 24 weeks, assessed by coronary
computed tomography angiography. <br/>RESULT(S): Among 150 randomized
participants, 149 (mean age, 56.8 years; 13.4% women) with 177 RA grafts
were assessed at least once by coronary computed tomography angiography,
including 50 participants with 64 RA grafts in the nicorandil group, 50
participants with 57 RA grafts in the isosorbide mononitrate group, and 49
participants with 56 RA grafts in the diltiazem group, respectively. At 1
week post-coronary artery bypass grafting, the RA graft failure rates were
lower with nicorandil versus diltiazem (19.4% versus 25.0%; difference,
-5.6% [95% CI, -20.6% to 9.3%]) and isosorbide mononitrate versus
diltiazem (18.2% versus 25.0%; difference, -6.8% [95% CI, -21.8% to
8.6%]). The RA graft failure rates were slightly higher with nicorandil
versus isosorbide mononitrate (19.4% versus 18.2%; difference, 1.2% [95%
CI, -13.3% to 15.2%]). At 24 weeks, RA graft failure rates were lower with
nicorandil versus diltiazem (16.1% versus 27.8%; difference, -11.7% [95%
CI, -26.6% to 3.4%]), and isosorbide mononitrate versus diltiazem (12.5%
versus 27.8%; difference, -15.3% [95% CI, -29.8% to -0.2%]), and slightly
higher with nicorandil versus isosorbide mononitrate (16.1% versus 12.5%;
difference, 3.6% [95% CI, -9.6% to 16.4%]). <br/>CONCLUSION(S): In this
pilot trial, treatment with nicorandil or isosorbide mononitrate was
associated with a lower RA graft failure rate compared with diltiazem.
Larger hypothesis-testing trials are warranted. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT04310995.<br/>Copyright &#xa9; 2025 Lippincott Williams and Wilkins.
All rights reserved.

<42>
Accession Number
2034205093
Title
Treatment of and outcomes from hypotension in the post-anaesthesia care
unit: A single-centre retrospective cohort study.
Source
Anaesthesia and Intensive Care. (no pagination), 2025. Date of
Publication: 2025.
Author
Douglas N.; Gilbert S.; Ong J.; Kave B.; Leslie K.; Darvall J.N.
Institution
(Douglas, Gilbert, Ong, Kave, Leslie, Darvall) Department of Anaesthesia
and Pain Management, The Royal Melbourne Hospital, Parkville, Australia
(Douglas, Leslie, Darvall) Department of Critical Care, Melbourne Medical
School, University of Melbourne, Parkville, Australia
Publisher
SAGE Publications Inc.
Abstract
Hypotension after non-cardiac surgery is common and associated with harm.
Anaesthetists treat hypotension in the post-anaesthesia care unit (PACU)
with intravenous (IV) fluids and vasopressor medications. Our aim was to
determine the incidence of hypotension after these treatments. We
conducted a single centre retrospective cohort study of all adult patients
who were hypotensive (systolic blood pressure less than 90 mmHg) in the
PACU after non-cardiac, non-obstetric surgery over a one-year period. The
primary outcome was a composite of hypotension or vasopressor infusion in
the 24 h after PACU discharge. During the study 459 patients were
hypotensive in the PACU. No treatment was administered in 232 (51%)
episodes, IV fluid alone was administered in 138 (30%) episodes,
vasopressors alone were administered in 22 (5%) episodes, and both fluid
and vasopressors were administered in 67 (14%) patients. A total of 167
patients (36%) met the primary outcome, of which 118 (25%) were
hypotensive and 49 (11%) required vasopressor infusions. The treatment
group was significantly associated with the primary outcome (P < 0.001),
with 36 (15%) patients who received no treatment becoming hypotensive,
compared with 67 (46%, P < 0.001) patients who received IV fluid alone, 12
(55%, P < 0.001) who received vasopressors alone and 52 (75%, P < 0.001)
who received both IV fluid and vasopressors. Patients who were hypotensive
in the PACU frequently developed later hypotension or required
vasopressors in the 24 h after PACU discharge. Treatments delivered in the
PACU had limited long-term effectiveness. Novel treatments to protect
patients from subsequent hypotension are urgently needed.<br/>Copyright
&#xa9; The Author(s) 2025.

<43>
Accession Number
2038413098
Title
Major Intraprocedural Complications During Transcatheter Aortic Valve
Implantation Requiring Emergent Cardiac Surgery: An Updated Systematic
Review.
Source
American Journal of Cardiology. 247 (pp 21-28), 2025. Date of Publication:
15 Jul 2025.
Author
Verolino G.; Di Mauro M.; Calderone D.; Lorusso R.
Institution
(Verolino, Lorusso) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht University, Maastricht, Netherlands
(Verolino, Calderone) Invasive Cardiology, IRCCS Istituto Auxologico
Italiano - San Luca Hospital, Milan, Italy
(Di Mauro, Lorusso) Cardiothoracic Surgery Department, Maastricht
University Medical Center, Maastricht, Netherlands
Publisher
Elsevier Inc.
Abstract
Transcatheter aortic valve implantation (TAVI) is an established treatment
for patients >75 years old with severe aortic stenosis. From the
technique's beginnings in the early 2000s, over 20 years of experience in
the TAVI procedure have allowed its wide diffusion with optimal procedural
results. Intraprocedural complications during TAVI are yet a fearful
scenario, sometimes requiring emergent open-heart surgery (EOHS) that is
burdened by high intraoperative mortality (50% at 30 days). Furthermore,
also when a surgical treatment is not needed, intraprocedural
complications have a challenging management and a critical impact on
patients' prognosis. The volume of procedures in the last 10 years has
been observed to increase substantially, with an incidence of major
intraprocedural complications of around 1%. However, the features and
specific incidence for each complication have not been revised recently.
This work aims to update the knowledge about major intraprocedural
complications during TAVI, considering the increased operators' experience
and recent device developments. An updated point of view on major
intraprocedural complications could suggest a need for change in the TAVI
paradigm, promoting TAVI programs even in centers without on-site cardiac
surgery.<br/>Copyright &#xa9; 2025 The Authors

<44>
Accession Number
2037440672
Title
Commentator Discussion: A randomized study of cryoablation of intercostal
nerves in patients undergoing minimally invasive thoracic surgery.
Source
Journal of Thoracic and Cardiovascular Surgery. 169(5) (pp 1383-1384),
2025. Date of Publication: 01 May 2025.
Author
Anonymous
Publisher
Elsevier Inc.

<45>
Accession Number
2038180656
Title
Ticagrelor Compared to Clopidogrel in Acute Coronary Syndromes trial
(TC4): a Bayesian pragmatic cluster randomized controlled trial.
Source
CMAJ. Canadian Medical Association Journal. 197(12) (pp E309-E318), 2025.
Date of Publication: 31 Mar 2025.
Author
Kutcher S.A.; Dendukuri N.; Dandona S.; Nadeau L.; Brophy J.M.
Institution
(Kutcher, Brophy) Department of Epidemiology, Biostatistics and
Occupational Health, McGill University, Canada
(Dendukuri, Nadeau, Brophy) McGill University, Centre for Outcomes
Research and Evaluation, Canada
(Dendukuri, Dandona) McGill University Health Centre Research Institute,
Department of Medicine, Canada
(Dendukuri, Dandona) McGill University, Montreal, QC, Canada
Publisher
Canadian Medical Association
Abstract
Background: Dual antiplatelet therapy is the standard of care for acute
coronary syndrome, but uncertainty exists regarding the optimal regimen
for patients in North America. We sought to compare the effectiveness and
safety of acetylsalicylic acid (ASA) and ticagrelor or clopidogrel in
patients with acute coronary syndrome from a single tertiary academic
centre in Montreal, Canada. <br/>Method(s): We conducted a pragmatic,
openlabel, timeclustered (bimonthly between October 2018 and March 2021),
randomized controlled trial. The primary effectiveness end point was a
composite of allcause mortality, nonfatal myocardial infarction, or
ischemic stroke. The primary safety end point was hospital admissions for
bleeding. We ascertained 12month outcomes from the Quebec universal
electronic health databases. We designed and analyzed the study within a
Bayesian paradigm to supplement existing knowledge. The primary analysis
was a Bayesian logistic regression model with an informed focused prior
from previously randomly assigned North American patients. Robustness was
evaluated with vague and other prespecified informative priors, spanning
reasonable preexisting beliefs. We defined clinically important benefits
and harms as risk reductions exceeding a 10% difference. <br/>Result(s):
We randomly assigned 1005 patients with acute coronary syndrome to
ticagrelor (n = 450) or clopidogrel (n = 555). Major acute cardiovascular
events occurred in 50 (11.1%) patients assigned to ticagrelor and 64
(11.5%) assigned to clopidogrel (relative risk [RR] 0.95, 95% credible
interval 0.67-1.35, with a vague prior). The primary analysis with an
informed focused prior resulted in probabilities of a clinically
meaningful ticagrelor benefit (RR < 0.9), equivalence (0.9 <= RR <= 1.1)
or harm (RR >= 1.1) of 2%, 41%, and 57%, respectively. For the safety end
point, there was no consistent signal of benefit or harm with ticagrelor.
Sensitivity analyses with a range of prior beliefs gave generally
consistent results. <br/>Interpretation(s): Whether we analyzed this trial
with a vague or a range of reasonable informed priors, we found no strong
evidence for the superiority of ticagrelor over clopidogrel in North
American patients. Current guidelines favouring ticagrelor over
clopidogrel might take this new evidence into future
consideration.<br/>Copyright &#xa9; 2025 CMA Impact Inc. or its licensors.

<46>
Accession Number
2035465271
Title
The influence of the American Association for Thoracic Surgery on clinical
trial development by cardiothoracic surgeons.
Source
Journal of Thoracic and Cardiovascular Surgery. 169(5) (pp 1409-1414),
2025. Date of Publication: 01 May 2025.
Author
Narahari A.K.; Horgan T.M.; Chandrabhatla A.S.; Kareddy A.; Gikandi A.;
Zenati M.A.; Harpole D.; Jones D.; Yarboro L.T.; Burt B.; Krupnick A.S.;
Mehaffey J.H.
Institution
(Narahari, Horgan, Chandrabhatla, Kareddy, Yarboro) Division of
Cardiothoracic Surgery, Department of Surgery, University of Virginia
Health, Charlottesville, VA, United States
(Gikandi) Harvard Medical School, Boston, Mass, United States
(Zenati) Division of Cardiac Surgery, Brigham and Women's Hospital and
Harvard Medical School, Boston, Mass, United States
(Harpole) Division of Cardiovascular and Thoracic Surgery, Department of
Surgery, Duke University School of Medicine, Durham, NC, United States
(Jones) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center, New York, NY, United States
(Burt) Division of Thoracic Surgery, Department of Surgery, Baylor College
of Medicine, Houston, Tex, United States
(Krupnick) Division of Thoracic Surgery, Department of Surgery, University
of Maryland School of Medicine, Baltimore, Md, United States
(Mehaffey) Division of Cardiac Surgery, Department of Cardiovascular and
Thoracic Surgery, West Virginia University School of Medicine, Morgantown,
WVa, United States
Publisher
Elsevier Inc.
Abstract
Objective: Clinical trials play a critical role in the rapidly evolving
field of cardiothoracic surgery and the American Association for Thoracic
Surgery Clinical Trials Methods Course has provided a biannual symposium
led by preeminent surgeons with vast experience in planning, conducting,
and analyzing surgical clinical trials. This study hypothesizes that
participation in the course is associated with future success in clinical
trial leadership. <br/>Method(s): A list of course attendees (2014-2022)
was queried in ClinicalTrials.gov, a database of clinical trials funded by
the US Department of Health and Human Services and the National Institutes
of Health. The type of clinical trial and publications from the trial were
collected. Demographic information about the participants was collected
from faculty pages. <br/>Result(s): A total of 107 participants from
various professional backgrounds attended the American Association for
Thoracic Surgery Clinical Trials Methods course and led 91 clinical
trials. The average time to starting a clinical trial after attending the
workshop was 3.04 years for participants who had not already been involved
with a trial. Of the 107 participants, 36 (33.6%) were either the
principal investigator or a subinvestigator for 91 clinical trials.
<br/>Conclusion(s): The American Association for Thoracic Surgery Clinical
Trials Methods course provides participants the tools for successfully
leading surgical clinical trials. Although participation has been limited,
those who attend the course and lead a clinical trial do so within
approximately 3 years. The Clinical Trials Methods Course provides an
excellent return on investment and the American Association for Thoracic
Surgery should continue sponsorship of this program because it supports
the develop of future leaders in cardiothoracic surgery.<br/>Copyright
&#xa9; 2024 The American Association for Thoracic Surgery

<47>
Accession Number
2036520926
Title
Hemoperfusion with the HA330/HA380 Cartridge in Intensive Care Settings: A
State-Of-The-Art Review.
Source
Blood Purification. 54(2) (pp 122-137), 2025. Date of Publication: 01 Feb
2025.
Author
Li Y.; Han M.; Yang M.; Su B.
Institution
(Li, Han, Su) Department of Nephrology, Kidney Research Institute, West
China Hospital of Sichuan University, Chengdu, China
(Yang) Department of Nephrology, The First People's Hospital of Shuangliu
District, Chengdu, China
(Su) Med+ Biomaterial Institute of West China Hospital, West China School
of Medicine, Sichuan University, Chengdu, China
(Su) Med-X Center for Materials, Sichuan University, Chengdu, China
Publisher
S. Karger AG
Abstract
Background: Hemoperfusion with the HA330/HA380 cartridge has markedly
evolved during the past decade and has thus been widely used in intensive
care settings to treat critical or hyperinflammatory illnesses. Numerous
clinical studies have demonstrated that HA330/HA380 hemoperfusion might
mitigate systemic inflammatory response syndrome and organ dysfunction in
ICU patients by removing inflammatory mediators and metabolic toxins from
the blood. However, there is currently lacking a systematic evaluation on
the safety and efficacy of HA330/HA380 hemoperfusion in intensive care
settings. <br/>Summary: We searched the PubMed database, Chinese Clinical
Trial Registry, and ClinicalTrials.gov for articles published from
inception to June 20, 2024 (updated on September 10, 2024) to perform a
state-of-theart review of HA330/HA380 hemoperfusion in daily critical care
practice. We discuss the basic technique characteristics and ex vivo
investigations of the HA330/ HA380 cartridge and summarize the latest
clinical evidence regarding the use of HA330/HA380 hemoperfusion for the
treatment of sepsis, severe COVID-19, cardiac surgery, acute pancreatitis,
liver failure, and blunt trauma. Ex vivo studies suggest that the
HA330/HA380 cartridge demonstrates satisfactory biocompatibility and
substantial adsorption capacity for inflammatory cytokines, such as
interleukin-6, interleukin-10, and tumor necrosis factor-?. Small-scale
clinical studies indicate that HA330/HA380 hemoperfusion may help reduce
plasma levels of inflammatory mediators, alleviate organ dysfunction, and
improve survival in some critically ill patients with sepsis, severe
COVID-19, acute pancreatitis, and blunt trauma. Key Messages: (i) The
HA330/HA380 cartridge contains abundant, coated, biocompatible sorbent
beads made of styrene-divinylbenzene copolymers. (ii) HA330/HA380
hemoperfusion, with or without combined continuous renal replacement
therapy, is a promising treatment option for some critically ill patients
by removing proinflammatory mediators and alleviating organ dysfunction.
(iii) The HA330/HA380 cartridge may adversely adsorb antibiotics, and
appropriate antibiotic dosing adjustment and plasma drug level monitoring
is recommended. (iv) There are currently numerous ongoing clinical trials
evaluating the safety and efficacy of HA330/ HA380 hemoperfusion in
critically ill patients who develop sepsis or undergo cardiopulmonary
bypass, which will certainly sharpen our future practice of HA330/ HA380
hemoperfusion in ICU.<br/>Copyright &#xa9; 2024 S. Karger AG, Basel.

<48>
Accession Number
2038401854
Title
Effect of perioperative intravenous ketamine on postoperative sleep
disturbance in patients undergoing non-cardiac surgery: A systematic
review and meta-analysis.
Source
Indian Journal of Anaesthesia. 69(5) (pp 434-449), 2025. Date of
Publication: 01 May 2025.
Author
Yang N.; Peng L.; Kuang R.; Xu R.; Zhou L.; Wang Y.
Institution
(Yang, Peng, Kuang, Xu, Zhou, Wang) Department of Anesthesiology, The
First Affiliated Hospital of Chongqing Medical University, Yuanjiagang,
Daping Street, Yuzhong District, Chongqing, China
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Postoperative sleep disturbance (PSD) is a common
condition that may lead to pain, cognitive impairment, depression, and
delayed recovery. This review evaluates the efficacy of perioperative
intravenous ketamine in alleviating PSD and offers evidence-based
recommendations for clinical practice. <br/>Method(s): A systematic search
was performed in PubMed, Embase, Cochrane Library, Wanfang Data, VIP
Information Resource System, China National Knowledge Infrastructure and
China Biology Medicine disc (SinoMed) up to 6 th November 2024. This
article included a meta-analysis of randomised controlled trials (RCTs)
along with a Grading of Recommendations Assessment, Development and
Evaluation analysis. <br/>Result(s): A total of 2355 patients from 21 RCTs
were analysed. The pooled results indicated that ketamine improved sleep
quality compared to placebo on the first postoperative day, as evidenced
by a reduction in Pittsburgh Sleep Quality Index scores [mean difference
(MD): -2.69; 95% confidence interval (CI): -3.95, -1.42; P < 0.0001,
I² = 96%]. Ketamine also improved sleep quality on the second
postoperative day (MD: -2.45; 95% CI: -3.99, -0.91; P = 0.002,
I² = 96%) and during the first three postoperative days (MD:
-2.90; 95% CI: -4.79, -1.00; P = 0.003, I² = 97%). In addition,
ketamine reduced Visual Analogue Scale scores for pain (MD: -0.38; 95% CI:
-0.55, -0.21; P < 0.00001, I² = 84%). These results suggest
that ketamine reduces PSDs and pain without significantly increasing
adverse reactions. However, given the high heterogeneity and limited
quality of evidence in this review, the results should be interpreted with
caution. <br/>Conclusion(s): This meta-analysis indicates that
administering ketamine during the perioperative period can enhance
postoperative sleep quality. However, the optimal dose, timing and method
of administration remain undetermined, emphasising the need for further
research to establish standardised guidelines.<br/>Copyright &#xa9; 2025
Indian Journal of Anaesthesia.

<49>
Accession Number
2034207843
Title
Left ventricular unloading and survival outcomes in pediatric acute
fulminant myocarditis patients receiving extracorporeal membrane
oxygenation: A systematic review and meta-analysis.
Source
Perfusion (United Kingdom). (no pagination), 2025. Date of Publication:
2025.
Author
Cho H.J.; Habimana R.; Choi I.; Song M.-K.; Yang J.-H.; Lee Y.; Ko H.; Di
Nardo M.; Jeong I.S.
Institution
(Cho, Choi) Department of Pediatrics, Chonnam National University
Children's Hospital and Medical School, Gwangju, South Korea
(Cho, Habimana, Choi, Jeong) Extracorporeal Circulation Research Team,
Chonnam National University Hospital, Gwangju, South Korea
(Habimana) Chonnam National University Graduate School, Gwangju, South
Korea
(Song) Department of Physical and Rehabilitation Medicine, Chonnam
National University Medical School, Gwangju, South Korea
(Yang, Lee) Department of Thoracic and Cardiovascular Surgery, Samsung
Medical Center, Sungkyunkwan University School of Medicine, Seoul, South
Korea
(Ko) Department of Pediatrics, Pusan National University Yangsan Hospital,
Pusan National University School of Medicine, South Korea
(Di Nardo) Pediatric Intensive Care Unit, Bambino Gesu Children's
Hospital, IRCCS, Rome, Italy
(Jeong) Department of Thoracic and Cardiovascular Surgery, Chonnam
National University Hospital and Medical School, Gwangju, South Korea
Publisher
SAGE Publications Ltd
Abstract
Background: Acute fulminant myocarditis (AFM) is a severe condition in
pediatric patients. Extracorporeal membrane oxygenation (ECMO) is often
used as a supportive therapy, but survival rates and the impact of
adjunctive therapies like left ventricular (LV) unloading and
bridge-to-heart transplantation remain unclear. This meta-analysis
evaluates survival outcomes in pediatric AFM patients treated with ECMO
and assesses the influence of these strategies. <br/>Method(s): This
systematic review and meta-analysis followed PRISMA guidelines. Databases,
including PubMed, Embase, and the Cochrane Library, were searched for
studies published in the last 10 years. Inclusion criteria were studies
reporting survival rates of pediatric AFM patients treated with ECMO. Data
were analyzed using fixed and random-effects models. Subgroup and
univariable meta-regression analyses identified factors associated with
survival. <br/>Result(s): From 2308 articles, 10 studies met the inclusion
criteria, totaling 210 pediatric patients. The pooled survival rate was
67% (95% CI: 37%-97%). Subgroup analyses showed higher survival in
patients receiving LV unloading (82% vs 63%; p <.01) and those bridged to
heart transplantation, though not statistically significant. Univariable
meta-regression identified LV unloading as a significant predictor of
survival (p =.02). Other factors, such as age, gender, and cardiac arrest
before ECMO, showed no significant associations with survival. Cumulative
meta-analysis indicated an improving trend in survival over the years.
<br/>Conclusion(s): This meta-analysis suggests an association between
ECMO and improved survival in children with AFM. While LV unloading may
offer benefits, the retrospective nature of the included studies, along
with potential confounding factors, necessitates cautious interpretation.
Further well-designed prospective studies are required to establish its
optimal role, indications, and timing in pediatric ECMO patients with
AFM.<br/>Copyright &#xa9; The Author(s) 2025.

<50>
Accession Number
2036477223
Title
A randomized study of cryoablation of intercostal nerves in patients
undergoing minimally invasive thoracic surgery.
Source
Journal of Thoracic and Cardiovascular Surgery. 169(5) (pp 1375-1382.e1),
2025. Date of Publication: 01 May 2025.
Author
Weksler B.; Maxwell C.; Drake L.; Crist L.; Specht K.; Kuchta P.; DeHaven
K.; Weksler I.; Williams B.A.; Fernando H.C.
Institution
(Weksler, Maxwell, Drake, Crist, Specht, Kuchta, DeHaven, Weksler,
Williams, Fernando) Division of Thoracic and Esophageal Surgery,
Cardiovascular Institute, Allegheny Health Network, Pittsburgh, PA, United
States
Publisher
Elsevier Inc.
Abstract
Objectives: Minimally invasive thoracic surgery can cause significant
pain, and optimizing pain control after surgery is highly desirable. We
examined pain control after intercostal nerve block with or without
cryoablation of the intercostal nerves. <br/>Method(s): This was a
randomized study (NCT05348447) of adults scheduled for a minimally
invasive thoracic procedure. Each intercostal space near the incision site
was injected with lidocaine and bupivacaine with epinephrine (standard of
care). The cryoanalgesia group also had 5 to 6 intercostal nerves ablated.
The primary outcome was the amount of narcotics (in morphine milligram
equivalents taken during the postoperative hospital stay and the first 2
weeks postdischarge. Secondary outcomes were incentive spirometry volume
and pain scores in the hospital and pain and neuropathy scores at 2 weeks.
<br/>Result(s): Our final cohort contained 103 patients (52 standard of
care and 51 cryoanalgesia). There were no differences between the
treatment groups in morphine milligram equivalents administered during the
hospital stay (44.9 vs 38.4 mg), total morphine milligram equivalents at 2
weeks (108.8 vs 95.2 mg), or pain assessed by visual analog scale on
postoperative day 1 (3.8 and 3.3), postoperative day 2 (2 and 3.5), or 2
weeks (2 and 3.5) for standard of care and cryoanalgesia group patients,
respectively. The decrease in incentive spirometry during the
postoperative period was not significantly different between the 2 groups.
Patients in the cryoanalgesia group had higher neuropathy scores (8 vs 13;
P = .019) 2 weeks after surgery. <br/>Conclusion(s): In this randomized
study, cryoanalgesia did not decrease postoperative pain or narcotic
requirements. Cryoanalgesia increased neuropathic pain 2 weeks after
surgery.<br/>Copyright &#xa9; 2024 The American Association for Thoracic
Surgery

<51>
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. (no pagination), 2025.
Date of Publication: 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.<br/>Copyright &#xa9; 2025 American College of Cardiology Foundation,
and the American Heart Association, Inc.

<52>
Accession Number
2037540471
Title
Nonocclusive Mesenteric Ischemia in Aortic Surgery: What You Need to Know.
Source
Annals of Vascular Surgery. 114 (pp 373-379), 2025. Date of Publication:
01 May 2025.
Author
Murtada A.; Jubouri M.; Refaie M.; Mohammed I.
Institution
(Murtada, Refaie) Department of General Surgery, Glan Clwyd Hospital,
Rhyl, United Kingdom
(Jubouri) Hull York Medical School, University of York, York, United
Kingdom
(Mohammed) Institute of Cardiac and Aortic Disorders, SRM Institutes for
Medical Science (SIMS Hospitals), Chennai, India
Publisher
Elsevier Inc.
Abstract
Background: Nonocclusive mesenteric ischemia (NOMI), a subtype of acute
mesenteric ischemia (AMI), is primarily caused by mesenteric arterial
vasoconstriction and decreased vascular resistance, leading to impaired
intestinal perfusion.Commonly observed after cardiac surgery, NOMI affects
older patients with cardiovascular or systemic diseases, accounting for
20-30% of AMI cases with a mortality rate of ~50%. This review explores
NOMI's pathophysiology, clinical implications in aortic dissection, and
the unmet needs in diagnosis and management, emphasizing its prognostic
significance. <br/>Method(s): A comprehensive literature review was
conducted using multiple electronic databases to extract relevant data and
information. <br/>Result(s): NOMI is a life-threatening condition
characterized by mesenteric vasoconstriction and reduced splanchnic blood
flow, often triggered by cardiac surgery, hemodialysis, or hypotensive
episodes. Epidemiological studies highlight its prevalence in intensive
care unit settings, with a high mortality rate linked to delayed diagnosis
and systemic hypoperfusion. Risk factors include advanced age, vasopressor
use, and inflammatory markers. Biomarkers such as intestinal fatty acid
binding protein, citrulline, and D-lactate show potential for early
detection but lack robust clinical validation. Management includes fluid
resuscitation, vasodilators, and surgical intervention for bowel necrosis.
Emerging endovascular approaches show promise but are limited to select
cases without bowel infarction. This review underscores the critical need
for timely diagnosis, risk factor identification, and tailored
interventions to improve outcomes. <br/>Conclusion(s): NOMI remains poorly
understood despite advances in surgical and perioperative care. Its
pathophysiology, linked to cardiopulmonary bypass and intraoperative
factors, requires heightened clinical vigilance. Limited evidence
underscores the need for a multidisciplinary approach involving surgeons,
radiologists, and anesthetists to improve diagnosis, management, and
outcomes in aortic surgery patients.<br/>Copyright &#xa9; 2025 Elsevier
Inc.

<53>
[Use Link to view the full text]
Accession Number
2036069254
Title
Effect of PCSK9 inhibitors on major cardiac adverse events and
lipoprotein-a in patients with coronary heart disease: a meta-analysis.
Source
Coronary Artery Disease. 36(3) (pp 200-210), 2025. Date of Publication: 01
May 2025.
Author
Hu E.; Wan M.
Institution
(Hu) Department of Pharmacy, The Sixth Hospital of Wuhan, Affiliated
Hospital of Jianghan University, Hubei Province, Wuhan, China
(Wan) Department of the Second Clinic, The 940 Hospital of Joint Logistics
Support Force of Chinese PLA, Gansu Province, Lanzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background Lipoprotein(a) [Lp(a)] is an independent risk factor for
cardiovascular disease due to its unique apo(a) component and its
association with atherosclerosis and thrombogenesis. This meta-analysis
was conducted to evaluate the effects of PCSK9 inhibitors on major adverse
cardiac events (MACE) and Lp(a) levels in patients with coronary heart
disease. Methods Randomized controlled trials (RCTs) were systematically
searched in PubMed, the Cochrane Library, and other databases. Stata 15.1
software was used for data analysis, and a random- or fixed-effects model
was selected based on inter-study heterogeneity. Egger's test was applied
to detect publication bias. Results A total of 12 RCTs were included,
involving 48 116 patients with a mean age of 62 years, comprising 65%
males and diverse ethnic backgrounds. The results showed that compared
with the control group, PCSK9 inhibitors significantly reduced low-density
lipoprotein cholesterol (WMD = -1.24 mmol/L, 95% confidence interval (CI):
-1.28 to -1.20), total cholesterol, triglycerides, and Lp(a) levels while
increasing high-density lipoprotein cholesterol levels. In terms of
safety, there was no increased risk of adverse reactions other than
injection site reactions. For MACE, PCSK9 inhibitors significantly reduced
the risk of nonfatal myocardial infarction, stroke, and coronary
revascularization events (RR = 0.87, 95% CI: 0.84-0.89). Conclusion PCSK9
inhibitors not only significantly improve blood lipid profiles and reduce
Lp(a) levels but also reduce the risk of MACE in patients with coronary
heart disease. Therefore, PCSK9 inhibitors offer an effective and safe
treatment option for these patients.<br/>Copyright &#xa9; 2024 Wolters
Kluwer Health, Inc. All rights reserved.

<54>
Accession Number
2038271425
Title
Low versus High Fraction of Inspired Oxygen During Lung Separation in
Thoracic Surgery: A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Spraider P.; Abram J.; Wally D.; Bernardi D.; Augustin F.; Hell T.;
Tscholl P.; Dejaco H.
Institution
(Spraider, Abram, Wally, Bernardi, Dejaco) Department of Anesthesia and
Intensive Care Medicine, Medical University of Innsbruck, Innsbruck,
Austria
(Augustin) Department of Visceral, Transplant and Thoracic Surgery,
Medical University of Innsbruck, Innsbruck, Austria
(Hell, Tscholl) Data Lab Hell, non-University Research Institution, Zirl,
Austria
Publisher
W.B. Saunders
Abstract
Objectives: To investigate whether a lower fraction of inspired oxygen
(FiO<inf>2</inf>) during the early phase of lung separation is able to
improve overall oxygenation of the blood assessed by the arterial partial
pressure of oxygen (PaO<inf>2</inf>)/FiO<inf>2</inf> ratio, and to
investigate its effect on lung collapse and postoperative pulmonary
complications (PPC). <br/>Design(s): Prospective, nonblinded, randomized
controlled trial. <br/>Setting(s): Single-center trial at a university
hospital. <br/>Participant(s): Patients scheduled for thoracic surgery
requiring one-lung ventilation (OLV). <br/>Intervention(s): Study
participants received either a low and then increasing oxygen
concentration after lung separation or pure oxygen and then a decreasing
oxygen concentration. <br/>Measurements and Main Results: The primary
endpoint was the PaO<inf>2</inf>/FiO<inf>2</inf> ratio 30 minutes after
the start of OLV. Secondary endpoint included lung collapse defined as
none, partial, or complete during the early phase of OLV and incidence of
PPC. A total of 55 patients were enrolled, 53 of whom were included in the
analysis. The primary endpoint, PaO<inf>2</inf>/FiO<inf>2</inf> ratio, was
comparable in the 2 groups, and the secondary endpoint, lung collapse, was
similar. However, the incidence of PPC was significantly reduced with a
low oxygen content strategy (19% vs 48%; p = 0.042). <br/>Conclusion(s): A
strategy of low FiO<inf>2</inf> before and after lung separation did not
improve the oxygenation capacity of the lungs, and lung collapse was
comparable in the 2 study groups. However, the occurrence of PPC was
significantly reduced in the group treated with low
FiO<inf>2</inf>.<br/>Copyright &#xa9; 2025 The Author(s)

<55>
[Use Link to view the full text]
Accession Number
2037605881
Title
Left Ventricular Entry to Reduce Brain Lesions during Catheter Ablation: A
Randomized Trial.
Source
Circulation. 151(15) (pp 1051-1059), 2025. Date of Publication: 15 Apr
2025.
Author
Marcus G.M.; Tung R.; Gerstenfeld E.P.; Hue T.F.; Lin F.; Cheng J.; Weiss
J.P.; Tzou W.S.; Hsia H.; Ehdaie A.; Cooper D.H.; Bunch T.J.; Arkles J.;
Nazer B.; Lee A.; Hadjis A.; Nguyen D.T.; Chelu M.G.; Moss J.; Hsu J.C.;
Valderrabano M.; Bhave P.D.; Beaser A.D.; Kanagasundram A.; Wazni O.;
Bradfield J.; Wall G.; Chang K.; Yang M.; Montenegro G.; Jarrott S.;
Kramer J.H.; Kim A.S.; Morris Y.M.; Dillon W.P.
Institution
(Marcus, Tung, Gerstenfeld, Hsia, Ehdaie, Lee, Moss, Wall, Chang, Yang,
Montenegro) Division of Cardiology, University of California, San
Francisco, United States
(Hue, Lin) Department of Epidemiology and Biostatistics, University of
California, San Francisco, United States
(Cheng) Oral Epidemiology & Dental Public Health, University of
California, San Francisco, United States
(Jarrott, Kramer, Kim) Department of Neurology, University of California,
San Francisco, United States
(Morris) Patient Author, University of California, San Francisco, United
States
(Dillon) Department of Radiology and Biomedical Imaging, University of
California, San Francisco, United States
(Tung, Weiss) Division of Cardiology, University of Arizona College of
Medicine-Phoenix, Banner - University Medical Center, United States
(Tzou) Division of Cardiology, University of Colorado Anschutz Medical
Center, Aurora, United States
(Ehdaie) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
United States
(Cooper) Cardiovascular Division, Washington University School of
Medicine, St. Louis, United States
(Bunch) Division of Cardiovascular Medicine, University of Utah, Salt Lake
City, United States
(Arkles) Cardiovascular Division, University of Pennsylvania,
Philadelphia, United States
(Nazer) Division of Cardiology, University of Washington, Seattle, United
States
(Hadjis) Division of Cardiology, Hopital du Sacre-Coeur de Montreal,
University of Montreal, Canada
(Nguyen) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Chelu) Department of Medicine-Cardiology, Cardiovascular Research
Institute, Baylor College of Medicine, Texas Heart Institute, Baylor St.
Luke's Medical Center, Houston, United States
(Hsu) Division of Cardiology, University of California, San Diego, United
States
(Valderrabano) Department of Cardiology, Houston Methodist Hospital, TX,
United States
(Bhave) Department of Cardiovascular Medicine, Wake Forest School of
Medicine, Winston-Salem, NC, United States
(Beaser) Section of Cardiology, University of Chicago, IL, United States
(Kanagasundram) Division of Cardiovascular Medicine, Vanderbilt University
Medical Center, Nashville, TN, United States
(Wazni) Department of Cardiovascular Medicine, Cleveland Clinic, OH,
United States
(Bradfield) Cardiac Arrhythmia Center, University of California, Los
Angeles, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Catheter ablation of ventricular arrhythmias, one of the most
rapidly growing procedures in cardiac electrophysiology, is associated
with magnetic resonance imaging-detected brain lesions in more than half
of cases. Although a retrograde aortic approach is conventional, modern
tools enable entry through a transseptal approach that may avoid
embolization of debris from the arterial system. We sought to test the
hypothesis that a transseptal puncture would mitigate brain injury
compared with a retrograde aortic approach. <br/>METHOD(S): The TRAVERSE
trial (Transseptal Versus Retrograde Aortic Ventricular Entry to Reduce
Systemic Emboli) was a multicenter randomized controlled comparative
effectiveness trial. Patients with left ventricular arrhythmias undergoing
catheter ablation procedures were randomly assigned to a transseptal
puncture approach compared (1:1) with a retrograde aortic approach. The
primary outcome was the presence of an acute brain lesion detected by
magnetic resonance imaging. Secondary outcomes included clinically
manifest complications, procedural efficacy, and 6-month neurocognitive
assessments. <br/>RESULT(S): Among the 62 patients randomly assigned to a
retrograde aortic approach with postoperative brain magnetic resonance
imaging, 28 (45%) exhibited an acute brain lesion compared with 19 of the
69 (28%) of those randomized to a transseptal puncture (P=0.036). No
differences in clinically manifest complications or procedural efficacy
were observed. More patients in the retrograde aortic arm were categorized
as having a high likelihood of cognitive impairment at 6 months (33%
compared with 19% of those in the transseptal arm), but substantial loss
to follow-up was present. <br/>CONCLUSION(S): Among patients undergoing
left ventricular catheter ablation procedures, a transseptal approach
reduced the risk of acute brain lesions by nearly half compared with a
retrograde aortic approach without sacrificing safety or efficacy. Given a
likely embolic pathogenesis, the brain magnetic resonance imaging findings
may reflect a propensity to other organ damage; these findings may extend
to other procedures requiring left ventricular entry.<br/>Copyright &#xa9;
2025 American Heart Association, Inc.

<56>
Accession Number
2037709313
Title
Early vs Delayed Bypass Surgery in Patients With Acute Coronary Syndrome
Receiving Ticagrelor: The RAPID CABG Randomized Open-Label Noninferiority
Trial.
Source
JAMA Surgery. 160(4) (pp 387-394), 2025. Date of Publication: 09 Apr 2025.
Author
So D.Y.F.; Wells G.A.; Lordkipanidze M.; Chong A.Y.; Ruel M.; Perrault
L.P.; Le May M.R.; Sun L.; Tran D.; Labinaz M.; Glover C.; Russo J.;
Welman M.; Chan V.; Chen L.; Bernick J.; Rubens F.; Tanguay J.-F.;
Salapang G.; MacPhee P.; Abarbanel T.; Mitchell C.; Racine K.; Amche R.;
Davies R.; Davis D.; Poulin A.; Nair G.; De Roock S.; Tran M.-L.
Institution
(So, Chong, Le May, Labinaz, Glover, Russo) Division of Cardiology,
Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON,
Canada
(Wells, Chen, Bernick) Cardiovascular Research Methods Centre, Department
of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
(Lordkipanidze, Welman) Montreal Heart Institute Research Centre,
Montreal, QC, Canada
(Lordkipanidze) Faculty of Pharmacy, University of Montreal, Montreal, QC,
Canada
(Ruel, Chan, Rubens) Division of Cardiac Surgery, Department of Surgery,
University of Ottawa Heart Institute, Ottawa, ON, Canada
(Perrault) Division of Cardiac Surgery, Department of Surgery, Montreal
Heart Institute, Montreal, QC, Canada
(Sun, Tran) Division of Cardiac Anesthesia, Department of Anesthesiology,
University of Ottawa Heart Institute, Ottawa, ON, Canada
(Tanguay) Department of Medicine, Montreal Heart Institute, University of
Montreal, Montreal, QC, Canada
(Salapang, MacPhee, Abarbanel, Mitchell, Racine, Davies, Davis, Nair, De
Roock, Tran) University of Ottawa, Heart Institute, Ottawa, ON, Canada
(Amche) Montreal Heart Institute, Montreal, QC, Canada
(Poulin) Quebec Heart and Lung Institute, Quebec City, QC, Canada
Publisher
American Medical Association
Abstract
Importance: Perioperative bleeding is a major concern in patients
receiving ticagrelor for acute coronary syndromes (ACS) when coronary
artery bypass graft (CABG) surgery is required. <br/>Objective(s): To
evaluate whether early CABG surgery at 2 to 3 days after ticagrelor
cessation is noninferior to waiting 5 to 7 days. <br/>Design, Setting, and
Participant(s): RAPID CABG was a noninferiority, open-label randomized
trial with 6 months of follow-up. Participants were patients with ACS who
had received ticagrelor and required CABG. Patients were enrolled in
tertiary centers in Canada between January 2016 and March 2021. Data were
analyzed from March 2021 to December 2023. <br/>Intervention(s): Early or
delayed CABG. <br/>Main Outcomes and Measures: The primary outcome was
based on noninferiority comparison of class 3 or 4 universal definition of
perioperative bleeding (UDPB). Noninferiority was prespecified as 8%
between groups. Twelve-hour chest tube drainage was reported as a
noninferiority comparison. Other bleeding, ischemic, and length-of-stay
outcomes were assessed for superiority. <br/>Result(s): Among 143
randomized patients, the median (IQR) age was 65 (58-72) years; there were
117 male patients (82%) and 26 female (18%). Of these, 123 patients
(86.0%) underwent surgery in the allocated time frame (per protocol). The
median (IQR) time to surgery was 3 (2-3) days in the early group and 6
(5-7) days in the delayed group (P <.001). In a per-protocol analysis,
severe or massive UDPB occurred in 3 of 65 early-group patients (4.6%) and
3 of 58 patients (5.2%) in the delayed group (between-group difference,
-0.6%; 95% CI, -8.3% to 7.1%; P =.03 for noninferiority). Median (IQR)
chest tube drainage was 470 (330-650) mL vs 495 (380-610) mL
(between-group difference -25 mL; 95% CI, -111.25 to 35; P =.01 for
noninferiority). Median (IQR) hospital stay was 9 (7-13) days and 12
(10-15) days for the early and delayed groups (P <.001). Conclusion and
Relevance: This study found that an early surgical strategy, 2 to 3 days
after ticagrelor cessation, was noninferior in incurring perioperative
bleeding. The data support a reduction in the delay between ticagrelor
cessation and CABG surgery and may decrease hospital length of
stay.<br/>Copyright &#xa9; 2025 American Medical Association. All rights
reserved, including those for text and data mining, AI training, and
similar technologies.

<57>
Accession Number
2037211194
Title
Patient and Health Professional's Perspectives of Periprosthetic Joint
Infection: A Systematic Review and Meta-Ethnography.
Source
Surgical Infections. 26(3) (pp 195-203), 2025. Date of Publication: 01 Apr
2025.
Author
Smith T.O.; Gorick H.; Arnold S.; Hopgood P.
Institution
(Smith, Arnold) Warwick Medical School, University of Warwick, Coventry,
United Kingdom
(Smith, Gorick, Hopgood) Norfolk and Norwich University Hospital, Norwich,
United Kingdom
(Gorick) School of Health Sciences, University of East Anglia, Norwich,
United Kingdom
Publisher
Mary Ann Liebert Inc.
Abstract
Background: Periprosthetic joint infection (PJI) is a major challenge for
surgical teams and patients following an orthopedic surgical procedure.
There is limited understanding on patient and health professional's
perception of PJI. The aim of this study was to examine the literature to
better understand the perspectives of patients, and those who manage PJI.
<br/>Method(s): Published and unpublished literature databases were
systematically searched from inception to June 21, 2024. Qualitative
studies reporting the perspectives of living with and managing PJI were
included. Data were synthesized using a meta-ethnography approach and the
GRADE-CERQual tool. <br/>Result(s): Of the 584 citations identified, 10
studies (n = 91 patients; n = 70 health professionals) met the eligibility
criteria and were included. Three themes, all moderate-certainty evidence,
were identified from the health professional data, including the
following: (1) importance of PJI; (2) impact on health professionals; and
(3) support for change. From the patient data, six themes on the basis of
moderate-certainty evidence were identified: (1) psychological and social
impact; (2) physical impacts; (3) relationship with health professionals;
(4) relationship with others; (5) uncertainty over the future; and (6)
support for change. A novel line of argument was developed offering
third-order constructs, on the basis of first- and second-order themes.
<br/>Conclusion(s): PJIs are perceived as devastating by both patients and
health professionals. They impact on all aspects of a patient's physical,
social and psychological health, each interacting on one another over the
course of infection and management. Strategies to improve communication,
multidisciplinary management, and personalization of care are advocated by
both patients and health professionals to promote better
outcomes.<br/>Copyright 2025, Mary Ann Liebert, Inc., publishers.

<58>
Accession Number
2033028993
Title
Vascular Healing After Biodegradable Polymer Sirolimus-Eluting Versus
Durable Polymer Everolimus-Eluting Stents in Chronic Total Occlusions.
Source
Catheterization and Cardiovascular Interventions. 105(5) (pp 1124-1133),
2025. Date of Publication: 01 Apr 2025.
Author
Wang G.; Lu W.; Xu Y.; Su X.; Chen S.; Li Y.; Han Y.
Institution
(Wang, Li, Li, Han) State Key Laboratory of Frigid Zone Cardiovascular
Diseases, Cardiovascular Research Institute and Department of Cardiology,
General Hospital of Northern Theater Command, Shenyang, China
(Lu) Department of Cardiology, Xuzhou Central Hospital, Xuzhou, China
(Xu) Department of Cardiology, Shanghai Tenth People's Hospital, Shanghai,
China
(Su) Department of Cardiology, Wuhan Asia Heart Hospital, Wuhan, China
(Chen) Department of Cardiology, Nanjing First Hospital, Nanjing, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Biodegradable polymer stents may reduce the risk of
neoatherosclerosis and stent thrombosis. Limited data is available for
biodegradable polymer sirolimus-eluting stent (BP-SES) and durable polymer
drug-eluting stents (DP-EES) in chronic total occlusions (CTO).
<br/>Aim(s): This study was to evaluate healing patterns of BP-SES versus
DP-EES in CTO at 3 and 13 months based on optical coherence tomography
(OCT). <br/>Method(s): The TARGET-CTO study is a prospective, multicenter,
randomized noninferiority controlled trial for BP-SES compared to DP-EES
in CTO. In the current predefined subanalysis, 44 consecutive patients
underwent OCT follow-up at 3 and 13 months. The primary endpoint was mean
neo-intimal thickness at 3 months. <br/>Result(s): At 3 months, mean
neo-intimal thickness was 47.6 +/- 15.7 microm in BP-SES and 62.5 +/- 37.3
microm in DP-EES (p = 0.384), meeting the noninferiority for BP-SES
(p<inf>noninferiority</inf> < 0.001). Mean neo-intimal thickness at 13
months was 76.4 +/- 34.1 microm in BP-SES and 106.6 +/- 54.9 microm in
DP-EES (p = 0.086). No significant differences in strut coverage were
observed at 3 or 13 months. At 13 months significantly higher percentages
of frames with layered neo-intima and neoatherosclerosis were observed in
DP-EES compared to BP-SES (p = 0.015 and p = 0.021, respectively).
<br/>Conclusion(s): BP-SES was noninferior to DP-EES in terms of
neo-intimal thickness at 3 months and healing responses at 3-month
follow-up were comparable. At 13 months, less advanced neoatherosclerosis
patterns were observed in BP-SES as compared to DP-EES.<br/>Copyright
&#xa9; 2025 The Author(s). Catheterization and Cardiovascular
Interventions published by Wiley Periodicals LLC.

<59>
Accession Number
2037330610
Title
Effect of del Nido Cardioplegia on Isolated Coronary Artery Bypass
Grafting: A Study-level Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(6) (pp 1538-1546),
2025. Date of Publication: 01 Jun 2025.
Author
Yamashita Y.; Baudo M.; Magouliotis D.E.; Sicouri S.; Wertan M.A.C.;
Spragan D.D.; Torregrossa G.; Ramlawi B.; Sutter F.P.
Institution
(Yamashita, Wertan, Spragan, Torregrossa, Ramlawi, Sutter) Department of
Cardiothoracic Surgery, Lankenau Heart Institute, Wynnewood, PA, United
States
(Yamashita, Baudo, Magouliotis, Sicouri, Ramlawi) Department of
Cardiothoracic Surgery Research, Lankenau Institute for Medical Research,
Wynnewood, PA, United States
Publisher
W.B. Saunders
Abstract
The purpose of this study was to evaluate the effect of del Nido
cardioplegia versus conventional cardioplegic solutions on early outcomes
of isolated coronary artery bypass grafting (CABG). PubMed, Scopus, and
the Cochrane Central Register of Controlled Trials were searched through
July 2024 to conduct a meta-analysis for a comparison between del Nido and
other cardioplegic solutions in isolated CABG. Major end points of the
study included operative mortality and morbidities. A random effects model
was used to estimate the pooled effect size. For subgroup analyses,
meta-analyses were conducted for outcomes derived from either randomized
controlled-trials, propensity score analysis, or multivariable analysis.
Twenty-four studies met our eligibility criteria, including 4 randomized
controlled trials and 5 propensity score-matched studies with a total of
34,737 patients. Operative mortality was not significantly associated with
cardioplegic solutions (del Nido vs other solutions; p = 0.262). The
incidence of postoperative stroke, reoperation, deep wound infection, and
atrial fibrillation was also comparable between the 2 groups. The
incidence of postoperative myocardial infarction and renal failure was
significantly lower in the del Nido group with a pooled odds ratio of 0.43
(95% confidence interval, 0.24-0.77) and 0.61 (95% confidence interval,
0.45-0.81), respectively. Subgroup analyses also demonstrated these
significant differences. In patients undergoing isolated CABG, del Nido
cardioplegia provides comparable mortality compared with other
cardioplegic solutions. Del Nido solution was significantly protective
against myocardial infarction and renal failure.<br/>Copyright &#xa9; 2025
Elsevier Inc.

<60>
Accession Number
2036149616
Title
Cerebral Embolic Protection Devices in Transcatheter Aortic Valve
Implantation: Meta-Analysis With Trial Sequential Analysis.
Source
Journal of the American Heart Association. 14(7) (no pagination), 2025.
Article Number: e038869. Date of Publication: 01 Apr 2025.
Author
Warraich N.; Sa M.P.; Jacquemyn X.; Kuno T.; Serna-Gallegos D.; Sultan I.
Institution
(Warraich, Serna-Gallegos, Sultan) Division of Cardiac Surgery, Department
of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA,
United States
(Warraich, Serna-Gallegos, Sultan) UPMC Heart and Vascular Institute,
University of Pittsburgh Medical Center, Pittsburgh, PA, United States
(Sa) Division of Cardiac Surgery, Massachusetts General Hospital, Harvard
Medical School, Boston, MA, United States
(Jacquemyn) KU Leuven, Leuven, Belgium
(Kuno) Division of Cardiology, Massachusetts General Hospital, Harvard
Medical School, Boston, MA, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: We aimed to reevaluate randomized controlled trial data on
outcomes of cerebral embolic protection device use during transcatheter
aortic valve implantation. A conventional meta-analysis followed by trial
sequential analysis was conducted to evaluate the strength of the current
evidence. METHODS AND RESULTS: Databases were searched for randomized
controlled trials. Primary outcomes included all stroke, disabling stroke,
and all-cause mortality. Conventional study-level meta-analysis was
performed using random-effects modeling. Trial sequential analysis was
conducted to generate adjusted significance boundaries, futility
boundaries, and the required information size considering a type I error
of 5% and a power of 90%. Seven trials were included with a total of 4031
patients, of whom 2171 were treated with a device and 1860 were not.
Conventional meta-analysis showed no significant difference in all stroke
(relative risk [RR], 0.85 [95% CI, 0.61-1.18]; P=0.339) and disabling
stroke (RR, 0.59 [95% CI, 0.30-1.13]; P=0.113) with device use. The trial
sequential analysis determined an absence of evidence for all stroke
(required information size of 71 650 [5.6%]) and disabling stroke
(required information size of 337 256 [1.2%]). Conventional meta-analysis
determined no significant difference in all-cause mortality (RR, 1.03 [95%
CI, 0.49-2.17]; P=0.928) with device use. The trial sequential analysis
determined that the futility boundary was reached (required information
size of 5772 [69.3%]). <br/>CONCLUSION(S): There are insufficient
randomized controlled trial data on cerebral embolic protection device use
to provide conclusive meta-analytic findings for stroke
outcomes.<br/>Copyright &#xa9; 2025 The Author(s).

<61>
Accession Number
2035610106
Title
Electroencephalography-Guided Anesthesia and Delirium in Older Adults -
Reply.
Source
JAMA. 332(20) (pp 1759-1760), 2024. Date of Publication: 26 Nov 2024.
Author
Deschamps A.; Avidan M.; Ben Abdallah A.
Institution
(Deschamps) Department of Anesthesiology, Montreal Heart Institute,
Montreal, QC, Canada
(Avidan, Ben Abdallah) Department of Anesthesiology, Washington University
School of Medicine, Missouri, St Louis, United States
Publisher
American Medical Association

<62>
Accession Number
2038332239
Title
Family Socioeconomic Status and Neurodevelopment Among Patients With
Dextro-Transposition of the Great Arteries.
Source
JAMA Network Open. 7(11) (no pagination), 2024. Article Number: e2445863.
Date of Publication: 19 Nov 2024.
Author
Cassidy A.R.; Rofeberg V.; Bucholz E.M.; Bellinger D.C.; Wypij D.;
Newburger J.W.
Institution
(Cassidy) Mayo Clinic, 200 First St SW, Rochester, MN, United States
(Cassidy) Department of Psychiatry and Psychology, Mayo Clinic, Rochester,
MN, United States
(Cassidy) Department of Pediatric and Adolescent Medicine, Mayo Clinic,
Rochester, MN, United States
(Rofeberg, Wypij, Newburger) Department of Cardiology, Boston Children's
Hospital, Boston, MA, United States
(Bucholz) Section of Cardiology, Department of Pediatrics, University of
Colorado School of Medicine, Aurora, United States
(Bellinger) Department of Neurology, Boston Children's Hospital, Harvard
Medical School, Boston, MA, United States
(Bellinger) Department of Psychiatry and Behavioral Sciences, Boston
Children's Hospital, Harvard Medical School, Boston, MA, United States
(Newburger) Department of Pediatrics, Harvard Medical School, Boston, MA,
United States
(Wypij) Department of Biostatistics, Harvard T.H. Chan School of Public
Health, Boston, MA, United States
Publisher
American Medical Association
Abstract
Key Points Question How is socioeconomic status (SES) associated with the
neurodevelopment over time of individuals with dextro-transposition of the
great arteries (d-TGA)? Findings In this cohort study of 164 patients with
d-TGA evaluated at 1, 4, 8, and 16 years, lower SES was associated with
worse neurodevelopmental outcomes from early childhood through
adolescence. Declining neurodevelopmental status over time was associated
with lower SES tertile and younger maternal age at childbirth. Meaning
Findings of this study suggest that neurodevelopmental monitoring and
intervention services should be intensified for children with critical
congenital heart disease, such as d-TGA, and low SES. IMPORTANCE Data are
limited on the longitudinal implications of socioeconomic status (SES) for
neurodevelopmental outcomes among persons with complex congenital heart
disease (CHD). OBJECTIVES To examine the association of family SES,
maternal educational level, and maternal IQ with the neurodevelopment of
individuals with dextro-transposition of the great arteries (d-TGA) from
age 1 to 16 years and to identify how SES-related disparities change with
age. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed data of
participants enrolled in the Boston Circulatory Arrest Study, a randomized
clinical trial conducted in Boston, Massachusetts, from 1988 to 1992.
Participants were infants with d-TGA who underwent arterial switch
operation and, after operation, underwent in-person neurodevelopmental
status evaluations at ages 1, 4, 8, and 16 years. Analyses were conducted
from April 2021 to August 2024. EXPOSURES Mean Hollingshead scores at
birth, age 1 year, and age 4 years were used to assign participants to SES
tertiles (lowest, middle, or highest). MAIN OUTCOMES AND MEASURES
Age-appropriate neurodevelopmental outcomes assessed at 4 study time
points (ages 1, 4, 8, and 16 years) via in-person administration of a
range of well-validated measures. Standardized neurodevelopmental
composite scores from each evaluation were derived from principal
component analysis and compared across SES tertiles, adjusting for birth
and medical characteristics. These scores were used to categorize the
sample into latent classes; patient and medical factors for a 3-class
model were used to estimate latent class using multinomial regression.
RESULTS The sample included 164 patients with d-TGA (123 males [75%]; mean
[SD] gestational age at birth, 39.8 [1.2] weeks; 3 with Asian [2%], 6 with
Black [4%], 5 with Hispanic [3%], and 146 with White [89%] race and
ethnicity) and their mothers (mean [SD] age at birth, 28.5 [5.2] years).
Lower SES tertile was associated with worse scores on most individual
neurodevelopmental tests and worse neurodevelopmental composite scores at
ages 4, 8, and 16 years. For example, mean (SD) neurodevelopmental
composite scores at age 4 years were -0.49 [0.83] for lowest, 0.00 [0.81]
for middle, and 0.47 [1.10] for highest SES tertile (F<inf>2</inf> = 15.5;
P < .001). When measured at consecutive time points, differences between
SES tertiles were of similar magnitude. A latent class analysis produced
2- and 3-class models representing patients with stable (103 [64%] and 85
[53%]), improving (20 [13%]), and declining (57 [36%] and 55 [34%])
neurodevelopmental status. Those experiencing declines in
neurodevelopmental status were more likely to have younger maternal age at
childbirth (26.6 [5.1] vs 29.6 [4.9] and 29.1 [5.1] years; P = .002),
lower maternal IQ (91.0 [14.1] vs 100.1 [11.1] and 96.2 [11.0]; P < .001),
and lower SES (35.2 [10.8] vs 40.9 [9.9] and 35.8 [10.1]; P = .003)
compared with those with stable or improving status. CONCLUSIONS AND
RELEVANCE This cohort study of individuals with d-TGA found an association
between lower family SES and worse neurodevelopmental outcomes in
childhood and continuing throughout adolescence as well as greater decline
in neurodevelopmental status over time. Effective strategies are needed to
improve access to neurodevelopmental monitoring and intervention services
for children with CHD from lower socioeconomic backgrounds.<br/>Copyright
&#xa9; 2024 Cassidy AR et al. JAMA Network Open.

<63>
Accession Number
2032206246
Title
Clinical Outcomes After Acute Coronary Syndromes or Revascularization
Among People Living With HIV: A Systematic Review and Meta-Analysis.
Source
JAMA Network Open. 7(5) (no pagination), 2024. Article Number: e2411159.
Date of Publication: 14 May 2024.
Author
Haji M.; Capilupi M.; Kwok M.; Ibrahim N.; Bloomfield G.S.; Longenecker
C.T.; Rodriguez-Barradas M.C.; Ashong C.N.; Jutkowitz E.; Taveira T.H.;
Richard M.; Sullivan J.L.; Rudolph J.L.; Wu W.-C.; Erqou S.
Institution
(Haji, Capilupi, Ibrahim, Taveira, Richard, Rudolph, Wu, Erqou) Department
of Medicine, Alpert Medical School of Brown University, Providence, RI,
United States
(Kwok) Department of Medicine, Washington University School of Medicine in
St Louis, St Louis, MO, United States
(Bloomfield) Department of Medicine, Duke Global Health Institute, Duke
Clinical Research Institute, Duke University, Durham, NC, United States
(Longenecker) Global Health Institute, University of Washington, Seattle,
United States
(Rodriguez-Barradas) Infectious Disease Section, Michael E. DeBakey VA
Medical Center, Houston, TX, United States
(Rodriguez-Barradas) Department of Medicine, Baylor College of Medicine,
Houston, TX, United States
(Ashong) Pharmacy Service, Michael E. DeBakey VA Medical Center, Houston,
TX, United States
(Jutkowitz, Sullivan, Rudolph, Wu, Erqou) Center of Innovation, Providence
VA Medical Center, Providence, RI, United States
(Jutkowitz, Rudolph, Erqou) Evidence Synthesis Program Center, Providence
VA Health Care System, Providence, RI, United States
(Taveira, Richard, Rudolph, Wu, Erqou) Department of Medicine, Providence
VA Medical Center, Providence, RI, United States
(Taveira) Department of Pharmacy, University of Rhode Island, Providence,
United States
(Sullivan) Department of Health Services, Policy and Practice, Brown
University, Providence, RI, United States
Publisher
American Medical Association
Abstract
IMPORTANCE Clinical outcomes after acute coronary syndromes (ACS) or
percutaneous coronary interventions (PCIs) in people living with HIV have
not been characterized in sufficient detail, and extant data have not been
synthesized adequately. OBJECTIVE To better characterize clinical outcomes
and postdischarge treatment of patients living with HIV after ACS or PCIs
compared with patients in an HIV-negative control group. DATA SOURCES Ovid
MEDLINE, Embase, and Web of Science were searched for all available
longitudinal studies of patients living with HIV after ACS or PCIs from
inception until August 2023. STUDY SELECTION Included studies met the
following criteria: patients living with HIV and HIV-negative comparator
group included, patients presenting with ACS or undergoing PCI included,
and longitudinal follow-up data collected after the initial event. DATA
EXTRACTION AND SYNTHESIS Data extraction was performed following the
Preferred Reporting Items for Systematic Reviews and Meta-Analysis
(PRISMA) statement. Clinical outcome data were pooled using a
random-effects model meta-analysis. MAIN OUTCOME AND MEASURES The
following clinical outcomes were studied: all-cause mortality, major
adverse cardiovascular events, cardiovascular death, recurrent ACS,
stroke, new heart failure, total lesion revascularization, and total
vessel revascularization. The maximally adjusted relative risk (RR) of
clinical outcomes on follow-up comparing patients living with HIV with
patients in control groups was taken as the main outcome measure. RESULTS
A total of 15 studies including 9499 patients living with HIV (pooled
proportion [range], 76.4% [64.3%-100%] male; pooled mean [range] age, 56.2
[47.0-63.0] years) and 1 531 117 patients without HIV in a control group
(pooled proportion [range], 61.7% [59.7%-100%] male; pooled mean [range]
age, 67.7 [42.0-69.4] years) were included; both populations were
predominantly male, but patients living with HIV were younger by
approximately 11 years. Patients living with HIV were also significantly
more likely to be current smokers (pooled proportion [range], 59.1%
[24.0%-75.0%] smokers vs 42.8% [26.0%-64.1%] smokers) and engage in
illicit drug use (pooled proportion [range], 31.2% [2.0%-33.7%] drug use
vs 6.8% [0%-11.5%] drug use) and had higher triglyceride (pooled mean
[range], 233 [167-268] vs 171 [148-220] mg/dL) and lower high-density
lipoprotein-cholesterol (pooled mean [range], 40 [26-43] vs 46 [29-46]
mg/dL) levels. Populations with and without HIV were followed up for a
pooled mean (range) of 16.2 (3.0-60.8) months and 11.9 (3.0-60.8) months,
respectively. On postdischarge follow-up, patients living with HIV had
lower prevalence of statin (pooled proportion [range], 53.3% [45.8%-96.1%]
vs 59.9% [58.4%-99.0%]) and beta-blocker (pooled proportion [range], 54.0%
[51.3%-90.0%] vs 60.6% [59.6%-93.6%]) prescriptions compared with those in
the control group, but these differences were not statistically
significant. There was a significantly increased risk among patients
living with HIV vs those without HIV for all-cause mortality (RR, 1.64;
95% CI, 1.32-2.04), major adverse cardiovascular events (RR, 1.11; 95% CI,
1.01-1.22), recurrent ACS (RR, 1.83; 95% CI, 1.12-2.97), and admissions
for new heart failure (RR, 3.39; 95% CI, 1.73-6.62). CONCLUSIONS AND
RELEVANCE These findings suggest the need for attention toward secondary
prevention strategies to address poor outcomes of cardiovascular disease
among patients living with HIV.<br/>Copyright &#xa9; 2024 Haji M et al.

<64>
[Use Link to view the full text]
Accession Number
647046720
Title
Dapagliflozin in Patients Undergoing Transcatheter Aortic-Valve
Implantation.
Source
The New England journal of medicine. 392(14) (pp 1396-1405), 2025. Date of
Publication: 10 Apr 2025.
Author
Raposeiras-Roubin S.; Amat-Santos I.J.; Rossello X.; Gonzalez Ferreiro R.;
Gonzalez Bermudez I.; Lopez Otero D.; Nombela-Franco L.; Gheorghe L.; Diez
J.L.; Baladron Zorita C.; Baz J.A.; Munoz Garcia A.J.; Vilalta V.;
Ojeda-Pineda S.; de la Torre Hernandez J.M.; Cordoba Soriano J.G.;
Regueiro A.; Bordes Siscar P.; Salgado Fernandez J.; Garcia Del Blanco B.;
Martin-Reyes R.; Romaguera R.; Moris C.; Garcia Blas S.; Franco-Pelaez
J.A.; Cruz-Gonzalez I.; Arzamendi D.; Romero Rodriguez N.; Diez-Del Hoyo
F.; Camacho Freire S.; Bosa Ojeda F.; Astorga Burgo J.C.; Molina Navarro
E.; Caballero Borrego J.; Ruiz Quevedo V.; Sanchez-Recalde A.; Peral
Disdier V.; Alegria-Barrero E.; Torres-Llergo J.; Feltes G.; Fernandez
Diaz J.A.; Cuellas C.; Jimenez Britez G.; Sanchez-Rubio Lezcano J.;
Barreiro-Pardal C.; Nunez-Gil I.; Abu-Assi E.; Iniguez-Romo A.; Fuster V.;
Ibanez B.
Institution
(Raposeiras-Roubin, Rossello, Fuster, Ibanez) Centro Nacional de
Investigaciones Cardiovasculares Carlos III, Madrid, Spain
(Raposeiras-Roubin, Gonzalez Ferreiro, Gonzalez Bermudez, Baz,
Iniguez-Romo) Cardiology Department, University Hospital Alvaro Cunqueiro
and Instituto de Investigacion Sanitaria Galicia Sur, Vigo, Spain
(Raposeiras-Roubin) University of Santiago de Compostela, Santiago de
Compostela, Spain
(Amat-Santos, Rossello, Lopez Otero, Baladron Zorita, Baz, Ojeda-Pineda,
Garcia Del Blanco, Garcia Blas, Cruz-Gonzalez, Iniguez-Romo, Ibanez)
Centro de Investigacion Biomedica en Red en Enfermedades Cardiovasculares,
Madrid, Spain
(Amat-Santos, Baladron Zorita) Cardiology Department, University Clinical
Hospital of Valladolid, Valladolid, Spain
(Rossello, Peral Disdier) Cardiology Department, University Hospital Son
Espases and Instituto de Investigacion Sanitaria Islas Baleares, Palma de
Mallorca, Spain
(Rossello) Universitat de les Illes Balears, Palma, Spain
(Lopez Otero) Cardiology Department, University Hospital Montecelo,
Pontevedra, Spain
(Nombela-Franco, Nunez-Gil) Cardiology Department, University Clinical
Hospital San Carlos, Madrid, Spain
(Gheorghe) Cardiology Department, University Hospital Puerta del Mar,
Cadiz, Spain
(Diez) Cardiology Department, University Hospital La Fe, Valencia, Spain
(Munoz Garcia) Cardiology Department, University Hospital Virgen de la
Victoria, Malaga, Spain
(Vilalta) Cardiology Department, University Hospital German Trias i Pujol,
Badalona, Spain
(Ojeda-Pineda) Cardiology Department, University Hospital Reina Sofia,
Cordoba, Spain
(de la Torre Hernandez) Cardiology Department, University Hospital Marques
de Valdecilla and Instituto de Investigacion Sanitaria Valdecilla,
Santander, Spain
(Cordoba Soriano) Cardiology Department, University Hospital of Albacete,
Albacete, Spain
(Regueiro) Cardiology Department, University Clinical Hospital, Barcelona,
Philippines
(Bordes Siscar) Cardiology Department, University General Hospital of
Alicante, Alicante, Spain
(Salgado Fernandez) Cardiology Department, University Hospital Juan
Canalejo, A Coruna, Spain
(Garcia Del Blanco) Cardiology Department, University Hospital Vall
d'Hebron, Barcelona, Philippines
(Martin-Reyes) Cardiology Department, University Hospital La Luz, Madrid,
Spain
(Romaguera) Cardiology Department, University Hospital Bellvitge,
Barcelona, Philippines
(Moris) Cardiology Department, University Hospital Central de Asturias,
Oviedo, Spain
(Garcia Blas) Cardiology Department, University Clinical Hospital of
Valencia, Valencia, Spain
(Franco-Pelaez, Ibanez) Cardiology Department, University Hospital
Fundacion Jimenez Diaz and Instituto de Investigacion Sanitaria-Fundacion
Jimenez Diaz, Universidad Autonoma de Madrid, Madrid, Spain
(Cruz-Gonzalez) Cardiology Department, University Clinical Hospital of
Salamanca, Salamanca, Spain
(Arzamendi) Cardiology Department, University Hospital Santa Creu i Sant
Pau, Biomedical Research Institute IIB-Sant Pau, Barcelona, Philippines
(Romero Rodriguez) Cardiology Department, University Hospital Virgen del
Rocio, Seville, Spain
(Diez-Del Hoyo) Cardiology Department, University Hospital 12 de Octubre,
Madrid, Spain
(Camacho Freire) Cardiology Department, University Hospital Juan Ramon
Jimenez, Huelva, Spain
(Bosa Ojeda) Cardiology Department, University Hospital of Canarias,
Tenerife, Spain
(Astorga Burgo) Cardiology Department, University Hospital of Cruces,
Spain
(Molina Navarro) Cardiology Department, University Hospital Virgen de las
Nieves, Granada, Spain
(Caballero Borrego) Cardiology Department, University Hospital San
Cecilio, Granada, Spain
(Ruiz Quevedo) Cardiology Department, University Hospital of Navarra,
Pamplona, Spain
(Sanchez-Recalde) Cardiology Department, University Hospital Ramon y
Cajal, Madrid, Spain
(Alegria-Barrero) Cardiology Department, University Hospital Torrejon and
University Francisco de Vitoria, Madrid, Spain
(Torres-Llergo) Cardiology Department, University Hospital of Jaen, Jaen,
Spain
(Feltes) Cardiology Department, University Hospital Vithas Arturo Soria,
Madrid, Spain
(Feltes, Nunez-Gil) University Europea of Madrid, Madrid, Spain
(Fernandez Diaz) Cardiology Department, University Hospital Puerta del
Hierro, Madrid, Spain
(Cuellas) Cardiology Department, University Hospital of Leon, Leon, Spain
(Jimenez Britez) Cardiology Department, Clinica Teknon, Barcelona,
Philippines
(Sanchez-Rubio Lezcano) Cardiology Department, University Hospital Miguel
Servet, Zaragoza, Spain
(Barreiro-Pardal) Anesthesiology Department, University Hospital
Montecelo, Pontevedra, Spain
(Nunez-Gil) Cardiology Department, University Hospital of Torrejon, Ribera
Salud Group, Madrid, Spain
(Abu-Assi) Cardiology Department, University Hospital of Povisa, Ribera
Salud Group, Vigo, Spain
(Fuster) Cardiovascular Institute, Icahn School of Medicine at Mount
Sinai, NY, United States
Abstract
BACKGROUND: Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the
risk of heart-failure admission among high-risk patients. However, most
patients with valvular heart disease, including those undergoing
transcatheter aortic-valve implantation (TAVI), have been excluded from
randomized trials. <br/>METHOD(S): We conducted this randomized,
controlled trial in Spain to evaluate the efficacy of dapagliflozin (at a
dose of 10 mg once daily) as compared with standard care alone in patients
with aortic stenosis who were undergoing TAVI. All the patients had a
history of heart failure plus at least one of the following: renal
insufficiency, diabetes, or left ventricular systolic dysfunction. The
primary outcome was a composite of death from any cause or worsening of
heart failure, defined as hospitalization or an urgent visit, at 1 year of
follow-up. <br/>RESULT(S): A total of 620 patients were randomly assigned
to receive dapagliflozin and 637 to receive standard care alone after
TAVI; after exclusions, a total of 1222 patients were included in the
primary analysis. A primary-outcome event occurred in 91 patients (15.0%)
in the dapagliflozin group and in 124 patients (20.1%) in the
standard-care group (hazard ratio, 0.72; 95% confidence interval [CI],
0.55 to 0.95; P = 0.02). Death from any cause occurred in 47 patients
(7.8%) in the dapagliflozin group and in 55 (8.9%) in the standard-care
group (hazard ratio, 0.87; 95% CI, 0.59 to 1.28). Worsening of heart
failure occurred in 9.4% and 14.4% of the patients, respectively
(subhazard ratio, 0.63; 95% CI, 0.45 to 0.88). Genital infection and
hypotension were significantly more common in the dapagliflozin group.
<br/>CONCLUSION(S): Among older adults with aortic stenosis undergoing
TAVI who were at high risk for heart-failure events, dapagliflozin
resulted in a significantly lower incidence of death from any cause or
worsening of heart failure than standard care alone. (Funded by Instituto
de Salud Carlos III and others; ClinicalTrials.gov number,
NCT04696185.).<br/>Copyright &#xa9; 2025 Massachusetts Medical Society.

<65>
Accession Number
2030824099
Title
Minimally invasive extracorporeal circulation versus conventional
cardiopulmonary bypass in patients undergoing cardiac surgery (MiECS):
Rationale and design of a multicentre randomised trial.
Source
Perfusion (United Kingdom). 40(4) (pp 923-932), 2025. Date of Publication:
01 May 2025.
Author
Anastasiadis K.; Antonitsis P.; Papazisis G.; Haidich B.; Liebold A.;
Punjabi P.; Gunaydin S.; El-Essawi A.; Rao V.; Serrick C.; Condello I.;
Nasso G.; Bozok S.; Daylan A.; Argiriadou H.; Deliopoulos A.;
Karapanagiotidis G.; Ashkanani F.; Moorjani N.; Cale A.; Erdoes G.;
Bennett M.; Starinieri P.; Carrel T.; Murkin J.
Institution
(Anastasiadis, Antonitsis, Argiriadou, Deliopoulos, Karapanagiotidis)
Cardiothoracic Department, School of Medicine, Aristotle University of
Thessaloniki, Thessaloniki, Greece
(Papazisis) Special Unit for Biomedical Research and Education, Aristotle
University of Thessaloniki School of Medicine, Thessaloniki, Greece
(Haidich) Department of Hygiene, Social-Preventive Medicine and Medical
Statistics, School of Medicine, Aristotle University of Thessaloniki,
Thessaloniki, Greece
(Liebold, Ashkanani) Department of Cardio-thoracic Surgery, University
Hospital Ulm, Ulm, Germany
(Punjabi) Department of Cardiothoracic Surgery, Hammersmith Hospital,
Imperial College Healthcare NHS Trust, London, United Kingdom
(Gunaydin) Department of Cardiovascular Surgery, Ankara City Hospital,
University of Health Sciences, Ankara, Turkey
(El-Essawi) Department of Thoracic and Cardiovascular Surgery, University
Medical Center Gottingen, Gottingen, Germany
(Rao, Serrick) Peter Munk Cardiac Centre, Toronto General Hospital,
Toronto, ON, Canada
(Condello, Nasso) Cardiac Surgery, Anthea Hospital Gvm Care & Research,
Bari, Italy
(Bozok, Daylan) Department of Cardiovascular Surgery, Izmir Bakircay
University, Izmir, Turkey
(Moorjani) Department of Cardiothoracic Surgery, Royal Papworth Hospital,
University of Cambridge, Cambridge, United Kingdom
(Cale) Department of Cardiac Surgery, Hull and East Yorkshire Hospitals
NHS Trust, Hull, United Kingdom
(Erdoes) Department of Anesthesiology and Pain Medicine, Inselspital, Bern
University Hospital, Bern, Switzerland
(Bennett) Department of Anesthesia, Morriston Hospital, Swansea Bay
University Health Board, Swansea, United Kingdom
(Starinieri) Department of Clinical Perfusion, Jessa Hospital, Hasselt,
Belgium
(Carrel) Department of Cardiac Surgery, University Hospital Zurich,
Switzerland
(Murkin) Department of Anesthesia and Perioperative Medicine, Schulich
School of Medicine and Dentistry, University of Western Ontario, London,
ON, Canada
Publisher
SAGE Publications Ltd
Abstract
Introduction: The ultimate answer to the question whether minimal invasive
extracorporeal circulation (MiECC) represents the optimal perfusion
technique in contemporary clinical practice remains elusive. The present
study is a real-world study that focuses on specific perfusion-related
clinical outcomes after cardiac surgery that could potentially be
favourably affected by MiECC and thereby influence the future clinical
practice. <br/>Method(s): The MiECS study is an international,
multi-centre, two-arm randomized controlled trial. Patients undergoing
elective or urgent coronary artery bypass grafting (CABG), aortic valve
replacement (AVR) or combined procedure (CABG + AVR) using extracorporeal
circulation will be randomized to MiECC or contemporary conventional
cardiopulmonary bypass (cCPB). Use of optimized conventional circuits as
controls is acceptable. The study design includes a range of features to
prevent bias and is registered at clinicaltrials.gov (NCT05487612).
<br/>Result(s): The primary outcome is a composite of postoperative
serious adverse events that could be related to perfusion technique
occurring up to 30 days postoperatively. Secondary outcomes include use of
blood products, ICU and hospital length of stay (30 days) as well as
health-related quality of life (30 and 90 days). <br/>Conclusion(s): The
MiECS trial has been designed to overcome perceived limitation of previous
trials of MiECC. Results of the proposed study could affect current
perfusion practice towards advancement of patient care.<br/>Copyright
&#xa9; The Author(s) 2024.

<66>
Accession Number
2032973050
Title
Machine-learning approaches for risk prediction in transcatheter aortic
valve implantation: Systematic review and meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 169(5) (pp 1460-1470.e15),
2025. Date of Publication: 01 May 2025.
Author
Jacquemyn X.; Van Onsem E.; Dufendach K.; Brown J.A.; Kliner D.; Toma C.;
Serna-Gallegos D.; Sa M.P.; Sultan I.
Institution
(Jacquemyn, Van Onsem) Department of Cardiovascular Sciences, KU Leuven,
Leuven, Belgium
(Dufendach, Brown, Serna-Gallegos, Sa, Sultan) Department of
Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, United
States
(Dufendach, Brown, Kliner, Toma, Serna-Gallegos, Sa, Sultan) UPMC Heart
and Vascular Institute, University of Pittsburgh Medical Center,
Pittsburgh, PA, United States
(Kliner, Toma) Department of Interventional Cardiology, University of
Pittsburgh, Pittsburgh, PA, United States
Publisher
Elsevier Inc.
Abstract
Objectives: With the expanding integration of artificial intelligence (AI)
and machine learning (ML) into the structural heart domain, numerous ML
models have emerged for the prediction of adverse outcomes after
transcatheter aortic valve implantation (TAVI). We aim to identify,
describe, and critically appraise ML prediction models for adverse
outcomes after TAVI. Key objectives consisted in summarizing model
performance, evaluating adherence to reporting guidelines, and
transparency. <br/>Method(s): We searched PubMed, SCOPUS, and Embase
through August 2023. We selected published machine learning models
predicting TAVI outcomes. Two reviewers independently screened articles,
extracted data, and assessed the study quality according to the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Outcomes included summary C-statistics and model risk of bias assessed
with the Prediction Model Risk of Bias Assessment Tool. C-statistics were
pooled using a random-effects model. <br/>Result(s): Twenty-one studies
(118,153 patients) employing various ML algorithms (76 models) were
included in the systematic review. Predictive ability of models varied:
11.8% inadequate (C-statistic <0.60), 26.3% adequate (C-statistic
0.60-0.70), 31.6% acceptable (C-statistic 0.70-0.80), and 30.3%
demonstrated excellent (C-statistic >0.80) performance. Meta-analyses
revealed excellent predictive performance for early mortality
(C-statistic: 0.81; 95% confidence interval [CI], 0.65-0.91), acceptable
performance for 1-year mortality (C-statistic: 0.76; 95% CI, 0.67-0.84),
and acceptable performance for predicting permanent pacemaker implantation
(C-statistic: 0.75; 95% CI, 0.51-0.90). <br/>Conclusion(s): ML models for
TAVI outcomes exhibit adequate-to-excellent performance, suggesting
potential clinical utility. We identified concerns in methodology and
transparency, emphasizing the need for improved scientific reporting
standards.<br/>Copyright &#xa9; 2024 The American Association for Thoracic
Surgery

<67>
Accession Number
2032783208
Title
The efficacy and safety of Empagliflozin on outcomes of patients with
myocardial infarction undergoing primary PCI: a systematic review and
meta-analysis.
Source
Naunyn-Schmiedeberg's Archives of Pharmacology. 398(5) (pp 4969-4977),
2025. Date of Publication: 01 May 2025.
Author
Alizadehasl A.; Hakimian H.; Abdolkarimi L.; Afsari Zonooz Y.;
Amini-Salehi E.; Hosseini Jebelli S.F.; Yalameh Aliabadi A.
Institution
(Alizadehasl, Hakimian, Afsari Zonooz, Hosseini Jebelli, Yalameh Aliabadi)
Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and
Research Center, Iran University of Medical Science, Tehran, Iran, Islamic
Republic of
(Abdolkarimi) Rajaie Cardiovascular Medical and Research Center, Iran
University of Medical Science, Tehran, Iran, Islamic Republic of
(Amini-Salehi) Guilan University of Medical Science, Rasht, Iran, Islamic
Republic of
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Empagliflozin, a sodium-glucose cotransporter-2 (SGLT2) inhibitor, has
garnered significant interest due to its potential cardiovascular
benefits, particularly in patients experiencing acute myocardial
infarction (AMI) who are undergoing primary percutaneous coronary
intervention (PCI). This systematic review aims to evaluate the
effectiveness of Empagliflozin in improving clinical outcomes in this
patient population. A systematic review of randomized controlled trials
(RCTs) was conducted to assess the effects of Empagliflozin on clinical
outcomes in patients with AMI undergoing primary PCI. Electronic
databases, including PubMed, Scopus, Web of Science, Cochrane, and the
Scientific Information Database, were searched up to July 31, 2024. The
risk of bias in the included studies was evaluated using the Cochrane
Collaboration criteria. Data analysis was performed using Comprehensive
Meta-Analysis software version 3, with outcomes expressed as risk ratios
(RR) and 95% confidence intervals (CI). Seven studies were included in the
meta-analysis. The results demonstrated that Empagliflozin significantly
reduced the risk of heart failure hospitalization compared to placebo,
with a risk ratio of 0.48 (95% CI: 0.23-0.99; P = 0.049), indicating a 52%
reduction in hospitalization risk. However, secondary outcomes showed that
Empagliflozin was associated with a reduction in cardiovascular mortality
(RR = 0.45; 95% CI: 0.06-3.02; P = 0.415) and the need for coronary
revascularization (RR = 0.75; 95% CI: 0.15-3.59; P = 0.717), although
these results did not achieve statistical significance. Empagliflozin is
associated with a significant reduction in heart failure hospitalizations
among patients with AMI undergoing primary PCI, while its effects on
cardiovascular mortality and the necessity for coronary revascularization
were not statistically significant. Despite these secondary outcomes, the
favorable safety profile of Empagliflozin supports its use as a treatment
option for high-risk patients following acute coronary events. Further
research is warranted to investigate the long-term impact of Empagliflozin
on cardiovascular outcomes in this population.<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part
of Springer Nature 2024.

<68>
Accession Number
2034183396
Title
Year in Review 2024: Noteworthy Literature in Cardiac Anesthesiology.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination),
2025. Date of Publication: 2025.
Author
Seres T.; Wilkey B.; Weitzel N.; Clendenen N.
Institution
(Seres, Wilkey, Clendenen) Department of Anesthesiology, University of
Colorado Anschutz Medical Campus School of Medicine, Aurora, CO, United
States
(Weitzel) Department of Anesthesiology and Pain Medicine, University of
California Davis Health, Sacramento, CA, United States
Publisher
SAGE Publications Inc.
Abstract
The research findings relevant for Cardiac Anesthesiology studies
published in 2024 involved key innovations in devices and gene therapy in
addition to the expansion of transcatheter techniques for valve repair or
replacement. We reviewed 447 relevant articles and selected 21 as the most
noteworthy studies published in 2024. Themes that emerged from our review
include the etiology and prevention of delirium or outcomes after
mechanical circulatory support. Robust clinical outcome data now supports
the use of microaxial flow devices for mechanical circulatory support for
cardiogenic shock due to acute myocardial infarction. Pharmacology
development presents colchicine as anti-inflammatory medication to prevent
atrial fibrillation or intravenous amino acids for kidney protection after
cardiopulmonary bypass. Technological advances include implantable
wireless pacing-defibrillator devices, pulmonary artery pressure
monitoring in heart failure patients, extracorporeal blood purification
for preventing acute kidney injury and hypothermic oxygenated perfusion of
the donor heart in heart transplantation. Transcatheter interventions on
mitral or aortic valve were gaining advances over surgical procedures.
Novel paradigms included treatments with gene therapy for cardiac
amyloidosis or refractory angina and the emerging risk of microplastic
exposure in cardiovascular events.<br/>Copyright &#xa9; The Author(s)
2025.

<69>
Accession Number
2038239325
Title
Advances in Cardiovascular Pharmacotherapy. II. Ivabradine, an Inhibitor
of the Hyperpolarization-Activated Cyclic Nucleotide-Gated Channel.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Pagel P.S.; Hang D.; Freed J.K.; Crystal G.J.
Institution
(Pagel, Hang, Freed) Department of Anesthesiology, the Medical College of
Wisconsin, Milwaukee, WI, United States
(Crystal) Department of Anesthesiology, University of Illinois College of
Medicine, Chicago, IL, United States
Publisher
W.B. Saunders
Abstract
Ivabradine selectively reduces heart rate by inhibiting the
hyperpolarization-activated cyclic nucleotide-gated (HCN) channel in the
sinoatrial node. Unlike other medications that produce negative
chronotropic effects [beta-blockers, calcium channel blockers], ivabradine
does not affect systemic, pulmonary, and coronary hemodynamics. Despite
several proof-of-concept clinical studies suggesting that ivabradine may
exert anti-ischemic effects, two large randomized trials did not support
its use in patients with chronic stable angina. Preliminary data also did
not support the use of ivabradine in patients with acute ST-segment
elevation myocardial infarction or acutely decompensated heart failure.
However, ivabradine improved outcome in patients with heart failure with
reduced ejection fraction (HFrEF), leading to its approval by the Food and
Drug Administration, but the drug failed to do so in those with heart
failure with preserved ejection fraction (HFpEF). Ivabradine may also be
useful in cardiac electrophysiology disorders characterized by tachycardia
(e.g., inappropriate sinus tachycardia, postural orthostatic tachycardia
syndrome), but it has not yet gained wide acceptance for these
indications. In this article, the authors briefly review the structure and
function of the cardiac HCN channel; discuss the development and actions
of drugs, including ivabradine, that modulate the channel's activity;
describe in detail the potential clinical applications of ivabradine in
patients with coronary artery disease, HFrEF and HFpEF, and cardiac
electrophysiology; comment on the adverse effects of ivabradine therapy;
and finally, consider the potential anesthetic implications of ivabradine
in patients undergoing noncardiac and cardiac surgery.<br/>Copyright
&#xa9; 2025 Elsevier Inc.

<70>
Accession Number
2038270824
Title
Concomitant Surgical Procedures and Aspirin Avoidance With Left
Ventricular Assist Device Therapy.
Source
JACC: Heart Failure. (no pagination), 2025. Date of Publication: 2025.
Author
Pagani F.D.; Netuka I.; Jorde U.P.; Katz J.N.; Gustafsson F.; Connors
J.M.; Uriel N.; Soltesz E.G.; Ivak P.; Bansal A.; Bitar A.; Vega J.D.;
Goldstein D.; Danter M.; Pya Y.; Ravichandran A.; Conway J.; Adler E.D.;
Chung E.S.; Grinstein J.; Dirckx N.; Iravani B.; Mehra M.R.
Institution
(Pagani, Bitar) University of Michigan, Ann Arbor, MI, United States
(Netuka, Ivak) Institute for Clinical and Experimental Medicine, Prague,
Czechia
(Jorde, Goldstein) Division of Cardiology, Montefiore Medical Center,
Albert Einstein College of Medicine, New York, NY, United States
(Katz) Division of Cardiology, Department of Medicine, NYU Grossman School
of Medicine and Bellevue Hospital, New York, NY, United States
(Gustafsson) Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
(Connors, Mehra) Department of Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Uriel) Division of Cardiology, Columbia University Irving Medical Center,
New York-Presbyterian Hospital, New York, NY, United States
(Soltesz) Thoracic and Cardiovascular Surgery, Cleveland Clinic,
Cleveland, OH, United States
(Bansal) Department of Cardiothoracic Surgery, Ochsner Clinic Foundation,
New Orleans, LA, United States
(Vega) Emory University Hospital, Atlanta, GA, United States
(Danter) Kansas University Medical Center, Kansas City, KS, United States
(Pya) Research Department of University Medical Center (Heart Center),
Astana, Kazakhstan
(Ravichandran) Ascension St Vincent, Indianapolis, IN, United States
(Conway) Stollery Children's Hospital, University of Alberta, Edmonton,
AB, Canada
(Adler) Division of Cardiology, Department of Medicine, University of
California San Diego, San Diego, CA, United States
(Chung) The Lindner Research Center at The Christ Hospital, Cincinnati,
OH, United States
(Grinstein) University of Chicago, Chicago, IL, United States
(Dirckx, Iravani) Abbott, Chicago, IL, United States
Publisher
Elsevier Inc.
Abstract
Background: ARIES-HM3 (Antiplatelet Removal and Hemocompatibility Events
With the HeartMate 3 Pump) demonstrated that aspirin avoidance with a
fully magnetically levitated HeartMate 3 (HM3) left ventricular assist
device (LVAD) reduces bleeding complications and does not increase
thromboembolism. Whether a concomitant surgical procedure modifies the
observed safety and benefits remains uncertain. <br/>Objective(s): This
prespecified analysis of ARIES-HM3 studied clinical outcomes when
concomitant surgical procedures are performed during LVAD implantation
with excluding aspirin but maintaining a vitamin K antagonist.
<br/>Method(s): Among 628 patients randomized to receive either placebo or
aspirin with a vitamin K antagonist, 589 (296 placebo and 293 aspirin)
contributed to the primary endpoint analysis. Sub-categorization with
receiving a concomitant surgical procedure (valvular procedure/coronary
artery bypass grafting or nonvalvular procedure) was done and the
composite primary endpoint of survival free from major nonsurgical (>14
days postimplant) hemocompatibility-related adverse events at 12 months
was assessed. <br/>Result(s): There were 155 (52%) and 145 (49%)
concomitant procedures in placebo and aspirin arms, respectively. The
percentage of subjects achieving primary endpoint success was higher with
the placebo group in patients with a concomitant procedure, and no
interaction was observed on primary outcomes between those with and
without concomitant surgical procedures (P<inf>int</inf> = 0.231, 0.298,
and 0.735 for any procedure, valvular/coronary artery bypass grafting, and
nonvalvular procedures, respectively). There was a similar reduction in
nonsurgical major hemorrhagic events with placebo compared with aspirin,
observed in patients with or without any concomitant procedure: 0.64 (95%
CI: 0.44-0.94) and 0.66 (95% CI: 0.46-0.93). <br/>Conclusion(s): Our
findings support the safety and efficacy of aspirin avoidance from the
antithrombotic regimen in HM3 LVAD patients undergoing concomitant
surgical procedures. (Antiplatelet Removal and Hemocompatibility Events
With the HeartMate 3 Pump [ARIES-HM3]; NCT04069156)<br/>Copyright &#xa9;
2025 The Authors

<71>
Accession Number
2038270805
Title
Left Main Spontaneous Coronary Artery Dissection: Clinical Features,
Management, and Outcomes.
Source
JACC: Cardiovascular Interventions. 18(8) (pp 975-983), 2025. Date of
Publication: 28 Apr 2025.
Author
Morosato M.; Gaspardone C.; Romagnolo D.; Pagnesi M.; Baldetti L.; Dormio
S.; Federico F.; Scandroglio A.M.; Chieffo A.; Godino C.; Margonato A.;
Adamo M.; Metra M.; Tchetche D.; Dumonteil N.; Tweet M.S.; Saw J.;
Beneduce A.
Institution
(Morosato, Dormio, Federico, Chieffo, Margonato) Vita-Salute San Raffaele
University, Milan, Italy
(Gaspardone, Godino, Margonato) Cardiology Unit, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Romagnolo) Cardiac Intensive Care Unit, IRCCS Humanitas Research
Hospital, Rozzano, Italy
(Pagnesi, Adamo, Metra) ASST Spedali Civili di Brescia and Department of
Medical and Surgical Specialties, Radiological Sciences, and Public
Health, University of Brescia, Brescia, Italy
(Baldetti, Scandroglio) Cardiac Intensive Care Unit, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Chieffo) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Tchetche, Dumonteil, Beneduce) Groupe Cardio-Vasculaire lnterventionnel,
Cinique Pasteur, Toulouse, France
(Tweet) Department of Cardiovascular Diseases, Mayo Clinic College of
Medicine, Rochester, MN, United States
(Saw) Division of Cardiology, Vancouver General Hospital, Vancouver, BC,
Canada
(Beneduce) Heart Valve Center, IRCCS San Raffaele Scientific Institute,
Milan, Italy
Publisher
Elsevier Inc.
Abstract
Background: Spontaneous coronary artery dissection (SCAD) is an uncommon
cause of acute myocardial infarction (MI) and is associated with
substantial adverse events. SCAD involving the left main coronary artery
(LM) is a rare but potentially life-threatening condition. Currently,
minimal data on LM SCAD have been reported. <br/>Objective(s): The aim of
this study was to investigate clinical features, contemporary management,
and clinical outcomes of patients with LM SCAD. <br/>Method(s): A
systematic review and pooled analysis of published case reports was
conducted using "left main" and "dissection" as keywords. The authors
screened 1,106 papers in MEDLINE and Embase published between 1990 and
2023. <br/>Result(s): The final analysis included 132 patients (mean age
40 +/- 11 years, 80% women) diagnosed with LM SCAD. Remarkably, 36% of
cases occurred during pregnancy, and 95% presented with acute coronary
syndrome, 22% with cardiogenic shock, and 8% with ventricular arrhythmias.
At 120-day median follow-up, all-cause death occurred in 9%, left
ventricular assist device implantation or heart transplantation in 4%,
recurrent MI in 13%, and urgent myocardial revascularization (MR) in 21%.
Compared with conservative management, early revascularization by
percutaneous coronary intervention or coronary artery bypass grafting
significantly reduced the composite endpoint of all-cause death, left
ventricular assist device implantation or heart transplantation, recurrent
MI, and urgent MR (adjusted HR: 0.37; 95% CI: 0.20-0.69; P < 0.001).
<br/>Conclusion(s): LM SCAD carried significant acute morbidity and
mortality. Early revascularization (percutaneous coronary intervention or
coronary artery bypass graft) was associated with a lower incidence of
early adverse outcomes compared with conservative management, driven
largely by reduction in recurrent MI and urgent MR. These
hypothesis-generating data should be confirmed in future prospective
registries and clinical trials.<br/>Copyright &#xa9; 2025 American College
of Cardiology Foundation

<72>
[Use Link to view the full text]
Accession Number
2038353617
Title
Anesthesia for pediatric organ transplantation, current concepts.
Source
Current Opinion in Anaesthesiology. (no pagination), 2025. Date of
Publication: 2025.
Author
Licata S.; Blasiole B.; Visoiu M.; Damian D.
Institution
(Licata, Blasiole, Visoiu, Damian) Department of Anesthesiology and
Perioperative Medicine, UPMC Children's Hospital of Pittsburgh,
Pittsburgh, PA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review Although less common than in adults, pediatric organ
transplantation has seen significant recent innovations in surgical
techniques, perioperative management, and postoperative outcomes. These
advances, which we will delve into in this review, are at the forefront of
improving the survival and quality of life of pediatric transplant
recipients. Recent findings Advances in donor utilization (e.g. donation
after circulatory death and split-liver grafts) and surgical approaches
(partial heart transplants and novel multiorgan procedures) have expanded
the donor pool and enhanced graft viability. Improved perioperative care,
including refined anesthetic monitoring, fluid management, and immediate
extubation, reduces the incidence of complications. Research into
model-informed precision dosing for antibiotics addresses under- or
overdosing in critically ill children, whereas emerging immunosuppressants
offer potential benefits over conventional regimens. Nonetheless,
coagulopathy, hemodynamic instability, and developmental variations remain
major challenges. Summary Optimization of pediatric transplantation is a
complex task that requires multidisciplinary collaboration. This review
underscores the importance of standardizing perioperative protocols,
advancing precision medicine, and refining surgical and anesthetic
techniques. It also highlights the need for dedicated pediatric transplant
registries and multicenter trials to generate robust data, minimize
practice variability, and improve outcomes.<br/>0952-7907 Copyright &#xa9;
2025 Wolters Kluwer Health, Inc. All rights reserved.

<73>
Accession Number
2034233521
Title
Impact of video-assisted thoracic surgery versus open thoracotomy on
postoperative wound infections in lung cancer patients: a systematic
review and meta-analysis.
Source
BMC Pulmonary Medicine. 25(1) (no pagination), 2025. Article Number: 159.
Date of Publication: 01 Dec 2025.
Author
Wang J.-Q.; Ma Z.-J.
Institution
(Wang) Department of Respiratory medicine, Tongde Hospital of Zhejiang
Province, Zhejiang Province, Hangzhou, China
(Ma) Department of Pulmonary and Critical Care Medicine, The Second
Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang
Province, Hangzhou, China
Publisher
BioMed Central Ltd
Abstract
Background: Lung cancer surgery has evolved significantly, with minimally
invasive video-assisted thoracic surgery (VATS) procedures being compared
with traditional open thoracotomies. The incidence of postoperative wound
infections is a significant factor influencing the choice of surgical
technique. This systematic review and meta-analysis aim to evaluate the
impact of thoracoscopic versus open thoracotomy procedures on
postoperative wound infections in lung cancer patients. <br/>Method(s):
Following PRISMA guidelines, a comprehensive search across PubMed, Embase,
Web of Science, and the Cochrane Library was conducted on September 19,
2023, without time or language restrictions. Peer-reviewed randomized
controlled trials, cohort studies, and case-control studies reporting on
postoperative wound infections were included. Studies not differentiating
between surgical techniques or focusing on irrelevant populations were
excluded. Data extraction and quality assessment were independently
carried out by two reviewers, using a fixed-effect model for meta-analysis
due to the absence of significant heterogeneity (I² = 0.0%, P =
0.766). <br/>Result(s): A total of six articles were included. The quality
assessment indicated a low risk of bias in most domains. The pooled
results showed that open thoracotomy procedures had a twofold increased
risk of postoperative wound infections (OR = 2.00, 95% CI: 1.04-3.85)
compared to VATS procedures. Publication bias assessment using funnel
plots and Egger's test revealed no significant biases (P > 0.05).
<br/>Conclusion(s): The findings suggest that VATS is associated with a
lower risk of postoperative wound infections compared to open thoracotomy,
which has implications for surgical decision-making in lung cancer
treatment. Clinical trial number: Not applicable.<br/>Copyright &#xa9; The
Author(s) 2025.

<74>
Accession Number
2038391143
Title
The impact of ascending aorta dilatation on transcatheter aortic valve
implantation outcomes.
Source
IJC Heart and Vasculature. 58 (no pagination), 2025. Article Number:
101680. Date of Publication: 01 Jun 2025.
Author
Saputra P.B.T.; Widiarti W.; Mustofa A.; Savitri C.G.; Putranto J.N.E.;
Ashari F.Y.; Multazam C.E.C.Z.; Alkaff F.F.; D'Oria M.
Institution
(Saputra, Savitri, Putranto) Department of Cardiology and Vascular
Medicine, Faculty of Medicine, Universitas Airlangga, Jl. Prof. DR.
Moestopo No.47, Pacar Kembang, Kec. Tambaksari, East Java, Surabaya,
Indonesia
(Saputra, Savitri, Putranto) Department of Cardiology and Vascular
Medicine, Dr. Soetomo General Academic Hospital, Jl. Prof. DR. Moestopo
No.6-8, Airlangga, Kec. Gubeng, East Java, Surabaya, Indonesia
(Widiarti, Mustofa) Faculty of Medicine, Universitas Airlangga, Jl. Prof.
DR. Moestopo No.47, Pacar Kembang, Kec. Tambaksari, East Java, Surabaya,
Indonesia
(Ashari) Faculty of Biology Medicine and Health Sciences, University of
Manchester, Oxford Rd, Manchester, United Kingdom
(Multazam) National Heart and Lung Institute, Imperial College London, Guy
Scadding Building, Dovehouse St, London, United Kingdom
(Alkaff) Department of Internal Medicine, University Medical Center
Groningen, Hanzeplein 1, Groningen, Netherlands
(Alkaff) Department of Anatomy, Histology, and Pharmacology, Faculty of
Medicine, Universitas Airlangga, Jl. Prof. DR. Moestopo No.47, Pacar
Kembang, Kec. Tambaksari, East Java, Surabaya, Indonesia
(D'Oria) Division of Vascular and Endovascular Surgery, Department of
Clinical Surgical and Health Sciences, University of Trieste, Strada di
Fiume, Trieste, Cattinara, Italy
Publisher
Elsevier Ireland Ltd
Abstract
The impact of ascending aorta dilatation (AAD) on transcatheter aortic
valve implantation (TAVI) outcomes, compared to non-AAD, remains unclear.
This meta-analysis aims to compare the outcomes of TAVI between patients
with and without AAD. We systematically searched PubMed, ScienceDirect,
Web of Science, Springer, Cochrane, and Clinicaltrials.gov. for articles
up to 25 March 2024 (PROSPERO ID CRD42024526311). A total of 204,078
patients from ten studies were included. Paravalvular regurgitation (RR
1.56 95 %CI: 1.32-1.84, p < 0.00001, I² = 0 %) and aortic
dissection (RR 3.55 95 %CI: 1.79-7.06, p = 0.0003, I² = 40 %)
were more common in AAD group. However, there were no differences in
peri-procedural (RR 1.09, 95 %CI: 0.83-1.42, p = 0.53, I² = 0
%) and 1-year (RR 0.79, 95 %CI: 0.51-1.23, p = 0.30, I² = 0 %)
mortality. Three-years (RR 0.88, 95 %CI: 0.54-1.44, p = 0.62) and
five-years (RR 0.85, 95 %CI: 0.45-1.6, p = 0.61) follow-up showed
comparable mortality between both groups. The other complications and the
need for second valve implantation (RR 1.24, 95 %CI: 0.70-20.20, p = 0.48,
I² = 65 %) were similar between both groups. Despite the higher
incidence of aortic dissection and paravalvular regurgitation in AAD than
in non-AAD patients, these complications were not associated with worse
short-term or long-term mortality. Therefore, TAVI remains a safe and
effective option for AAD patients.<br/>Copyright &#xa9; 2025 The Author(s)

<75>
Accession Number
2038325298
Title
Alternative LDL Cholesterol-Lowering Strategy vs High-Intensity Statins in
Atherosclerotic Cardiovascular Disease: A Systematic Review and Individual
Patient Data Meta-Analysis.
Source
JAMA Cardiology. 10(2) (pp 137-144), 2025. Date of Publication: 12 Feb
2025.
Author
Lee Y.-J.; Hong B.-K.; Yun K.H.; Kang W.C.; Hong S.J.; Lee S.-H.; Lee
S.-J.; Hong S.-J.; Ahn C.-M.; Kim J.-S.; Kim B.-K.; Ko Y.-G.; Choi D.;
Jang Y.; Hong M.-K.
Institution
(Lee, Lee, Lee, Hong, Ahn, Kim, Kim, Ko, Choi, Hong) Division of
Cardiology, Severance Hospital, Yonsei University College of Medicine,
Seoul, South Korea
(Hong) Gangnam Severance Hospital, Seoul, South Korea
(Yun) Wonkwang University Hospital, Iksan, South Korea
(Kang) Gachon University College of Medicine, Incheon, South Korea
(Hong) Korea University College of Medicine, Seoul, South Korea
(Jang) CHA University College of Medicine, Seongnam, South Korea
Publisher
American Medical Association
Abstract
Importance: In patients with atherosclerotic cardiovascular disease
(ASCVD), intensive lowering of low-density lipoprotein (LDL) cholesterol
levels with high-intensity statins is generally recommended. However,
alternative approaches considering statin-related adverse effects and
intolerance are needed. <br/>Objective(s): To compare the long-term
efficacy and safety of an alternative LDL cholesterol-lowering strategy vs
high-intensity statin strategy in patients with ASCVD in randomized
clinical trials. <br/>Data Sources: PubMed, Embase, and other websites
(ClinicalTrials.gov, European Society of Cardiology, tctMD) were
systematically searched from inception to April 19, 2024. Study Selection:
Randomized clinical trials comparing an alternative LDL
cholesterol-lowering strategy vs a high-intensity statin strategy in
patients with ASCVD, with presence of cardiovascular events as end points.
Data Extraction and Synthesis: Individual patient data were obtained from
randomized clinical trials that met the prespecified eligibility criteria:
RACING (Randomized Comparison of Efficacy and Safety of Lipid-Lowering
With Statin Monotherapy vs Statin/Ezetimibe Combination for High-Risk
Cardiovascular Disease) and LODESTAR (Low-Density Lipoprotein
Cholesterol-Targeting Statin Therapy vs Intensity-Based Statin Therapy in
Patients With Coronary Artery Disease). The moderate-intensity statin with
ezetimibe combination therapy in the RACING trial and the treat-to-target
strategy in the LODESTAR trial were classified as alternative LDL
cholesterol-lowering strategies. The primary analysis was based on a
1-stage approach. <br/>Main Outcomes and Measures: The primary end point
was a 3-year composite of all-cause death, myocardial infarction, stroke,
or coronary revascularization. The secondary end points comprised clinical
efficacy and safety end points. <br/>Result(s): Individual patient data
from 2 trials including 8180 patients with ASCVD (mean [SD] age, 64.5
[9.8] years; 2182 [26.7%] female; 5998 male [73.3%]) were analyzed. The
rate of the primary end point did not differ between the alternative
strategy and high-intensity statin strategy groups (7.5% [304 of 4094] vs
7.7% [310 of 4086]; hazard ratio, 0.98; 95% CI, 0.84-1.15; P =.82). The
mean (SD) LDL cholesterol level during treatment was 64.8 (19.0) mg/dL in
the alternative strategy group and 68.5 (20.7) mg/dL in the high-intensity
statin strategy group (P <.001). The alternative strategy group had a
lower rate of new-onset diabetes (10.2% [271 of 2658] vs 11.9% [316 of
2656]; P =.047), initiation of antidiabetic medication for new-onset
diabetes (6.5% [173 of 2658] vs 8.2% [217 of 2656]; P =.02), and
intolerance-related discontinuation or dose reduction of assigned therapy
(4.0% [163 of 4094] vs 6.7% [273 of 4086]; P <.001). <br/>Conclusions and
Relevance: Results of this systematic review and individual patient data
meta-analysis suggest that compared with a high-intensity statin strategy,
the alternative LDL cholesterol-lowering strategy demonstrated comparable
efficacy regarding 3-year death or cardiovascular events in patients with
ASCVD, with an associated reduction in LDL cholesterol levels and risk for
new-onset diabetes and intolerance.<br/>Copyright &#xa9; 2024 American
Medical Association. All rights reserved,

<76>
Accession Number
2038208169
Title
Prevalence of postoperative neurocognitive disorders in older non-cardiac
surgical patients: A systematic review and meta-analysis.
Source
Journal of Clinical Anesthesia. 103 (no pagination), 2025. Article Number:
111830. Date of Publication: 01 Apr 2025.
Author
Huang W.W.Y.; Fan S.; Li W.-Y.; Thangavelu V.; Saripella A.; Englesakis
M.; Yan E.; Chung F.
Institution
(Huang) School of Medicine, University of Limerick, Limerick, Ireland
(Fan) Schulich School of Medicine and Dentistry, Western University,
London, ON, Canada
(Li, Saripella, Yan, Chung) Department of Anesthesia and Pain Management,
Toronto Western Hospital, University Health Network, University of
Toronto, ON, Canada
(Thangavelu, Yan, Chung) Institute of Medical Science, Temerty Faculty of
Medicine, University of Toronto, ON, Canada
(Englesakis) Library & Information Services, University Health Network,
Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Study objective: The growing number of older persons undergoing surgery
are at a higher risk of neurocognitive disorder due to multimorbidity and
age-related changes. Previous reviews estimated postoperative
neurocognitive disorder or cognitive dysfunction (POCD) prevalence without
accounting for the sample size or study quality. The prevalence of POCD in
this population requires further investigation. This systematic review and
meta-analysis applies systematic weighting to estimate the pooled
prevalence of POCD in older non-cardiac surgical patients. <br/>Design(s):
Systematic review and meta-analysis. <br/>Setting(s): MEDLINE, MEDLINE
ePub, Embase, Cochrane Central Register of Controlled Trials and Cochrane
Database of Systematic Reviews for relevant articles. <br/>Patient(s):
Non-cardiac surgical patients aged >=60 years old. <br/>Intervention(s):
Perioperative cognitive assessments. Measurement: The primary outcome was
the prevalence of POCD. <br/>Main Result(s): Thirty-nine studies (n =
12,921) were included with mean age of 70.0 +/- 8.9 years and 44.3 %
women. The overall prevalence of POCD was 23 % (95 % CI: 20 %, 27 %) at
day 7, 16 % (95 % CI: 7 %, 25 %) at 1 month, 10 % (95 % CI: 8 %, 13 %) at
3 months and 3 % (95 % CI: 2 %, 4 %) at 1 year. Our meta-regression showed
a higher prevalence of POCD in abdominal surgeries at day 7 (beta = 0.13,
95 % CI: 0.03-0.22, P = 0.01) and 3 months (beta = 0.49, 95 % CI:
0.40-0.58, P < 0.001), versus orthopedic surgeries. <br/>Conclusion(s):
The overall prevalence of POCD in older non-cardiac surgical populations
was 23 %, 16 %, 10 %, and 3 % at day 7, 1 month, 3 months, and 1 year,
respectively. Abdominal surgery had a higher prevalence of POCD than
orthopedic surgery. The substantial risk of POCD calls for cognitive
screening, risk mitigation and interventions to improve surgical outcomes.
Through routine preoperative cognitive screening and addressing modifiable
risk factors, the incidence and impact of POCD can be markedly reduced,
enhancing patient outcomes and recovery.<br/>Copyright &#xa9; 2025

<77>
Accession Number
2038223523
Title
The effects of rhythmic handgrip exercise on muscle sympathetic nerve
activity: A systematic review and meta-analysis.
Source
Autonomic Neuroscience: Basic and Clinical. 259 (no pagination), 2025.
Article Number: 103272. Date of Publication: 01 Jun 2025.
Author
Maier L.E.; Meyer S.E.; Deprato A.; Busch S.; Sivak A.; Davenport M.H.;
Steinback C.D.
Institution
(Maier, Meyer, Deprato, Busch, Davenport, Steinback) Program for Pregnancy
and Postpartum Health, Neurovascular Health Laboratory, Women and
Children's Health Research Institute, Alberta Diabetes Institute, Faculty
of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton,
AB, Canada
(Sivak) H.T. Coutts Education and Physical Education Library, University
of Alberta, Edmonton, AB, Canada
Publisher
Elsevier B.V.
Abstract
This systematic review and meta-analysis was conducted to quantify the
sympathetic response to rhythmic handgrip exercise in healthy and diseased
populations. Structured searches of databases were performed until June
12, 2024. We included all primary studies (other than systematic reviews
and meta-analyses), and inclusion criteria were: population (all
populations); intervention (rhythmic handgrip); comparator (baseline); and
outcome (MSNA, BP, HR). Forty-nine studies (n = 930) were included. Burst
frequency was elevated by 6.1 bursts/min during rhythmic handgrip (95 %
CI, 4.52, 7.63; I² = 53 %; p < 0.00001) across all populations.
Similarly, burst incidence and total activity showed significant increases
during handgrip (BI: MD, 3.0 bursts/100 hbs; 95 % CI, 0.11, 5.85;
I² = 0 %; p = 0.04; TA: MD, 49.4 a.u.; 95 % CI, 36.56, 62.20;
I² = 86 %; p < 0.00001). Subgroup analyses found greater
responses in MSNA during rhythmic handgrip in healthy individuals compared
to cardiovascular diseases and other conditions. Specifically, the change
in burst frequency during handgrip (p = 0.0009) and total activity during
handgrip (p < 0.00001) suggest a blunted sympathetic response to rhythmic
handgrip in diseased populations. Meta-regression analyses in healthy
populations found no relationship between the volume of handgrip applied
with the associated change in sympathetic activity; however, there was a
significant positive relationship between both the change in heart rate
(slope = 0.131; adjusted R² = 0.2773; p = 0.002) and the change
in mean blood pressure (slope = 0.163; adjusted R² = 0.3594; p
< 0.001) with handgrip volume. An increase in MSNA is observed during
rhythmic handgrip despite ranging protocols, populations, and
co-interventions. These results suggest exercise is a unique stressor and
challenges the understanding of general sympathetic hyperactivity in
diseased populations.<br/>Copyright &#xa9; 2025 Elsevier B.V.

<78>
Accession Number
2038253991
Title
Effectiveness of Point-of-Care High-Sensitivity Troponin Testing in the
Emergency Department: A Randomized Controlled Trial.
Source
Annals of Emergency Medicine. (no pagination), 2025. Date of Publication:
2025.
Author
Thulin V.I.L.; Jordalen S.M.F.; Myrmel G.M.S.; Lekven O.C.; Krishnapillai
J.; Steiro O.T.; Body R.; Collinson P.; Apple F.S.; Cullen L.; Norekval
T.M.; Wisloff T.; Vikenes K.; Bjorneklett R.O.; Omland T.; Aakre K.M.
Institution
(Thulin, Jordalen, Lekven, Krishnapillai, Bjorneklett) Emergency Care
Clinic, Haukeland University Hospital, Bergen, Norway
(Myrmel, Lekven, Krishnapillai, Steiro, Norekval, Vikenes, Aakre)
Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
(Body) Division of Cardiovascular Sciences, Faculty of Biology, the
University of Manchester, Manchester, United Kingdom
(Body) Emergency Department, Manchester University NHS Foundation Trust,
Manchester, United Kingdom
(Collinson) St George's University of London, London, United Kingdom
(Apple) Department of Laboratory Medicine and Pathology, Hennepin
Healthcare/HCMC, Minneapolis, MN, United States
(Apple) Department of Laboratory Medicine and Pathology, University of
Minnesota, Minneapolis, MN, United States
(Cullen) Department of Emergency Medicine, Royal Brisbane and Women's
Hospital, Brisbane, Australia
(Cullen) School of Medicine, University of Queensland, Brisbane, Australia
(Cullen) Faculty of Health, Queensland University of Technology, Brisbane,
Australia
(Norekval, Vikenes, Aakre) Department of Clinical Science, University of
Bergen, Bergen, Norway
(Wisloff) Health Services Research Unit, Akershus University Hospital,
Lorenskog, Norway
(Wisloff, Omland) Institute of Clinical Medicine, University of Oslo,
Oslo, Norway
(Bjorneklett) Department of Clinical Medicine, University of Bergen,
Bergen, Norway
(Omland) Department of Cardiology, Akershus University Hospital,
Lorenskog, Norway
(Aakre) Department of Medical biochemistry and Pharmacology, Haukeland
University Hospital, Bergen, Norway
Publisher
Elsevier Inc.
Abstract
Study objective: To compare the effectiveness of high-sensitivity cardiac
troponin (hs-cTn) point-of-care testing to central laboratory hs-cTn
measurements when investigating patients presenting to the emergency
department (ED) with symptoms of acute coronary syndrome. <br/>Method(s):
The WESTCOR point-of-care study was a single-center prospective randomized
controlled trial where we randomized patients presenting with possible
acute coronary syndrome in a 1:1 fashion to receive either 0/1-hour
centralized hs-cTnT measurements (control) or 0/1-hour point-of-care
hs-cTnI testing (intervention). We defined length of stay (LOS) in the ED
as the primary endpoint and the minimum clinically meaningful difference
as 15 minutes. <br/>Result(s): We included 1,494 patients in the final
analysis, 728 in the point-of-care group, and 766 in the control group.
The median (interquartile range) age was 61 (22) years, and 635 (42.5%)
were women. Median LOS in the ED was 174 (95% confidence interval [CI] 167
to 181) and 180 (95% CI 175 to 189) minutes in the point-of-care and
control group, respectively, resulting in a reduction in median LOS of 6
minutes (95% CI -4 to 17). Acute myocardial infarction, death, or acute
revascularization occurred in 83/728 (11.4%) of point-of-care and 72/766
(9.4%) of control patients. <br/>Conclusion(s): We found that implementing
point-of-care hs-cTnI testing in the ED with a 0/1-hour diagnostic
algorithm did not lead to a clinically meaningful reduction in ED LOS. We
observed no difference in the incidence of myocardial infarction, acute
coronary revascularization, or death during 30 days
follow-up.<br/>Copyright &#xa9; 2025 American College of Emergency
Physicians

<79>
Accession Number
2034180568
Title
Impact of high-fidelity simulation on the performance of oxygenator
change-outs among perfusion students.
Source
Perfusion (United Kingdom). (no pagination), 2025. Date of Publication:
2025.
Author
Collins J.; Voitik A.; Leonor A.R.; Juricek L.T.; Ellis M.; Kaur R.;
Weinberg A.
Institution
(Collins, Juricek, Ellis, Kaur, Weinberg) Department of Cardiovascular
Perfusion, College of Health Sciences, Rush University, Chicago, IL,
United States
(Voitik) Perfusion Services, University of Washington Medical Center,
Seattle, WA, United States
(Leonor) Perfusion Services, UC Health University of Colorado Hospital,
Auroura, CO, United States
(Kaur) Department of Respiratory Care, College of Health Sciences, Rush
University, Chicago, IL, United States
Publisher
SAGE Publications Ltd
Abstract
Background: Simulation is increasingly utilized in the clinical training
of healthcare professionals. Many perfusion programs in the United States
use simulation to teach students both technical skills and effective
communication. However, there is a lack of clarity regarding the optimal
timing for introducing simulation into the curriculum and how to assess
students' competencies. This study aims to evaluate whether combining
simulation with didactic education is more effective than didactic
education alone for learning perfusion-specific tasks, such as oxygenator
changeouts. <br/>Method(s): This was a pilot, randomized controlled study
conducted during November 2020. Subjects who were in their first year and
enrolled in a cardiovascular perfusion program at the university were
included. Subjects were randomly assigned to receive didactic education
alone (control) or didactic in combination with the simulation training
(experimental). Both groups received the didactic portion of the
oxygenator change out procedure and the experimental group received
supplemental simulation training. The primary outcome was oxygenator
change-out completion time (recorded in minutes and seconds) to identify
and change-out an oxygenator in a cardiopulmonary bypass circuit. The
secondary outcome was total communication score and subject's overall
performance assessment using the scoring system referenced by Burkhart et
al. <br/>Result(s): The experimental group (n = 8) performed the
oxygenator change-out significantly faster (363.63 +/- 87.1 seconds vs
558.11 +/- 185.75 seconds, p =.016) as compared to the control group (n =
9). However, there was no significant difference between the control and
experimental groups in overall communication skills (p =.152) or the
scoring system (p =.053) used to score subjects technical skills.
<br/>Conclusion(s): The study findings revealed that the group receiving
both didactic instruction and simulation performed an oxygenator
change-out significantly faster than the group that received only didactic
instruction. These results suggest that incorporating simulation of
emergency scenarios into perfusion training can enhance students' speed in
performing complex tasks, better preparing them for real clinical
situations.<br/>Copyright &#xa9; The Author(s) 2025.

<80>
Accession Number
2038177480
Title
SAPIEN 3 versus Myval transcatheter heart valves for transcatheter aortic
valve implantation (COMPARE-TAVI 1): a multicentre, randomised,
non-inferiority trial.
Source
The Lancet. 405(10487) (pp 1362-1372), 2025. Date of Publication: 19 Apr
2025.
Author
Terkelsen C.J.; Freeman P.; Dahl J.S.; Thim T.; Norgaard B.L.; Mogensen
N.S.B.; Tang M.; Eftekhari A.; Povlsen J.A.; Poulsen S.H.; Pedersen L.;
Hjort J.; Ellert J.; Christiansen E.H.; Sorensen H.T.; Nissen H.
Institution
(Terkelsen, Thim, Norgaard, Povlsen, Poulsen, Christiansen) Department of
Cardiology, Aarhus University Hospital, Aarhus, Denmark
(Hjort) Department of Clinical Medicine, Aarhus University Hospital,
Aarhus, Denmark
(Tang) Department of Cardiothoracic and Vascular Surgery, Aarhus
University Hospital, Aarhus, Denmark
(Freeman, Eftekhari) Department of Cardiology, Aalborg University
Hospital, Aalborg, Denmark
(Dahl, Mogensen, Ellert, Nissen) Department of Cardiology, Odense
University Hospital, Odense, Denmark
(Pedersen, Sorensen) Department of Clinical Epidemiology, Aarhus
University Hospital and Aarhus University, Aarhus, Denmark
Publisher
Elsevier B.V.
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is a
guideline-directed treatment for severe aortic stenosis and degenerated
aortic bioprostheses. When new transcatheter heart valve (THV) platforms
for TAVI are launched, they should be compared with best-in-practice
contemporary THVs for their short-term and long-term performance. The
COMPARE-TAVI 1 trial was designed to provide a head-to-head comparison of
the SAPIEN 3 or SAPIEN 3 Ultra THVs and the Myval or Myval Octacor THVs.
<br/>Method(s): This multicentre, all-comers, randomised, non-inferiority
trial was done at three university hospitals in Denmark. Eligible patients
were aged 18 years or older, scheduled for transfemoral TAVI, and eligible
for treatment with SAPIEN 3 THVs or Myval THVs. Patients were randomly
assigned (1:1) to treatment with SAPIEN 3 (29 mm diameter) or SAPIEN 3
Ultra (20 mm, 23 mm, or 26 mm diameter) THVs or Myval or Myval Octacor
THVs (20-32 mm diameter). The TAVI procedure was performed according to
local practice and under local anaesthesia unless leaflet laceration was
performed. The primary endpoint was a composite of death, stroke, moderate
or severe aortic regurgitation, or moderate or severe haemodynamic THV
deterioration at 1 year according to Third Valve Academic Research
Consortium criteria. All patients assigned to THV treatment were included
in the intention-to-treat analysis, and all patients who were treated as
randomly assigned were included in the per-protocol analysis. With an
expected event rate of 13%, the prespecified non-inferiority margin was
5.3%. This trial is registered with ClinicalTrials.gov, NCT04443023, and
is closed to accrual. <br/>Finding(s): Between June 15, 2020, and Nov 3,
2023, 1031 patients were enrolled. Enrolment was paused twice because of
patent-related legal proceedings. Of 1031 patients, 517 patients were
randomly assigned to SAPIEN 3 THVs and 514 to Myval THVs. The median
patient age was 81.6 years (IQR 77.6-85.0), and 415 (40%) of 1031 patients
were female and 616 (60%) were male. The primary endpoint occurred in 67
(13%) of 517 patients randomly assigned to SAPIEN 3 THVs versus 71 (14%)
of 514 patients randomly assigned to Myval THVs (risk difference -0.9%
[one-sided upper 95% CI 4.4%]; p<inf>non-inferiority</inf>=0.019).
<br/>Interpretation(s): Myval THVs were non-inferior to SAPIEN 3 THVs in
terms of a 1-year composite endpoint of death, stroke, moderate or severe
aortic regurgitation, or moderate or severe haemodynamic THV
deterioration. <br/>Funding(s): Meril Life Sciences, Vingmed Denmark, the
Danish Heart Foundation, and the Central Denmark Region.<br/>Copyright
&#xa9; 2025 Elsevier Ltd

<81>
Accession Number
2034218513
Title
Defining "early palliative care" for adults diagnosed with a life-limiting
illness: a scoping review.
Source
BMC Palliative Care. 24(1) (no pagination), 2025. Article Number: 93. Date
of Publication: 01 Dec 2025.
Author
Kircher C.E.; Hanna T.P.; Tranmer J.; Goldie C.E.; Ross-White A.; Moulton
E.; Flegal J.; Goldie C.L.
Institution
(Kircher, Tranmer, Goldie) School of Nursing, Faculty of Health Sciences,
Queen's University, Cataraqui Building, 92 Barrie Street, Kingston, ON,
Canada
(Kircher, Tranmer, Ross-White, Goldie) Queen's Collaboration for Health
Care Quality, A JBI Centre of Excellence, Kingston, ON, Canada
(Hanna) Division of Cancer Care and Epidemiology, Cancer Research
Institute, Queen's University, Kingston, ON, Canada
(Hanna) Department of Oncology, School of Medicine, Faculty of Health
Sciences, Queen's University, Kingston, ON, Canada
(Hanna, Tranmer) ICES, Queen's University, Kingston, ON, Canada
(Goldie) Division of Palliative Medicine, Department of Medicine, School
of Medicine, Faculty of Health Sciences, Queen's University, Kingston, ON,
Canada
(Ross-White) Bracken Health Sciences Library, Queen's University,
Kingston, ON, Canada
(Moulton, Flegal) School of Nursing, St. Lawrence College, Kingston, ON,
Canada
Publisher
BioMed Central Ltd
Abstract
Background: Palliative care is for people suffering from life-limiting
illnesses that focuses on providing relief from symptoms and stress of
illness. Previous studies have demonstrated that specialist palliative
care consultation delivered earlier in the disease process can enhance
patients' quality of life, reduce their symptom burden, reduce use of
hospital-based acute care services and extend their survival. However,
various definitions exist for the term early palliative care (EPC).
<br/>Objective(s): To investigate how EPC has been defined in the
literature for adults with life- limiting illnesses. <br/>Method(s): This
review was conducted in accordance with the Preferred Reporting Items for
Systematic Reviews and Meta-Analysis (PRISMA) extension for Scoping
Reviews guidelines and follows the Joanna Briggs Institution methodology
for scoping reviews. The literature search was conducted using MEDLINE
(Ovid), CINAHL (EBSCO), Embase (Ovid), PsycINFO (Ovid), Web of Science
Core Collection, Ovid Cochrane Library, and ProQuest (Health and Medicine
and Sociology Collections). All articles retrieved were screened by three
independent reviewers. <br/>Result(s): 153 articles met the inclusion
criteria between 2008 and 2024. Five categories of definitions for EPC
were created to organize definitions: (1) time-based (e.g. time from
advanced cancer diagnosis to EPC initiation); (2) prognosis-based (e.g.
prognosis or the 'surprise question'); (3) location-based (e.g. access
point within the healthcare system such as outpatient setting); (4)
treatment-based (e.g. physician's judgement or prior to specific
therapies); and (5) symptom-based (e.g. using symptom intensity
questionnaires). Many studies included patients with cancer (n = 103),
with the most common definition category being time-based (n = 53).
Amongst studies focusing on multiple or non-cancer diagnoses (n = 50), the
most common definition category was symptom-based (n = 16).
<br/>Conclusion(s): Our findings provide a useful reference point for
those seeking to understand the scope and breadth of existing EPC
definitions in cancer and non-cancer illnesses and contemplate their
application within clinical practice.<br/>Copyright &#xa9; The Author(s)
2025.

<82>
Accession Number
2032965896
Title
Pre-operative subjective functional capacity and postoperative outcomes in
adult non-cardiac surgery: a systematic review and meta-analysis.
Source
Anaesthesia. 80(5) (pp 561-571), 2025. Date of Publication: 01 May 2025.
Author
Takahashi K.; Chiba K.; Honda A.; Iizuka Y.; Yoshinaga K.; Deo A.S.;
Uchida T.
Institution
(Takahashi, Uchida) Department of Anaesthesiology, Institute of Science
Tokyo Hospital, Tokyo, Bunkyo, Japan
(Chiba, Honda, Iizuka) Department of Anaesthesiology and Critical Care
Medicine, Jichi Medical University Saitama Medical Centre, Saitama, Omiya,
Japan
(Yoshinaga) Department of Anaesthesiology and Critical Care Medicine,
Jichi Medical University, Tochigi, Shimotsuke, Japan
(Deo) Department of Anaesthesiology, NU Hospitals, Karnataka, Bengaluru,
India
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Assessment of functional capacity is an essential part of
peri-operative risk stratification. Subjective functional capacity is
easier to examine than objective tests of patient fitness. However, the
association between subjective functional capacity and postoperative
outcomes has not been established. <br/>Method(s): Four databases were
searched for studies describing the associations between subjective
functional capacity and postoperative outcomes in adults undergoing
non-cardiac surgery. Meta-analysis was conducted among studies where
functional capacity was expressed in metabolic equivalents. The primary
outcome was postoperative major adverse cardiovascular events. Secondary
outcomes were mortality and postoperative overall complications. We
estimated the ORs of the outcomes in patients with poor functional
capacity (< 4 metabolic equivalents) as compared with those with good
functional capacity (>= 4 metabolic equivalents). Random-effects models
were used for the meta-analysis. <br/>Result(s): We identified 7835
abstracts. After screening and a full-text review, 23 studies were
selected. Evaluation methods of functional capacity included:
questionnaires (n = 7); specific questions (n = 6); and subjective
assessment by anaesthetists (n = 5). The probability of major
postoperative adverse cardiovascular events was significantly higher in
patients with poor functional capacity (OR 1.84, 95%CI 1.62-2.08) than in
those with good functional capacity. Patients with poor functional
capacity also had higher odds of mortality (OR 2.48, 95%CI 1.45-4.25) and
postoperative complications (OR 1.85, 95%CI 1.34-2.55).
<br/>Discussion(s): Subjective functional capacity of < 4 metabolic
equivalents was associated with postoperative complications including
cardiovascular events and other serious outcomes. The results need to be
interpreted with caution due to the diverse measures used to assess
functional capacity.<br/>Copyright &#xa9; 2025 Association of
Anaesthetists.

<83>
Accession Number
2034108578
Title
A multifactorial intervention to improve cardiovascular outcomes in adults
with type 2 diabetes and current or previous diabetic foot ulcer disease:
Protocol for a multi-centre randomised control trial (MiFoot study).
Source
Diabetic Medicine. (no pagination), 2025. Date of Publication: 2025.
Author
Onuwe T.; Highton P.J.; Batchelor D.; Brennan A.; Caba M.; Davies M.J.;
Funnell M.P.; Game F.; Gillies C.L.; Glab A.; Gray L.J.; Gregg E.;
Hadjiconstantinou M.; Hall V.; Johnson V.; Petrie J.R.; Pollard D.;
Rowntree H.; Tesfaye S.; Valabhji J.; Webb D.; Zaccardi F.; Khunti K.
Institution
(Onuwe, Highton, Caba, Davies, Funnell, Gillies, Hadjiconstantinou, Webb,
Khunti) Diabetes Research Centre, Leicester General Hospital, University
of Leicester, Leicester, United Kingdom
(Onuwe, Highton, Funnell, Gray, Hadjiconstantinou, Khunti) National
Institute for Health and Care Research Applied Research Collaboration East
Midlands, Leicester, United Kingdom
(Batchelor) Patient and Public Involvement and Engagement Representative,
Leicester, United Kingdom
(Brennan, Pollard) School of Medicine and Population Health, University of
Sheffield, Sheffield, United Kingdom
(Davies, Gray) National Institute for Health and Care Research Leicester
Biomedical Research Centre, Leicester, United Kingdom
(Game) Department of Research and Development, University Hospitals of
Derby and Burton NHS Foundation Trust, Derby, United Kingdom
(Gillies, Zaccardi) Leicester Real World Evidence Unit, Leicester Diabetes
Centre, University of Leicester, Leicester, United Kingdom
(Glab, Hall, Johnson, Rowntree) Leicester Diabetes Centre, University
Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester,
United Kingdom
(Gray) Department of Population Health Sciences, University of Leicester,
Leicester, United Kingdom
(Gray) Leicester British Heart Foundation Centre of Research Excellence,
University of Leicester, Leicester, United Kingdom
(Gregg) School of Population Health, RCSI University of Medicine and
Health Sciences, Dublin, Ireland
(Gregg) School of Public Health, Imperial College London, London, United
Kingdom
(Petrie) School of Health and Wellbeing, College of Medical Veterinary and
Life Sciences, University of Glasgow, Glasgow, United Kingdom
(Tesfaye) Diabetes Research Unit, Sheffield Teaching Hospitals NHS
Foundation Trust, Sheffield, United Kingdom
(Valabhji) Department of Metabolism, Digestion and Reproduction, Faculty
of Medicine, Chelsea and Westminster Hospital Campus, Imperial College
London, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: In the United Kingdom, the prevalence of diabetes-related foot
ulcer disease (DFUD) is 6.3%, and cardiovascular disease (CVD) is the
leading cause of mortality in people with DFUD. This study aims to
evaluate the effectiveness of a multifactorial intervention to reduce CVD
events and mortality in adults with type 2 diabetes (T2D) and DFUD.
<br/>Method(s): The MiFoot study is a multi-centre, pragmatic randomised
controlled trial to test intervention effectiveness and cost-effectiveness
compared to usual care that will include an internal feasibility study and
a process evaluation. English-speaking adults (>=18 years; n = 392) with
T2D and current/previous (within 5 years) DFUD will be recruited from
multiple sites across the United Kingdom and randomised 1:1 to
intervention (MiFoot multifactorial intervention plus usual care) or
control (usual care), with data collected at baseline, 12- and 24-month
follow-up. The MiFoot intervention comprises an individualised assessment
with a healthcare practitioner to optimise treatment and assess the
suitability of physical activity participation; group-based disease self
management education and physical activity sessions; and a digital-based
programme, consisting of cohort-relevant topics, physical activity
guidance and peer support functionality. The primary outcome will be
extended major adverse cardiovascular events (MACE, i.e. myocardial
infarction, stroke, cardiovascular death, peripheral arterial bypass,
coronary artery bypass, coronary angioplasty or peripheral artery
angioplasty) at 24 months. <br/>DISCUSSION(S): This study will provide
evidence on the feasibility and clinical effectiveness, and
cost-effectiveness of a multifactorial intervention to prevent or slow the
progression of CVD-related complications in the extremely high-risk
population with T2D and DFUD.<br/>Copyright &#xa9; 2025 The Author(s).
Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes
UK.

<84>
Accession Number
2034362640
Title
Everolimus and sirolimus in the treatment of cardiac rhabdomyomas in
neonates.
Source
Pediatric Research. (no pagination), 2025. Article Number: 11. Date of
Publication: 2025.
Author
Hurtado-Sierra D.; Ramos Garzon J.X.; Romero-Guevara S.L.; Serrano-Garcia
A.Y.; Rojas L.Z.
Institution
(Hurtado-Sierra) Pediatric Cardiology Unit, Instituto del Corazon de
Bucaramanga, Bucaramanga, Colombia
(Ramos Garzon, Romero-Guevara) Nursing School, Universidad Industrial de
Santander, Bucaramanga, Colombia
(Serrano-Garcia, Rojas) Research Center, Fundacion Cardiovascular de
Colombia, Floridablanca, Colombia
Publisher
Springer Nature
Abstract
Background and objectives: Cardiac rhabdomyoma (CR) is the principal
cardiac tumor diagnosed in pediatric age and is commonly associated with
tuberous sclerosis complex. In some patients, these masses can cause heart
failure and difficult-to-control arrhythmias. There are multiple case
reports on use of mammalian target of rapamycin (mTOR) inhibitors,
everolimus or sirolimus, in treatment of CRs. We reviewed the current data
regarding effectiveness of everolimus and sirolimus in treating of CRs in
newborns with hemodynamic repercussions. <br/>Method(s): This systematic
review was reported according to the PRISMA guidelines. The EBSCO, PubMed,
EMBASE, and Lilacs databases were searched for full-text articles
reporting the use of everolimus or sirolimus in the treatment of CRs in
neonates and infants. <br/>Result(s): Thirty-one articles met inclusion
criteria, totaling 48 patients. Hemodynamic instability prompted treatment
in 89.5% of cases. Everolimus was used in 83.3% of cases and sirolimus in
16.6%. The median treatment duration was 67 days, with a 57 +/- 23%
average CR size reduction. Common adverse events included
hypertriglyceridemia, infections, and hematological abnormalities.
<br/>Conclusion(s): mTOR inhibitors appear effective and safe for treating
CRs in neonates and infants. The average daily doses were 1.03 mg/m2/day
for everolimus and 1.37 mg/m2/day for sirolimus. Randomized controlled
clinical trials are necessary to confirm these findings and establish
optimal treatment protocols. Impact: Currently, there are no results from
randomized clinical trials evaluating the efficacy of mammalian target of
rapamycin inhibitors in patients with symptomatic cardiac rhabdomyomas.
This is the first systematic review that evaluates the efficacy and safety
of the use of everolimus and sirolimus in the non-surgical treatment of
cardiac rhabdomyomas with hemodynamic repercussions in neonates.
Everolimus and sirolimus may be particularly useful in the neonatal period
when the hemodynamic complications caused by cardiac rhabdomyomas are more
severe.<br/>Copyright &#xa9; The Author(s) 2025.

<85>
Accession Number
2038432593
Title
Comparison of Endoaortic Balloon Occlusion and Transthoracic Aortic Clamp
for Minimally Invasive Cardiac Surgery: Systematic Review and
Meta-analysis.
Source
International Journal of Angiology. (no pagination), 2025. Date of
Publication: 2025.
Author
Naito N.; Takagi H.
Institution
(Naito, Takagi) Department of Cardiovascular Surgery, Shizuoka Medical
Center, Shizuoka, Japan
Publisher
Thieme Medical Publishers, Inc.
Abstract
Objective This meta-analysis aimed to compare short-term outcomes in
patients undergoing minimally invasive cardiac surgery (MICS) using
endoaortic balloon (EAB) and transthoracic aortic clamp (TAC) techniques.
Materials and Methods A comprehensive search of relevant databases was
conducted through July 2024. Pooled results were calculated, and subgroup
analyses of studies published during early and late eras were performed.
Additionally, a meta-regression analysis based on the year of publication
was conducted to assess potential influences on outcomes. Results The
systematic review identified 17 non-randomized studies encompassing a
total of 8,253 patients. In terms of intraoperative outcomes, no
significant differences were observed in operation duration, aortic
cross-clamp time, cardiopulmonary bypass time, or rates of sternotomy
conversion and iatrogenic aortic dissection. However, subgroup analysis of
early-era studies demonstrated significantly longer operation times in the
EAB cohort (p = 0.03). Meta-regression analysis indicated that the
standardized mean differences in cardiopulmonary bypass time between the
two groups decreased in favor of EAB as publication years progressed (p =
0.01). For postoperative outcomes, no significant differences were found
in postoperative stroke rate, the rate of reoperation for bleeding, or
length of hospital stay. However, the EAB group had significantly lower
rates of postoperative atrial fibrillation (OR = 0.82 [0.70-0.95], p <
0.01) and short-term mortality (OR = 0.60 [0.39-0.92], p = 0.04).
Conclusion This meta-analysis demonstrated that EAB is associated with
perioperative outcomes comparable to TAC in select patients. The
cumulative experience and evolution of techniques may have contributed to
improved outcomes with EAB over time.International Journal of
Angiology<br/>Copyright &#xa9; 2025. All rights reserved.

<86>
Accession Number
2034368361
Title
Fasting Versus Non-Fasting Before Cardiac Catheterization: A Systematic
Review and Meta-Analysis of Randomized Controlled Trials.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Muniz J.; Goncalves Neto A.O.; Morais B.A.A.H.; Suciu-Bogdan C.; Ferreira
D.; Braghiroli J.; Camara S.F.; Ribeiro H.B.
Institution
(Muniz, Suciu-Bogdan) Internal Medicine Department, Schmieder Klinik
Heidelberg, Heidelberg, Germany
(Goncalves Neto) Federal University of Parana, Curitiba, Brazil
(Morais) Centro Universitario CESMAC, Maceio, Brazil
(Ferreira) Cardiovascular Department, John Hunter Hospital, Newcastle,
Australia
(Braghiroli) Department of Cardiology, Jackson Memorial Hospital, FL,
United States
(Camara, Ribeiro) Heart Institute of Sao Paulo (InCor), University of Sao
Paulo, Sao Paulo, Brazil
Publisher
John Wiley and Sons Inc
Abstract
Background: Current guidelines recommend routine fasting before cardiac
catheterization under conscious sedation. However, data supporting this
practice have been limited. <br/>Aim(s): We aimed to compare the safety
and patient well-being of a non-fasting strategy to standard fasting in
patients who undergo heart catheterization procedures. <br/>Method(s): We
conducted a meta-analysis of randomized studies comparing fasting versus
non-fasting before cardiac catheterization. We systematically reviewed
PubMed, Embase, and Cochrane databases until October 2024. We incorporated
unpublished subgroup data from the previously published SCOFF Trial,
exclusively on patients who underwent catheterization procedures.
<br/>Result(s): We included 7 RCTs comprising 3289 patients who underwent
cardiac catheterization procedures. The pooled analysis demonstrated the
non-inferiority of the non-fasting strategy, with no significant
differences in the incidences of nausea/vomiting (RR 0.90; 95% CI
0.50-1.61; p = 0.72), hypoglycemia (RR 0.78; 95% CI 0.45-1.35, p = 0.38),
acute kidney injury (RR 1.45; 95% CI 0.77-2.75, p = 0.251), and length of
hospital stay (SMD 0.005, 95% CI -0.109 to 0.099, p = 0.92) compared to
the fasting strategy. The non-fasting strategy was significantly
associated with reduced rates of intraprocedural hypotension and showed a
statistically significant improvement in overall patient satisfaction (SMD
-0.749; 95% CI -1.26; -0.234, p = 0.004) when compared to the fasting
strategy. <br/>Conclusion(s): A non-fasting strategy before cardiac
catheterization procedures is as safe as the standard fasting protocol and
demonstrates a significant improvement of overall patient satisfaction.
These findings support the consideration of non-fasting protocols as a
patient-centered approach that maintains safety while enhancing the
patient experience.<br/>Copyright &#xa9; 2025 Wiley Periodicals LLC.

<87>
Accession Number
2038472487
Title
Design and Rationale of Lp(a)HORIZON Trial: Assessing the Effect of
Lipoprotein(a) Lowering With Pelacarsen on Major Cardiovascular Events in
Patients With CVD and Elevated Lp(a).
Source
American Heart Journal. 287 (pp 1-9), 2025. Date of Publication: 01 Sep
2025.
Author
Cho L.; Nicholls S.J.; Nordestgaard B.G.; Landmesser U.; Tsimikas S.;
Blaha M.J.; Leitersdorf E.; Lincoff A.M.; Lesogor A.; Manning B.;
Kozlovski P.; Cao H.; Wang J.; Nissen S.E.
Institution
(Cho, Lincoff, Nissen) Cleveland Clinic Heart Vascular Thoracic Institute,
Cleveland, OH, United States
(Nicholls) Monash University Victoria Heart Institute, Melbourne,
Australia
(Nordestgaard) University of Copenhagen, Copenhagen, Denmark
(Landmesser) Deutsches Herzzentrum Charite, Berlin, Germany
(Tsimikas) University of California San Diego, La Jolla, CA, United States
(Blaha) Johns Hopkins University, Baltimore, MD, United States
(Leitersdorf) Haddassah Hebrew University, Jerusalem, Israel
(Lesogor, Kozlovski) Novartis Pharmaceutical Corp, Basel, Switzerland
(Manning, Cao, Wang) Novartis Pharmaceutical Corp, East Hanover, NJ,
United States
Publisher
Elsevier Inc.
Abstract
Background: Lipoprotein(a), abbreviated Lp(a), consists of apolipoprotein
B-100 covalently bound to apolipoprotein(a), and represents an
independent, genetically-determined, causal risk factor for
atherosclerotic cardiovascular disease (CVD) and calcific aortic stenosis.
More than 20% of the world CVD population has elevated Lp(a). Currently
there are no approved pharmacologic treatments to lower Lp(a) levels, and
no randomized trials have demonstrated that lowering Lp(a) reduces CVD
risk. <br/>Study Design: Lp(a) HORIZON is a phase 3, randomized,
placebo-controlled, double-blind, parallel-group, multinational trial in
8,323 patients with established CVD and elevated Lp(a) levels of >=70
mg/dL (approximately 149 nmol/L), testing the effect of pelacarsen, an
antisense oligonucleotide (ASO) on the incidence of major adverse
cardiovascular events (MACE). Established CVD is defined as history of
myocardial infarction (MI), ischemic stroke or symptomatic peripheral
artery disease. The minimum follow-up is required to be 2.5 years. The
study will end when 993 CEC confirmed primary CV events have accumulated.
Based on the current event accrual trend, the overal study duration is
anticipated to be approximately 6 years. Patients were randomized in a 1:1
ratio to receive either monthly subcutaneous (SQ) injections of pelacarsen
80 mg or matching placebo on a background of optimized standard of care
therapy for CVD. The primary endpoint is a composite of cardiovascular
death, nonfatal MI, nonfatal stroke, or urgent coronary revascularization
requiring hospitalization. This endpoint will be evaluated in the overall
population and in a subpopulation of Lp(a) >=90 mg/dL (approximately 192
nmol/L) at screening, with multiplicity control designed to test the
primary endpoint in both the overall population and the subpopulation.
<br/>Conclusion(s): Lp(a) HORIZON will determine the effect of pelacarsen
on cardiovascular morbidity and mortality in patients with elevated Lp(a)
and established CVD. Trial Registration: NCT 04023552.<br/>Copyright
&#xa9; 2025 The Author(s)

<88>
Accession Number
2038412442
Title
Aortic and mitral structural interventions in the absence of cardiac
surgery.
Source
European Heart Journal, Supplement. 27(Supplement_3) (pp iii64-iii68),
2025. Date of Publication: 01 Mar 2025.
Author
Iannopollo G.; Capecchi A.; Verardi R.; Biasco L.; Pedone C.; Lanzilotti
V.; Bruno M.; Nobile G.; Casella G.
Institution
(Iannopollo, Capecchi, Verardi, Pedone, Lanzilotti, Bruno, Nobile,
Casella) Cardiology Unit, Ospedale Maggiore, Largo Nigrisoli 2, Bologna,
Italy
(Biasco) Department of Biomedical Sciences, University of Italian
Switzerland, Lugano, Switzerland
(Biasco) Azienda Sanitaria Locale Torino 4, Department of Cardiology,
Cirie, Turin, Italy
Publisher
Oxford University Press
Abstract
Traditionally, structural heart interventions have been performed at heart
valve centres with on-site heart surgery to maximize expertise and deal
with complications requiring emergent cardiac surgery (ECS). However, at
present, only transcatheter aortic-valve implantation (TAVI) must be
performed at centres with on-site heart surgery according to current
guidelines, while mitral transcatheter edge-to-edge repair, or left
appendage atrial occlusion could be performed also in centres without
on-site cardiac surgery. Today, ageing of the population and improved
results of TAVI have increased the need for such procedures posing strong
pressure to traditional heart valve centres, prolonging waiting times for
TAVI and increasing access disparities. Fortunately, TAVI procedures have
a very low rate of complications, including those necessitating ECS, and
observational data suggest that TAVI can be safely performed in centres
without on-site cardiac surgery. However, guideline recommendations need
randomized clinical trials like the TRanscatheter Aortic-Valve
Implantation with or without on-site Cardiac Surgery (TRACS) trial to be
updated. The TRACS trial randomizes high-risk symptomatic aortic stenosis
patients to treatment by the same operators either at centres with or
without on-site cardiac surgery and compares 1-year follow-up. Key issues
for structural interventions, in particular TAVI, at centres without
on-site surgery are shared indications through heart team evaluation,
consistent experiences and competences of non-surgical centres, and strong
networking with the Hub centre. The increasing demand for structural heart
interventions highlights the need for innovative care models and the
careful introduction of a 'Hub-and-Spoke' approach for high-volume heart
valve networks could be a study option.<br/>Copyright &#xa9; 2025 The
Author(s). Published by Oxford University Press on behalf of the European
Society of Cardiology.

<89>
Accession Number
2034333983
Title
Intraoperative Hemoadsorption in Heart Transplant Surgery: A 5-Year
Experience.
Source
Journal of Cardiovascular Development and Disease. 12(4) (no pagination),
2025. Article Number: 119. Date of Publication: 01 Apr 2025.
Author
Sliskovic N.; Sestan G.; Gjorgjievska S.; Baric D.; Unic D.; Varvodic J.;
Kusurin M.; Susnjar D.; Singer S.; Rudez I.
Institution
(Sliskovic, Sestan, Gjorgjievska, Baric, Unic, Varvodic, Kusurin, Susnjar,
Singer, Rudez) Department of Cardiac and Transplant Surgery, Dubrava
University Hospital, Zagreb, Croatia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Hyperimmune response and cytokine release post-reperfusion
might occur after orthotopic heart transplantation (HTx). Intraoperative
hemoadsorption (HA) has been introduced to remove such elevated cytokines.
We aimed to analyze the effect of intraoperative HA in patients undergoing
orthotopic HTx. <br/>Method(s): Between 2018 and 2022, 40 consecutive
orthotopic HTx patients who underwent intraoperative hemoadsorption HA
integrated into the cardiopulmonary bypass were compared to 41 historical
controls. Primary outcome measures included postoperative hemodynamic
stability and blood product requirements, while secondary outcomes were
the incidence of acute kidney injury requiring dialysis (AKI-d) and 30-day
mortality. <br/>Result(s): Postoperatively, the vasoactive-inotropic score
(VIS) did not significantly differ between the groups. However, the use
duration for milrinone and dobutamine was shortened by one day compared to
controls. The HA group had fewer red blood cell transfusions (765 vs. 1330
mL, p = 0.01) and lower fresh frozen plasma requirements (945 vs. 1200 mL,
p = 0.04). Mechanical ventilation duration was reduced (22 vs. 28 h, p =
0.02). AKI-d rates were similar, and 30-day mortality favored
non-significantly the HA group (5% vs. 14.6%, p = ns). No device-related
adverse events were observed. <br/>Conclusion(s): These findings suggest
that intraoperative HA might improve immediate postoperative outcomes;
however, further validation in larger randomized controlled trials is
warranted.<br/>Copyright &#xa9; 2025 by the authors.

<90>
Accession Number
2034333981
Title
A Narrative Review of the Evidence for Transcatheter Aortic Valve
Implants.
Source
Journal of Cardiovascular Development and Disease. 12(4) (no pagination),
2025. Article Number: 113. Date of Publication: 01 Apr 2025.
Author
Lee L.; Chan B.M.-W.; Spencer M.; Leung J.; Liew D.; Kim H.
Institution
(Lee, Spencer, Kim) School of Medicine and Dentistry, Griffith University,
Gold Coast, QLD, Australia
(Lee, Chan) Faculty of Medicine and Health, University of Sydney, Sydney,
NSW, Australia
(Leung) Faculty of Medicine, University of Queensland, Brisbane, QLD,
Australia
(Liew) Faculty of Health, Medicine and Behavioural Sciences, University of
Queensland, Brisbane, QLD, Australia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Currently, multiple transcatheter aortic valves exist in clinical use,
with varying efficacy and safety rates. This review aims to evaluate the
evidence base for current transcatheter valves used in the management of
aortic stenosis in Australia to improve informed decision making for both
clinicians and patients. The evidence base included published
peer-reviewed human studies of aortic valves with approval for use in
Australia through the Therapeutic Goods Administration (TGA). Embase was
utilised on the 17 September 2024, and one hundred ninety-seven
publications met the inclusion criteria, including six from citation
searching. The Sapien series led with the largest number of patients
reported in the literature (n = 91,614) and publications (n = 147),
followed by the CoreValve/Evolut series with 65,459 patients and 125
publications. Evidence for both of these transcatheter aortic valve series
were also published in high impact journals, with the greatest H-index
journal being The New England Journal of Medicine. In conclusion, the
evidence base for the safety and efficacy of the Sapien and
CoreValve/Evolut series currently leads in both quantity and quality. This
review also summarises the Australian medical device regulatory and
funding process in the context of transcatheter aortic
valves.<br/>Copyright &#xa9; 2025 by the authors.

<91>
Accession Number
2036168944
Title
Efficacy and Safety of Concomitant Surgical Ablation During Mitral Valve
Replacement: A Systematic Review.
Source
Journal of the Saudi Heart Association. 37(2) (no pagination), 2025. Date
of Publication: 2025.
Author
Hamodat O.; Almuzainy S.; Yahya R.; Alzaatreh R.; Haroon S.; Koniali S.
Institution
(Hamodat, Almuzainy, Yahya, Alzaatreh, Haroon, Koniali) College of
Medicine, University of Sharjah, Sharjah, United Arab Emirates
Publisher
Saudi Heart Association
Abstract
Objectives: Atrial fibrillation (AF) is a common comorbidity in patients
undergoing mitral valve surgery (MVS), significantly increasing the risk
of thromboembolism, heart failure, and mortality. Surgical ablation has
recently been given a Class IA recommendation for concomitant MVS,
reinforcing its role in restoring sinus rhythm and improving outcomes in
this population. However, concerns about procedural complexity, extended
operative time, and postoperative risks have limited its widespread
adoption. This systematic review aims to synthesize evidence from recent
randomized controlled trials to evaluate the safety and efficacy of
surgical ablation for AF in patients undergoing MVS, addressing critical
gaps in current clinical practice. Methodology: We systematically searched
Scopus, PubMed, and Ovid up to December of 2024 for randomized controlled
trials (RCTs) that investigated surgical ablation concomitant to mitral
valve repair or replacement (MVR) as the intervention, compared to
isolated MVR. <br/>Result(s): This review included 15 RCTs with 1219
patients (681 in the MVR + ablation group and 538 in the MVR-only group).
Sinus rhythm restoration was significantly higher in the MVR + ablation
group at discharge (64.7% vs. 18.8%), 6 months (62.5% vs. 22.4%), and 1
year (66.0% vs. 25.7%), indicating both immediate and sustained benefits.
Short-term mortality rates were similar between groups (2.2% vs. 1.97%),
while 1-year mortality was lower in the MVR + ablation group (5.43% vs.
5.91%). Pacemaker implantation rates were slightly higher in the MVR +
ablation group, while stroke and thromboembolic events were rare and
comparable between groups. <br/>Conclusion(s): Surgical ablation combined
with mitral valve surgery significantly improves sinus rhythm outcomes.
While stroke and short-term mortality remain comparable between groups,
one-year mortality was lower in the ablation group, warranting further
investigation. Additionally, the increased pacemaker implantation rate in
specific populations warrants tailored approaches.<br/>Copyright &#xa9;
2025 Saudi Heart Association.

<92>
[Use Link to view the full text]
Accession Number
2038463849
Title
Meta-Analysis on Comparison of Fasting Versus No Fasting Before Cardiac
Catheterization.
Source
Cardiology in Review. (no pagination), 2025. Article Number:
10.1097/CRD.0000000000000930. Date of Publication: 2025.
Author
Basit J.; Ahmed M.; Burhan M.; Shahzad M.; Ahsan A.; Ullah W.; Alonso A.
Institution
(Basit, Ahmed, Burhan) Department of Medicine, Rawalpindi Medical
University, Rawalpindi, Pakistan
(Shahzad) Department of Medicine, Dow University of Health Sciences,
Karachi, Pakistan
(Ahsan) Department of Medicine, Foundation University Medical College,
Islamabad, Pakistan
(Ullah, Alonso) Department of Interventional Cardiology, University of
Massachusetts, Worcester, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Patients undergoing cardiac catheterization are advised not to take
anything by mouth after midnight. However, limited scientific data exist
on whether fasting before catheterization procedures improves clinical
outcomes compared with nonfasting. A comprehensive literature search was
performed by investigators using major bibliographic databases to identify
studies that compared clinical outcomes for fasting versus nonfasting
patient groups following cardiac catheterization procedures. The risk
ratios (RR) and mean difference (MD) were pooled along with 95% confidence
intervals (CIs) for dichotomous and continuous outcomes using R studios. A
total of 9 trials were included in the review reporting data for 3432
patients (fasting: 1710 and nonfasting: 1702). There was no statistically
significant difference between the 2 groups for incidence of procedural
complications (RR: 1.05, 95% CI: 0.78-1.40; P = 0.757), 30-day mortality
(RR: 0.83, 95% CI: 0.32-2.18; P = 0.71), 30-day readmissions (RR: 1.05,
95% CI: 0.74-1.49; P = 0.77), aspiration (RR: 0.45, 95% CI: 0.06-3.50; P =
0.45), contrast-associated acute kidney injury (RR: 0.90, 95% CI:
0.52-1.58; p 0.72), hypoglycemia (RR: 1.27, 95% CI: 0.74-2.17; P = 0.39),
and nausea/vomiting (RR: 0.83, 95% CI: 0.46-1.51; P = 0.55). The
nonfasting group was associated with significantly better satisfaction
scores compared to the fasting group (standardized MD: 0.70, 95% CI:
0.13-1.27; P = 0.02). Before cardiac catheterization, a nonfasting
approach is associated with higher satisfaction and similar procedural
outcomes and adverse events compared to a fasting approach. The practice
of routine fasting before cardiac catheterization should be
reconsidered.<br/>Copyright &#xa9; 2025 Wolters Kluwer Health, Inc.

<93>
Accession Number
2036167259
Title
Comparison between Levobupivacaine and Levobupivacaine with Clonidine in
Erector Spinae Plane Block in Patients undergoing open Cholecystectomy: A
Prospective Randomized Double Blinded Study.
Source
JK Science. 27(2) (pp 113-117), 2025. Date of Publication: 01 Apr 2025.
Author
Sahoo S.; Chattopadhyay S.; Datta S.; Bhar D.; Maiti A.K.
Institution
(Sahoo, Chattopadhyay, Datta, Bhar, Maiti) Department of Anaesthesiology,
Midnapore Medical College, Vidyasagar Road, Paschim Medinipur, West
Bengal, Midnapore, Kolkata, India
Publisher
JK Science
Abstract
Background: Erector spinae plane (ESP) block is effective for
post-operative analgesia in thoracic and abdominal surgeries. There is
minimal experience with clonidine (alpha2 agonist) as an adjuvant to
levobupivacaine in ESP block. The objective of the present study is to
compare the duration of postoperative analgesia between levobupivacaine
and levobupivacaine with clonidine in open cholecystectomy following ESP
block. <br/>Method(s): One hundred patients, randomly divided into two
groups, undergoing open cholecystectomy under general anaesthesia (GA),
were given ESP block 20 min before administration of GA. Group L received
19 ml of 0.25% levobupivacaine with 1 ml of normal saline and group LC
received clonidine (1.5 mcg/ kg) prepared in 1 ml of normal saline as
adjuvant with 19 ml of 0.25% levobupivacaine for ESP block. In the
postoperative period, the duration and requirement of analgesia were
recorded. <br/>Result(s): Duration of post-operative analgesia in group LC
was 595.78+/- 71.5 min compared to 357.2+/- 18.14 min in group L.
(P<0.0001). The requirement of analgesic in the first 24 hours was also
significantly less in group LC (P<0.0001). <br/>Conclusion(s): Clonidine
as adjuvant with levobupivacaine in erector spinae plane block provides
longer duration of analgesia and reduces analgesic requirement
postoperatively without any significant adverse effects.<br/>Copyright
&#xa9; 2025 JK Science.

<94>
Accession Number
647144830
Title
Continuous postoperative pericardial flushing to reduce the risk of
postoperative bleeding after elective adult cardiac surgery - a
study-level meta-analysis.
Source
Journal of cardiothoracic surgery. 20(1) (pp 195), 2025. Date of
Publication: 12 Apr 2025.
Author
Jain S.N.; Jhala H.S.; Uzzaman M.; Buchan K.G.
Institution
(Jain, Jhala, Buchan) Department of Cardiothoracic Surgery, Aberdeen Royal
Infirmary, Foresterhill Road, Aberdeen, United Kingdom
(Uzzaman) Department of Cardiothoracic Surgery, New Cross University
Hospital, Wolverhampton road, Wolverhampton, United Kingdom
Abstract
BACKGROUND: Retained blood syndrome contributes to higher morbidity and
mortality post cardiac surgery. We investigate the benefits of continuous
postoperative pericardial flushing (CPPF) over standard care chest
drainage in elective adult cardiac surgery patients. <br/>METHOD(S):
Various online databases were screened for randomised controlled trials
(RCTs) and observations studies comparing CPPF to standard care. PRIMARY
OUTCOMES: 12-hour and total blood loss, cardiopulmonary bypass (CPB) and
aortic cross-clamp (ACC) times; surgical re-intervention for bleeding,
mortality, sternal wound infections and pericardial or pleural fluid
re-accumulation at discharge. SECONDARY OUTCOMES: perioperative blood
transfusion, time to extubation and total hospital stay. <br/>RESULT(S):
586 patients from four studies with matched characteristics were included.
CPPF was associated with less blood loss at 12 h and in total: Odds Ratio
(OR) (95% CI) 0.71 (-0.91 to 0.51) and 0.49 (-0.67 to -0.32) (both p <
0.00001). CPPF had lower need for transfusion of blood products RR 0.57
(0.36-0.89) (p = 0.01)). There were no significant differences in surgical
re-intervention rates, overall mortality, CPB, ACC times, length of
hospital stay, time until extubation or sternal wound infections. Risk of
pericardial or pleural fluid re-accumulation was lower in the CPPF groups
RR 0.88 (0.80-0.97) (p = 0.01). <br/>CONCLUSION(S): CPPF has shown
promising results in reducing postoperative blood loss and fluid
re-accumulation with fewer blood transfusions, and lower surgical
re-intervention rates across all ranges of cardiac surgical procedures. It
is safe, feasible and effective in all types of cardiac surgery, however
further studies are needed to validate these findings.<br/>Copyright
&#xa9; 2025. The Author(s).

<95>
Accession Number
2038412443
Title
Ten years of transcatheter aortic valve implantation in the NOTION study:
The good and the bad.
Source
European Heart Journal, Supplement. 27(Supplement_3) (pp iii153-iii155),
2025. Date of Publication: 01 Mar 2025.
Author
Ferrarotto L.; Imme S.; Tamburino C.
Institution
(Ferrarotto, Imme, Tamburino, Tamburino) C.C.D. G.B. Morgagni, Department
Surgical and Medical Cardiac Department, Pedara, Catania, Italy
Publisher
Oxford University Press
Abstract
Transcatheter aortic valve implantation (TAVI) has transformed the
treatment of severe aortic stenosis, becoming a preferred option for
patients at high and moderate surgical risk and for individuals over 75
years of age. The NOTION study represents the first randomized clinical
trial to reach a 10-year follow-up in patients at low surgical risk,
comparing TAVI with surgical valve replacement (SAVR). The results show
comparable clinical outcomes between TAVI and SAVR in terms of all-cause
mortality, stroke, and myocardial infarction. TAVI demonstrated a better
haemodynamic profile and a lower incidence of structural valve
deterioration (SVD), but showed higher rates of pacemaker requirement and
paravalvular leakage compared with surgical replacement. The trial
highlights the excellent durability of transcatheter bioprostheses,
although new-generation devices and advanced techniques could further
reduce adverse events. The study confirms the increasing role of TAVI even
in younger patients, but further long-term data will be needed to evaluate
its full potential.<br/>Copyright &#xa9; 2025 The Author(s). Published by
Oxford University Press on behalf of the European Society of Cardiology.

<96>
Accession Number
2034315830
Title
CT-derived adipose tissue characteristics and TAVI all-cause mortality and
complications: a systematic review.
Source
European Journal of Medical Research. 30(1) (no pagination), 2025. Article
Number: 325. Date of Publication: 01 Dec 2025.
Author
Pekar M.; Branny P.; Jiravsky O.; Spacek R.; Mohr J.A.; Ranic I.; Godula
B.J.; Konecna A.C.; Kantor M.; Hecko J.; Neuwirth R.; Sknouril L.; Novak
J.
Institution
(Pekar, Branny, Jiravsky, Spacek, Mohr, Ranic, Godula, Konecna, Kantor,
Hecko, Neuwirth, Sknouril) Hospital AGEL Trinec-Podlesi, Konska 453,
Trinec, Czechia
(Pekar, Mohr, Novak) Department of Physiology Faculty of Medicine Masaryk
University Kamenice, Brno, Czechia
(Branny, Godula) Faculty of Medicine, Palacky University, Krizkovskeho
511/8, Olomouc, Czechia
(Jiravsky, Ranic, Konecna, Sknouril) Medicine, Faculty of Medicine,
University of Ostrava, Syllabova 19, Ostrava, Czechia
(Spacek) Third Faculty of Medicine, Charles University, Ruska 87, Prague
10, Czechia
(Hecko) Faculty of Electrical Engineering and Computer Science, VSB -
Technical University of Ostrava, 17. Listopadu Street 2172/15, Ostrava,
Czechia
(Neuwirth) Faculty of Medicine Masaryk University Kamenice, Brno, Czechia
(Novak) Second Department of Internal Medicine St. Anne's University
Hospital in Brno, Pekarska 53, Brno, Czechia
Publisher
BioMed Central Ltd
Abstract
Transcatheter Aortic Valve Implantation (TAVI) has revolutionized severe
aortic stenosis treatment, but risk stratification remains challenging.
This systematic review examined the association between computed
tomography (CT)-derived adipose tissue parameters and TAVI outcomes. We
searched major databases for studies on visceral (VAT), subcutaneous
(SAT), and intramuscular (IMAT) adipose tissue parameters and post-TAVI
outcomes. Fourteen studies (9692 patients) were included. Higher SAT
area/volume was consistently associated with better survival (5 studies,
HR range: 0.83-2.77, p < 0.05). Lower SAT and VAT density also correlated
with better survival (5 and 4 studies, respectively, HR range: 1.31-1.46,
p < 0.05). VAT area showed mixed results. A VAT:SAT ratio < 1 was
associated with better cardiovascular outcomes in one study. Lower IMAT
index correlated with shorter hospital stays in a single study. This
review reveals complex relationships between adipose tissue parameters and
TAVI outcomes. Lower adipose tissue density and higher subcutaneous
adiposity were most consistently associated with better outcomes. These
findings suggest that detailed analysis of adipose tissue characteristics
may enhance risk stratification in TAVI candidates.<br/>Copyright &#xa9;
The Author(s) 2025.

<97>
Accession Number
2034343390
Title
Artificial Intelligence in Thoracic Surgery: A Review Bridging Innovation
and Clinical Practice for the Next Generation of Surgical Care.
Source
Journal of Clinical Medicine. 14(8) (no pagination), 2025. Article Number:
2729. Date of Publication: 01 Apr 2025.
Author
Leivaditis V.; Maniatopoulos A.A.; Lausberg H.; Mulita F.;
Papatriantafyllou A.; Liolis E.; Beltsios E.; Adamou A.; Kontodimopoulos
N.; Dahm M.
Institution
(Leivaditis, Lausberg, Papatriantafyllou, Dahm) Department of
Cardiothoracic and Vascular Surgery, Westpfalz Klinikum, Kaiserslautern,
Germany
(Maniatopoulos) Department of Electrical and Computer Engineering,
Democritus University of Thrace, Xanthi, Greece
(Mulita) Department of General Surgery, General Hospital of Eastern
Achaia-Unit of Aigio, Aigio, Greece
(Liolis) Department of Oncology, General University Hospital of Patras,
Patras, Greece
(Beltsios) Department of Anesthesiology and Intensive Care, Hannover
Medical School, Hannover, Germany
(Adamou) Institute of Diagnostic and Interventional Neuroradiology,
Hannover Medical School, Hannover, Germany
(Kontodimopoulos) Department of Economics and Sustainable Development,
Harokopio University, Athens, Greece
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Artificial intelligence (AI) is rapidly transforming thoracic
surgery by enhancing diagnostic accuracy, surgical precision,
intraoperative guidance, and postoperative management. AI-driven
technologies, including machine learning (ML), deep learning, computer
vision, and robotic-assisted surgery, have the potential to optimize
clinical workflows and improve patient outcomes. However, challenges such
as data integration, ethical concerns, and regulatory barriers must be
addressed to ensure AI's safe and effective implementation. This review
aims to analyze the current applications, benefits, limitations, and
future directions of AI in thoracic surgery. <br/>Method(s): This review
was conducted following the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature
search was performed using PubMed, Scopus, Web of Science, and Cochrane
Library for studies published up to January 2025. Relevant articles were
selected based on predefined inclusion and exclusion criteria, focusing on
AI applications in thoracic surgery, including diagnostics,
robotic-assisted surgery, intraoperative guidance, and postoperative care.
A risk of bias assessment was conducted using the Cochrane Risk of Bias
Tool and ROBINS-I for non-randomized studies. <br/>Result(s): Out of 279
identified studies, 36 met the inclusion criteria for qualitative
synthesis, highlighting AI's growing role in diagnostic accuracy, surgical
precision, intraoperative guidance, and postoperative care in thoracic
surgery. AI-driven imaging analysis and radiomics have improved pulmonary
nodule detection, lung cancer classification, and lymph node metastasis
prediction, while robotic-assisted thoracic surgery (RATS) has enhanced
surgical accuracy, reduced operative times, and improved recovery rates.
Intraoperatively, AI-powered image-guided navigation, augmented reality
(AR), and real-time decision-support systems have optimized surgical
planning and safety. Postoperatively, AI-driven predictive models and
wearable monitoring devices have enabled early complication detection and
improved patient follow-up. However, challenges remain, including
algorithmic biases, a lack of multicenter validation, high implementation
costs, and ethical concerns regarding data security and clinical
accountability. Despite these limitations, AI has shown significant
potential to enhance surgical outcomes, requiring further research and
standardized validation for widespread adoption. <br/>Conclusion(s): AI is
poised to revolutionize thoracic surgery by enhancing decision-making,
improving patient outcomes, and optimizing surgical workflows. However,
widespread adoption requires addressing key limitations through
multicenter validation studies, standardized AI frameworks, and ethical AI
governance. Future research should focus on digital twin technology,
federated learning, and explainable AI (XAI) to improve AI
interpretability, reliability, and accessibility. With continued
advancements and responsible integration, AI will play a pivotal role in
shaping the next generation of precision thoracic surgery.<br/>Copyright
&#xa9; 2025 by the authors.

<98>
[Use Link to view the full text]
Accession Number
2038463867
Title
Perioperative Outcomes in Patients Undergoing Transcatheter Aortic Valve
Replacement with Concomitant Mitral Regurgitation: A Meta-Analysis.
Source
Cardiology in Review. (no pagination), 2025. Article Number:
10.1097/CRD.0000000000000919. Date of Publication: 2025.
Author
Amani-Beni R.; Darouei B.; Rabiee Rad M.; Ghasempour Dabaghi G.; Eshraghi
R.; Bahrami A.; Amini-Salehi E.; Hashemi S.M.; Mazaheri-Tehrani S.;
Movahed M.R.
Institution
(Amani-Beni, Darouei, Rabiee Rad, Ghasempour Dabaghi) Isfahan
Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Eshraghi) Social Determinants of Health Research Center, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Bahrami) Kashan University of Medical Sciences, Kashan, Iran, Islamic
Republic of
(Amini-Salehi) School of Medicine, Guilan University of Medical Sciences,
Rasht, Iran, Islamic Republic of
(Hashemi) Cardiovascular Research Center, Hormozgan University of Medical
Sciences, Bandar Abbas, Iran, Islamic Republic of
(Mazaheri-Tehrani) Child Growth and Development Research Center, Research
Institute for Primordial Prevention of Non-Communicable Disease, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Movahed) Department of Medicine, University of Arizona, College of
Medicine, Phoenix, United States
(Movahed) Department of Medicine, University of Arizona, Sarver Heart
Center, Tucson, AZ, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Transcatheter aortic valve replacement (TAVR) is widely performed in
high-risk patients with severe aortic stenosis. However, the effects of
baseline concomitant mitral regurgitation (MR) on perioperative outcomes
remain unclear. This study evaluated the impact of concomitant MR severity
on short-term TAVR outcomes. A systematic search of 6 electronic databases
was conducted. Studies that stratified patients based on MR severity (MR
>=2 vs. <2 or MR >=3 vs. <3) and reported perioperative outcomes,
including short-term mortality, in-hospital mortality, acute kidney injury
(AKI), pacemaker implantation, bleeding, vascular complications, and MR
improvement (up to 1 week and 1 month) were eligible. Data from 26 studies
(32,453 patients) demonstrated that patients with baseline
moderate-to-severe MR (MR >=2) had a 49% (95% confidence interval (CI),
1.32-1.70) increased risk of short-term mortality, a 41% (95% CI,
1.22-1.63) higher risk of in-hospital mortality, and a 38% (95% CI,
1.17-1.62) higher risk of AKI than those with none-to-mild MR (MR<2).
Patients with an MR >=3 had an even greater 72% (95% CI, 1.37-2.16)
increase in short-term mortality. No significant differences were observed
in pacemaker implantation, bleeding, or vascular complications between
groups. Additionally, after TAVR, MR improved in 36% of patients by at
least 1 grade within 1 week, increasing to 44% by 1 month. In TAVR
patients, MR >=2 was associated with significantly higher early mortality
and AKI risk, underscoring the need for a comprehensive perioperative risk
assessment. Future studies should examine the differential impact of
functional and degenerative MR.<br/>Copyright &#xa9; 2025 Wolters Kluwer
Health, Inc.

<99>
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. (no pagination), 2025. Article
Number: e014961. Date of Publication: 2025.
Author
Kjaergaard J.; Moller C.H.; Wiberg S.; Mikkelsen A.D.; Moller-Sorensen H.;
Ravn H.; Ravn J.; Olsen P.S.; Hofsten D.; Boesgaard S.; 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, Denmark
(Moller, Ravn, Olsen) Department of Cardiothoracic Surgery, Copenhagen
University Hospital Rigshospitalet, Denmark
(Wiberg, Moller-Sorensen, Nilsson) Department of Cardiothoracic
Anesthesiology, Copenhagen University Hospital 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.
<br/>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 and aortic
valve replacement. Patients were predominantly low risk. The intervention
was an infusion of 17.4 microg 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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2025 Lippincott Williams and Wilkins.
All rights reserved.

<100>
Accession Number
2038418316
Title
Letter by Xu et al Regarding Article, "effect of Delayed Remote Ischemic
Preconditioning on Acute Kidney Injury and Outcomes in Patients Undergoing
Cardiac Surgery: A Randomized Clinical Trial".
Source
Circulation. 151(16) (pp e957-e958), 2025. Date of Publication: 22 Apr
2025.
Author
Xu X.; Zhu H.; Cai L.
Institution
(Xu, Cai) Center of Laboratory Medicine, Hangzhou Red Cross Hospital,
China
(Zhu) Department of Cardiology, Hangzhou Traditional Chinese Medicine
Hospital Affiliated, Zhejiang Chinese Medical University, China
Publisher
Lippincott Williams and Wilkins

<101>
Accession Number
2034317072
Title
The Impact of Concomitant Mitral Regurgitation on Echocardiography
Parameters After TransCatheter Aortic Valve Replacement: A Systematic
Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Darouei B.; Amani-Beni R.; Rabiee Rad M.; Ghasempour Dabaghi G.; Eshraghi
R.; Bahrami A.; Amini-Salehi E.; Hashemi S.M.; Mazaheri-Tehrani S.;
Movahed M.R.
Institution
(Darouei, Amani-Beni, Rabiee Rad, Ghasempour Dabaghi) Isfahan
Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Eshraghi) Social Determinants of Health Research Center, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Bahrami) Student Research Committee, Kashan University of Medical
Sciences, Kashan, Iran, Islamic Republic of
(Amini-Salehi) Guilan University of Medical Sciences, Rasht, Iran, Islamic
Republic of
(Hashemi) Cardiovascular Research Center, Hormozgan University of Medical
Sciences, Bandar Abbas, Iran, Islamic Republic of
(Mazaheri-Tehrani) Child Growth and Development Research Center, Research
Institute for Primordial Prevention of Non-Communicable Disease, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Movahed) Department of Medicine, University of Arizona College of
Medicine, Phoenix, United States
(Movahed) Department of Medicine, University of Arizona Sarver Heart
Center, Tucson, AZ, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Mitral regurgitation (MR) commonly coexists with aortic
stenosis (AS) and is a potential risk factor influencing outcomes
following transcatheter aortic valve replacement (TAVR). This
meta-analysis aimed to evaluate the mean changes in key echocardiographic
parameters before and after TAVR and to compare these changes between
patients with moderate-to-severe MR (MR >= 2) and those with none-to-mild
MR (MR < 2). <br/>Method(s): A comprehensive literature search was
conducted using six electronic databases. We included studies that
evaluated patients undergoing TAVR, classified them based on baseline MR
grade >= 2 (moderate/severe MR) or MR grade < 2 (none/mild MR), and
reported the mean difference (MD) in echocardiographic parameters before
and after TAVR in both groups. The primary outcomes included changes in
ejection fraction (EF), LV end-diastolic volume (LVEDV) index, LV
end-systolic volume (LVESV) index, LV end-diastolic diameter (LVEDD), LV
end-systolic diameter (LVESD), aortic valve area (AVA), and the mean
aortic gradient. Pooled MDs were analyzed using a random-effects model.
<br/>Result(s): Thirteen studies with 7163 patients were included, of
which 2376 had an MR >= 2. The MR < 2 and MR >= 2 groups experienced
significant improvements in AVA and reductions in mean aortic gradient,
LVEDV index, LVESV index, LVEDD, and LVESD. Compared to MR < 2 patients,
those with MR >= 2 exhibited significantly greater improvements in EF (MD
= 2.03; 95% CI: 0.81, 3.24), LVEDV index (MD = -5.55; 95% CI: -7.85,
-3.26), LVESV index (MD = -5.43; 95% CI: -7.28, -3.58), LVESD (MD = -2.23;
95% CI: -3.71, -0.26), and mean aortic gradient (MD = 1.43; 95% CI: 0.79,
2.07). However, the changes in LVEDD and AVA were not significantly
different between the groups. <br/>Conclusion(s): These findings suggest
that patients with moderate-to-severe baseline MR before TAVR showed
greater pronounced improvements in specific echocardiographic parameters
related to LV function and geometry, particularly in LVEF, LVEDV index,
LVESV index, and LVESD, compared to those with none-to-mild MR. Future
studies should focus on stratifying outcomes according to MR etiology and
using advanced imaging techniques to delineate better the mechanisms
underlying these improvements.<br/>Copyright &#xa9; 2025 Wiley Periodicals
LLC.

<102>
Accession Number
2034219574
Title
Effectiveness of a Rotating-Leg Prepper for Reducing Pressure Injury and
Preventing Surgical Site Infection in Patients Undergoing Heart Surgery:
Paired Matching Randomised Controlled Trial.
Source
International Wound Journal. 22(4) (no pagination), 2025. Article Number:
e70371. Date of Publication: 01 Apr 2025.
Author
Chiannilkulchai N.; Pichaiphanupatt P.
Institution
(Chiannilkulchai) Ramathibodi School of Nursing, Faculty of Medicine
Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
(Pichaiphanupatt) Division of Perioperative Nursing, Department of
Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University,
Bangkok, Thailand
Publisher
John Wiley and Sons Inc
Abstract
This study aims to evaluate the effectiveness of a rotating-leg prepper
(intervention) compared with a rolled gauze bandage (control) in reducing
pressure injury and preventing surgical site infection in the legs of
patients undergoing heart surgery. The paired-matched, open, randomised
controlled trial was conducted from September 2022 to July 2024. The
participants were composed of the patient and the staff groups. Sixty
patients were paired-matched to the intervention and control groups.
Before painting the resting area with an antiseptic, the ankle presented
non-blanchable erythema, which was recorded as a pressure injury. The
intervention group showed significantly lower pressure injury (0% vs.
76.6%, p = 0.001) than the control group, with a relative risk of 5.29
(95% CI: 2.71-10.30). Both groups exhibited no significant difference in
surgical site infection. However, the relative risk of surgical site
infection in the control group was 2.03 (95% CI: 1.57-2.64). Thirty staff
participants were purposively sampled to evaluate the effects of both leg
lifting methods and assess their satisfaction with the leg prepper. The
overall satisfaction with the rotating-leg prepper was 4.87 +/- 0.22.
Rotating-leg preppers can reduce pressure injury and prevent surgical site
infections in patients' legs during heart surgery.<br/>Copyright &#xa9;
2025 The Author(s). International Wound Journal published by
Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<103>
Accession Number
2034333995
Title
Paravalvular Leak in Transcatheter Aortic Valve Implantation: A Review of
Current Challenges and Future Directions.
Source
Journal of Cardiovascular Development and Disease. 12(4) (no pagination),
2025. Article Number: 125. Date of Publication: 01 Apr 2025.
Author
Synetos A.; Ktenopoulos N.; Katsaros O.; Vlasopoulou K.; Drakopoulou M.;
Koliastasis L.; Kachrimanidis I.; Apostolos A.; Tsalamandris S.; Latsios
G.; Toutouzas K.; Patrikios I.; Tsioufis C.
Institution
(Synetos, Ktenopoulos, Katsaros, Vlasopoulou, Drakopoulou, Koliastasis,
Kachrimanidis, Apostolos, Tsalamandris, Latsios, Toutouzas, Tsioufis)
First Department of Cardiology, National and Kapodistrian University of
Athens, Hippokration General Hospital of Athens, Athens, Greece
(Synetos, Patrikios) Medical School, European University of Cyprus,
Egkomi, Cyprus
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Transcatheter aortic valve implantation (TAVI) has emerged as a
revolutionary therapeutic modality for the management of severe aortic
stenosis (AS), particularly in patients who are at high or prohibitive
risk for surgical aortic valve replacement (SAVR). Over the past decade,
extensive clinical evidence has expanded the indications for TAVI to
include intermediate- and low-risk populations, which usually represent a
population of younger age, in which the most common complications of TAVI,
including paravalvular leak (PVL) and pacemaker implantation, should be
avoided. This review focuses on the incidence and predictors of PVL in
various types of TAVI implantation, its clinical implication, and the
prevention strategies to tackle this complication.<br/>Copyright &#xa9;
2025 by the authors.

<104>
Accession Number
2034262482
Title
Short-Term, Mid-Term, and Long-Term Outcomes of Transcatheter Aortic Valve
Replacement With Balloon-Expandable Versus Self-Expanding Valves: A
Meta-Analysis of Randomized Controlled Trials.
Source
Clinical Cardiology. 48(4) (no pagination), 2025. Article Number: e70134.
Date of Publication: 01 Apr 2025.
Author
Tavakoli K.; Mohammadi N.S.H.; Bahiraie P.; Saeidi S.; Shaker F.; Moghadam
A.S.; Namin S.M.; Rahban H.; Pawar S.; Tajdini M.; Soleimani H.; Jenab Y.;
Ahmad Y.; Iskander F.H.; Alkhouli M.; Makkar R.; Gupta A.; Hosseini K.
Institution
(Tavakoli, Mohammadi, Saeidi, Shaker, Moghadam, Namin, Tajdini, Soleimani,
Jenab, Hosseini) Tehran Heart Center, Cardiovascular Diseases Research
Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Bahiraie) School of Medicine, Shahid Beheshti University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Rahban) Cardiovascular Research Foundation of Southern California,
Beverly Hills, CA, United States
(Rahban) Department of Cardiovascular Disease, Creighton University School
of Medicine, St. Joseph Hospital and Medical Center, Phoenix, AZ, United
States
(Pawar, Makkar, Gupta) Cedars Sinai Medical Center, California, United
States
(Tajdini, Soleimani, Jenab, Hosseini) Cardiac Primary Prevention Research
Center, Cardiovascular Diseases Research Institute, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Ahmad) Yale School of Medicine, Yale University, New Haven, CT, United
States
(Iskander) Department of Cardiology, Medstar Union Memorial Hospital,
Baltimore, MD, United States
(Alkhouli) Department of Cardiology, Mayo Clinic School of Medicine,
Rochester, MN, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Comparisons of outcomes after transcatheter aortic valve
replacement with balloon-expandable (BEV) versus self-expanding (SEV)
valves are limited. Hypothesis: This study aimed to compare clinical and
hemodynamic outcomes of BEV and SEV at short-term (30 days), midterm (1
year), and long-term (> 1 year) endpoints. <br/>Method(s): PubMed, Embase,
Scopus, and Cochrane Library databases were searched until July 2024 for
randomized controlled trials. Random-effect model (DerSimonian-Laird
method) was used to pool the risk ratios (RR), mean differences, and 95%
confidence intervals (CI). <br/>Result(s): A total of 10 studies
comprising 4325 patients (2295 BEV, 2030 SEV) were included. In
short-term, cardiovascular (RR: 0.56, 95% CI: 0.36-0.87) and all-cause
mortality (RR: 0.54, 95% CI: 0.35-0.81) were lower in the BEV group. Risk
of moderate to severe paravalvular leak (PVL) was lower among BEV patients
in short-term (RR: 0.28, 95% CI: 0.17-0.49) and long-term (RR: 0.28, 95%
CI: 0.1-0.79). A limited number of studies showed a greater risk of
clinical valve thrombosis on BEV in midterm and long-term. The need for
permanent pacemaker implantation was lower in BEV at both short-term (RR:
0.56, 95% CI: 0.37-0.87), and midterm (RR: 0.78, 95% CI: 0.64-0.94). The
SEV group had a larger effective orifice area with lower mean
transvalvular pressure gradient at all endpoints. <br/>Conclusion(s): BEV
is associated with reduced risk of clinical outcomes in short-term;
however, most differences diminish in longer evaluations, except for
moderate to severe PVL, which remains elevated for SEV. SEVs had better
hemodynamic results and lower risk of clinical valve
thrombosis.<br/>Copyright &#xa9; 2025 The Author(s). Clinical Cardiology
published by Wiley Periodicals, LLC.

<105>
Accession Number
2038408457
Title
To Compare The Efficacy Of Isobaric Levobupivacaine And Isobaric
Ropivacaine In Patients Undergoing Breast Cancer Surgeries Under Thoracic
Segmental Spinal Anaesthesia.
Source
International Journal of Life Sciences Biotechnology and Pharma Research.
14(4) (pp 851-858), 2025. Date of Publication: 01 Apr 2025.
Author
Kaur H.; Kaur G.; Makhni R.; Ravipaul
Institution
(Kaur, Kaur, Makhni, Ravipaul) Department of anesthesiology, GMC, Punjab,
Amritsar, India
Publisher
International Journal of Life Sciences Biotechnology and Pharma Research
Abstract
Background- Breast cancer is the second most common cause of cancer deaths
in women around the world and the main modality of its treatment is
surgery, which is associated with postoperative nausea-vomiting (PONV) and
pain. It is commonly performed under general anesthesia (GA), but can also
be performed under regional anaesthesia such as thoracic segmental spinal
anaesthesia (TSSA), which is an effective alternative to GA especially in
patients who are at risk under GA. The aim of the study is to compare the
efficacy of isobaric levobupivacaine and ropivacaine in patients
undergoing breast cancer surgeries under TSSA. Methods- The study enrolled
60 patients scheduled for Modified Radical Mastectomy, divided randomly
into two groups of 30 each (group L and R), belonging to the age group
18-60 years of ASA grade l and ll. Group L received 1.8 ml 0.5% isobaric
levobupivacaine and group R received 1.8 ml 0.5% isobaric ropivacaine.
Results- The mean onset of sensory block of group R (7.18+/-0.62 min) was
more than group L (3.66+/-0.51 min). The mean time to attain maximum
sensory level in group R (7.91+/-0.47 min) was more than group L
(5.33+/-0.63 min). Total duration of the sensory block was more in group L
(180.83+/-6.17 min) than group R (129.50+/-6.47 min). Intraoperative and
postoperative hemodynamics were stable and no PONV was seen in either
group. The total number of rescue analgesia doses were more in group R
(2.16+/-0.83) than group L (1.46+/-0.62). Conclusion- Isobaric
levobupivacaine provides adequate subarachnoid block for breast cancer
surgeries under thoracic segmental spinal anaesthesia than isobaric
ropivacaine with longer duration of sensory block.<br/>Copyright
&#xa9;2025Int. J. LifeSci.Biotechnol.Pharma.Res.

<106>
[Use Link to view the full text]
Accession Number
2038415710
Title
Intensive Lowering of LDL Cholesterol Levels With Evolocumab in Autoimmune
or Inflammatory Diseases: An Analysis of the FOURIER Trial.
Source
Circulation. (no pagination), 2025. Date of Publication: 2025.
Author
Zimerman A.; Kunzler A.L.F.; Weber B.N.; Ran X.; Murphy S.A.; Wang H.;
Honarpour N.; Keech A.C.; Sever P.S.; Sabatine M.S.; Giugliano R.P.
Institution
(Zimerman, Kunzler) Hospital Moinhos de Vento, Moinhos de Vento College of
Health Sciences, Porto Alegre, Brazil
(Ran, Murphy, Sabatine, Giugliano) TIMI Study Group, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA, United States
(Weber) Division of Cardiovascular Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Wang) Amgen, Thousand Oaks, CA, United States
(Honarpour) Global Development, Amgen, Thousand Oaks, CA, United States
(Keech) Sydney Medical School, National Health and Medical Research
Council Clinical Trials Centre, University of Sydney, Australia
(Sever) National Heart and Lung Institute, Imperial College London, United
Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Patients with an autoimmune or inflammatory disease (AIID) are
at increased cardiovascular risk and may benefit more from statin therapy.
In the FOURIER trial (Further Cardiovascular Outcomes Research with PCSK9
Inhibition in Subjects with Elevated Risk), the PCSK9 (proprotein
convertase subtilisin/kexin type 9) inhibitor evolocumab lowered
low-density lipoprotein cholesterol levels, but not hsCRP
(high-sensitivity C-reactive protein) levels, and reduced the risk of
cardiovascular events. <br/>METHOD(S): FOURIER was a randomized trial of
evolocumab versus placebo in 27 564 patients with stable atherosclerosis
who were taking statins. This analysis focused on the effect of evolocumab
in patients with or without an AIID, defined as any autoimmune or chronic
inflammatory condition. The primary end point was a composite of
cardiovascular death, myocardial infarction, stroke, unstable angina, or
coronary revascularization. <br/>RESULT(S): At baseline, 889 patients
(3.2%) had an AIID, most commonly rheumatoid arthritis (33.7%) or
psoriasis (15.6%). Median (interquartile range) low-density lipoprotein
cholesterol levels were 90.0 mg/dL (79.5-105.5) and 91.5 mg/dL
(79.5-108.5) in patients with or without an AIID, respectively (P=0.025),
and the placebo-adjusted percent reduction with evolocumab was consistent
(60.2% versus 59.0%; P=0.57). Baseline hsCRP was higher in patients with
an AIID (median 2.1 versus 1.7 mg/L; P<0.001) and did not significantly
change with evolocumab in either group. Compared with placebo, evolocumab
reduced the rate of the primary end point by 14% in patients without an
AIID (hazard ratio, 0.86 [95% CI, 0.80-0.93]) and by 42% in patients with
an AIID (hazard ratio, 0.58 [95% CI, 0.38-0.89];
P<inf>interaction</inf>=0.066). Likewise, evolocumab reduced the key
secondary end point of cardiovascular death, myocardial infarction, or
stroke by 19% in patients without an AIID (hazard ratio, 0.81 [95% CI,
0.74-0.89]) and 58% in those with an AIID (hazard ratio, 0.42 [95% CI,
0.24-0.74]; P<inf>interaction</inf>=0.022). <br/>CONCLUSION(S): Intensive
lowering of low-density lipoprotein cholesterol levels with evolocumab may
lead to greater relative reduction in cardiovascular events in patients
with an AIID.<br/>Copyright &#xa9; 2025 American Heart Association, Inc.

<107>
Accession Number
2034293830
Title
Probiotic mitigates gut hypoperfusion-associated acute gastrointestinal
injury in patients undergoing cardiopulmonary bypass: a randomized
controlled trial.
Source
BMC Medicine. 23(1) (no pagination), 2025. Article Number: 238. Date of
Publication: 01 Dec 2025.
Author
Yang X.; Liu R.; An Z.; Li B.; Lin Y.; Li Y.; Song B.; Yuan J.; Meng W.;
Waydhas C.
Institution
(Yang, Liu, Meng) The First School of Clinical Medicine, Lanzhou
University, Gansu, Lanzhou, China
(Yang, Liu, An, Li, Song) Department of Cardiovascular Surgery, The First
Hospital of Lanzhou University, Gansu, Lanzhou, China
(Lin, Meng) Department of General Surgery, The First Hospital of Lanzhou
University, Gansu, Lanzhou, China
(Meng) Gansu Province Key Laboratory of Biological Therapy and
Regenerative Medicine Transformation, Gansu, Lanzhou, China
(Li) Department of Pharmacy, The First Hospital of Lanzhou University,
Gansu, Lanzhou, China
(Yuan) Clinical Research Center, Big Data Center, The Seventh Affiliated
Hospital, Sun Yat-Sen University, Guangdong, Shenzhen, China
(Waydhas) Trauma Intensive Care, Department of Trauma Surgery, University
Hospital Essen, University Duisburg-Essen, Essen, Germany
Publisher
BioMed Central Ltd
Abstract
Background: Acute gastrointestinal injury (AGI) after cardiopulmonary
bypass (CPB) is associated with poor prognosis. This study aimed to
evaluate the effect of preoperative probiotic supplementation on the
incidence of AGI in patients undergoing CPB procedure. <br/>Method(s):
This was a double-blind, randomized controlled trial conducted in a single
center. The patients undergoing HVR with CPB between September 2022 and
February 2023 were randomly assigned to receive either probiotic (Lac
group) or placebo (Placebo group). The probiotic was administered daily
for seven days prior to surgery.Univariate and multivariate logistic
regression analysis was performed to identify independent risk factors for
AGI. A P-value < 0.05 was considered statistically significant. Gut
microbiota composition was assessed using 16 s rRNA analysis.
<br/>Result(s): A total of 52 patients were randomly assigned to two
groups (26 in the Lac group, 26 in the Placebo group). Patients were
followed for at least 30 days after surgery. During the follow-up period,
15 of the 52 patients (28.85%) developed AGI. The incidence of AGI was
significantly lower in the Lac group (15.38%) compared to the Placebo
group (42.31%), with a difference of 26.93% (P = 0.032). Moreover,
patients in the Lac group had a significantly shorter ICU stay (6 [5, 36]
vs. 5 [4, 5.5] days, P = 0.041) and a lower incidence of nosocomial
infections (11.54% vs. 34.62%, P = 0.048). Multivariate analysis
identified a higher Cardiac Surgery Score (CASUS) and CPB duration >= 132
min as independent risk factors for AGI, whereas probiotic supplementation
was the only protective factor. Furthermore, 16S rRNA sequencing revealed
significant differences in gut microbiota composition between the Lac and
Placebo groups. <br/>Conclusion(s): Preoperative probiotic supplementation
may be an effective strategy to reduce the incidence of AGI and
AGI-related complications in CPB patients. These findings suggest that
probiotics could be considered a preventive intervention for AGI in this
patient population. Trial registration: ClinicalTrials.gov:
NCT05498948.<br/>Copyright &#xa9; The Author(s) 2025.

<108>
Accession Number
2038407791
Title
Comparison of PCI vs. CABG in Multi-Vessel Disease.
Source
European Journal of Cardiovascular Medicine. 15(4) (pp 587-592), 2025.
Date of Publication: 01 Apr 2025.
Author
Haridas P.V.; Das A.
Institution
(Haridas) Dept of Cardiology, Malabar Medical College Hospital & Research
Centre, Ulliyeri, Kerala, Calicut, India
(Das) Dept of Community Medicine, PSP Medical College, Tamil Nadu,
Chennai, India
Publisher
Healthcare Bulletin
Abstract
Background: Coronary artery bypass grafting (CABG) and percutaneous
coronary intervention (PCI) are the two primary revascularization
strategies for multivessel coronary artery disease (MVD) and left main
coronary artery disease (LMCAD). While PCI offers a minimally invasive
alternative, concerns remain regarding its long-term efficacy compared to
CABG. This study aims to compare the long-term outcomes of CABG and PCI in
patients with MVD and LMCAD. <br/>Method(s): A retrospective cohort study
was conducted on patients undergoing revascularization for MVD and LMCAD.
Clinical outcomes, including major adverse cardiac events (MACE),
all-cause mortality, myocardial infarction, and repeat revascularization,
were assessed over a long-term follow-up period. Kaplan-Meier survival
curves were used to evaluate event-free survival rates. Statistical
analysis was performed using a Cox proportional hazards model to adjust
for confounding variables. <br/>Result(s): The results supported that
although CABG was associated with reduced occurrence of major adverse
cardiovascular events (MACE) and repeat revascularization rates compared
to PCI, survival at the end-results was similar among the two. Event-free
survival was superior within the CABG group at each follow-up duration, in
harmony with prior meta-analyses. Nonetheless, PCI still held acceptable
long-term results, particularly in selected subjects with less elaborate
coronary anatomy, affirming the validity of alternative use of surgery for
revascularization. <br/>Conclusion(s): CABG and PCI are both effective
forms of revascularization in patients with multivessel coronary artery
disease (MVD) and left main coronary artery disease (LMCAD). Although CABG
might be superior in event prevention in the long term, PCI is not
necessarily inferior in general and especially not in properly selected
cases. Personalized treatment planning on the basis of patient risk
profile and anatomical complexity is paramount. More research is needed to
improve selection criteria and long-term cardiovascular results for both
modalities.<br/>Copyright &#xa9; 2025 Healthcare Bulletin. All rights
reserved.

<109>
Accession Number
2038455402
Title
Preoperative iron supplementation in non-anemic patients undergoing major
surgery: a systematic review and meta-analysis.
Source
Brazilian Journal of Anesthesiology (English Edition). 75(3) (no
pagination), 2025. Article Number: 844618. Date of Publication: 01 May
2025.
Author
Toledo F.V.; De Carli D.; Meletti J.F.A.; Togo H.Y.A.; Gomes I.P.;
Sakashita R.M.; Montes L.F.; Tiburcio R.S.; Miranda C.D.A.
Institution
(Toledo, De Carli, Meletti, Togo, Gomes, Sakashita, Montes, Tiburcio,
Miranda) Faculdade de Medicina de Jundiai (FMJ), Departamento de
Anestesiologia, SP, Jundiai, Brazil
Publisher
Elsevier Editora Ltda
Abstract
Background: Blood transfusions are associated with increased morbidity and
mortality, and maintaining global blood supplies can be a challenge. This
systematic review investigates the impact of preoperative iron
supplementation on the risk of blood transfusion among non-anemic patients
undergoing major surgeries. <br/>Method(s): We conducted a systematic
search of PubMed, Embase, and Cochrane Central for randomized controlled
trials published up to May 2024. Studies involving the use of
erythropoietin, or patients already using iron supplementation when trial
randomization was conducted were excluded. Outcomes assessed included the
number of individuals who received blood transfusions, and mean hemoglobin
levels at the first day and by the first postoperative week.
<br/>Result(s): A total of 1,162 non-anemic patients from 9 studies were
included. Of these, 54% received preoperative iron supplementation. The
average age was 71 years, and 44% were women. Preoperative iron
supplementation was associated with a significantly lower risk of
receiving a blood transfusion (OR = 0.54; 95% CI 0.40 to 0.75; p < 0.001).
At the first postoperative day, the iron supplementation group had
significantly higher mean hemoglobin levels compared to the no-treatment
group (MD = 0.22 g.dL^-1; 95% CI 0.02 to 0.42; p = 0.03).
However, the pooled results could not rule out the null hypothesis for the
difference in mean hemoglobin levels throughout the first week (MD = 0.12
g.dL^-1; 95% CI -0.12 to 0.35; p = 0.34). <br/>Conclusion(s):
Preoperative intravenous iron supplementation in non-anemic patients
undergoing major surgeries, particularly cardiac procedures, significantly
reduces transfusion requirements. However, the benefits of oral iron
remain uncertain, and further research is warranted to establish
standardized perioperative supplementation protocols. PROSPERO identifier:
CRD42024552559.<br/>Copyright &#xa9; 2025 Sociedade Brasileira de
Anestesiologia

<110>
Accession Number
2034263713
Title
Epidural anesthesia and analgesia in neonates and infants: Protocol for a
scoping review.
Source
Acta Anaesthesiologica Scandinavica. 69(5) (no pagination), 2025. Article
Number: e70029. Date of Publication: 01 May 2025.
Author
Larsen L.G.; Hansen T.G.
Institution
(Larsen) Anestesiologic-Intensive Ward V, Odense University Hospital,
Odense, Denmark
(Hansen) Departpent of Anestesia and Intensive care, Akershus University
Hospital, Nordbyhagen, Norway
Publisher
John Wiley and Sons Inc
Abstract
Background: Surgery and anesthesia in neonates and infants are performed
only when necessary due to their immature physiological systems and
limited cardiorespiratory reserves, rendering them particularly
susceptible to complications. Effective pain management in the context of
major surgical procedures presents a considerable challenge. Untreated
pain activates cellular and humoral pathways that are detrimental to
recovery. Although opioids are effective analgesics, their use is
associated with hypoventilation and may exacerbate the physiological apnea
commonly observed in newborns. This can extend the requirement for
positive pressure ventilation, increasing the risks of both immediate and
long-term adverse outcomes. Epidural anesthesia and analgesia offer a
promising alternative by providing effective pain relief while reducing
opioid consumption, thus minimizing respiratory impairment and promoting
more rapid recovery. This scoping review aims to map existing knowledge,
to shed light on knowledge gaps, and lay the groundwork for further
research. <br/>Method(s): This review will follow the JBI methodology and
adhere to the PRISMA guidelines for Scoping Reviews. A comprehensive
search will be conducted across peer-reviewed databases, published
literature, online resources, ongoing studies, and gray literature to
identify all available evidence on epidural anesthesia and analgesia in
thoracic and abdominal surgeries in neonates and infants. <br/>Result(s):
The findings from the included studies will be synthesized narratively and
presented with tables and figures to ensure a clear and structured
overview. <br/>Conclusion(s): This scoping review aims to summarize the
current evidence on epidural anesthesia and analgesia in neonates and
infants. It will highlight well-researched areas, identify gaps in the
literature, and outline existing knowledge and unmet research needs in
this field.<br/>Copyright &#xa9; 2025 The Author(s). Acta
Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on
behalf of Acta Anaesthesiologica Scandinavica Foundation.

<111>
Accession Number
2038418486
Title
Response by Jia et al to Letter Regarding Article, "Effect of Delayed
Remote Ischemic Preconditioning on Acute Kidney Injury and Outcomes in
Patients Undergoing Cardiac Surgery: A Randomized Clinical Trial".
Source
Circulation. 151(16) (pp e959-e960), 2025. Date of Publication: 22 Apr
2025.
Author
Jia P.; Luo Z.; Ding X.
Institution
(Jia, Ding) Department of Nephrology, Zhongshan Hospital, Fudan
University, Shanghai Medical Center of Kidney, Shanghai Key Laboratory of
Kidney and Blood Purification, China
(Luo) Cardiac Intensive Care Center, Zhongshan Hospital, Fudan University,
China
Publisher
Lippincott Williams and Wilkins

<112>
Accession Number
2034316412
Title
Redo aortic root-complexity vs simplicity with choice of device selected.
Source
Expert Review of Medical Devices. (no pagination), 2025. Date of
Publication: 2025.
Author
He C.; Norton E.L.; Chen E.P.
Institution
(He, Norton) Division of Cardiothoracic Surgery, Department of Surgery,
Emory University School of Medicine, Atlanta, GA, United States
(Chen) Division of Cardiovascular and Thoracic Surgery, Department of
Surgery, Duke University Medical Center, Durham, NC, United States
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: The field of cardiac surgery continues to evolve
significantly and one such example of advancement is aortic root
replacement. In the setting of prior cardiac surgery, operative complexity
increases due to adhesions, surgically-altered anatomy, and previously
implanted prosthetic graft material. Device choice plays a significant
role in balancing operative complexity with achieving simplicity and
optimal clinical outcomes. Areas covered: This review explores the
critical considerations necessary in performing redo aortic root surgery
and the impact that device selection can have on the procedural complexity
and clinical outcomes. This review was formulated by a systematic
identification of published and unpublished laboratory and clinical
studies evaluating these technologies. Expert opinion: Redo aortic root
surgery represents one of the most challenging procedures in cardiac
surgery, and the choice of both surgical technique and prosthetic device
used are critical factors which influence the clinical success of the
operation and the long-term outcomes for patients. By understanding the
unique challenges of root replacement in a reoperative setting and the
characteristics of different prosthetic devices, a tailored approach must
be employed toward the best possible outcomes.<br/>Copyright &#xa9; 2025
Informa UK Limited, trading as Taylor & Francis Group.

<113>
Accession Number
2034300753
Title
Optimal duration of anticoagulation after left atrial appendage closure: a
systematic review and meta-analysis.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
304. Date of Publication: 01 Dec 2025.
Author
Lu X.; Yang Z.; Fang W.; Niu X.; Wang Q.; Li Y.
Institution
(Lu, Yang, Fang, Niu, Wang, Li) Department of Cardiology, Tangdu Hospital,
The Fourth Military Medical University, Xi'an, China
Publisher
BioMed Central Ltd
Abstract
Background: Left atrial appendage closure (LAAC) has become the treatment
of choice for stroke prevention in patients with nonvalvular atrial
fibrillation who are at high risk of bleeding or with contraindications
for anticoagulation. However, the optimal duration of anticoagulation
after LAAC remains uncertain. The aim of this study was to evaluate the
optimal duration of treatment with novel oral anticoagulants (NOACs) after
LAAC. <br/>Method(s): We searched the PubMed, Embase, Cochrane Library,
and Web of Science databases for studies related to LAAC published from
inception to 20 December 2023, and performed a meta-analysis comparing the
efficacy and safety of 45-day and 3-month postoperative NOAC treatment
using R4.3.1 software. <br/>Result(s): A total of 14 studies were included
in this study, of which 4 were prospective cohort studies and 10 were
retrospective cohort studies. The incidence of stroke or transient
ischaemic attack (0.018 [95% CI: 0.007-0.033] in the 3-month group and
0.005 [95% CI: 0.001-0.011] in the 45-day group; P = 0.07) and the
incidence of device-related thrombus (0.025 [95% CI: 0.002-0.065] in the
3-month group and 0.020 [95% CI: 0.007-0.037] in the 45-day group; P =
0.81) were not significantly different. However, the incidence of major
bleeding was significantly greater in the 3-month group than in the 45-day
group (0.033 [95% CI: 0.018-0.053] in the 3-month group and 0.003 [95% CI:
0.000-0.008] in the 45-day group; P < 0.01). <br/>Conclusion(s): Compared
with the 3-month scheme, 45 days of postoperative anticoagulation
significantly reduced the risk of major bleeding in patients without
compromising the efficacy of preventing stroke or transient ischaemic
attack and device-related thrombus. Trial registration: Our meta-analysis
was registered in the PROSPERO international database
(CRD42024524661).<br/>Copyright &#xa9; The Author(s) 2025.

<114>
Accession Number
2038411834
Title
Even aortic insufficiency can be treated percutaneously: Right?.
Source
European Heart Journal, Supplement. 27(Supplement_3) (pp iii105-iii110),
2025. Date of Publication: 01 Mar 2025.
Author
Guicciardi N.A.; Beneduce A.; Maisano F.
Institution
(Guicciardi, Beneduce, Maisano) Department of Cardiac Surgery, Valve
Center - Irccs San Raffaele Hospital, Milan, Italy
Publisher
Oxford University Press
Abstract
Moderate or severe aortic insufficiency (AI) is a relatively rare
condition but with significant clinical implications, especially in
elderly patients at high surgical risk. Although surgical aortic valve
replacement remains the gold standard for treatment, a significant
proportion of patients are not eligible due to the high surgical risk. In
recent years, transcatheter aortic valve implantation (TAVI) has
revolutionized the treatment of aortic stenosis, but its application to AI
has encountered significant challenges, mainly related to specific
anatomical characteristics of this population. This review provides an
overview of the evolution of the transcatheter treatment of AI,
highlighting the critical issues of first-generation TAVI devices and the
improvements achieved with new-generation and dedicated devices, such as
JenaValve and J-Valve. Preliminary data demonstrate encouraging procedural
results, including a reduction in residual insufficiency and improved
safety in patients at high surgical risk. However, limitations remain,
including the high incidence of pacemaker implantation and the lack of
long-term randomized clinical trials. In light of technological advances,
TAVI represents a promising therapeutic option for selected patients with
AI, if performed in high-volume centres with extensive experience in the
treatment of aortic disease.<br/>Copyright &#xa9; 2025 The Author(s).
Published by Oxford University Press on behalf of the European Society of
Cardiology.

<115>
Accession Number
2038409717
Title
PO-02-025 BETA-BLOCKERS FOR PROPHYLAXIS OF POST-OPERATIVE ATRIAL
FIBRILLATION AFTER CARDIAC SURGERY: A SYSTEMATIC REVIEW AND NETWORK
META-ANALYSIS.
Source
Heart Rhythm. Conference: Heart Rhythm 2025. San Diego United States. 22(4
Supplement) (pp S241-S242), 2025. Date of Publication: 01 Apr 2025.
Author
Kaur H.; Pandey A.K.; Oraii A.; Conen D.; Devereaux P.J.; d'Entremont
M.A.; Ali S.; Healey J.S.; Spence J.D.; Benz A.P.; Wang M.K.; Um K.J.;
Whitlock R.; Belley-Cote E.P.; McIntyre W.F.
Publisher
Elsevier B.V.
Abstract
Background: Based on high-quality evidence from randomized trials,
clinical practice guidelines recommend beta-blockers to prevent
post-operative atrial fibrillation (POAF) in patients undergoing cardiac
surgery. However, the comparative efficacy of the many available
beta-blockers is unclear. <br/>Objective(s): We conducted a network
meta-analysis to compare the effectiveness of different beta-blockers in
reducing the incidence of POAF in patients undergoing cardiac surgery.
<br/>Method(s): We updated a 2019 pairwise Cochrane review, searching
CENTRAL, MEDLINE, EMBASE, and CINAHL for randomized trials of adults
without a history of AF who were undergoing cardiac surgery, including
studies that compared a beta-blocker (irrespective of of route of
administration or dose) to placebo or standard care. or compared two
beta-blockers. The primary outcome was the incidence of POAF following
cardiac surgery. We performed study screening, data extraction and quality
assessments in duplicate. We assessed the risk of bias in individual
trials using the Cochrane Collaboration Tool and the quality of the
overall evidence using the GRADE framework. We performed network
meta-analyses using DataParty.ca, applying both fixed and random effects
models, with non-informative prior distributions and node-splitting for
indirect estimates. We calculated odds ratios (OR) with 95% credible
intervals. <br/>Result(s): We included 56 randomized trials with 9,901
total participants. The most frequently studied beta-blockers were
metoprolol (16), sotalol (14), and propranolol (10 trials). Table 1 groups
beta-blockers according to efficacy for POAF reduction and certainty of
evidence. Landiolol and sotalol were most effective as compared to control
or placebo, both with moderate certainty evidence. Betaxolol and
carvedilol were likely superior to metoprolol. Sotalol may be superior to
metoprolol, betaxolol, and carvedilol. Adverse effects were reported
variably, precluding comparisons between agents. <br/>Conclusion(s): Based
on moderate quality evidence, landiolol and sotalol (a drug that also
blocks potassium channels) are likely the most effective beta-blockers for
preventing POAF in patients undergoing cardiac surgery. Propranolol and
metoprolol are likely the next most effective. [Formula
presented]<br/>Copyright &#xa9; 2025

<116>
Accession Number
2038419002
Title
Cytomegalovirus Specific Cell Mediated Immunity in Cytomegalovirus
Seropositive Heart Transplant Recipients According to the Serological
Status of the Donor.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S415-S416), 2025.
Date of Publication: 01 Apr 2025.
Author
Garcia-Romero E.; Diez-Lopez C.; Bestard O.; Trenado V.D.; Garcia-Cosio
M.; Ortiz-Bautista C.; Perez F.H.; Couto-Mallon D.; Gonzalez-Vilches F.;
Hernandez-Ruiz C.; Lopez-Lopez L.; Trillo A.G.; Molina M.G.; Vilalta L.R.;
Caballero S.I.; Casassas L.D.; Sabe N.; Gonzalez-Costello J.
Institution
(Garcia-Romero, Diez-Lopez, Gonzalez-Costello) Department of Cardiology.
Bioheart Group (IDIBELL). Ciber Cardiovascular Group (CIBER-CV), Bellvitge
University Hospital, Barcelona, Spain
(Bestard, Casassas) Nephrology, Vall d'Hebron University Hospital,
Barcelona, Spain
(Trenado) La Fe University Hospital, Valencia, Spain
(Garcia-Cosio) 12 Octubre University Hospital, Madrid, Spain
(Ortiz-Bautista) Cardiology, Gregorio Maranon University Hospital, Madrid,
Spain
(Perez) Cardiology, Puerta de Hierro University Hospital, Madrid, Spain
(Couto-Mallon) Cardiology, A Coruna University Hospital Complex, A Coruna,
Spain
(Gonzalez-Vilches) Cardiology, Marques de Valdecilla University Hospital,
Santander, Spain
(Hernandez-Ruiz) Cardiology, Valladolid University Hospital, Valladolid,
Spain
(Lopez-Lopez) Cardiology, Santa Creu i Sant Pau Hospital, Barcelona, Spain
(Trillo) Cardiology, Virgen del Rocio University Hospital, Sevilla, Spain
(Molina) Cardiology, Virgen de la Arrixaca University Hospital, Murcia,
Spain
(Vilalta, Caballero) Cardiology, Bellvitge University Hospital, Barcelona,
Spain
(Sabe) Infectious Diseases, Bellvitge University Hospital, Barcelona,
Spain
Publisher
Elsevier Inc.
Abstract
Purpose: Improving risk stratification for Cytomegalovirus (CMV) infection
in heart transplant (HT) patients using cell mediated immunity (CMI)
assays is needed to guide preventive strategies. This pre-specified
secondary analysis from the ELISPOT-TC trial aimed to evaluate the utility
of CMV-specific ELISPOT post-HT according to the CMV serological status of
the donor. <br/>Method(s): The ELISPOT-TC was a multicenter, randomized,
controlled phase IV trial, with a non-inferiority design. CMV seropositive
HT recipients were randomly assigned (2:1) to preventive strategy based on
10 days post-transplant CMI (patients with low CMI received valgancyclovir
for 3 months and those with high CMI were treated with pre-emptive
therapy); or Universal prophylaxis with Valgancyclovir for 3 months. 190
patients were included. Per protocol analysis have been previously
published. <br/>Result(s): Amongst all patients included, 68 % were D+/R+
and 25 % were D-/R+. About 80% received basiliximab. D+/R+ patients
received more inotropes, had a higher rate of short-term mechanical
circulatory support and infection prior to HT. Mean CMI against IE-1 or
pp65 was not different between both groups at none of the time points
(pre-HT, 10 days post-HT and 3 months post-HT). Amongst D+/R+ patients,
85% and 62% had low CMI at 10 days and 3 months post-HT vs 90% and 52%,
respectively in the D-/R+ group. Despite no significant differences
according to the ELISPOT assay, a higher risk of CMV infection and CMV
infection requiring treatment during the first year post-HT was observed
in the D+/R+ group (57% vs 38% HR 1.8 [1.06-3.07] and 36% vs 12% HR 3.36
[1.32-8.53]). <br/>Conclusion(s): Approximately 90% of CMV seropositive HT
patients present low CMV-specific CMI 10 days post-HT, regardless of the
serological status of the donor. However, an increased risk of CMV
infection and CMV infection requiring treatment has been observed amongst
D+/R+ patients, with no difference in the rate of CMV disease. [Formula
presented]<br/>Copyright &#xa9; 2025

<117>
Accession Number
2038409095
Title
PO-06-002 PACEMAKER IMPLANTATION AFTER AORTIC VALVE REPLACEMENT IN
PATIENTS WITH RIGHT BUNDLE BRANCH BLOCK: COMPARATIVE META-ANALYSIS OF
TECHNIQUES, VALVE TYPES AND GENERATIONS.
Source
Heart Rhythm. Conference: Heart Rhythm 2025. San Diego United States. 22(4
Supplement) (pp S632), 2025. Date of Publication: 01 Apr 2025.
Author
Nedios S.; Abraham J.; Sokhal B.S.; Intzes S.; Symeonidou M.; Gkoutzios
C.; Flores-Gonzalez E.; Elsaify S.; Seewoster T.; Hilbert S.; Bode K.
Publisher
Elsevier B.V.
Abstract
Background: Pacemaker (PM) implantation is common after aortic valve
replacement (AVR), with right bundle branch block (RBBB) as a significant
risk factor. <br/>Objective(s): This meta-analysis aimed to evaluate the
impact of valve types, techniques, and generations on PM-requirement in
RBBB patients. <br/>Method(s): A systematic search identified studies
reporting PM implantation post-AVR in patients with baseline RBBB. After
study selection and quality assessment, a random-effects analysis using
Review Manager 5.3 and R was conducted to report odds ratios (ORs) with
95% confidence intervals (CIs). <br/>Result(s): Among 43.213 patients in
82 studies (2003-23), 20% required PM after AVR. PM-need was higher in
RBBB patients (40% vs. 13% in non-RBBB), in self-expandable than
balloon-expandable-valve-studies (SEV:25% vs. BEV:13%) and in earlier
valve generations (Gen1: 26%, Gen2: 16%, Gen3: 15%). The OR for PM-need in
RBBB-patients was 5.41 (CI: 4.8-6.1). The subgroup ORs were: SAVR 5.51
(CI: 2.9-10.4), TAVR 5.90 (CI: 5.4-6.5), BEV 6.95 (CI: 5.7-8.5), and SEV
5.26 (CI: 4.1-6.8). The ORs for generation 1, 2, and 3 were 6.09
(5.03-7.4), 7.12 (CI: 4.0-12.5), and 7.8 (CI: 5.3-11.2), respectively.
<br/>Conclusion(s): The risk for PM-requirement after AVR in RBBB patients
is similar regardless of valve implantation technique (SAVR/TAVR) or valve
type (SEV/BEV). TAVR advancements have reduced overall PM needs, but
increased the risk in RBBB patients. Further technical improvements are
needed for this group. [Formula presented]<br/>Copyright &#xa9; 2025

<118>
Accession Number
2038409355
Title
PO-03-004 IMPACT OF STROKE RISK ON OUTCOMES AFTER CATHETER ABLATION: A
SUBANALYSIS OF THE OPTION TRIAL COMPARING LEFT ATRIAL APPENDAGE CLOSURE
AND ORAL ANTICOAGULATION AFTER CATHETER ABLATION FOR ATRIAL FIBRILLATION.
Source
Heart Rhythm. Conference: Heart Rhythm 2025. San Diego United States. 22(4
Supplement) (pp S336-S337), 2025. Date of Publication: 01 Apr 2025.
Author
Doshi R.N.; Reddy V.Y.; Chaudhry G.M.; Mittal S.; Gonzalez I.C.; Joyner
C.; Boveda S.; Loureiro R.E.; Kim J.H.; Reiss J.A.; Sanchez C.; Holshouser
J.W.; Helsop J.; Mikaelian B.J.; Gopinathannair R.; Gharib W.; Schuler B.;
Roy K.; Christen T.; Sutton B.; Wazni O.M.
Publisher
Elsevier B.V.
Abstract
Background: The OPTION trial demonstrated left atrial appendage closure
(LAAC) was associated with a lower risk of non-procedure-related bleeding
than oral anticoagulation (OAC) and was noninferior to OAC with respect to
the composite of all-cause death, stroke, or systemic embolism at 36
months in catheter ablation patients at moderate/high risk for stroke.
Patient benefit of LAAC after AF ablation based on estimated stroke risk
has not been characterized. <br/>Objective(s): Examine stroke and bleeding
risk as a function of CHA<inf>2</inf>DS<inf>2</inf>-VASc score.
<br/>Method(s): Patients with AF and an elevated
CHA<inf>2</inf>DS<inf>2</inf>-VASc score undergoing catheter ablation were
randomly assigned (1:1) to catheter-based LAAC versus OAC in the
randomized OPTION clinical trial. Patients underwent an AF catheter
ablation procedure either sequentially or concomitantly. The primary
safety endpoint was non-procedural major or clinically-relevant non-major
bleeding at 36 months. The primary efficacy endpoint was the composite of
all-cause death, stroke, or systemic embolism at 36 months. The secondary
endpoint was major bleeding through 36 months, including procedural
bleeding. In this subanalysis, patients were stratified by stroke risk
(CHA<inf>2</inf>DS<inf>2</inf>-VASc score: 2-3, 4-5, >=6). <br/>Result(s):
The OPTION trial enrolled 1600 patients with a mean
CHA<inf>2</inf>DS<inf>2</inf>-VASc score of 3.5+/-1.3. A total of 803 were
randomized to ablation+LAAC and 797 to ablation+OAC. Within each stroke
risk group, age, sex, and HAS-BLED were similar between the LAAC and OAC
cohorts. Primary efficacy and safety results were maintained across the
groups. In both treatment cohorts (LAAC and OAC), there was a trend toward
an increase in the risk of stroke (Figure left) and bleeding (Figure
right) with increasing stroke risk. <br/>Conclusion(s): In this
prespecified subanalysis of OPTION, with increasing stroke risk, the risk
of thromboembolic and bleeding events rises even with effective therapy
demonstrating that many patients remain at relatively high risk of stroke
despite catheter ablation of AF. Regardless of stroke risk, LAAC is
comparable to OAC in stroke protection while demonstrating greater freedom
from bleeding in this patient population. [Formula
presented]<br/>Copyright &#xa9; 2025

<119>
Accession Number
2038419829
Title
Prognostic Significance of Cardiopulmonary Exercise Testing in HFrEF: A
Meta-Analysis of Peak VO2 and VE/VCO2 Slope.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S623), 2025. Date of
Publication: 01 Apr 2025.
Author
Younis A.K.; Hatamleh M.; Dabbah Y.; Aloqaili T.; Shdaifat A.; Al-Qalqili
L.; Bani-Khaled F.; Albdour K.; Turk A.
Institution
(Younis, Hatamleh, Dabbah, Aloqaili, Shdaifat, Al-Qalqili, Bani-Khaled,
Albdour) The University of Jordan, Amman, Jordan
(Turk) The Advanced Heart Diseases Center, Amman, Jordan
Publisher
Elsevier Inc.
Abstract
Purpose: This study evaluates the prognostic value of Peak VO2 and VE/VCO2
slope in patients with heart failure with reduced ejection fraction
(HFrEF). By synthesizing evidence from multiple studies, it aims to
determine the utility of these cardiopulmonary exercise testing (CPET)
metrics in guiding clinical decision-making and enhancing risk
stratification strategies. <br/>Method(s): A systematic search was
conducted using PubMed, Cochrane, Web of Science, and Scopus for studies
evaluating CPET metrics in adults (>=18 years) diagnosed with HFrEF. The
search was completed on September 25, 2023. We included cohort studies,
case-control studies, and randomized controlled trials. The primary
outcomes analyzed were mortality, hospitalization, LVAD implantation, and
heart transplantation. The QUIPS tool was employed to assess the risk of
bias. A random-effects meta-analysis was performed to calculate pooled
hazard ratios (HR) and 95% confidence intervals (CI). <br/>Result(s): Our
search identified 2,670 studies, with 31 selected after full-text
screening. Of these, 15 studies were excluded due to ineligibility. An
analysis of 16 studies involving 14,580 patients found that each 1
mL/kg/min increase in Peak VO2 was associated with an 18% reduction in
adverse outcomes (HR: 0.82; 95% CI: 0.77-0.87)(Fig.1). Additionally, 13
studies comprising 13,405 patients demonstrated that each 1-unit increase
in VE/VCO2 slope was associated with a 16% increase in risk (HR: 1.16; 95%
CI: 1.07-1.25) (Fig.2). <br/>Conclusion(s): Peak VO2 and VE/VCO2 slope are
robust prognostic markers in HFrEF, providing valuable insights for
clinical management and patient risk stratification. These findings
underscore the importance of incorporating CPET metrics into routine
practice to optimize patient care and outcomes. [Formula
presented]<br/>Copyright &#xa9; 2025

<120>
Accession Number
2038420444
Title
Circulating Donor-Derived Cell-Free DNA as a Marker for Rejection After
Heart Transplantation: A Systematic Review and Meta-Analysis.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S649), 2025. Date of
Publication: 01 Apr 2025.
Author
Brignoli K.; Xourgia E.; Martinelli M.; Hunziker Munsch L.; Schnegg B.
Institution
(Brignoli, Xourgia, Martinelli, Hunziker Munsch, Schnegg) Cardiology,
Inselspital, University of Bern, Bern, Switzerland
Publisher
Elsevier Inc.
Abstract
Purpose: Post-transplant management requires careful monitoring for
cellular (ACR) and antiBody-mediated acute rejection (AMR). Due to the
costs and risks of endomyocardial biopsy (EMB), interest in non-invasive
screening methods is increasing. We performed a meta-analysis to evaluate
the use of donor-derived cell-free DNA (ddcfDNA) as a screening tool for
rejection. <br/>Method(s): We included studies presenting data on ddcfDNA
in transplant patients experiencing acute rejection. The primary outcomes
of the meta-analysis were ddcfDNA for ACR ISHLT>=1, ISHLT>=2 and pAMR>=1
compared with no-rejection patients (NR). We pooled the diagnostic
accuracy metrics of the studies. Random effect models were used. We
pre-registered the meta-analysis on PROSPERO (CRD42024583998).
<br/>Result(s): ddcfDNA was increased both in ISHLT>=2R and pAMR >= 1 (SMD
1.98, 95% CI 1.03 to 2.93, p<0.00001; 7 studies; 3647 EMBs), and ISHLT>=1R
(SMD 0.23, 95% CI 0.15 to 0.32, p<0.00001; 5 studies; 2335 EMBs) versus
NR. The results persisted in the sensitivity analysis for low risk-of bias
studies. The ddcfDNA test yielded a pooled sensitivity of 0.776 (95% CI:
0.562 to 0.903), a false positive rate (FPR) of 0.223 (95% CI: 0.141 to
0.333) and an area under the curve of 0.839 for ISHLT>=2R and/or pAMR>=1
and a sensitivity of 0.740 (95% CI: 0.614 to 0.836), FPR of 0.222 (95% CI:
0.158 to 0.301) and AUC of 0.826 for ISHLT>=1R. <br/>Conclusion(s):
ddcfDNA shows promise as a non-invasive screening tool for acute
rejection, with good diagnostic performance for both mild and severe
rejection cases and could provide a non-invasive alternative to EMBs for
transplant monitoring. [Formula presented] [Formula
presented]<br/>Copyright &#xa9; 2025

<121>
Accession Number
2038420370
Title
Significance of Artificial Intelligence in Predicting 1-year Post-Heart
Transplant Mortality in Children: A Systematic Review and Meta-Analysis.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S234-S235), 2025.
Date of Publication: 01 Apr 2025.
Author
Das B.; Ansari M.; Deshpande S.
Institution
(Das) Pediatrics, University of Mississippi Medical Center, Jackson, MS,
United States
(Ansari) Data Science, University of Mississippi Medical Center, Jackson,
MS, United States
(Deshpande) Pediatrics, Children's National Hospital, George Washington
University, Washington D.C., WA, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Heart transplantation (HT) is a life-saving procedure for
children with end-stage heart failure (HF). Despite advancements in
long-term outcomes, 1-year post-HT mortality remains high. Artificial
intelligence (AI) has significantly improved risk stratification by
utilizing a broader set of variables in adult donor-recipient pairs. This
study aims to systematically review and perform a meta-analysis of
published studies on AI's role in predicting 1-year post-HT mortality in
children. <br/>Method(s): We searched the Embase, PubMed, and Scopus
databases for literature on AI's use in predicting 1-year post-HT
mortality in children. The Quality Assessment of Diagnostic Accuracy
Studies 2 criteria assessed each study's quality and risk bias. We used a
random-effects model to account for study heterogeneity to enhance the
prediction of 1-year post-HT mortality in children. Sensitivity,
specificity, and diagnostic odds ratio measures were calculated using a
proportional logit transformation and analyzed with the DerSimonian-Laird
method for random effects. Heterogeneity was quantified using the I2
statistic. We reported both fixed-effect (common effect model) and
random-effects model results for comparison. <br/>Result(s): Four studies,
including 26,855 subjects, were analyzed. All studies were conducted at
different intervals using pediatric patient cohorts from the UNOS
database. Using the random-effects model, the pooled sensitivity for
predicting 1-year post-HT mortality was 0.86 (95% CI 0.70 - 0.95),
specificity was 0.92 (95% CI 0.83 - 0.97), and the diagnostic odds ratio
was 75.99 (9.75 - 592.09) (Figure). However, significant heterogeneity was
observed between studies, indicated by a Higgins I2 value of 99-100%.
<br/>Conclusion(s): AI can enhance the prediction of 1-year
post-transplant mortality in children. However, there is considerable
heterogeneity among AI algorithms, necessitating improvements in study
quality and design. [Formula presented]<br/>Copyright &#xa9; 2025

<122>
Accession Number
2038409542
Title
PO-02-197 PERCUTANEOUS LEFT ATRIAL APPENDAGE CLOSURE VERSUS ORAL
ANTICOAGULANTS IN ATRIAL FIBRILLATION: A META-ANALYSIS OF RANDOMIZED
CLINICAL TRIALS.
Source
Heart Rhythm. Conference: Heart Rhythm 2025. San Diego United States. 22(4
Supplement) (pp S324), 2025. Date of Publication: 01 Apr 2025.
Author
Turagam M.K.; Musikantow D.; Whang W.; Koruth J.S.; Miller M.A.; Maan A.;
Lampert J.; Dukkipati S.R.; Reddy V.Y.
Publisher
Elsevier B.V.
Abstract
Background: Percutaneous left atrial appendage closure (LAAC) has been
compared to oral anticoagulation (OAC) for stroke prevention in
non-valvular AF in 5 RCTs: (i) PROTECT AF and PREVAIL, comparing the
Watchman device to warfarin; (ii) PRAGUE-17, comparing Amulet/Watchman to
NOAC; (iii) WATCH-TAVR, comparing Watchman to OAC (warfarin or NOAC) in
patients undergoing TAVR; and (iv) OPTION, comparing Watchman to NOAC in
patients undergoing AF ablation. <br/>Objective(s): To assess the safety
and efficacy of LAAC with OAC in preventing cardiovascular and
neurological events. <br/>Method(s): A meta-analysis of five RCTs was
conducted, analyzing outcomes including all-stroke/systemic embolism,
ischemic stroke (IS), major bleeding (MB), and mortality. A random-effects
model using the Mantel-Haenszel method was employed, with results
expressed as relative risk (RR) and 95% confidence intervals (CI). Study
heterogeneity was assessed using Higgins' I2 statistic. <br/>Result(s):
Among 3,465 randomized patients (LAAC=1,913; OAC=1,552), the mean age was
73.3+/-7.6 years, with CHA2DS2-VASc 3.7+/-1.3. In the OAC group, 68%
received NOACs and 32% warfarin, with a mean follow-up of 3.5 years. No
significant differences were observed in all-stroke/systemic embolism (RR
1.11, p=0.50) or IS (RR 1.16, p=0.43). MB rates were similar (RR 0.92,
p=0.46); however, significant reductions were noted in hemorrhagic stroke
(RR 0.34, p=0.007), non-procedure-related bleeding (RR 0.49, p<0.0001),
cardiovascular death (RR 0.69, p=0.01), and all-cause death (RR 0.81,
p=0.02), all favoring LAAC. No heterogeneity was detected (I2=0).
<br/>Conclusion(s): LAAC is non-inferior to OAC (warfarin or NOAC) for
ischemic stroke prevention in non-valvular AF, while significantly
reducing hemorrhagic stroke, non-procedure-related bleeding, and
cardiovascular/all-cause mortality. These latter mortality benefits appear
to be driven by a 66% reduction in hemorrhagic stroke and a 51% reduction
in non-procedure-related bleeding. [Formula presented]<br/>Copyright
&#xa9; 2025

<123>
Accession Number
2038419024
Title
Developing a Psychological Prehabilitation Programme for Prospective Adult
Heart Transplant Recipients.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S320-S321), 2025.
Date of Publication: 01 Apr 2025.
Author
Sharp J.
Institution
(Sharp) Psychology, NHS Golden Jubilee, Glasgow, United Kingdom
Publisher
Elsevier Inc.
Abstract
Purpose: Heart transplantation is the treatment of choice for selected
patients with advanced heart failure who have limiting symptoms despite
optimal conventional treatment and evidence of a poor prognosis. The
limited number of available donor hearts restricts this treatment to a
small fraction of potential recipients and demands that the scarce
resource of a donor heart is allocated to patients most able and likely to
benefit. Psychological factors influence health behaviours predictive of
post-operative morbidity, mortality and length of hospital stay.
Prehabilitation aims to optimise patients physiologically, nutritionally,
and psychologically prior to surgery. To date, only three studies have
investigated the benefits of prehabilitation for adult heart transplant
candidates and, of these, only one featured a psychological intervention.
We aimed to investigate the feasibility of investigating the efficacy of a
structured psychology-led support programme delivered between decision to
list for transplant and the heart transplant procedure. <br/>Method(s):
The current study was early phase research to establish processes to
inform a larger scale RCT. A cohort study was use with the intention to
study recruitment, randomisation, treatment, administration of outcome
measures, and acceptability of the intervention. This feasibility study
assessed uncertainties in relation to the potential of a larger study
including consideration of participants' perspective on the acceptability
of the intervention, willingness to participate, and appropriateness of
key components. <br/>Result(s): The study will report on outcomes
including:* Acceptability of the intervention to the users * Uptake and
adherence to the intervention * Ways to ensure representative recruitment
and engagement * The choice of primary outcomes and their characteristics
* Follow-up rates, response rates to questionnaires, adherence rates *
Practicality of delivering the intervention in the proposed setting
Conclusion The study will report on the uptake, acceptability and
feasibility of routinely delivered psychologically informed
prehabilitation and how the current findings will informed the design of a
larger trial to assessing intervention efficacy to confirm indications of
prehabilitation for prospective heart transplant recipients.<br/>Copyright
&#xa9; 2025

<124>
Accession Number
2038410420
Title
PO-02-188 OUTCOMES OF LEFT ATRIAL APPENDAGE OCCLUSION IN HEART FAILURE: A
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Heart Rhythm. Conference: Heart Rhythm 2025. San Diego United States. 22(4
Supplement) (pp S320), 2025. Date of Publication: 01 Apr 2025.
Author
Shahabi M.; Shahzad M.; Ahsan M.; Shaikh R.H.; Ahmed R.; Park C.; Agrawal
H.; Fenrich A.L.; Grimm J.; Kalra K.; Salehi N.; Hassan S.Z.
Publisher
Elsevier B.V.
Abstract
Background: Atrial fibrillation (AF) and heart failure (HF) often coexist
due to shared risk factors and pathophysiology. Although oral
anticoagulants (OACs) effectively prevent stroke in AF, HF patients face
increased bleeding risks and anticoagulation-related complications. Left
atrial appendage occlusion (LAAO) offers an alternative for stroke
prevention, particularly in those unsuitable for long-term
anticoagulation. However, data on LAAO's safety and efficacy in HF
patients remain limited. <br/>Objective(s): To compare outcomes of LAAO in
patients with and without baseline HF. <br/>Method(s): We searched PubMed,
Embase, Scopus, and Web of Science through November 2024 for randomized
controlled trials (RCTs) and observational studies. HF was defined as left
ventricular systolic or diastolic dysfunction. Data were pooled using
generic inverse variance with a random-effects model. Odds ratios (ORs)
were used for periprocedural outcomes and risk ratios (RRs) for long-term
outcomes, with 95% confidence intervals (CIs). Review Manager 5.4 was used
for statistical analysis. <br/>Result(s): Fourteen observational studies
and one RCT, comprising 40,878 HF patients, were included in the final
analysis. Periprocedural (OR 2.24[1.04-4.83] p=0.04) and long-term
mortality (RR 1.87[1.49-2.34] p<0.00001) were higher in the HF group.
Long-term major bleeding (RR 1.42[1.08-1.87] p=0.01), but not
periprocedural major bleeding (OR 0.88[0.15-5.17] p=0.23), were also
higher in HF. HF patients had an elevated risk of long-term major adverse
events (RR 1.80[1.43-2.26]; p<0.00001). However, the risk of
periprocedural or long-term stroke was not different between the HF and no
HF groups (periprocedural OR 0.86[0.67-1.10] p=0.22; long-term RR
1.14[0.44-2.96] p=0.78). HF did not increase the risk of device-related
thrombus (DRT) at long-term follow-up (RR 1.27[0.92-1.75] p=0.15).
<br/>Conclusion(s): HF patients undergoing LAAO have higher risks of
mortality, major bleeding, and major adverse events than patients without
HF. Our findings underscore the importance of risk stratification and
careful patient selection in LAAO, and warrant validation by large RCTs
and cohort studies. [Formula presented]<br/>Copyright &#xa9; 2025

<125>
Accession Number
2038419004
Title
Exploring Mobile Health Technologies to Promote Medication Adherence in
Pediatric Heart Transplant Recipients: A Scoping Review.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S320), 2025. Date of
Publication: 01 Apr 2025.
Author
Killian M.; Brumm S.; Mayewski S.; Gupta D.
Institution
(Killian, Brumm, Mayewski) Florida State University, Tallahassee, FL,
United States
(Gupta) UF College of Medicine, Gainesville, FL, United States
Publisher
Elsevier Inc.
Abstract
Purpose: The purpose of this scoping review was to examine the existing
research literature on the use of mobile health (mHealth) technologies in
promoting medication adherence among pediatric transplant recipients. This
review identified the range of mHealth interventions, assess their
effectiveness, and highlight current knowledge gaps to guide future
research in this area. <br/>Method(s): A comprehensive scoping review was
conducted using the PRISMA-ScR framework to systematically identify and
evaluate literature on mHealth technologies and medication adherence in
pediatric transplant patients. Multiple databases, including PubMed,
PsycINFO, CINAHL, and Cochrane Library, were searched using a combination
of keywords such as "mHealth," "mobile health," "medication adherence,"
"transplant," and "pediatric." Studies on mHealth interventions like
mobile apps, text messaging services, and other digital health tools were
included. Data extraction focused on study designs, sample
characteristics, outcomes, and the reported impact of these technologies.
<br/>Result(s): The literature indicated that mHealth technologies,
including smartphone applications and SMS-based reminders, have the
potential to significantly enhance medication adherence in pediatric heart
transplant recipients. Mobile apps with customizable reminders,
gamification elements, educational content, and real-time tracking can
actively engage patients. Text messaging interventions may provide
motivational and behavioral support, offering regular prompts that help
address barriers like forgetfulness. Despite these promising findings,
current research is limited in evaluating the long-term sustainability of
these interventions and overall impact on outcomes, such as graft
survival, hospitalizations, and quality of life. <br/>Conclusion(s): This
scoping review demonstrates that mHealth technologies represent a strategy
for promoting medication adherence in pediatric heart transplant
recipients. The findings underscore the potential benefits of
personalized, accessible, and engaging digital tools in fostering better
adherence behaviors. However, there is a need for further research to
explore the long-term effects and integration of these technologies into
routine healthcare settings to support adherence and improve
post-transplant outcomes.<br/>Copyright &#xa9; 2025

<126>
[Use Link to view the full text]
Accession Number
647111853
Title
Perioperative Nitric Oxide Conditioning Reduces Acute Kidney Injury in
Cardiac Surgery Patients with Chronic Kidney Disease (the DEFENDER-trial):
a Randomized Controlled Trial.
Source
Anesthesiology. (no pagination), 2025. Date of Publication: 09 Apr 2025.
Author
Kamenshchikov N.O.; Tyo M.A.; Berra L.; Kravchenko I.V.; Kozlov B.N.;
Gusakova A.M.; Podoksenov Y.K.
Institution
(Kamenshchikov, Tyo, Kravchenko, Kozlov, Gusakova, Podoksenov) Cardiology
Research Institute, Tomsk National Research Medical Center, Russian
Academy of Sciences, 111a Kievskaya St., Tomsk, Russian Federation
(Berra) Department of Anaesthesia, Critical Care and Pain Medicine,
Massachusetts General Hospital, Boston, United States
(Berra) Department of Anaesthesia, Harvard Medical School, Boston, United
States
(Berra) Respiratory Care Service, Patient Care Services, Massachusetts
General Hospital, Boston, United States
Abstract
BACKGROUND: Postoperative Acute kidney injury (AKI) is a significant
concern for cardiac surgery patients with chronic kidney disease (CKD).
Effective pharmacological interventions to mitigate these risks are
urgently needed. This study aimed to evaluate the efficacy and safety of
perioperative nitric oxide (NO) administration in preventing AKI and
limiting CKD progression in patients undergoing cardiac surgery.
<br/>METHOD(S): A total of 136 patients with CKD undergoing elective
cardiac surgery with cardiopulmonary bypass (CPB) were randomized into two
equal groups: the NO group (n=68), receiving 80 parts per million NO
during the intraoperative period and for 6 hours post-surgery, and the
control group (n=68), receiving a sham treatment. The primary outcome was
AKI incidence within 7 days post-surgery. <br/>RESULT(S): AKI incidence
was significantly lower in the NO group (16/68 patients, 23.5%) compared
to the control group (27/68 patients, 39.7%) with a relative risk (RR) of
0.59 (95% CI 0.35-0.99; p=0.043). Six months post-surgery, the glomerular
filtration rate was higher in the NO group (50 mL/min/1.73 m2 [45; 54])
compared to the control group (45 mL/min/1.73 m2 [41; 51], p=0.038).
Postoperative pneumonia was significantly less frequent in the NO group:
10/68 (14.7%) vs 20/68 (29.4%) RR 0.5; (95% CI 0.25-0.99; p=0.039). NO
administration was safe: methemoglobin and nitrogen dioxide levels
remained within acceptable ranges, oxidative-nitrosyl stress did not
increase, and there were no significant differences between the groups in
blood transfusion requirements, platelet counts, or postoperative blood
loss volumes. <br/>CONCLUSION(S): Perioperative NO administration in CKD
patients undergoing cardiac surgery with CPB is safe, reduces the
incidence of AKI, and slows the progression of renal
dysfunction.<br/>Copyright &#xa9; 2025 American Society of
Anesthesiologists. All Rights Reserved.

<127>
Accession Number
2038420671
Title
Long-Term Outcomes in Patients with Fulminant Myocarditis Supported with
Extracorporeal Membrane Oxygenation Surviving to Hospital Discharge.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S268), 2025. Date of
Publication: 01 Apr 2025.
Author
Lambadaris M.; Vishram-Nielsen J.; Okumura T.; Chen Y.; Cheng A.; Sun H.;
Loforte A.; Asaumi Y.; Sawada K.; Huang M.; Lee W.C.; Fux T.; Pozzi M.;
Ross H.; Gustafsson F.; Moller-Sorensen H.; Okumura M.; Ariza-Sole A.;
Senechal M.; Turgeon P.; Martinez-Selles M.; Hernandez-Perez F.J.; Lorusso
R.; Billia F.; Alba A.
Institution
(Lambadaris) Cardiology, Toronto General Hospital, University Health
Network, Toronto, ON, Canada
(Vishram-Nielsen) Roskilde Hospital, Roskilde, Denmark
(Okumura) Cardiology, Nagoya University Graduate School of Medicine,
Nagoya, Japan
(Chen, Cheng) Division of Infectious Diseases, Department of Internal
Medicine, National Taiwan University Hospital, Taipei, Taiwan (Republic of
China)
(Sun) National Taiwan University Hospital, Tapei, Taiwan (Republic of
China)
(Loforte) Cardiac Surgery, University of Turin, S. Orsola University
Hospital, Turin, Italy
(Asaumi, Sawada) National Cerebral and Cardiovascular Center, Osaka, Japan
(Huang) Cardiothoracic Surgery, National Heart Centre Singapore,
Singapore, Singapore
(Lee) Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (Republic
of China)
(Fux) Perioperative Medicine and Intensive Care; Physiology and
Pharmacology, Karolinska Institute, Stockholm, Sweden
(Pozzi) Louis Pradel Cardiologic Hospital, Lyon, France
(Ross) Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, ON,
Canada
(Gustafsson) Rigshospitalet, Copenhagen, Denmark
(Moller-Sorensen) Rigshospitalet, University Hospital of Copenhagen,
Copenhagen, Denmark
(Okumura) Osaka Toneyama Medical Center, Japan
(Ariza-Sole) Cardiology, Hospital Universitari de Bellvitge, L'Hospitalet
de Llobregat, Barcelona, Spain
(Senechal) Laval University, Quebec, QC, Canada
(Turgeon) Institut Universitaire de Cardiologie et Pneumologie de Quebec,
Quebec, QC, Canada
(Martinez-Selles) Cardiology, Hospital General Universitario Gregorio
Maranon, Madrid, Spain
(Hernandez-Perez) Hospital Universitario Puerta de Hierro Majadahonda,
Madrid, Spain
(Lorusso) Maastricht University Medical Center, Maastricht, Netherlands
(Billia) University Health Network, Toronto, ON, Canada
(Alba) Toronto General Hospital, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Purpose: Fulminant myocarditis (FM) is a morbid disease that can progress
rapidly to refractory cardiogenic shock requiring venoarterial
extracorporeal membrane oxygenation (V-A ECMO). This study aimed to
identify long term outcomes in patients with FM who were successfully
weaned from V-A ECMO and discharged without durable mechanical circulatory
support or heart transplantation (HTx). <br/>Method(s): This is a
retrospective analysis of patient level data of studies identified in a
recent systematic review published by our centre on adult patients with FM
supported with V-A ECMO. Among the 16 centres that participated (440
patients), we included patients who survived to hospital discharge to
evaluate long-term mortality and need for HTx or left ventricular assist
device (LVAD). Using a univariable Cox regression model, we also evaluated
the association between LVEF at discharge with long-term mortality, HTx or
LVAD. <br/>Result(s): Of the 440 patients with FM on V-A ECMO support, 113
were discharged without LVAD or HTx. Average age was 43.4 +/- 16.7 years,
42% were male, 26% required CPR pre-ECMO and the average LVEF was 23 +/-
11.9% prior to V-A ECMO cannulation. During a median follow-up of 4.4
years (IQR 1.6-7.9), there were 3 deaths, 1 HTx and 1 LVAD. The composite
risk of death, LVAD or HTx at 1 year was 3.0% and 6.9% at 5 years. Of the
113 patients, 106 had documented LVEF at discharge. By univariate
analysis, LVEF <50% (n=37, 2 deaths) in comparison to LVEF >50% (n=69, 1
LVAD, 1 death) was not associated with increased risk of the composite end
point of death, HTx or mortality (HR 2.9, 95%CI 0.19-42.9).
<br/>Conclusion(s): Our study suggests low long-term mortality or need for
advanced therapy among patients with FM requiring V-A ECMO who survived to
hospital discharge. We did not find an increased risk of the composite
endpoint regardless of LVEF at the time of discharge.<br/>Copyright &#xa9;
2025

<128>
Accession Number
647113051
Title
Cardiovascular Disorders in Systemic Lupus Erythematosus.
Source
Current vascular pharmacology. (no pagination), 2025. Date of
Publication: 08 Apr 2025.
Author
Manolis A.A.; Manolis T.A.; Manolis A.S.
Institution
(Manolis) Department of Internal Medicine, Elpis General Hospital of
Athens, Athens, Greece
(Manolis) Department of Psychiatry, Aiginiteio University Hospital,
Athens, Greece
(Manolis) Athens University School of Medicine, Athens, Greece
Abstract
Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease with
multiorgan and system involvement, including the Cardiovascular (CV)
system. Cardiac involvement in these patients is frequent and most often
asymptomatic, at least in the early stages. It includes accelerated
atherosclerosis, premature Coronary Artery Disease (CAD), and a high risk
of CV complications. The risk of developing CV Disease (CVD) in SLE is
linked not only with classical CV risk factors but also with
disease-specific factors, like the degree of activity, autoantibodies,
organ damage, and type of therapy. Clinical presentation comprises several
clinical manifestations ranging from angina to acute Myocardial Infarction
(MI) and Sudden Cardiac Death (SCD). The leading cause of death in SLE
patients is from CVD due to accelerated atherosclerosis, which often has a
more rapid progression compared with the general population. The CV risk
in SLE is greater when antiphospholipid antibodies are present. Regarding
diagnosis, apart from relevant blood tests, the simplest and readily
available diagnostic test, echocardiography, with its contemporary
techniques that include global longitudinal strain, is needed to provide a
more thorough cardiac evaluation and allow for early management. These
aspects of the disease, together with issues regarding phenotypes,
biomarkers, neonatal lupus, heart block, SLE-related CV ailments such as
coronary artery disease, myocarditis, valvular heart disease, and the
antiphospholipid syndrome, as well as diagnostic modalities, drug and
interventional therapies, and current relevant guidelines are all
thoroughly reviewed and discussed in this article.<br/>Copyright&#xa9;
Bentham Science Publishers; For any queries, please email at
epub@benthamscience.net.

<129>
Accession Number
2038419877
Title
Outcomes After Heart Transplantation from Donors After Circulatory Death
versus Brain Death: A Systematic Review and Meta-Analysis.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S157-S158), 2025.
Date of Publication: 01 Apr 2025.
Author
Picado-Loaiza S.; Morgado Ferreira R.O.; Luiz L.; Chanda V.; Rivera A.;
Amador Y.; Fuentes R.A.
Institution
(Picado-Loaiza) Cardiovascular Surgery, Caja Costarricense del Seguro
Social, San Jose, Costa Rica
(Morgado Ferreira) Federal University of Santa Catarina, Florianopolis,
Brazil
(Luiz) Universidade da Regiao de Joinville, Santa Catarina, Brazil
(Chanda) Johns Hopkins University, Maryland, MD, United States
(Rivera) Nove de Julho University, Sao Bernardo do Campo, Brazil
(Amador) Kingston Health Science Center, Toronto, ON, Canada
(Fuentes) Robert Bosch Hospital, Stuttgart, Germany
Publisher
Elsevier Inc.
Abstract
Purpose: Heart transplantation (HT) is the definitive treatment for
patients with end-stage heart failure. Traditionally, HTs have relied on
donation after brain death (DBD). However, the growing disparity between
the number of available donor heart and the waitlist for HT has led to the
exploration of donation after circulatory death (DCD) as a potential
alternative. We performed a systematic review and meta-analysis comparing
DCD versus DBD in patients undergoing HT. <br/>Method(s): We
systematically searched PubMed, Embase, and Cochrane databases for studies
comparing clinical outcomes in patients undergoing HT with donor hearts
from DCD versus DBD. Statistical analyses included pooled risk ratios (RR)
for binary outcomes and mean differences (MD) for continuous outcomes,
both with 95% confidence intervals (CI). Random-effects models were
employed for all endpoints. All analyses were conducted using R version
4.2.3. <br/>Result(s): This meta-analysis included 1 randomized controlled
trial and 10 observational studies. There was no significant difference
between groups in mortality at 1 (RR 0.65; 95% CI 0.28-1.53; p=0.32), 6
(RR 0.67; 95% CI 0.30-1.51; p=0.33), and 12 months (RR 0.96; 95% CI
0.68-1.36; p=0.81). No significant difference occurred in need for
extracorporeal membrane oxygenation (ECMO) (RR 0.84; 95% CI 0.36-1.95;
p=0.68) and intraaortic balloon pump (IABP) (1.29; 0.93-1.72; p=0.13). ICU
and hospital length of stay (LOS) were similar between groups (MD 0.85
days; -0.22-1.91; p=0.12; and MD 0.77 days; -2.20-0.67; p=0.29,
respectively).The DBD group showed a significantly lower incidence of
primary graft dysfunction (PGD) (RR 2.10; 95% CI 1.06-1.95; p=0.033) and
need for dialysis or hemofiltration (RR 1.31; 95% CI 1.04-1.64; p=0.023).
<br/>Conclusion(s): There were no statistically significant differences in
mortality outcomes, hospital and ICU LOS, ECMO use, and IABP. DCD
recipients have a higher risk of PGD and dialysis or hemofiltration.
[Formula presented]<br/>Copyright &#xa9; 2025

<130>
Accession Number
2038420551
Title
Glomerular Filtration Rate Evolution in Post-Heart Transplant Patients
Using SGLT2 Inhibitors.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S638), 2025. Date of
Publication: 01 Apr 2025.
Author
Guazzelli D.L.; Sguario R.M.; Macaciel J.; Carbonera A.; Treib T.C.;
Mendonca R.R.; Faria V.S.; Marcondes-Braga F.; Seguro L.; Aulicino G.;
Mangini S.; Avila M.; Campos I.W.; Bacal F.
Institution
(Guazzelli, Sguario, Macaciel, Carbonera, Treib, Mendonca, Faria,
Marcondes-Braga, Seguro, Aulicino, Mangini, Avila, Campos, Bacal) Heart
Institute (InCor), Hospital das Clinicas, Universidade de Sao Paulo, Sao
Paulo, Brazil
Publisher
Elsevier Inc.
Abstract
Purpose: SGLT-2 inhibitors (SGLT-2i), initially developed for
glucose-lowering, have shown renal benefits in high-risk T2D populations,
reducing cardiovascular mortality. SGLT-2i may benefit T2D patients
post-HT by lowering kidney risks, but data are limited since many studies
exclude immunosuppressed patients.The aim of this study was to describe
the HT patients with T2D in use of SGLT2i, focusing on its effect on
glomerular filtration rate (GFR) and hemoglobin A1c (HbA1c) after HT.
<br/>Method(s): A retrospective cohort analysis evaluated HT patients
(2013-2023). T2D patients on SGLT-2i were analyzed using medical records
and the Redcap database. GFR (via CKD-EPI) was assessed before starting
medication and at 2, 4, 6, and 12 months post-initiation. HbA1c levels and
adverse events were also tracked. <br/>Result(s): Among 490 HT patients,
290 had T2D, and 37 used SGLT-2i during follow-up. The majority of
diabetic patients on SGLT2i were male (63%), had media of HbA1c 7.2 +/-
1.14 (SD). Metformin was used by 71%, gliclazide by 26%, and insulin by
36%. Regarding GRF, the media before treatment initiation was 52.55 +/-
22.52 (SD). During 1-year follow up, GFR curve showed an initial decrease
during the first two months of medication use, followed by an increase in
subsequent months (Figure 1). The evolution of the GFR over time
demonstrated a trend similar to previous studies on non-transplant
populations using SGLT2 inhibitors.The glycemic control was also reported
and there was a reduction in hemoglobin A1c of 0.5% compared to baseline
after one year of SGLT2 inhibitor use. (Figure 2)In terms of adverse
events, only three patients discontinued medication due to recurrent
GUTIs. <br/>Conclusion(s): This small retrospective cohort suggests
potential renal and glycemic benefits from SGLT-2i in post-HT T2D
patients, with a favorable safety profile. However, this study only
provides preliminary insights into the use of SGLT2i in HT patients.
Randomized controlled trials are needed to confirm the safety and efficacy
of SGLT-2i in this population. [Formula presented]<br/>Copyright &#xa9;
2025

<131>
Accession Number
2038410197
Title
PO-02-204 A META-ANALYSIS COMPARING CLINICAL OUTCOMES WITH CONSCIOUS
SEDATION AND GENERAL ANESTHESIA FOR LEFT ATRIAL APPENDAGE OCCLUSION.
Source
Heart Rhythm. Conference: Heart Rhythm 2025. San Diego United States. 22(4
Supplement) (pp S327), 2025. Date of Publication: 01 Apr 2025.
Author
Jain H.; Cheema A.H.; Jain J.; Khan R.; Passey S.; Patel R.; Ahmed R.
Publisher
Elsevier B.V.
Abstract
Background: In poor candidates for long-term anticoagulation in patients
with atrial fibrillation, non-pharmacological stroke prevention with
percutaneous LAAO may be considered. Data on the impact of conscious
sedation (CS) or general anesthesia (GA) on periprocedural clinical
outcomes in LAAC are lacking. <br/>Objective(s): The objective of this
meta-analysis is to compare clinical outcomes between CS and GA in
patients undergoing percutaneous LAAO. <br/>Method(s): Major bibliographic
databases were searched to identify relevant RCTs and observational
studies until November 2024. For pooling effect estimates, odds ratios
(OR) and risk ratios (RR) with 95% CIs were combined using the
inverse-variance random effects model; with p<0.05 considered
statistically significant. <br/>Result(s): A total of three studies,
encompassing 1395 patients with AF undergoing LAAO [CS=605 and GA=790],
were included. CS and GA demonstrated no significant differences in terms
of device success [OR: 0.87; 95% CI: 0.38, 1.98], all-cause mortality [RR:
1.10; 95% CI: 0.40, 3.06], cardiovascular mortality [RR: 1.73; 95% CI:
0.19, 15.43], stroke [RR: 3.45; 95% CI: 0.75, 15.92], and peri-device leak
(>5 mm) [RR: 0.56; 95% CI: 0.25, 1.25]. However, CS was associated with a
significantly lower risk of device-related thrombus [RR: 0.14; 95% CI:
0.02, 0.83; p=0.03] compared to GA. <br/>Conclusion(s): In patients
undergoing LAAO, this meta-analysis reports that CS and GS showed
comparable device success rates and the risks of adverse clinical
outcomes. Traditionally, LAAO has been performed under GA because of the
need to maneuver the transesophageal echocardiography probe without
restriction and technical protection against aspiration. However, the
increasing use of CS in percutaneous cardiac procedures appears safe,
particularly for LAAO procedures. Further randomized prospective studies
are warranted to validate the results of this meta-analysis. [Formula
presented]<br/>Copyright &#xa9; 2025

<132>
Accession Number
2038419378
Title
Speckle-Tracking Echocardiography of Left and Right Ventricle and Acute
Cellular Rejection in Orthotropic Heart Transplantation.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S651), 2025. Date of
Publication: 01 Apr 2025.
Author
Xourgia E.; Brignoli K.; Linder O.; Neagoe A.; Capek L.; Bruno J.;
Strickler E.; Bakula A.; Pavlicek M.; Furholz M.; Muster C.; Malagutti P.;
Martinelli M.; Munsch L.H.; Schnegg B.
Institution
(Xourgia, Neagoe, Capek, Bruno, Strickler, Bakula, Pavlicek, Furholz,
Muster, Malagutti, Martinelli, Munsch, Schnegg) Cardiology, Inselspital,
University of Bern, Bern, Switzerland
(Brignoli, Linder) Internal Medicine, Burgerspital Solothurn, Solothurn,
Switzerland
Publisher
Elsevier Inc.
Abstract
Purpose: After cardiac transplantation, steering of immunosuppression
requires active search for acute cellular rejection (ACR). Given the costs
and potential complications of endomyocardial biopsy (EMB), there is
growing interest in the use of non-invasive screening. Thus, we conducted
a systematic review and meta-analysis to evaluate speckle-tracking
echocardiography as a screening method for ACR. <br/>Method(s): We
searched PubMed and gray literature for studies presenting data on speckle
tracking echocardiography in transplant patients experiencing ACR. The
primary outcomes of the meta-analysis were left and right ventricular
global longitudinal strain. We used random effects models for all
analyses. We pre-registered the meta-analysis with PROSPERO
(CRD42024508654). <br/>Result(s): Both left (LVGLS, MD -1.96, 95% CI -2.85
to -1.07, p<0.0001; 16 studies; 2274 EMBs), and right (RVGLS, MD -2.90,
95% CI -4.03 to -1.76, p<0.00001; 5 studies; 1254 EMBs), global
ventricular longitudinal strain were lower among patients without ACR.
Left circumferential strain (LVCS, MD -2.83, 95% CI -5.30 to -0.36,
p=0.02; 10 studies; 1069 EMBs) was also lower among patients without ACR,
while left radial strain (LVRS, p=0.05; 6 studies; 885 EMBs),
circumferential (p=0.11; 3 studies; 186 EMBs) and longitudinal strain
rates (p=0.05; 4 studies; 406 EMBs) were similar between groups. RVFWS was
increased in ACR (MD -2.64, 95% CI -4.72 to -0.56, p=0.01; 6 studies; 1188
EMBs). In the subgroup analysis of first post-transplant year versus
various follow-up times, no difference was observed (Chi²=0.44,
p=0.51). The change of LVGLS from baseline over time until the rejection
event or follow-up censoring was greater in ACR (MD -2.43, 95% CI -4.82 to
-0.05, p=0.045). <br/>Conclusion(s): Myocardial strain measured by speckle
tracking echocardiography appears affected in ACR and could potentially be
used as a rule-out strategy for early rejection, leading to a reduction of
routine biopsies in heart transplant follow-up. [Formula
presented]<br/>Copyright &#xa9; 2025

<133>
Accession Number
2038410449
Title
PO-02-059 EXPLORING ALTERNATIVES: CAN LAAO COMPETE WITH ORAL
ANTICOAGULANTS IN STROKE PREVENTION?.
Source
Heart Rhythm. Conference: Heart Rhythm 2025. San Diego United States. 22(4
Supplement) (pp S258), 2025. Date of Publication: 01 Apr 2025.
Author
Bandarupalli T.; Babu A.D.; Gorantla A.R.; Herweg B.
Publisher
Elsevier B.V.
Abstract
Background: Atrial fibrillation (AF) increases the risk of
thromboembolism, traditionally managed with long-term oral anticoagulation
(OAC). Left atrial appendage occlusion (LAAO) offers a mechanical
alternative that aims to mitigate thromboembolic events while potentially
reducing bleeding complications. <br/>Objective(s): This meta-analysis
evaluates the efficacy and safety of LAAO versus OAC in patients with
atrial fibrillation (AF). <br/>Method(s): A search of PubMed, EMBASE, and
Cochrane databases was conducted up to November 2024 for studies on
clinical outcomes of patients with a history of AF treated with an LAAO
device or OAC. The outcomes assessed were major bleeding, stroke, systemic
embolism, and cardiovascular mortality. Odds ratios (ORs) with 95%
confidence intervals were calculated using a random effects REML method.
<br/>Result(s): Four RCTs involving 3,116 patients (32% female) were
analyzed, with two studies using warfarin and two using NOACs. The mean
age was 72.15 (+/-7.73) years in the LAAO group (n=1,736) and 72.60
(+/-7.81) years in the standard group (n=1,380). The mean follow-up was
35.4 months. CHADS-VASc scores were 3.25 (LAAO) vs. 3.28 (standard), and
HAS-BLED scores were 2.67 vs. 2.73, with persistent AF rates of 29.52% vs.
27.81%. LAAO patients had significantly lower odds of major bleeding [OR
0.70, 95% CI 0.51-0.97, p<0.05, I² =0%], but no significant
differences in stroke [OR 0.92, 95% CI 0.61-1.41, p=0.72,I²
=0%], systemic embolism [OR 1.52, 95% CI 0.36-6.44, p=0.57, I²
=0%] and cardiovascular mortality [OR 0.69, 95% CI 0.41-1.14, p=0.14,
I² =36.68%], when compared to the standard treatment group
(Figures A-D). <br/>Conclusion(s): LAAO demonstrates a significantly lower
risk of major bleeding with comparable stroke, systemic embolism, and
cardiovascular mortality outcomes when compared to OAC in patients with
AF. These findings suggest that LAAO may be a viable alternative for
patients at high risk of bleeding or with contraindications to long-term
anticoagulation. [Formula presented]<br/>Copyright &#xa9; 2025

<134>
Accession Number
2038421099
Title
Evaluating Postoperative Outcomes of Heart Transplant Recipients from
Active COVID19 Positive and Negative Donors Using Induction Therapy.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S403-S404), 2025.
Date of Publication: 01 Apr 2025.
Author
Mohamed M.
Institution
(Mohamed) University of Connecticut School of Medicine, Farmington, CT,
United States
Publisher
Elsevier Inc.
Abstract
Purpose: A recent meta-analysis of the UNOS database has revealed
increased long-term all-cause mortality in heart transplant recipients
from COVID-19 positive donors, raising concerns over appropriate
immunosuppression strategies. Studies suggest that Anti-thymocyte globulin
(ATG) induction may offer a mortality benefit. This study aims to compare
patient outcomes between induction and maintenance immunotherapy in
managing heart transplant recipients of COVID-19 positive donors using
UNOS data. <br/>Method(s): We retrospectively analyzed all adult patients
(age >= 18 years) that are included in the UNOS database who underwent
heart transplantation between 2020 and 2024. Patients with prior
transplants, unknown COVID-19 status, and multiple organ transplants were
excluded. We assessed the impact of induction therapy that included an IL2
receptor antagonist and ATG compared to that of maintenance therapy in a
chi-squared analysis. All-cause mortality was the primary outcome measure.
<br/>Result(s): 5793 patients were included in the final analysis. No
significant differences were found in demographics between those using
induction and maintenance therapy except in education status and gender (p
< .0001). A total of 2039 (35.2%) patients with known covid status
received induction therapy and 2441(64.8%) received maintenance therapy.
In both maintenance and induction therapy groups, COVID positive followed
up less than COVID negative patients (p = < .00001). In the Induction
therapy group, COVID positive were more likely to have a failed graft than
COVID negative patients (P = 0.01605). There was no difference in
mortality status or hospitalizations due to infection at a follow-up of 12
months. <br/>Conclusion(s): Our results showed no difference in mortality
or number of hospitalizations between HTx patients using induction and
maintenance therapy. Despite these results, HTx recipients of COVID
positive donors were interestingly less likely to follow up at 6 and 12
months compared to HTx recipients of COVID negative donors. Additionally,
HTx recipients of COVID positive donors were more likely to have graft
failures at 12 months follow up compared to HTx recipients of COVID
negative donors in the induction therapy group. We conclude that there is
no indication that induction therapy confers a mortality benefit over
maintenance therapy.<br/>Copyright &#xa9; 2025

<135>
Accession Number
2038409916
Title
CE-499646-001 COMPARISON OF LEFT ATRIAL APPENDAGE CLOSURE AND ORAL
ANTICOAGULATION AFTER CATHETER ABLATION FOR ATRIAL FIBRILLATION:
CONCOMITANT AND SEQUENTIAL COHORTS OF THE OPTION RANDOMIZED CONTROLLED
TRIAL.
Source
Heart Rhythm. Conference: Heart Rhythm 2025. San Diego United States. 22(4
Supplement) (pp S32), 2025. Date of Publication: 01 Apr 2025.
Author
Saliba W.I.; Nair D.G.; Swarup V.; Hall T.; Iyer V.; Perez G.C.; Weiner
S.; Shah M.H.; Islam N.; Grygier M.; Schuler B.; Ibanez Criado J.L.;
Duthoit G.; Reddy Y.V.; Roy K.; Christen T.; Sutton B.; Wazni O.M.
Publisher
Elsevier B.V.
Abstract
Background: Guidelines recommend continuation of anticoagulation following
atrial fibrillation (AF) ablation in patients at high risk for stroke.
Left atrial appendage closure (LAAC) has not been well-studied for routine
use post ablation. LAAC can be performed in separate procedures with
cardiac ablation (sequentially) or concomitantly in the same operative
session. <br/>Objective(s): In this prespecified subanalysis of the OPTION
trial, timing of ablation relative to LAAC will be evaluated.
<br/>Method(s): OPTION is a multicenter, prospective randomized clinical
trial. Patients with AF and an elevated CHA<inf>2</inf>DS<inf>2</inf>-VASc
score undergoing catheter ablation were randomly assigned (1:1) to
catheter-based LAAC versus oral anticoagulation. Patients underwent an AF
catheter ablation procedure between 90 and 180 days prior to randomization
(sequential) or were planning to have catheter ablation within 10 days of
randomization (concomitant). The primary safety endpoint was
non-procedural major or clinically-relevant non-major bleeding. The
primary efficacy endpoint was the composite of all-cause death, stroke, or
systemic embolism at 36 months. The secondary endpoint was major bleeding
through 36 months, including procedural bleeding. <br/>Result(s): A total
of 1600 patients with a mean age (+/-SD) of 70+/-8 years, and a
CHA<inf>2</inf>DS<inf>2</inf>-VASc score of 3.5+/-1.3 were randomized to
anticoagulation. Ablation and LAAC (n=803) were performed concomitantly in
41% of cases (n=328; 99% on same day). LAAC occurred 90-180 days after AF
ablation in 59% of cases (n=475). In the control arm (n=797), AF ablation
was concomitant with randomization in 41% of patients (n=326) or
sequential in 59% (n=471). Patients in the sequential cohort had more
somewhat more clinical comorbidities (Table). Clinical and imaging
outcomes at 3 years will be available at the time of the presentation.
<br/>Conclusion(s): This subanalysis of OPTION will examine whether LAAC
is a reasonable alternative to contemporary OAC after sequential or
concomitant AF ablation in patients currently guideline recommended to
stay on oral anticoagulation. [Formula presented]<br/>Copyright &#xa9;
2024

<136>
Accession Number
2038408917
Title
PO-03-198 A BAYESIAN META-ANALYSIS ON RECURRENCE OF ATRIAL ARRHYTHMIA
BETWEEN HYBRID AND ENDOCARDIAL ATRIAL FIBRILLATION ABLATION.
Source
Heart Rhythm. Conference: Heart Rhythm 2025. San Diego United States. 22(4
Supplement) (pp S424-S425), 2025. Date of Publication: 01 Apr 2025.
Author
Khanra D.; Rashid W.; Gupta A.; Deshpande S.A.; Mukherjee A.; Dutta A.;
Choudhury M.; Phan T.T.
Publisher
Elsevier B.V.
Abstract
Background: The outcome of ablation in persistent atrial fibrillation (AF)
has been modest despite adding linear ablation or substrate modification.
Hybrid AF ablation is being emerged as an alternative to endocardial
ablation. Comparative studies are characterised by limited sample size,
diverse results and variations in lesions set. <br/>Objective(s): This is
the first meta-analysis of studies comparing the outcome of Hybrid
ablation to endocardial ablation for persistent AF patients with Bayesian
meta-regression analysis [CRD42024601042]. <br/>Method(s): A systematic
literature search was performed to include all studies comparing hybrid
ablation to endocardial ablation for persistent AF. Primary outcome was
recurrence of atrial arrhythmia. Secondary outcomes were procedural
complications and hospital stay. <br/>Result(s): 15 studies (4 RCT; 2
multi-centric; 10 thoracoscopic; 7 staged hybrid) were selected for the
meta-analysis including a total of 1671 patients of persistent and
long-standing persistent AF. The frequentist model showed significantly
lower recurrence of atrial arrhythmia in the hybrid ablation group [log RR
-0.27; 95%CI (-0.53, -0.02)] (Fig 1A), and the effect was maintained even
after the Bayesian adjustment [log RR -0.29; 95%CI (-0.57, -0.03)] (Fig
1B) and the effect strengthened [log RR -0.36; 95%CI (-0.59, -0.14)] after
adjusting for significant small study-bias (Fig 1C). In the
meta-regression analysis age, LA size, follow-up duration, lesions sets,
LAA occlusion, previous AF ablations, and duration of AF, design of the
study or even use of non-thoracoscopic approach had any significant effect
on the recurrence of atrial arrhythmia. Short-term complications were
significantly higher and the duration of hospital stay was longer in the
hybrid group (Fig 1D). <br/>Conclusion(s): Hybrid AF ablation was found to
be superior to catheter ablation even after Bayesian and small study-bias
adjustments, however complications were more and hospital stays were
longer. [Formula presented]<br/>Copyright &#xa9; 2025

<137>
Accession Number
2038420908
Title
Initial Analysis of Immune Phenotypes in Heart Transplant Recipients of
the ALL IN HEART (Tocilizumab) Trial.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S384-S385), 2025.
Date of Publication: 01 Apr 2025.
Author
Jain R.; Garcia B.; Mortensen E.; Falk B.; Kobashigawa J.; Madsen J.C.;
Heeger P.
Institution
(Jain, Garcia, Mortensen, Falk, Kobashigawa, Heeger) Cedars-Sinai Medical
Center, Los Angeles, CA, United States
(Madsen) Massachusetts General Hospital, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Outcomes after heart transplant (Tx) are suboptimal. We
hypothesize that early post-transplant inflammation and other downstream
effects of interleukin-6 (IL-6) contribute to graft injury and survival.
The ALL IN HEART trial is a randomized, blinded, placebo-controlled
multicenter study testing the hypothesis that a 5-month course of
tocilizumab (anti-IL-6 receptor, IL6R) plus standard 3-drug
immunosuppression will improve Tx outcomes. The trial enrolled 135
subjects to be followed for 1 year. Herein, we report immune phenotypes of
a subset of 38 subjects to assess the potential immunological effects of
the study drug. <br/>Method(s): Peripheral blood samples from subjects
were collected at 1 week, 1-, 3-, 6- and 12-months post-Tx. As IL-6
signaling induces liver production of C-reactive protein (CRP) we analyzed
serum CRP levels in each subject. We also analyzed serum levels of 25
cytokines/chemokines by Luminex and quantified T cell subsets by flow
cytometry. <br/>Result(s): Analysis of 1-mo post-Tx CRP levels in the 38
subjects segregated them into 2 groups - high CRP (Group 1, mean CRP
9205.1 ng/mL, n=17) and low CRP (Group 2, mean CRP 179.7 ng/mL, n=21, p <
0.0001). Serum cytokine analyses showed lower TNFalpha and higher IL-10 in
Group 2 at 1 wk and 1 mo, respectively, without statistical differences
noted for most other cytokines. Flow cytometry analyses showed
significantly higher ratios of regulatory T cells (Tregs)
(CD4+CD25+CD3+CD127lo) / IL-17 producing T cells (Th17)
(CD4+CXCR3-CCR6+CXCR5+PD1+) in Group 2 (95% CI of difference 15.7, 154.3,
p = 0.02), during the initial 6 post-Tx months, without differences in
other T cell subsets (Figure 1). <br/>Conclusion(s): These data suggest
that IL6R blockade can promote a favorable immunoregulatory phenotype in
heart Tx recipients, but complete analyses of all study subjects and
unblinding of the data will be required to make definitive conclusions.
Whether and how these immune phenotypes associate with study endpoints
will be reported as the data become available. [Formula
presented]<br/>Copyright &#xa9; 2025

<138>
Accession Number
2038421290
Title
Norepinephrine Donor Support and Outcomes in Heart Transplantation: A
Single-Center Analysis.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S509-S510), 2025.
Date of Publication: 01 Apr 2025.
Author
Parigino D.; Giovannico L.; Fischetti G.; Savino L.; Mazzone F.; Leo C.;
Cristiano G.; Bari N.D.; Padalino M.; Bottio T.
Institution
(Parigino, Fischetti, Savino, Mazzone, Leo, Cristiano, Bari, Padalino,
Bottio) University of Bari, Bari, Italy
(Giovannico) Cardiac Surgery Unit - University Hospital Bari, Bari, Italy
Publisher
Elsevier Inc.
Abstract
Purpose: The growing disparity between available donor hearts and patients
on the waiting list has led to increased use of donors with extended
criteria. Donors requiring high-dose catecholamine support, especially
norepinephrine (NE), are often considered with caution. This study aims to
evaluate the impact of high-dose NE donor support on post-transplant
outcomes in HTx recipients in our transplant center. <br/>Method(s): We
retrospectively analyzed 109 HTx recipients transplanted between June 2022
and September 2024 in Bari. The dataset was stratified based on NE dose
administered to donors prior to procurement, dividing into three groups:
Group 1: 0 mcg/kg/min, Group 2: 0.01 to 0.2 mcg/kg/min, Group 3: >0.2
mcg/kg/min. Primary outcome measures included overall survival, 30-day and
1-year mortality, incidence of primary graft dysfunction (PGD), and other
secondary outcomes such as prolonged ICU stay, ventilatory support, and
renal replacement therapy. Statistical analyses were performed using a
multivariate Cox proportional hazards models. <br/>Result(s): Out of 109
patients, 11 received hearts without NE support, while 89,9 % received
hearts supported with NE (Group 2 and 3). No significant differences in
overall survival were observed across the groups (Group 2 vs 1: HR 1,11;
Group 3 vs 1: HR 0,98; p = 0,656). Similarly, 30-day and 1-year mortality
rates did not differ significantly between the groups. However, a higher
incidence of prolonged ICU stay was observed in Groups 2 and 3 compared to
Group 1 (p = 0,005). <br/>Conclusion(s): Our findings align with previous
studies: use of NE-supported donor hearts, even at high doses, does not
compromise recipient outcomes, provided careful donor selection. The
higher incidence of prolonged ICU stays observed may reflect the severity
of donors' pre-procurement conditions rather than the direct effect of NE
on organs. Cautiously expanding the criteria for donor heart acceptance to
include those supported by higher-dose vasoconstrictors could potentially
increase the available donor pool without compromising recipient survival
outcomes. In conclusion, the data from this analysis suggest that
high-dose NE donor support is not associated with increased mortality or
severe complications in heart transplant recipients. With appropriate
donor selection, these organs may safely contribute to addressing the
shortage of donor hearts for transplantation.<br/>Copyright &#xa9; 2025

<139>
Accession Number
2038421386
Title
Intravascular Ultrasound (IVUS) Assessment of Cardiac Allograft
Vasculopathy in the TEAMMATE Trial.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S347), 2025. Date of
Publication: 01 Apr 2025.
Author
Bock M.J.; Auerbach S.R.; Kuhn M.A.; Lu M.; Sleeper L.A.; Miyamoto S.D.;
Pietra B.A.; Almond C.S.; Daly K.P.; Investigators F.T.T.T.
Institution
(Bock) Pediatric Cardiology, Rady Children's Hospital / UC San Diego, San
Diego, CA, United States
(Auerbach, Miyamoto) Pediatric Cardiology, Children's Hospital Colorado,
Denver, CO, United States
(Kuhn) Pediatric Cardiology, Loma Linda University, Loma Linda, CA, United
States
(Lu, Sleeper, Daly, Investigators) Cardiology, Boston Children's Hospital,
Boston, MA, United States
(Pietra) Pediatric Cardiology, University of Florida Congenital Heart
Center, Gainesville, FL, United States
(Almond) Pediatric Cardiology, Stanford University, Palo Alto, CA, United
States
Publisher
Elsevier Inc.
Abstract
Purpose: Intravascular ultrasound (IVUS) is used to evaluate for cardiac
allograft vasculopathy (CAV) early after heart transplant (HTX). IVUS
evidence suggests an improved freedom from CAV in those receiving
proliferation signal inhibitors (PSI), such as everolimus, compared to
other regimens. We sought to evaluate differences in CAV as assessed by
IVUS at 12, 24, and 36 months post-HTX in pediatric HTX recipients
receiving low-dose tacrolimus with everolimus (TAC-EVL) and usual-dose
tacrolimus with mycophenolate (TAC-MMF). Additionally, we sought to
evaluate differences in the assessment of CAV by IVUS as compared with
coronary angiography. <br/>Method(s): We evaluated differences in and
changes to mean maximal intimal thickness (MIT), and Stanford IVUS
Classification (SIC) between those randomized to TAC-EVL or TAC-MMF at 12,
24, and 36 months after HTX in the TEAMMATE Trial using basic comparison
statistics and mixed effects regression models. We also evaluated
differences in CAV grading by IVUS as compared to coronary angiography at
these timepoints using Spearman correlation. <br/>Result(s): Of the 211
subjects in the TEAMMATE Trial, 21 underwent 45 CAV evaluations via IVUS.
13 subjects were randomized to TAC-MMF, while 8 subjects were randomized
to TAC-EVL. 17 studies were in TAC-EVL subjects and 28 were in TAC-MMF
subjects. 7 subjects underwent testing at two time points and 8 had
testing at all three time points. Mean (SD) MIT was 0.3 mm (0.2) for
TAC-EVL and 0.2 mm (0.1) for TAC-MMF and was not different between groups
(p=0.44) or between different time points (p=0.16-0.90). SIC was abnormal
(class 2-3) in 35% of TAC-EVL and 37% of TAC-MMF studies (p=0.91). Mixed
effects modeling did not suggest a difference in MIT (p=0.42) or SIC
(p=0.85) between groups. There were also no changes over time
(p=0.16-0.69). 3 subjects had abnormal angiography (2 in TAC-EVL group and
1 in TAC-MMF group). One subject in each group had grade 3 CAV by
angiography; corresponding SICs were class 1 for the TAC-EVL subject and
class 2 for the TAC-MMF subject. Spearman correlation between IVUS SIC and
angiography grade was R=0.3 (p=0.08). <br/>Conclusion(s): In this small
subset of TEAMMATE Trial subjects undergoing CAV evaluation with IVUS, no
differences in MIT or SIC were observed over time or between
immunosuppressive regimens over the 30-month trial period. Also,
correlation between IVUS and angiography was modest at best.<br/>Copyright
&#xa9; 2025

<140>
Accession Number
2038408615
Title
PO-06-139 OPTIMAL MANAGEMENT STRATEGIES FOR DIRECT ORAL ANTICOAGULANTS
(DOACS) IN CARDIAC RHYTHM DEVICE SURGERY: A META-ANALYSIS OF CONTINUED AND
INTERRUPTED APPROACHES.
Source
Heart Rhythm. Conference: Heart Rhythm 2025. San Diego United States. 22(4
Supplement) (pp S692-S693), 2025. Date of Publication: 01 Apr 2025.
Author
Palicherla A.; Balakrishna A.M.; Alla V.M.; Roka A.
Publisher
Elsevier B.V.
Abstract
Background: Periprocedural bleeding is one of the major complications of
cardiac implantable electronic device (CIED) implants. Many patients are
anticoagulated due to comorbidities, where interruption of anticoagulation
may increase the thromboembolic risk. Best management of DOACs
(continuation vs interruption) during CIED implants is yet to be
determined. <br/>Objective(s): We aimed to systematically assess the
safety and efficacy of DOAC management strategies in patients undergoing
CIED implant procedures. <br/>Method(s): We searched multiple databases
for studies comparing Interrupted vs continued strategy of DOACs during
CEID procedures. We used a random-effects model to calculate risk ratios
(RRs) with 95% confidence intervals (CIs). Outcomes included clinically
significant device-pocket hematoma, thromboembolic events, and any
device-pocket hematoma. <br/>Result(s): We identified 4 comparable studies
(observational and randomized controlled trials) with 1347 patients, of
which 667 with continued and 680 with interrupted DOAC strategy. There
were no significant differences between continued and interrupted
strategies in clinically significant device-pocket hematoma (RR 1.70; 95%
CI 0.84-3.45; p=0.14), thromboembolic events (RR 0.35; 95% CI 0.04-3.32;
p=0.36), and any device-pocket hematoma (RR 1.41; 95% CI 0.91-2.20;
p=0.13) [Figure 1]. <br/>Conclusion(s): The current level of certainty in
this evidence is limited, emphasizing the necessity for further studies to
substantiate these findings. Customizing an individualized strategy
remains crucial at this juncture. [Formula presented]<br/>Copyright &#xa9;
2025

<141>
Accession Number
2038420456
Title
A Novel Mechanical Perfusion Transportation Device (Organ Angel) in a Pig
Model.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S665), 2025. Date of
Publication: 01 Apr 2025.
Author
Besanko J.E.; Ou R.; Edwards J.R.; Worthington M.G.; Beltrame J.; Toby C.
Institution
(Besanko) Department of Cardiothoracic Surgery, Royal Adelaide Hospital,
Adelaide, Australia
(Ou) Cardiothoracic Surgery, Baker Insitute, Melbourne, Australia
(Edwards, Worthington) Cardiothoracic Surgery, Royal Adelaide Hospital,
Adelaide, Australia
(Beltrame) Cardiology, Queen Eliazbeth Hospital, Adelaide, Australia
(Toby) Transplant, Royal Adelaide Hospital, Adelaiade, Australia
Publisher
Elsevier Inc.
Abstract
Purpose: Evidence from randomised human and experimental trials indicate
that the results of heart transplantation improve with the use of
perfusion of donor hearts. The two devices currently approved for this
purpose are large and expensive, often requiring a charter aircraft.
Recently an Australian team has developed a small, portable oxygenated
hypothermic perfusion device which weighs 16kg, operates from batteries
and fits in a standard economy domestic airline seat. This device has been
subjected to validation in a randomised trial in a porcine model.
<br/>Method(s): 12 porcine hearts were randomised to perfusion with the
Organ Angel device (n=6) or cooling in an ice slurry (n=6) for 6 hours.
After warming and reversal of cardioplegia cardiac function was assessed
on a working heart reanimation circuit for 2 hours. Samples were taken for
electron microscopy and biochemical studies. <br/>Result(s): The
mechanical perfusion device demonstrated superior preservation compared to
cold storage in terms of cardiac performance (Cardiac output) p=0.01 on
the bench bypass circuit, electron microscopy, and biochemical normality.
<br/>Conclusion(s): These preliminary studies demonstrate early
indications of superiority to cold storage preservation in terms of
cardiac performance electron microscopy and biochemical normality. Thus
this machine provides an alternative to cold storage preservation and
potentially other mechanical perfusion devices. After further studies this
new device could have a role to play in the transport of donor hearts in
Australia and abroad.<br/>Copyright &#xa9; 2025

<142>
Accession Number
647108293
Title
Determinants Of Atrial Fibrillation Mechanisms Using Metabolomic
Profiling.
Source
Circulation Research. Conference: American Heart Association's Basic
Cardiovascular Sciences Scientific Sessions 2021: New Frontiers in
Cardiovascular Research and Therapy. Virtual. 129(Supplement 1) (no
pagination), 2021. Date of Publication: 01 Sep 2021.
Author
Sirish P.; Overton J.; Yang J.; Nader C.; Kiaii B.; Srivatsa U.; Hammock
B.D.; Chiamvimonvat N.
Institution
(Sirish, Yang, Nader) University Of California Davis, Davis, CA, United
States
(Overton, Hammock) UC Davis, Davis, CA, United States
(Kiaii, Srivatsa) UCD Med Cntr, Sacramento, CA, United States
(Chiamvimonvat) Univ of California, Davis, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Atrial fibrillation (AF) represents one of the most common
arrhythmias seen clinically, yet, current treatment paradigms have proven
largely inadequate. One of the main contributors to the pathophysiology of
AF is inflammation. Hence, reduction of inflammation associated atrial
remodeling represents a novel therapeutic strategy for the treatment of
AF. Oxylipins are derived from arachidonic acid, which is metabolized
through three pathways including the cytochrome P450 (CYP450) pathway. The
CYP450 products, epoxyeicosatrienoic acids (EETs), are major
anti-inflammatory metabolites with several cardioprotective effects. The
central hypothesis to be tested is that patients with AF will demonstrate
an increase in oxylipin profiles towards inflammatory features compared to
patients with normal sinus rhythm (NSR). We further hypothesize that lipid
mediators may represent a new therapeutic target for AF. <br/>Method(s):
In the cross sectional study, human atrial appendage specimens and blood
from informed and consented patients undergoing coronary artery bypass
graft surgery were obtained in accordance with the approved UC Davis IRB
protocol. Metabolomic profiling and inflammatory cytokines were assessed
from the plasma of patients using LC-MS/MS. The underlying mechanisms of
AF were determined using an integrated approach with molecular biology,
flow cytometry, and electrophysiology. <br/>Result(s): Metabolomic
profiling shows a significant decrease in the EETs/DHETs ratios and
EpOMEs/DiHOMEs ratios in the cohort with AF compared to patients in NSR.
There was a significant increase in inflammatory cytokine, chemokine
levels and oxidative stress in patients with AF compared to patients in
NSR. There was a significant increase in nuclear translocation of
NF-kappaB (nNF-kappaB) from patients with AF compared to NSR using western
blot analysis. Assessment of total IkappaB and phosphorylated-IkappaB
(pIkappaB) levels showed a decrease in IkappaB level and an increase in
the pIkappaB levels associated with the activation of NF-kappaB in AF
compared to the NSR cohort. <br/>Conclusion(s): The study provides
important insights into metabolomic profiles in patients with AF and
reveals the prospect of oxylipins being a novel therapeutic target in the
treatment of AF.

<143>
Accession Number
647095997
Title
Surgical Neuromodulation Therapies to Prevent Postoperative Atrial
Fibrillation: A Meta-Analysis, Meta Regression and Trial Sequential
Analysis of Randomized Controlled Trials.
Source
Heart rhythm. (no pagination), 2025. Date of Publication: 04 Apr 2025.
Author
Consoli L.N.; Cetinel E.; Lajczak P.; Koziakas I.G.; Majeed M.W.; Wijaya
P.; Salha I.; Samanidis G.
Institution
(Consoli) Federal University of Bahia, Salvador, Brazil
(Cetinel) San Raffaele University, Milan, Italy
(Lajczak) Medical University of Silesia, Katowice, Poland
(Koziakas, Samanidis) Cardiac Surgery Department, Onassis Hospital,
Athens, Greece
(Majeed) Government Medical College Srinagar, J&K, India
(Wijaya) Universitas Indonesia, Depok, Indonesia
(Salha) Trinity Centre for Global Health, Trinity College Dublin, Dublin,
Ireland
Abstract
BACKGROUND: Postoperative atrial fibrillation (POAF) occurs frequently
after cardiac surgery and is associated with increased mortality.
<br/>OBJECTIVE(S): Surgical neuromodulation therapies (SNMTs) have been
explored as a preventive strategy, but their efficacy and safety remain
uncertain. <br/>METHOD(S): We searched PubMed, Embase and the Cochrane
library for eligible randomized controlled trials. Meta-analysis was
performed for primary (POAF) and secondary (hospital stay; complications;
atrial fibrillation at 1 year; operation time; POAF burden; ICU stay)
endpoints. Subgroup analysis was conducted for each technique. We compared
endpoints using risk ratio (RR) for binary and mean difference for
continuous outcomes. We calculated 95% confidence intervals for all
outcomes. We carried out a trial sequential analysis for primary (POAF)
and secondary (hospital stay; complications) endpoints. We conducted
meta-regression for all covariates with at least 10 observations.
<br/>RESULT(S): We included 20 trials (n=3348). Seven studied anterior fat
pad (AFP) preservation, 5 pulmonary vein isolation (PVI), 2 ganglionic
plexus (GP) ablation, 1 partial cardiac denervation (PCD) and 5 assessed
epicardial injections. POAF incidence was lower in the SNMT group (RR 0.62
(0.48; 0.79), p < 0.001), driven by the AFP preservation, PCD and PVI
subgroups. Epicardial injections were only effective in patients
undergoing coronary surgery. SNMTs also reduced hospital stay (p=0.03).
All meta-regression analyses were insignificant. In the trial sequential
analysis, a positive effect for POAF was observed. <br/>CONCLUSION(S):
This meta-analysis found a significant reduction in POAF incidence with
implementation of AFP preservation, PCD and PVI. Epicardial injections
were only effective for patients undergoing coronary bypass.<br/>Copyright
&#xa9; 2025. Published by Elsevier Inc.

<144>
Accession Number
2038409672
Title
Comparative effectiveness of transcatheter vs surgical aortic valve
replacement: A systematic review and meta-analysis.
Source
World Journal of Cardiology. 17(4) (no pagination), 2025. Article Number:
104168. Date of Publication: 26 Apr 2025.
Author
Moradi I.; Mustafa M.S.; Sardar Sheikh J.; Shojai Rahnama B.; Fredericks
M.; Kumar Yennam A.; Arain M.; Saha U.; Richard Ma A.; Nagendran A.; Bin
Omer M.; Armaghan M.; Jaimes D.C.C.; Avinash Bojanki N.L.S.V.; Shafique
M.A.
Institution
(Moradi, Shojai Rahnama, Fredericks, Richard Ma) Department of Medicine,
Saint George's University, Grenada, Grenada
(Mustafa, Shafique) Department of Medicine, Jinnah Sindh Medical
University, Sindh, Karachi, Pakistan
(Sardar Sheikh, Bin Omer, Armaghan) Department of Medicine, CMH Lahore
Medical College, Institute of Dentistry, Punjab, Lahore, Pakistan
(Kumar Yennam) Department of Medicine, Emilio Aguinaldo College, Manila,
Philippines
(Arain) Department of Medicine, Dow University of Health Sciences,
Karachi, Pakistan
(Saha) Department of Medicine, Icahn School of Medicine at Mount Sinai
Queens, New York, NY, United States
(Nagendran) Department of Medicine, Rochester Regional Health-Unity
Hospital, Rochester, NY, United States
(Jaimes) Department of Medicine, Xavierian Pontifical University, Bogota,
Colombia
(Avinash Bojanki) Department of Medicine, Dr. NTR University of Health
Sciences, Andha Pradesh, India
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND The management of severe symptomatic aortic stenosis has been
revolutionized by transcatheter aortic valve replacement (TAVR), offering
a minimally invasive alternative to surgical aortic valve replacement
(SAVR). However, the comparative safety and efficacy of these
interventions remain subjects of ongoing investigation. AIM To compare the
clinical outcomes and safety of TAVR vs SAVR in patients with severe
symptomatic aortic stenosis. METHODS A systematic review and meta-analysis
were conducted according to PRISMA guidelines. Randomized controlled
trials (RCTs) comparing TAVR and SAVR were identified from databases
including PubMed, Scopus, and Web of Science up to May 31, 2024. Data were
extracted on clinical outcomes, including mortality, procedural
complications, and post-procedure adverse events. Risk ratios (RRs) with
95%CIs were calculated using a random-effects model. RESULTS A total of 10
RCTs were included. TAVR demonstrated a significantly lower risk of acute
kidney injury (RR: 0.33; 95%CI: 0.25-0.44), major bleeding (RR: 0.37;
95%CI: 0.30-0.46), and new-onset atrial fibrillation (RR: 0.44; 95%CI:
0.34-0.57) compared to SAVR. However, TAVR was associated with higher
risks of new permanent pacemaker implantation (RR: 3.49; 95%CI:
2.77-4.39), major vascular complications (RR: 2.47; 95%CI: 1.91-3.21), and
paravalvular leaks (RR: 4.15; 95%CI: 3.14-5.48). Mortality at 30 days was
comparable (RR: 0.95; 95%CI: 0.78-1.15), but long-term mortality was
slightly higher with TAVR in some analyses (RR: 1.23; 95%CI: 1.01-1.49).
Rates of stroke (RR: 0.97; 95%CI: 0.81-1.17) and myocardial infarction
(RR: 0.91; 95%CI: 0.67-1.24) were similar between the groups. CONCLUSION
TAVR offers a less invasive option with significant benefits in reducing
acute kidney injury, major bleeding, and new-onset atrial fibrillation,
making it particularly advantageous for high-risk surgical candidates.
However, higher risks of permanent pacemaker implantation, vascular
complications, and paravalvular leaks highlight the need for
individualized patient selection and shared decision-making to optimize
outcomes.<br/>Copyright &#xa9;The Author(s) 2025. Published by Baishideng
Publishing Group Inc. All rights reserved.

<145>
Accession Number
647099146
Title
Intracardiac or transesophageal echocardiography for left atrial appendage
occlusion? an updated systematic review and meta-analysis.
Source
European Heart Journal Cardiovascular Imaging. Conference: 24th annual
congress of the European Association of Cardiovascular Imaging. Berlin
Germany. 26(Supplement 1) (pp i592-i593), 2025. Date of Publication: 01
Jan 2025.
Author
Beneki E.; Dimitriadis K.; Theofilis P.; Pyrpyris N.; Kalompatsou A.;
Kostakis P.; Koukos M.; Tzimas G.; Tsioufis K.; Lancellotti P.; Aggeli C.
Institution
(Beneki, Dimitriadis, Theofilis, Pyrpyris, Kalompatsou, Kostakis, Koukos,
Tsioufis, Aggeli) Ippokrateio General Hospital of Athens, Athens, Greece
(Tzimas) University Hospital Centre Vaudois (CHUV), Department of
Cardiology, Lausanne, Switzerland
(Lancellotti) University Hospital of Liege (CHU), Department of
Cardiology, Liege, Belgium
Publisher
Oxford University Press
Abstract
Background: Percutaneous left atrial appendage occlusion (LAAO) is
typically performed under the guidance of transesophageal echocardiography
(TEE) and fluoroscopy. Intracardiac echocardiography (ICE) appears to be a
potential alternative to guide implantation. <br/>Purpose(s): We sought to
perform a meta-analysis comparing ICE vs TEE for the guidance of
percutaneous LAAO. <br/>Method(s): A comprehensive literature search was
performed using MEDLINE, Scopus and Web of Science electronic databases
from their inception to November 2023 regarding published abstracts and
manuscripts. Studies reporting clinical outcomes comparing ICE vs TEE for
percutaneous LAAO were included. Primary efficacy and safety outcomes
included technical success and the occurrence of any reported
procedure-related and device-related complication. Secondary outcomes
included procedural characteristics such as procedural time, fluoroscopy
time and the volume of contrast agent used. <br/>Result(s): A total of 18
studies with 124,230 patients fulfilled the criteria. Outcomes assessed
including procedure time between ICE vs TEE (risk ratio [RR], 1.01; 95%
CI, 1.00-1.01), fluoroscopy time (MD: 1.45 minutes, 95% CI -1.32 to 4.22,
p=0.30) and contrast medium volume (SMD: 0.02, 95% CI -0.23 to 0.26,
p=0.89) were found to be similar between both groups. Technical success
with higher odds was found with the use of ICE (OR: 1.36, 95% CI 1.14 to
1.63, p=0.006) and fewer devices employed in cases of ICE guidance (SMD:
-0.22, 95% CI -0.43 to -0.01, p=0.04, I2=62%). There was also no
significant difference in procedure- or device-related adverse events
between both groups. Interestingly, patients undergoing LAAO under ICE
guidance had higher risk for pericardial effusion/tamponade and iatrogenic
residual shunts compared to those in the TEE group (11 studies, RR: 1.66,
95% CI 1.13 to 2.43, p=0.014) and (4 studies, RR: 1.53, 95% CI 1.12 to
2.09, p=0.02, I2=1%), respectively. More vascular complications were noted
in cases of ICE (RR: 1.56, 95% CI 1.06 to 2.32, p=0.03).
<br/>Conclusion(s): Although TEE is the gold standard for perioperative
guidance of LAAO, imaging with ICE is an effective alternative to TEE in
LAAO procedures. However, further studies are needed to clarify safety of
this new perioperative imaging technique. (Figure Presented).

<146>
[Use Link to view the full text]
Accession Number
647097771
Title
IMPACT OF PREOPERATIVE EDUCATION ON OUTCOMES IN PATIENTS UNDERGOING OPEN
HEART SURGERY: A SYSTEMATIC REVIEW.
Source
Cardiopulmonary Physical Therapy Journal. Conference: Combined Sections
Meeting of the American Physical Therapy Association, CSM 2025. Houston,
TX United States. 36(1) (pp A4-A5), 2025. Date of Publication: 01 Jan
2025.
Author
Bauman M.; Spearen K.J.; Blevins E.W.; Bose S.; Mehta S.
Publisher
Lippincott Williams and Wilkins
Abstract
PURPOSE/HYPOTHESIS: Patients undergoing open heart surgery (OHS)
experience complications such as increased length of stay (LoS), emotional
distress, and increased pain levels, collectively affecting health-related
quality of life (HRQOL). Some studies have proposed presurgical education
interventions explaining the postsurgical recovery process and patient
empowerment to decrease complications and improve HRQOL after OHS. This
scoping review located and synthesized the literature examining the
effectiveness of pre-surgical interventions in improving HRQOL, physical
health, and psychological well-being after OHS. NUMBER OF SUBJECTS: N/A.
MATERIALS AND METHODS: A librarian searched PubMed, CINAHL, and Cochrane
Databases to locate relevant literature. Randomized trials,
quasi-experimental studies, or retrospective studies examining the
benefits of pre-surgical education interventions in OHS were included. Two
authors independently reviewed all the citations to determine their
eligibility. These reviewers also extracted data concerning the education
provided presurgery, sample recruited, outcomes assessed, and benefits of
the interventions. The Risk of Bias (RoB) was independently appraised by
the 2 reviewers using the PEDro Scale. Due to considerable clinical
heterogeneity in the type of education provided, outcomes assessed, and
measures selected to assess these outcomes, meta-analyses of pooled data
could not be performed to determine composite estimates of effect.
Therefore, a narrative synthesis of data was performed to illustrate
common elements of the education provided and the effectiveness of these
interventions. <br/>RESULT(S): Of the 1365 citations found in the
literature search, 10 studies meeting the eligibility criteria were
included. The RoB was low in 4 studies (PEDro score of >=7/10) and
moderate in = studies (PEDro score >=5/10 but <7/10). Presurgical
education included elements of anxiety, pain, mucociliary clearance, lung
volumes, & preconditioning regimen. There was a broad consensus in the
results where the pre-surgery education increased adherence to cardiac
rehab, improved HRQOL, reduced hospital stay duration, and lowered rates
for complications such as dyspnea, pain, or pulmonary complications after
OHS. Two studies examining the benefits of pre-surgery education on
psychological well-being yielded no conclusive results in favor of
education intervention. No adverse events were recorded in any of these
studies within the presurgery education group. <br/>CONCLUSION(S):
Synthesis of the prevalent data suggests that pre-surgery education has a
beneficial effect on improved HRQOL and reduced rates of complications
post-OHS. Nonetheless, pre-surgery education does not have a beneficial
effect on psychological well-being after OHS. CLINICAL RELEVANCE: The
results of this study support pre-surgery education to maximize HRQOL and
reduce complications after OHS. The literature is scant on the benefits of
pre-surgery education on physical health after OHS. Physical therapists
should conduct exploratory research to determine the benefits of targeted
pre-surgery education to maximize outcomes and functioning after OHS..

<147>
Accession Number
647097252
Title
Surgical innovation, statistical analysis, and professional culture:
thymectomy for myasthenia gravis, 1936-2016.
Source
Medical history. (pp 1-17), 2025. Date of Publication: 07 Apr 2025.
Author
Weatherall M.W.
Institution
(Weatherall) Stoke Mandeville Hospital, Aylesbury, United Kingdom
Abstract
This paper provides an account of a specific operation - the removal of
the thymus gland (thymectomy) to treat the rare neurological condition
myasthenia gravis - from its first performance in 1936, by the American
surgeon Alfred Blalock, to the publication in 2016 of an international
multicentre randomised controlled trial (RCT) of the technique. Thymectomy
was the subject of a transatlantic controversy in the 1950s, in which the
main players were the English surgeon Geoffrey Keynes, and American
neurologists and surgeons from New York, Boston, and the Mayo Clinic. The
resolution of this controversy involved the use of increasingly
sophisticated statistical techniques, but also crucially other influences
including the social transformation of thoracic surgery, and competition
between the leading American centres. The consensus achieved after this
controversy was challenged in the late 1970s, eventually prompting the
implementation of a trial acceptable to twenty-first-century
evidence-based medicine. This account will demonstrate that surgical
innovation in the period covered required increasing attention to the
statistical basis of patient selection and outcome evaluation; that the
processes of technical innovation cannot be regarded as separate from
developments in the professional culture of surgery, and that one of the
consequences of these changes has been the gradual eclipse of the
prestigious autonomous surgeon.

<148>
Accession Number
2038420611
Title
Hypothermic Oxygenated Perfusion of the Donor Heart in Heart
Transplantation: The One Year Outcome from a Randomized, Controlled,
Open-Label, Multicenter Clinical Trial.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S49), 2025. Date of
Publication: 01 Apr 2025.
Author
Rega F.; Lebreton G.; Para M.; Michel S.; Schramm R.; Begot E.;
Vandendriessche K.; Kamla C.; Gerosa G.; Berman M.; Boeken U.; Clark S.;
Ranasinghe A.; Ius F.; Forteza A.; Pivodic A.; Hennig F.; Guenther S.;
Zuckermann A.; Knosalla C.; Dellgren G.; Wallinder A.
Institution
(Rega, Vandendriessche) Cardiac Surgery, University Hospitals Leuven,
Leuven, Belgium
(Lebreton, Begot) Cardiac Surgery Department, Pitie-Salpetriere Hospital,
APHP, Sorbonne University, Paris, France
(Para) Department of Cardiovascular Surgery and Transplantation, Bichat
Hospital, Universite Paris Cite, Paris, France
(Michel, Kamla) Clinic of Cardiac Surgery, Ludwig-Maximilians-University
of Munich, Munich, Germany
(Schramm, Guenther) Clinic for Thoracic and Cardiovascular Surgery, Heart
and Diabetes Center North Rhine Westfalia, Ruhr-University Bochum, Bad
Oeynhausen, Germany
(Gerosa) Department of Cardiac, Thoracic, Vascular Sciences and Public
Health, University of Padua, Padua, Italy
(Berman) Cadiothoracic Surgery, Royal Papworth Hospital NHS Foundation
Trust, Cambridge, United Kingdom
(Boeken) Department of Cardiac Surgery, Heinrich Heine University,
Dusseldorf, Germany
(Clark) Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne,
United Kingdom
(Ranasinghe) Cardiac Surgery, Queen Elizabeth Hospital, University
Hospitals Birminghem NHS Trust, Birmingham, United Kingdom
(Ius) Department of Cardiothoracic, Transplant and Vascular Surgery,
Hannover Medical School, Hannover, Germany
(Forteza) Department of Cardiac Surgery, Puerta de Hierro Majadahonda
University Hospital, Madrid, Spain
(Pivodic) APNC, Moldnal, Sweden
(Hennig, Knosalla) Department of Cardiothoracic and Vascular Surgery,
Deutsches Herzzentrum der Charite, Berlin, Germany
(Zuckermann) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Dellgren) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Wallinder) XVIVO Perfusion, Gothenburg, Sweden
Publisher
Elsevier Inc.
Abstract
Purpose: A recent randomized, controlled, open-label, multicenter clinical
trial demonstrated beneficial short-term effects of hypothermic oxygenated
machine perfusion (HOPE) on donor hearts. The one-year outcomes from this
trial are now available. <br/>Method(s): A multicenter, open-label RCT
with superiority design across 15 transplant centers in eight European
countries. Adult candidates for heart transplantation were included. For
HOPE a portable machine perfusion system (XVIVO Perfusion) was used and
for the control group ischemic static cold storage (SCS). 30-day outcomes
were previously reported. This analysis includes the first 12-month follow
up for the modified intention to treat population. <br/>Result(s):
Patients were enrolled between November 2019 and May 2023. The 30 day
survival was 96% in both study groups. Between day 30 and 12-months, 4
patients died in the HOPE group and 10 patients in the SCS group,
resulting in an overall 12-month survival rate of 92% and 86%. No
retransplantation occurred. Biopsy verified acute cellular rejection >
grade 1, was reported in 14% of patients in the HOPE group and 13% of
patients in the SCS group during the first 12 months. There were a total
of 14 and 20 adverse allograft rejection events in the HOPE and SCS group
respectively. Cardiac allograft vasculopathy (CAV) was diagnosed in 4 HOPE
patients, 2 of whom were transplanted with donors heart with known
non-significant coronary stenosis, and in 2 SCS patients. Major adverse
cardiac transplant events affected 26% of HOPE patients and 41% of SCS
patients (p = 0.019). <br/>Conclusion(s): This is the first RCT that has
demonstrated a reduction in PGD after heart transplantation. The 61% risk
reduction of PGD, appears to be reflected in the 12-month survival and
reduction in major transplant complications. Our findings support the
concept that HOPE mitigates graft injury, leading to improved patient
outcomes. Follow-up will continue for five years post-transplant. *
p-value from log-rank test. **2 patients with donor hearts with non-sign
coronary stenosis pre-TX [Formula presented]<br/>Copyright &#xa9; 2025

<149>
Accession Number
2038419983
Title
Outcomes After DCD Cardiac Transplantation: An International, Multicentre
Retrospective Study.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S23), 2025. Date of
Publication: 01 Apr 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.; Park S.; Cain
M.; 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, Ochsner, Sinha) University of Cambridge, Cambridge, United Kingdom
(Bhagra, Pettit, Large) Royal Papworth Hospital, Cambridge, United Kingdom
(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, Ashley) Stanford University, Palo Alto, CA, United States
(Luikart) Stanford, Stanford University, Palo Alto, CA, United States
(Moazami, James) NYU Langone Health, New York, NY, United States
(Dar, Konicoff) Harefield Hospital, London, United Kingdom
(Urban) UNMC, Omaha, NE, United States
(Um, Castleberry) University of Nebraska, Omaha, NE, United States
(Hoffman) University of Colorado School of Medicine, Boulder, CO, United
States
(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, Murcia, Spain
(Brouckaert, Rega) University Hospitals Leuven, Leuven, Belgium
(Tchana-Sato) CHU Liege, Liege, Belgium
(Berman, Bae) Royal Papworth Hospital, Cambridge, United Kingdom
(Messer) Golden Jubilee National Hospital, Glasgow, United Kingdom
Publisher
Elsevier Inc.
Abstract
Purpose: Donation after circulatory determination of death (DCD) has been
shown to be a safe and effective method of increasing the size of the
potential donor pool. The DCD heart is ischaemic and requires a period of
resuscitative reperfusion which can take place either in the donor (known
as thoraco-abdominal normothermic regional perfusion - taNRP) or outside
the donor known as direct procurement and preservation (DPP). This study
aimed to compare the outcomes of DCD heart transplantation across Europe
and the US to identify whether there are any significant differences in
recipient outcomes between taNRP and DPP. <br/>Method(s): This was a
retrospective observational study across Europe and the US. It included 20
heart transplant centres across Belgium, Spain, the UK and the US. All
participants who had undergone a DCD heart transplant at participating
centres from the start of their respective programmes until 1^st
January 2023 were included. The censor date for the study was
1^st January 2024 to ensure at least one year of follow up data
on all participating patients. This study included 504 DCD cases from 28th
February 2015 - 1st Jan 2023. 223 patients received hearts that had been
procured with taNRP. 281 patients received hearts that were procured by
DPP. <br/>Result(s): The data demonstrate a similar one-year and
three-year survival between taNRP and DPP heart recipients (0.91 vs 0.88
p= 0.16, 0.85 vs 0.78 p=0.1). The taNRP group had a significantly reduced
need for mechanical circulatory support (MCS) post transplant compared to
the DPP group (7.6% vs 19.2% p < 0.001) and a significantly lower rate of
acute rejection requiring treatment in the first year (13% vs 25%
p<0.001). The taNRP group also had a higher ejection fraction at 1-month
(63.8% vs 57.5%, p<0.001)and 1-year (61% vs 57.5%, p<0.001) post
transplant. <br/>Conclusion(s): This international, retrospective study
demonstrated that taNRP is associated with a lower need for mechanical
circulatory support and acute rejection requiring treatment. There is a
need for a randomised control trial to definitively confirm these results.
These results are significant as mechanical support is associated with
significant financial cost and morbidity. The significance of higher rates
of acute rejection in the DPP group are not yet known.<br/>Copyright
&#xa9; 2025

<150>
Accession Number
2038420987
Title
Evolocumab Reduces Progression of Cardiac Allograft Vasculopathy in Heart
Transplant Recipients with Increased Intimal Thickness at Baseline: A
Post-HOC Analysis of the EVOLVD Trial.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S18-S19), 2025. Date
of Publication: 01 Apr 2025.
Author
Arora S.; Gullestad L.; Lemstrom K.; Gustafsson F.; Eiskjaer H.; Karason
K.; Gjesdal G.; Pentikainen M.; Lommi J.; Gude E.; Andreassen A.;
Clemmensen T.; Christiansen E.H.; Bjorkelund E.; Broch K.
Institution
(Arora, Gullestad, Gude, Andreassen, Bjorkelund, Broch) Oslo University
Hospital, Oslo, Norway
(Lemstrom) University of Helsinki, Helsinki, Finland
(Gustafsson) Rigshospitalet, Copenhagen, Denmark
(Eiskjaer, Clemmensen, Christiansen) Aarhus University Hospital, Aarhus,
Denmark
(Karason) Transplant Institute, Sahlgrenska University Hospital,
Sahlgrenska, Sweden
(Gjesdal) Lund University Hospital, Lunde, Sweden
(Pentikainen, Lommi) Helsinki University Hospital, Helsinki, Finland
Publisher
Elsevier Inc.
Abstract
Purpose: Cardiac allograft vasculopathy (CAV) is a leading cause of
morbidity and mortality in heart transplant (HTx) recipients. The EVOLVD
trial demonstrated that evolocumab, a PCSK9 inhibitor, significantly
reduced low-density lipoprotein (LDL) cholesterol but did not reduce
maximal intimal thickness (MIT) or percent atheroma volume (PAV) overall.
This post-hoc analysis evaluated CAV progression based on baseline MIT and
PAV to assess evolocumab's efficacy across different levels of disease
severity. <br/>Method(s): The EVOLVD trial enrolled 128 HTx recipients
from Nordic transplant centers between June 2019 and May 2022. Four to
eight weeks post-HTx, patients were randomized to monthly subcutaneous
injections of evolocumab 420 mg or placebo. Baseline MIT and PAV were
measured using intracoronary ultrasound. The primary outcomes were MIT and
PAV at 12 months, analyzed with ANCOVA, adjusting for baseline values.
Matched coronary ultrasound images were available for 56 patients
allocated to evolocumab and 54 patients allocated to placebo.
<br/>Result(s): In patients with baseline MIT above the median, mean CAV
progression was 0.02 +/- 0.07 mm in the evolocumab group versus 0.07 +/-
0.08 mm in the placebo group (adjusted mean difference: 0.05 mm, p =
0.015). In patients with baseline MIT below the median, progression was
0.04 +/- 0.04 mm with evolocumab versus 0.02 +/- 0.03 mm with placebo
(adjusted mean difference: -0.02 mm, p = 0.184). Patients with baseline
PAV above the median had a mean increase of 0.77% +/- 2.35% in the
evolocumab group versus 2.63% +/- 2.55% in the placebo group (adjusted
mean difference: 1.86%, p = 0.014). In patients with baseline PAV below
the median, the increase was 1.94% +/- 2.86% with evolocumab versus 1.17%
+/- 1.58% with placebo (adjusted mean difference: -0.77%, p = 0.256).
<br/>Conclusion(s): Twelve months of evolocumab treatment reduced CAV
progression in patients with elevated baseline MIT and PAV. In patients
with less disease at baseline, progression was minimal and not
significantly different between groups. These findings suggest that
baseline MIT and PAV may help identify HTx recipients most likely to
benefit from PCSK9 inhibition. Further research is needed to confirm these
results and inform personalized treatment strategies.<br/>Copyright &#xa9;
2025

<151>
Accession Number
2038419593
Title
Successful Prevention of Intrapericardial Adhesions After Central
Extracorporeal Life Support Implantation by Synthetic Polyethylene
Glycols-Based "BAX602": Outcomes of a Multicenter Randomized Comparative
Study.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S22), 2025. Date of
Publication: 01 Apr 2025.
Author
Fukushima S.; Tonai K.; Ushijima T.; Kinoshita O.; Shiose A.; Ono M.;
Fujita T.
Institution
(Fukushima) Adult Cardiac Surgery, National Cerebral and Cardiovascular
Center, Suita, Japan
(Tonai) National Cerebral and Cardiovascular Center, Suita, Japan
(Ushijima, Shiose) Kyushu University Hospital, Fukuoka, Japan
(Kinoshita) Saitama Medical University International Medical Center,
Hidaka, Japan
(Ono) The University of Tokyo Hospital, Tokyo, Japan
(Fujita) Cardiovascular Surgery, Institute of Science Tokyo, Tokyo, Japan
Publisher
Elsevier Inc.
Abstract
Purpose: Intrapericardial adhesions are risk of any cardiac surgical
procedures. The study purpose was to evaluate effects of BAX602, known as
COSEAL, spray over cardiac surface on prevention of intrapericardial
adhesions in patients undergoing extracorporeal life support (ECLS)
implantation by central cannulation via median sternotomy. <br/>Method(s):
This study was an investigator-initiated, multicenter, two-arm,
open-label, randomized trial, with a total of 30 cases being enrolled,
registered in UMIN Clinical Trials Registry (000038998). The cases were
assigned to have BAX602 sprayed over the cardiac surface or no treatment
before the sternum approximation in the central ECLS implantation surgery
for cardiogenic shock. The primary outcome measure was the severity of
intrapericardial adhesions, which was evaluated by at the redo sternotomy
surgery performed in 2 weeks or later after the primary ECLS surgery.
<br/>Result(s): The primary outcome was evaluated in 26 cases (13 each
group). The total score of the adhesion severity, which was the sum of
four-grade adhesion score, raging 0 to 3, in the five predefined
intrapericardial sites, was 3.5+/-2.4 in the BAX602 group, which was
significantly smaller than that of 12.1+/-2.7 in the control group
(P<0.0001). In addition, the total number of adhesions with dense/vascular
or cohesive adhesions, which was graded as 2 or 3, across all five sites
was significantly smaller in the BAX602 group than that in the control
group (p<0.0001). Moreover, time of adhesiolysis in the redo surgery was
significant shorter in the BAX602 group than that of the control group.
There was no significant difference in the safety assessment between the
two groups. <br/>Conclusion(s): BAX602 spray over cardiac surface was
effective in preventing intrapericardial adhesions after central ECLS
implantation, suggesting that potentially redo sternotomy
surgery-requiring cases, such as bridge-to-transplant candidates, would
benefit from BAX602 spray in the primary cardiac surgery.<br/>Copyright
&#xa9; 2025

<152>
Accession Number
2038419803
Title
Targeting Inflammation and Alloimmunity in Heart Transplant Recipients
with Tocilizumab: Preliminary Results of the "All in Heart" Randomized
Clinical Trial.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S17), 2025. Date of
Publication: 01 Apr 2025.
Author
Kobashigawa J.; Heeger P.; Bridges N.D.; Morrison Y.; Bagiella E.; Arroyo
L.; Hall S.; Kao A.; Lewis G.; Patel J.; Starling R.; Stehlik J.; Madsen
J.C.
Institution
(Kobashigawa, Patel) Cedars-Sinai Smidt Heart Institute, Los Angeles, CA,
United States
(Heeger) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Bridges, Morrison) National Institutes of Health, Bethesda, MD, United
States
(Bagiella) Mount Sinai, New York, NY, United States
(Arroyo) Tampa General Hospital, Tampa, FL, United States
(Hall) Baylor University Medical Center, Dallas, TX, United States
(Kao) St. Luke's Cardiovascular Consultants, Inc., Kansas City, MO, United
States
(Lewis, Madsen) Massachusetts General Hospital, Boston, MA, United States
(Starling) Cleveland Clinic, Cleveland, OH, United States
(Stehlik) University of Utah, Salt Lake City, UT, United States
Publisher
Elsevier Inc.
Abstract
Purpose: IL-6 signaling blockade using tocilizumab has emerged as an
exciting and effective new therapy in the field of autoimmunity. The
purpose of this multicenter double blind randomized clinical trial is to
compare the efficacy of standard of care triple maintenance
immunosuppression plus tocilizumab treatment versus standard of care
triple maintenance immunosuppression plus placebo on outcomes as defined
by a composite 1 year post-transplant endpoint of a) detection of
donor-specific antibodies (DSA), b) acute cellular rejection (ACR), c)
antibody mediated rejection (AMR), d) hemodynamic compromise (HDC)
rejection in absence of biopsy or histological rejection, e) death, and f)
re-transplantation. <br/>Method(s): 151 patients from 17 heart transplant
centers in the United States were randomized 1:1 to either standard of
care triple maintenance immunosuppression plus tocilizumab or standard of
care triple maintenance immunosuppression plus placebo. Study therapy
(tocilizumab/placebo) was administered within the first 72 hours and at
week 4, week 8, month 3, month 4 and month 5 post-transplant. Patients
were followed for 12 months. Endpoints: The primary endpoint is a
composite incidence of first occurrence of the following events: any
detection of de novo donor-specific antibodies (dnDSA), acute cellular
rejection (ACR) > ISHLT 2R rejection, antibody mediated rejection (AMR) >
ISHLT AMR 1, hemodynamic compromise rejection in the absence of a biopsy
or histological rejection, death or re-transplantation. Hemodynamic
compromise-rejection was defined as follows: a) ejection fraction of <40%
or a 20% decrease from baseline, and the need for inotropic agents, or b)
fractional shortening of <20% or a 25% decrease from baseline, and the
need for inotropic agents, plus c) the need for inotropic agents due to a
cardiac index (CI) <2.0 L/min/m2 or a 25% decrease from baseline.
Exploratory mechanistic endpoints were also assessed. Preliminary results
will be presented at the time of presentation. Exploratory mechanistic
endpoints will be reported separately.<br/>Copyright &#xa9; 2025

<153>
Accession Number
647095705
Title
Comparison of Liposomal Bupivacaine versus Bupivacaine in Superficial
Parasternal Intercostal Plane Block for Cardiac Surgery with Median
Sternotomy.
Source
Annals of thoracic and cardiovascular surgery : official journal of the
Association of Thoracic and Cardiovascular Surgeons of Asia. 31(1) (no
pagination), 2025. Date of Publication: 2025.
Author
Qiu R.-E.; Lan Y.-P.; Liu S.; Fang X.-Y.; Zhang Y.-F.
Institution
(Qiu, Lan, Liu, Fang, Zhang) Anesthesiology Department, Quzhou Affiliated
Hospital of Wenzhou Medical University, Quzhou People' s Hospital, Quzhou,
Zhejiang, China
Abstract
PURPOSE: This study aimed to compare the efficacy and safety of liposomal
bupivacaine (Lip-BPVC) versus standard bupivacaine (BPVC) for superficial
parasternal intercostal plane block in patients undergoing elective
coronary artery bypass grafting (CABG) via median sternotomy.
<br/>METHOD(S): A total of 82 adult patients were randomly assigned to the
BPVC group (n = 41) or the Lip-BPVC group (n = 41). <br/>RESULT(S): The
Lip-BPVC group demonstrated significantly lower pain scores at all
postinjection time points compared to the BPVC group with fewer opioid
analgesics. Lip-BPVC demonstrated an initial heightened inflammatory
response postoperatively compared to standard BPVC, indicated by
significantly lower levels of pro-inflammatory markers at 24 and 48 hours
postinjection with BPVC. However, by 72 hours, inflammatory markers did
not differ significantly between Lip-BPVC and BPVC groups. No significant
differences were observed between the groups in terms of surgery duration,
extubation time, intensive care unit and hospital length of stay, or
incidence of postoperative nausea and vomiting. <br/>CONCLUSION(S):
Lip-BPVC initially increased inflammatory markers postoperatively, but
levels were comparable to BPVC by 72 hours. It provided superior pain
control and reduced opioid use compared to standard BPVC in CABG patients,
with similar safety and recovery outcomes.

<154>
Accession Number
2038419438
Title
Utility of Cell Mediated Immunity Assay T-SPOT.CMV to Predict Likelihood
of Post-Prophylaxis Infection in Seropositive for Cytomegalovirus Heart
Transplant Recipients.
Source
Journal of Heart and Lung Transplantation. Conference: 57th ASH Annual
Meeting. Orlando United States. 44(4 Supplement) (pp S46-S47), 2025. Date
of Publication: 01 Apr 2025.
Author
Garcia-Romero E.; Diez-Lopez C.; Bestard O.; Trenado V.D.; Garcia-Cosio
M.; Ortiz-Bautista C.; Perez F.H.; Couto-Mallon D.; Gonzalez-Vilches F.;
Hernandez-Ruiz C.; Lopez-Lopez L.; Trillo A.G.; Molina M.G.; Vilalta L.R.;
Caballero S.I.; Casassas L.D.; Sabe N.; Gonzalez-Costello J.
Institution
(Garcia-Romero, Diez-Lopez) Department of Cardiology. Bioheart Group
(IDIBELL). Ciber Cardiovascular Group (CIBER-CV), Bellvitge University
Hospital, Barcelona, Spain
(Bestard, Casassas) Nephrology, Vall d'Hebron University Hospital,
Barcelona, Spain
(Trenado) Cardiology, La Fe University Hospital, Valencia, Spain
(Garcia-Cosio) Cardiology, 12 Octubre University Hospital, Madrid, Spain
(Ortiz-Bautista) Cardiology, Gregorio Maranon University Hospital, Madrid,
Spain
(Perez) Cardiology, Hospital Univ, Puerta De Hierro, Madrid, Spain
(Couto-Mallon) Cardiology, A Coruna University Hospital Complex, A Coruna,
Spain
(Gonzalez-Vilches) Cardiology, Marques de Valdecilla University Hospital,
Santander, Spain
(Hernandez-Ruiz) Cardiology, Valladolid University Hospital, Valladolid,
Spain
(Lopez-Lopez) Cardiology, Santa Creu i Sant Pau Hospital, Barcelona, Spain
(Trillo) Cardiology, Virgen del Rocio University Hospital, Sevilla, Spain
(Molina) Cardiology, Virgen de la Arrixaca University Hospital, Murcia,
Spain
(Vilalta, Caballero) Cardiology, Bellvitge University Hospital, Barcelona,
Spain
(Sabe) Infectious Diseases, Bellvitge University Hospital, Barcelona,
Spain
(Gonzalez-Costello) Department of Cardiology. Bioheart Group (IDIBELL).
Ciber Cardiovascular Group (CIBER-CV), Bellvitge Hospital, Barcelona,
Spain
Publisher
Elsevier Inc.
Abstract
Purpose: Use of Cell mediated immunity (CMI) assays in heart transplant
(HT) recipients has considerable potential to improve risk stratification
for CMV, allowing individualization of patient management around the
timing of infection prophylaxis. Using data from the ELISPOT-TC trial, we
have attempted to determine utility of T-SPOT.CMV to predict likehood of
post-prophylaxis infection. <br/>Method(s): This is a multicenter,
randomized, open-label, controlled phase IV trial, with a non-inferiority
design. Seropositive for CMV HT recipients have been randomly assigned
(2:1) to group 1: preventive strategy based on post-transplant CMI
(patients with low CMI will receive valganciclovir for 3 months and
patients with high CMI will be treated with pre-emptive therapy); or group
2: Standard of care, universal prophylaxis for 3 months. 190 patients from
11 Spanish hospitals have been included. Per protocol analysis have been
carried out. <br/>Result(s): Amongst all patients included in the trial,
86% presented a low CMI 10 days post-HT and 58% maintained a low CMI three
months post-HT. Mean CMV-specific CMI against either IE-1 or pp65 was not
different between control and experimental group at three months post-HT.
Patients with a low CMI three months post-HT received more inotropic
treatment, more long-term mechanical circulatory support and presented a
higher rate of mechanical ventilation before HT. A slightly higher rate of
infection prior to HT was also observed. Basiliximab was used as induction
therapy in 75% of these patients. No significant differences were found in
the cumulative incidences of CMV infection, CMV infection requiring
treatment or CMV disease from the third month post-HT between patients
with a low CMI vs high CMI at three months post-HT. <br/>Conclusion(s):
Cell mediated immunity assay T-SPOT.CMV does not predict risk of
post-prophylaxis infection at 3 months in CMV seropositive HT recipients
[Formula presented]<br/>Copyright &#xa9; 2025

<155>
[Use Link to view the full text]
Accession Number
2038232181
Title
A Comprehensive Review of Effusive-Constrictive Pericarditis, Diagnosis,
and Management.
Source
Cardiology in Review. (no pagination), 2025. Date of Publication: 2025.
Author
Jamaleddin Ahmad F.A.; Ali Abdi S.I.; Verma T.; Barsinge T.; Banderas
Echeverry W.M.; Sampath N.; Fathima A.; Khelifi A.; Ashraf Sanour O.;
Zerin A.; Mowo-Wale A.; Khan S.
Institution
(Jamaleddin Ahmad) American University of the Caribbean Medical School,
Sint Maarten, Netherlands
(Ali Abdi, Khan) Thumbay University Hospital, Ajman, United Arab Emirates
(Verma) Indira Gandhi Medical College, Shimla, India
(Barsinge) Seth GS Medical College and King Edward Memorial Hospital,
Mumbai, India
(Banderas Echeverry) Universidad Libre, Cali, Colombia
(Sampath, Fathima) Sri Ramachandra Medical College, Chennai, India
(Khelifi) University of Jordan, Amman, Jordan
(Ashraf Sanour) Hawler Medical University, Erbil, Iraq
(Zerin) All India Institute of Medical Sciences, Bhubaneswar, India
(Mowo-Wale) Obafemi Awolowo College of Health Sciences/Olabisi Onabanjo
University, Ago-Iwoye, Nigeria
Publisher
Lippincott Williams and Wilkins
Abstract
Effusive-constrictive pericarditis (ECP) is characterized by fluid
accumulation in the pericardial space and a rigid, fibrotic pericardium
that restricts heart filling. Its diverse causes include infectious
agents, systemic inflammatory conditions, malignancies, and iatrogenic
factors. ECP is more prevalent in areas burdened by contagious diseases,
such as tuberculous pericardial effusion, and it is found in about 6.7% of
patients with tuberculous pericardial effusion. The diagnosis of ECP has
improved with advanced imaging techniques, yet challenges persist.
Although Doppler echocardiography is sensitive, it lacks specificity, and
cardiac catheterization remains the gold standard. Emerging biomarkers
such as interleukin-10 may enhance diagnosis, but further validation is
needed. Techniques such as cardiac magnetic resonance imaging and computed
tomography are used to identify structural abnormalities, but their
routine application is still developing. Management of ECP is based on its
underlying cause and severity, often starting with pericardiocentesis
followed by anti-inflammatory treatments. For severe cases with
significant fibrosis, pericardiectomy is the definitive solution.
Prognosis varies, with malignancy-related cases typically yielding poorer
outcomes than infectious origins. This review explores ECP's
pathophysiology, diagnostic challenges, and treatment strategies. It
highlights knowledge gaps and suggests future research directions. A
multidisciplinary approach is crucial for understanding and improving
patient care for this complex condition.<br/>Copyright &#xa9; 2025 Wolters
Kluwer Health, Inc. All rights reserved.

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Accession Number
647093148
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
The Annals of thoracic surgery. (no pagination), 2025. Date of
Publication: 03 Apr 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) Division of Cardiothoracic Surgery, Michael E. DeBakey Department
of Surgery, Baylor College of Medicine and Department of Cardiovascular
Surgery, Texas Heart Institute, Houston, TX, United States
(Cangut) Department of Cardiovascular Surgery, Mount Sinai School of
Medicine. New York NY
(Hickey) Division of Cardiology, University of Pittsburgh School of
Medicine. Pittsburgh PA
(Lorusso) Cardio-Thoracic Surgery Department, Maastricht University
Medical Centre (MUMC), Cardiovascular Research Institute Maastricht
(CARIM), 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 and 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 Cardiothoracic Surgery, Michael E. DeBakey
Department of Surgery, Baylor College of Medicine and Department of
Cardiovascular Surgery, Texas Heart Institute, Houston, TX; Divisions of
Acute Care Surgery/Trauma and Cardiothoracic Surgery, Michael E. DeBakey
Department of Surgery, Baylor College of Medicine, Houston, TX
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. <br/>METHOD(S): An interdisciplinary, international
expert panel utilizing 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 non-recovery.
Individual statements were graded based on the quality of available
evidence. <br/>RESULT(S): The panel addressed four main questions aimed at
initiation, escalation and de-escalation of tMCS. Based on available
literature review and expert consensus, 11 recommendations were
formulated. Key principles included recognition of the need for CS
patients with 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 prior to 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
wean from tMCS, evaluation should include interdisciplinary assessment for
advanced therapies with palliation included as a consideration in care
discussions. <br/>CONCLUSION(S): A practical guide to initiation,
escalation, and de-escalation of temporary MCS is provided.
Center-specific approaches based on local capabilities should be
implemented.<br/>Copyright &#xa9; 2025. Published by Elsevier Inc.