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<1>
Accession Number
2038552620
Title
Impact of PCI strategies on outcomes of patients undergoing Transcatheter
Aortic Valve Implantation with concomitant coronary artery disease: A
systematic review and meta-analysis.
Source
PLoS ONE. 20(4 April) (no pagination), 2025. Article Number: e0321395.
Date of Publication: 01 Apr 2025.
Author
Wang D.; Lai S.; Wang Z.; Xuan C.; Ren X.; Peng W.; Pan G.
Institution
(Wang) Institute of Cardiovascular Diseases, Dongzhimen Hospital, Beijing
University of Chinese Medicine, Beijing, China
(Wang, Wang, Xuan, Ren, Peng, Pan) Second Department of Cardiology,
Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing,
China
(Lai) Beijing Hospital of Traditional Chinese Medicine, Beijing, China
Publisher
Public Library of Science
Abstract
The aim of this study is to compare the clinical benefits associated with
different percutaneous coronary intervention (PCI) timing strategies in
patients undergoing transcatheter aortic valve implantation (TAVI) who
have coexisting coronary artery disease (CAD). A systematic review and
meta-analysis were conducted. PubMed, EMBASE, Cochrane Library and Web of
Science databases were searched for relevant articles up to April 10th,
2024. Studies that reported comparisons of clinical outcomes between PCI
before/concomitant with TAVI (PCI-TAVI) vs. TAVI alone, or comparisons
between PCI before/concomitant with TAVI vs. PCI after TAVI (TAVI-PCI)
were selected. Primary outcomes were all-cause mortality in the
short-term, mid-term and long-term follow-up. A total of 23 studies
pooling 15812 patients were included. Compared to TAVI alone, PCI-TAVI
showed no significant difference in all-cause mortality at short- and
mid-term (RR<inf>short-term</inf> = 1.10 95%CI 0.88-1.38;
RR<inf>mid-term</inf> = 1.12 95%CI 0.97-1.30), but an increase during
long-term follow-up (RR<inf>long-term</inf> = 1.20 95%CI 1.06-1.36).
Compared with PCI-TAVI, TAVI-PCI is associated with lower rate of
all-cause mortality at both short- and long-term follow-ups. PCI before or
concomitant with TAVI may not offer clinical benefits and could
potentially lead to worse outcomes in the long term. Conversely, PCI after
TAVI is associated with improved clinical outcomes in both the short and
long term. Copyright © 2025 Wang et al. This is an open access
article distributed under the terms of the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in
any medium, provided the original author and source are credited.

<2>
Accession Number
2038576627
Title
Comparison of the postoperative analgesic effects of bupivacaine and
ropivacaine in infraorbital nerve block anesthesia for cheiloplasty in
infants.
Source
International Journal of Pediatric Otorhinolaryngology. 193 (no
pagination), 2025. Article Number: 112373. Date of Publication: 01 Jun
2025.
Author
Zhou W.; Li Y.; Lin N.; Cai Z.; Mao C.; Lai Y.; Lu M.
Institution
(Zhou, Li, Cai, Mao, Lai, Lu) Department of Oral and Maxillofacial
Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road,
Fujian, Fuzhou, China
(Zhou, Li) Fujian Key Laboratory of Oral Diseases & Fujian Provincial
Engineering Research Center of Oral Biomaterial & Stomatological Key
Laboratory of Fujian College and University, School and Hospital of
Stomatology, Fujian Medical University, No.88 Jiaotong Road, Fujian,
Fuzhou, China
(Lin) Department of Anesthesiology, Fujian Medical University Union
Hospital, No. 29 Xinquan Road, Fujian, Fuzhou, China
Publisher
Elsevier Ireland Ltd
Abstract
Obejective: This prospective study aimed to evaluate the analgesic
efficacy of ropivacaine and bupivacaine for infraorbital nerve block
following cheiloplasty. Additionally, it investigated the safety and
feasibility of these agents in infants and young children. Method(s):
Participants were divided into three groups: Control (physiological
saline), Group L (ropivacaine), and Group B (bupivacaine). Bilateral
infraorbital nerve block anesthesia was performed at the beginning of
surgery, followed by general anesthesia for the procedure. Postoperative
pain was scored using the FLACC scale. Result(s): Group B had a
significantly lower heart rate post-surgery compared to the other groups
(P < 0.05). FLACC pain scores at 30 min, 1 h, and 4 h post-surgery were
significantly lower in Groups L and B compared to the control group (P <
0.05). Side effects included edema, hematoma, nausea, vomiting, cyanosis,
and convulsions, with no adverse reactions in the control group. Group L
had one case of lip cyanosis and convulsions, and Group B had one case of
nausea and vomiting. No significant differences were found in age, weight,
and surgical time among the three groups (P > 0.05). Conclusion(s):
Ropivacaine showed similar analgesic effects to bupivacaine but with
higher safety for postoperative pain relief in cleft lip repair in infants
and young children, suggesting its clinical utility. Copyright ©
2025 Elsevier B.V.

<3>
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Accession Number
2038237109
Title
2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients
With Acute Coronary Syndromes: A Report of the American College of
Cardiology/American Heart Association Joint Committee on Clinical Practice
Guidelines.
Source
Circulation. 151(13) (pp e771-e862), 2025. Date of Publication: 01 Apr
2025.
Author
Rao S.V.; O'Donoghue M.L.; Ruel M.; Rab T.; Alexander J.H.; Baber U.;
Baker H.; Cohen M.G.; Cruz-Ruiz M.; Davis L.L.; de Lemos J.A.; DeWald
T.A.; Elgendy I.Y.; Feldman D.N.; Goyal A.; Isiadinso I.; Menon V.; Morrow
D.A.; Mukherjee D.; Platz E.; Promes S.B.; Sandner S.; Sandoval Y.;
Schunder R.; Shah B.; Stopyra J.P.; Talbot A.W.; Taub P.R.; Williams M.S.;
Beavers C.J.; Beckie T.; Blankenship J.; Diercks D.; Lo B.; Louis C.;
Merchant F.M.; Nazir N.T.; So D.; Tomey M.; Welt F.; Otto C.M.; Beckman
J.A.; Armbruster A.; Blumer V.; de las Fuentes L.; Deswal A.; Ferrari
V.A.; Fremes S.E.; Gaudino M.; Hernandez A.F.; Jneid H.; Johnson H.M.;
Jones W.S.; Khan S.S.; Khazanie P.; Kittleson M.M.; Palaniappan L.; Sharma
G.; Shimbo D.; Tamis-Holland J.E.; Woo Y.J.; Ziaeian B.; Biga C.; Gates
C.C.; Kovacs R.J.; Turco J.V.; Saraco M.J.; Ronan G.D.; Patterson L.;
Getchius T.S.D.; Abdullah A.R.; Churchwell K.; Brown N.; Jessup M.; Sapio
N.A.; Singh R.R.; Nedungadi P.; St. Laurent P.; Hundley J.
Institution
(Sapio) Office of Science Strategies and Operations
(Singh, St. Laurent) Office of Science and Medicine
(Hundley) Office of Science Operations
Publisher
Lippincott Williams and Wilkins
Abstract
Aim: The "2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of
Patients With Acute Coronary Syndromes" incorporates new evidence since
the "2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial
Infarction" and the corresponding "2014 AHA/ACC Guideline for the
Management of Patients With Non-ST-Elevation Acute Coronary Syndromes" and
the "2015 ACC/AHA/SCAI Focused Update on Primary Percutaneous Coronary
Intervention for Patients With ST-Elevation Myocardial Infarction." The
"2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients
With Acute Coronary Syndromes" and the "2021 ACC/AHA/SCAI Guideline for
Coronary Artery Revascularization" retire and replace, respectively, the
"2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet
Therapy in Patients With Coronary Artery Disease." Methods: A
comprehensive literature search was conducted from July 2023 to April
2024. Clinical studies, systematic reviews and meta-analyses, and other
evidence conducted on human participants were identified that were
published in English from MEDLINE (through PubMed), EMBASE, the Cochrane
Library, Agency for Healthcare Research and Quality, and other selected
databases relevant to this guideline. Structure: Many recommendations from
previously published guidelines have been updated with new evidence, and
new recommendations have been created when supported by published
data. Copyright © 2025 by the American College of Cardiology
Foundation and the American Heart Association, Inc.

<4>
Accession Number
2038623475
Title
Does the surgical access matter in myectomy for hypertrophic obstructive
cardiomyopathy?.
Source
International Journal of Cardiology. 434 (no pagination), 2025. Article
Number: 133349. Date of Publication: 01 Sep 2025.
Author
Seggewiss H.; Batzner A.
Institution
(Seggewiss, Batzner) University Hospital Wurzburg, Medizinische Klinik 1,
Oberdurrbacher Str. 6, Wurzburg, Germany
Publisher
Elsevier Ireland Ltd

<5>
Accession Number
2034437734
Title
Abbreviated dual antiplatelet therapy in patients undergoing percutaneous
coronary intervention: a systematic review and meta-analysis of randomized
controlled trials.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
343. Date of Publication: 01 Dec 2025.
Author
Soleimani H.; Karimi E.; Mahalleh M.; Entezari F.J.; Nasrollahizadeh A.;
Rafiee H.; Kalhor P.; Al-Azizi K.M.; Rios L.H.P.; Aronow W.S.; Ambrosy
A.P.; Hosseini K.
Institution
(Soleimani, Karimi, Mahalleh, Entezari, Nasrollahizadeh, Nasrollahizadeh,
Rafiee, Kalhor, Hosseini) Tehran Heart Center, Cardiovascular Diseases
Research Institute, Tehran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Mahalleh) Rheumatology Research Center, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Nasrollahizadeh) Faculty of Medicine, Isfahan University of Medical
Sciences, Isfahan, Iran, Islamic Republic of
(Al-Azizi) Department of Cardiology, Baylor Scott and White The Heart
Hospital, Plano, TX, United States
(Rios) Division of Cardiology, Rooney Heart Institute, Naples, FL, United
States
(Aronow) Departments of Cardiology and Medicine, Westchester Medical
Center and New York Medical College, Valhalla, NY, United States
(Ambrosy) Department of Cardiology, Kaiser Permanente San Francisco
Medical Center, San Francisco, CA, United States
Publisher
BioMed Central Ltd
Abstract
Background: Dual antiplatelet therapy (DAPT), combining aspirin and a
P2Y12 receptor inhibitor, is a standard post-percutaneous coronary
intervention (PCI) treatment to reduce thrombosis and ischemic events.
However, the optimal DAPT duration remains unclear, with concerns about
bleeding risks associated with long-term potent P2Y12 inhibitors. This
systematic review and meta-analysis investigates the safety and efficacy
of shortened DAPT regimens. Method(s): A comprehensive search of
PubMed, Scopus, and EMBASE identified randomized controlled trials (RCTs)
comparing conventional DAPT (>= 12 months) and abbreviated DAPT (<= 3
months) post-PCI. Primary outcomes were 1-year all-cause mortality and
bleeding, assessed using the Bleeding Academic Research Consortium (BARC)
classification. Secondary outcomes included cardiovascular mortality,
non-fatal myocardial infarction (MI), stroke, and major adverse
cardiovascular events (MACE). Risk of bias was assessed with the Cochrane
tool, and meta-analyses used random-effects models. Result(s): Forty
studies involving 54,233 participants were included. Abbreviated DAPT
significantly reduced all-cause mortality (RR: 0.90, 95%CI: 0.82-0.98) and
bleeding (BARC 3 or 5: RR: 0.77, 95%CI: 0.60-0.97). No significant
differences were observed in cardiovascular mortality, stroke, non-fatal
MI, revascularization, or in-stent thrombosis. Subgroup analyses showed
lower mortality with 1-month DAPT and reduced bleeding in patients with
high bleeding risk, acute coronary syndrome (ACS), and complex PCI.
 Conclusion(s): Abbreviated DAPT post-PCI is associated with lower
all-cause mortality and bleeding without compromising ischemic protection,
supporting its use in specific patient populations. Individualized DAPT
durations should be considered to balance bleeding and ischemic
risks. Copyright © The Author(s) 2025.

<6>
Accession Number
2038615710
Title
Differences in Clinical Efficacy of Erector Spinae Plane Block Performed
at the Medial and Lateral Transverse Processes: A Randomised Controlled
Trial.
Source
Journal of the College of Physicians and Surgeons Pakistan. 35(5) (pp
556-561), 2025. Date of Publication: 01 May 2025.
Author
Chen C.; Dai H.; Jiang X.; Nuermaimaiti M.; Ren Y.; Wang T.
Institution
(Chen, Jiang, Ren, Wang) Department of Anaesthesiology, Affiliated Cancer
Hospital of Xinjiang Medical University, Xinjiang, Urumqi, China
(Dai) School of Basic Medical Sciences, Xinjiang Medical University,
Xinjiang, Urumqi, China
(Nuermaimaiti) Experimental Animal Centre, Xinjiang Medical University,
Xinjiang, Urumqi, China
Publisher
College of Physicians and Surgeons Pakistan
Abstract
Objective: To compare the clinical efficacy of erector spinae plane block
(ESPB) administered at the medial versus lateral aspect of the fifth
thoracic transverse process (TP) apex and to investigate the potential
influence of the intermuscular partitioning fascia (IMPF) on medicine
diffusion. Study Design: Randomised controlled trial. Place and
Duration of the Study: Department of Anaesthesiology, Affiliated Cancer
Hospital of Xinjiang Medical University, Xinjiang, China, from August 2023
to April 2024. Methodology: Twenty patients undergoing thoracic surgery
were randomly allocated to the medial TP apex group (M Group, n = 10) or
lateral TP apex group (L Group, n = 10). ESPB was performed at the T5
level, and sensory blockade regions were evaluated 30 minutes
post-injection. Result(s): All patients in the M Group (10/10)
exhibited sensory blockade covering the posterior midline to 2 cm
laterally (L group: 0/10, p <0.001). The M Group also demonstrated a
significantly higher blockade rate at the T11-T12 region (7/10 vs. 1/10, p
= 0.020). Anatomical analysis indicated that the IMPF at the TP apex
segregated medial and lateral medicine diffusion pathways.
 Conclusion(s): ESPB administered at the medial TP apex provides a
broader blockade range, potentially mediated by the IMPF restricting
multidirectional medicine diffusion. This fascial barrier may influence
clinical efficacy by directing medicine spread. Copyright © 2025
College of Physicians and Surgeons Pakistan. All rights reserved.

<7>
Accession Number
2037784119
Title
Aortic Annular Enlargement: Y-Incision Rationale, Technique, and Outcomes.
Source
Annals of Thoracic Surgery. 119(6) (pp 1151-1165), 2025. Date of
Publication: 01 Jun 2025.
Author
Chen S.A.; Do-Nguyen C.C.; Titsworth M.; Yang B.
Institution
(Chen) Division of Cardiac Surgery, University of California, Davis,
Sacramento, California, United States
(Do-Nguyen, Titsworth, Yang) Department of Cardiac Surgery, University of
Michigan, Ann Arbor, MI, United States
Publisher
Elsevier Inc.
Abstract
Background: Trials comparing transcatheter aortic valve replacement and
surgical aortic valve replacement (SAVR) have shown that in patients with
annuli <26 mm, SAVR had negative hemodynamic and clinical outcomes.
Recently, studies revealed that the effective orifice diameter of surgical
prosthetic valves is 5-7 mm smaller than the labeled valve size. To
improve outcomes of SAVR, the Y-incision aortic annular enlargement (AAE)
enlarges the surgical aortic annulus to accommodate a prosthetic valve 3-4
sizes larger with an effective orifice area that matches the patient's
native annulus. This review discusses when and how the Y-incision AAE
should be performed. Method(s): OVID MEDLINE, OVID Embase, and
Cochrane Library were searched with terms that included "Y-incision aortic
annular enlargement," "valve sizes," and "long-term survival." The search
included publications after 2020. The reference lists of included studies
were reviewed to retrieve additional studies. Result(s): In patients
with matched native annular sizes, AAE significantly improved midterm
survival without increasing perioperative complications. Patients treated
with a larger valve had notably better long-term survival and small valve
sizes were significant risk factors for operative and long-term mortality.
Compared with patients treated with a Nicks or Manougian procedure, the
hemodynamics in patients treated with Y-incision AAE were significantly
better. Conclusion(s): Y-incision AAE could be routinely considered
for patients with a normal annulus (17-25 mm) undergoing
SAVR. Copyright © 2025 The Society of Thoracic Surgeons

<8>
Accession Number
2032776445
Title
Effect of neighborhood socioeconomic disadvantage on 30-day readmissions:
A systematic review.
Source
Journal of Hospital Medicine. 20(5) (pp 489-504), 2025. Date of
Publication: 01 May 2025.
Author
Garrett L.; Muhammad A.; Kulshreshtha A.
Institution
(Garrett, Kulshreshtha) Department of Family and Preventive Medicine,
Emory University School of Medicine, Atlanta, GA, United States
(Muhammad, Kulshreshtha) Department of Epidemiology, Emory University
Rollins School of Public Health, Atlanta, GA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The area deprivation index (ADI) is a measure of neighborhood
disadvantage. It uses census-level information to quantify a person's
neighborhood deprivation level based on their address. Recent studies have
used ADI to examine the relationship between a patient's address and
various health outcomes, including 30-day readmissions. Objective(s):
This systematic review was conducted to determine the effect of ADI on
30-day readmissions for both medical and surgical conditions.
 Method(s): We performed a comprehensive literature search in
scientific databases, including PubMed, Embase, Web of Science, and SCOPUS
from 2013 to 2024. Our search included terms related to ADI and 30-day
readmissions in adult populations in the United States. Studies were
included if they utilized ADI as their primary exposure and examined the
risk of readmissions within 30 days as an outcome. Two reviewers
independently extracted the data and assessed quality and biases in the
studies. Result(s): Of the 66 papers found through database search,
23 (35%) were included. These studies focused on conditions such as
cardiac, diabetic, neurological, and pulmonary diseases, as well as
postsurgical and septic patients, with three studies examining all
patients in general. When examining the highest level of ADI, 15 (65%)
studies (6 of which focused on postsurgical patients) found that high ADI
(most disadvantaged) is significantly associated with 30-day readmissions.
 Conclusion(s): Living in a high ADI area moderately impacts 30-day
readmissions, particularly for patients who have undergone surgery or have
undifferentiated problems. Copyright © 2024 Society of Hospital
Medicine.

<9>
Accession Number
2038500476
Title
Expanding Transcatheter Aortic Valve Replacement Use in Younger Patients
and Bicuspid Valves: Risks, Evidence Gaps, and Regulatory Action.
Source
Annals of Thoracic Surgery. 119(6) (pp 1166-1174), 2025. Date of
Publication: 01 Jun 2025.
Author
Miller D.C.
Institution
(Miller) Department of Cardiothoracic Surgery, Falk Cardiovascular
Research Center, Stanford University Medical School, Stanford, California,
United States
Publisher
Elsevier Inc.
Abstract
This expert review examines the expanding use of transcatheter aortic
valve replacement (TAVR) in younger patients with bicuspid aortic valves
(BAV), highlighting midterm outcomes, including elevated mortality,
stroke, and pacemaker dependency, compared with surgical aortic valve
replacement. The untested and unproven long-term effectiveness and
durability of TAVR in patients aged <70 years and the growing use of
"valve-in-valve" for surgical aortic valve replacement bioprosthetic
degeneration and TAVR failure are also highlighted. Summarizing recent
observational studies, registry data, and the limited randomized evidence
available, the author calls for new rigorous, long-term randomized
controlled trials before broader adoption of TAVR and valve-in-valve TAVR
in these populations, and urges the United States Food and Drug
Administration and Centers for Medicare and Medicaid Services to align
policy with evidence challenging the erosion of guideline-directed care
driven by market forces. Copyright © 2025 The Society of Thoracic
Surgeons

<10>
Accession Number
2038599396
Title
Early Aortic-Valve Replacement in Patients With Asymptomatic Severe Aortic
Stenosis With Preserved Left Ventricular Systolic Function: A Systematic
Review and Meta-Analysis.
Source
American Journal of Cardiology. 248 (pp 73-79), 2025. Date of Publication:
01 Aug 2025.
Author
de Pontes V.B.; Clemente M.R.C.; Trevisan T.; Jaramillo S.; Boneli M.F.;
Felix N.; Gameiro L.G.S.; Garot P.; Gomes W.F.
Institution
(de Pontes, Trevisan, Boneli, Gameiro) University Centre of Associated
Colleges for Education, Sao Joao da Boa Vista, Brazil
(Clemente) Petropolis School of Medicine, Petropolis, Brazil
(Jaramillo) Austral University, Pilar, Argentina
(Felix) Federal University of Campina Grande, Campina Grande, Brazil
(Garot) Paris Sud Cardiovascular Institute, Jacques Cartier Hospital,
Massy, Ramsay-Sante, France
(Gomes) Inc. Hospital, Curitiba, Brazil
(Gomes) Pequeno Principe College, Curitiba, Brazil
Publisher
Elsevier Inc.
Abstract
Current guidelines recommend routine clinical surveillance for patients
with asymptomatic severe aortic stenosis (AS) and preserved left
ventricular ejection fraction (LVEF). However, the role of early aortic
valve replacement (AVR) as compared with conservative treatment in these
patients remains unclear. We systematically searched PubMed, Embase and
Cochrane databases to identify studies comparing early AVR versus
conservative treatment in asymptomatic patients with severe AS and
preserved LVEF. All statistical analyses were performed using R software
version 4.3.1 with a random-effects model. Seven studies comprising 2,531
patients with asymptomatic severe AS and preserved LVEF were included, of
whom 1,234 (49%) underwent AVR. Median follow-up time was 49.3 months.
Early AVR was associated with significantly lower incidence of all-cause
(HR 0.51; 95% CI 0.31 to 0.83) and cardiac mortality (RR 0.51; 95% CI 0.30
to 0.89). There were no significant differences between early AVR and
conservative treatment in terms of sudden death, hospitalization for
cardiovascular (CV) causes, stroke, or myocardial infarction (MI).
However, upon a subanalysis of randomized controlled trials (RCTs) only,
patients undergoing early AVR had lower rates of hospitalization for CV
causes (RR 0.41; 95% CI 0.27 to 0.63) and stroke (RR 0.62; 95% CI 0.40 to
0.95), with no difference in terms of all-cause mortality, sudden death,
MI, or cardiac death. In this meta-analysis, early AVR was associated with
reduced rates of all-cause and cardiac mortality, while yielding similar
rates of stroke, hospitalization for CV causes, MI, or sudden death in the
overall cohort analysis as compared with conservative
treatment. Copyright © 2025 Elsevier Inc.

<11>
Accession Number
2038571674
Title
Individual patient data meta-analysis of paclitaxel-coated balloons vs.
drug-eluting stents for small-vessel coronary artery disease: the
ANDROMEDA study.
Source
European Heart Journal. 46(17) (pp 1586-1599), 2025. Date of Publication:
01 May 2025.
Author
Fezzi S.; Giacoppo D.; Fahrni G.; Latib A.; Alfonso F.; Colombo A.;
Mahfoud F.; Scheller B.; Jeger R.; Cortese B.
Institution
(Fezzi) Division of Cardiology, Department of Medicine, Verona University
Hospital, Verona, Italy
(Giacoppo) Department of General Surgery and Medical-Surgical Specialties,
University of Catania, Catania, Italy
(Giacoppo) Cardiovascular Research Institute Dublin, Royal College of
Surgeons in Ireland, Dublin, Ireland
(Giacoppo) ISAResearch Zentrum, Deutsches Herzzentrum Munchen, Munich,
Germany
(Fahrni, Jeger) Division of Cardiology, Department of Medicine, Triemli
Hospital Zurich, Zurich, Switzerland
(Latib) Montefiore-Einstein Center for Heart and Vascular Care, Montefiore
Medical Center, Albert Einstein College of Medicine, Bronx, NY, United
States
(Alfonso) Servicio de Cardiologia, Hospital Universitario de la Princesa,
IIS-IP, CIBERCV, Universidad Autonoma de Madrid, Madrid, Spain
(Colombo) Cardio Center, Humanitas Clinical and Research Hospital IRCCS,
Rozzano, Milan, Italy
(Mahfoud) Department of Cardiology, University Hospital Basel, Basel,
Switzerland
(Scheller, Cortese) University of Saarland, Homburg/Saar, Germany
(Jeger) University of Basel, Basel, Switzerland
(Cortese) Fondazione Ricerca e Innovazione Cardiovascolare, Via E. Ponti,
49, Milan, Italy
(Cortese) DCB Academy, Milan, Italy
Publisher
Oxford University Press
Abstract
Background and Aims: In randomized clinical trials of patients undergoing
percutaneous coronary intervention (PCI) for de novo small-vessel coronary
artery disease (SV-CAD), paclitaxel-coated balloon (PCB) angioplasty
showed mid-term angiographic or clinical non-inferiority to drug-eluting
stent (DES) implantation. Nevertheless, these trials have sample size
limitations, and the relative safety and efficacy beyond the first year
remain uncertain. Method(s): The ANDROMEDA study was a collaborative,
investigator-initiated, individual patient data meta-analysis comparing 3
year clinical outcomes between PCB angioplasty and DES implantation for
the treatment of de novo SV-CAD. Multiple electronic databases (PubMed,
Scopus, ScienceDirect, and Web of Science) were searched from May 2010 to
June 2024 to identify eligible trials. All the following eligibility
criteria were required: (i) random allocations of treatments; (ii)
patients with SV-CAD; (iii) treatment with PCB or DES; and (iv) clinical
follow-up of at least 36 months. The primary and co-primary endpoints were
major adverse cardiac events (MACE) and target lesion failure (TLF),
respectively. The protocol was registered with PROSPERO (CRD42023479035).
 Result(s): Individual patient data from three randomized trials,
including a total of 1154 patients and 1360 lesions, were combined. At 3
years, PCB was associated with a lower risk of MACE compared with DES
[hazard ratio (HR) 0.67, 95% confidence interval (CI) 0.47-0.96], due to a
lower risk of myocardial infarction and target vessel revascularization.
This benefit persisted after multivariable adjustment (HR 0.75, 95% CI
0.58-0.96), but did not reach statistical significance in the two-stage
analysis (HR 0.67, 95% CI 0.43-1.04). At the landmark analysis, the risk
of MACE between groups was consistent over time. At 3 years, TLF was not
significantly different between PCB and DES groups. Reconstructed
time-to-event information from a fourth trial was included in a
sensitivity analysis (1384 patients and 1590 lesions), showing consistent
results in terms of TLF (HR 0.87, 95% CI 0.63-1.20). The comparison
between PCB and second-generation DES did not reveal significant
differences in 3 year TLF (HR 1.03, 95% CI 0.70-1.50). Conclusion(s):
In patients undergoing PCI for de novo SV-CAD, PCB angioplasty is
associated with a reduction in MACE and a non-significant difference in
TLF at 3 year follow-up compared with DES implantation. The restriction of
the comparator group to second-generation DES does not alter the main
conclusions. Larger trials comparing contemporary devices at a more
prolonged follow-up are warranted to confirm these findings. Copyright
© 2025 The Author(s). Published by Oxford University Press on behalf
of the European Society of Cardiology. All rights reserved. For commercial
re-use, please contact reprints@oup.com for reprints and translation
rights for reprints. All other permissions can be obtained through our
RightsLink service via the Permissions link on the article page on our
site - for further information please contact
journals.permissions@oup.com.

<12>
Accession Number
2038569416
Title
Transcatheter aortic valve replacement in low-risk patients: an updated
meta-analysis of randomized controlled trials.
Source
IJC Heart and Vasculature. 59 (no pagination), 2025. Article Number:
101692. Date of Publication: 01 Aug 2025.
Author
Meeus R.; Dhondt P.; Hariyanto J.; Ashraf H.; Lecchi C.; Fischer-Bacca
C.O.; Langenhoven L.V.; Minten L.; Dubois C.
Institution
(Meeus, Dhondt, Minten, Dubois) Department of Cardiovascular Medicine,
University Hospitals Leuven, Leuven, Belgium
(Hariyanto) Gedung Fakultas Kedokteran UPH, Tangerang, Indonesia
(Ashraf) Rawalpindi Medical University, Rawalpindi, Pakistan
(Lecchi) University of Trieste, Trieste, Italy
(Fischer-Bacca) UNIDAVI, Rio do Sul, Brazil
(Langenhoven) Leuven Biostatistics and Statistical Bioinformatics Centre,
KU Leuven, Leuven, Belgium
(Dubois) Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
Publisher
Elsevier Ireland Ltd
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is increasingly
used in patients with aortic valve stenosis (AS) at low risk for surgical
aortic valve replacement (SAVR), despite uncertainty regarding medium and
long-term clinical outcomes. Objective(s): We performed an updated
meta-analysis comparing TAVR with SAVR in this population. Method(s):
We searched PubMed, EMBASE and Cochrane Central for randomized controlled
trials (RCT) comparing TAVR with SAVR in low-risk patients with either
bicuspid or tricuspid AS. Outcomes of interest were all-cause mortality,
rehospitalization and stroke at 30 days, 1 year and up to 5 years
follow-up. Result(s): We included six RCTs with in total 4487
patients, mean age 74.2 +/- 5.5y and of which 50.1 % underwent TAVR. The
STS-PROM Score was similar for TAVR and SAVR (2.1 +/- 0.7 vs. 2.2 +/- 0.8
%). Thirty-day all-cause mortality showed a borderline significant
difference favoring TAVR (RR 0.55; 95 % CI 0.30-1.01; p = 0.05). One-year
all-cause mortality was significantly lower for TAVR (RR 0.60; 95 % CI
0.41-0.98; p = 0.01), while no differences were seen at 5-year follow up
(RR 1.02; 95 % CI 0.81-1.29; p = 0.85). TAVR was associated with reduced
30-day (RR 0.67; 95 % CI 0.46-0.95; p = 0.03) and one-year
rehospitalization rates (RR 0.72; 95 % CI 0.53-0.98; p = 0.04). Stroke
rates at 30 days (RR 0.78; 95 % CI 0.48-1.32; p = 0.37), one-year (RR
0.79; 95 % CI 0.48-1.32; p = 0.37) and 5-year follow-up (RR 1.09; 95 % CI
0.81-1.46; p = 0.56) were not significantly different. Conclusion(s):
TAVR in low-risk patients with AS results in reduced 1-year all-cause
mortality and rehospitalization rates as compared with SAVR. This benefit
is attenuated during protracted follow-up. Copyright © 2025 The
Author(s)

<13>
Accession Number
2038562937
Title
Interleukin-6 modifies Lipoprotein(a) and oxidized phospholipids
associated cardiovascular disease risk in a secondary prevention cohort.
Source
Atherosclerosis. 405 (no pagination), 2025. Article Number: 119211. Date
of Publication: 01 Jun 2025.
Author
Mohammadnia N.; van Broekhoven A.; Bax W.A.; Eikelboom J.W.; Mosterd A.;
Fiolet A.T.L.; Tijssen J.G.P.; Thompson P.L.; de Kleijn D.P.V.; Tsimikas
S.; Cornel J.H.; Yeang C.; El Messaoudi S.
Institution
(Mohammadnia, van Broekhoven, Cornel, El Messaoudi) Department of
Cardiology, Radboud University Medical Center, Nijmegen, Netherlands
(Bax) Department of Internal Medicine, Northwest Clinics, Alkmaar,
Netherlands
(Eikelboom) Department of Medicine, McMaster University, Hamilton, ON,
Canada
(Mosterd, Fiolet, Cornel) Dutch Network for Cardiovascular Research (WCN),
Utrecht, Netherlands
(Mosterd) Department of Cardiology, Meander Medical Center, Amersfoort,
Netherlands
(Fiolet) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Tijssen) Department of Cardiology, Amsterdam University Medical Centers,
Amsterdam, Netherlands
(Thompson) Heart and Vascular Research Institute of Western Australia,
Perth, Australia
(Thompson) School of Medicine, University of Western Australia, Perth,
Australia
(Thompson) Sir Charles Gairdner Hospital, Perth, Australia
(de Kleijn) The Netherlands Heart Institute, Utrecht, Netherlands
(de Kleijn) Department of Vascular Surgery, University Medical Center
Utrecht, Utrecht, Netherlands
(Tsimikas, Yeang) Department of Medicine, University of California, La
Jolla, San Diego, CA, United States
(Cornel) Department of Cardiology, Northwest Clinics, Alkmaar, Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Background and aims: There is a need for effective tools to stratify and
modify cardiovascular risk associated with elevated lipoprotein(a) [Lp(a)]
and oxidized phospholipids (OxPL). The objective of this analysis was to
explore the modifying effects of low-grade inflammation on Lp(a)- and
OxPL-associated risk in a secondary prevention cohort. Method(s):
Levels of Lp(a), OxPL associated with apolipoprotein(a) (OxPL-apo[a]) and
apolipoprotein B (OxPL-apoB) were determined in the placebo-arm of the
low-dose colchicine 2 trial. Patients were between 35 and 82 years, had
established chronic coronary syndrome (CCS), and were clinically stable
for at least six months prior to randomization. The outcome was the
incidence of the composite endpoint of spontaneous myocardial infarction,
ischemic stroke, or ischemia-driven coronary revascularization stratified
by biomarker levels using a Cox regression model. Result(s): There
was a significant interaction between Lp(a) and IL-6 <3.2 ng/L (median)
and IL-6 >=3.2 ng/L for the composite endpoint (HR 0.90; 95 %CI 0.78-1.03
vs HR 1.18; 95 %CI 1.01-1.39, P<inf>interaction</inf> = 0.01). No
interaction was found for Lp(a) levels in participants with hsCRP <2 mg/L
(HR 1.00; 95 %CI 0.89-1.14) versus those with hsCRP >=2 mg/L (HR 1.04; 95
%CI 0.86-1.25, P<inf>interaction</inf> = 0.79). In line with Lp(a) levels,
significant interaction was observed between OxPL-apo(a) as well as
OxPL-apoB levels for the composite endpoint with IL-6
(P<inf>interaction</inf><0.01 and 0.03, respectively), but not for hsCRP.
 Conclusion(s): In patients with CCS, Lp(a), OxPL-apo(a) and OxPL-apoB
associated cardiovascular risk was only pertinent in those with elevated
IL-6 but not hsCRP levels. Copyright © 2025 The Authors

<14>
Accession Number
2038513167
Title
The randomized controlled trial to compare temporary permanent pacemaker
vs temporary pacemaker in patients with conduction block after
transcatheter aortic valve replacement: Rationale and design of the
RECOVER trial.
Source
American Heart Journal. 287 (pp 41-49), 2025. Date of Publication: 01 Sep
2025.
Author
Jiang Z.; Chang S.; Tao L.; Luo J.; Fu G.; Wang Y.; Pan W.; Chen L.; Fang
Z.; Li Y.; Bai M.; Yu B.; Cheng X.; Peng X.; Jilaihawi H.; Piazza N.;
Modine T.; Song G.
Institution
(Jiang, Chang, Song) Interventional Center of Valvular Heart Disease,
Beijing AnZhen Hospital, Capital Medical University, National Clinical
Research Centre for Cardiovascular Diseases, Beijing, China
(Tao) Department of Cardiology, Xijing Hospital, Fourth Military Medical
University, Xi'an, China
(Luo) Guangdong Provincial People's Hospital, Guangdong Academy of Medical
Sciences, Guangdong Cardiovascular Institute, Guangzhou, China
(Fu) Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang
University of Medicine, Hangzhou, China
(Wang) Xiamen Heart Center, Xiamen University, Xiamen, China
(Pan) Department of Cardiology, Shanghai Institute of Cardiovascular
Disease, Zhongshan Hospital, Fudan University, Shanghai, China
(Chen) Department of Cardiology, Fujian Medical University Union Hospital,
Fuzhou, China
(Fang) Departments of Cardiology, The Second Xiangya Hospital of Central
South University, Hunan, China
(Li, Yu) Department of Cardiology, Tangdu Hospital, Fourth Military
Medical University, Xi'an, China
(Bai) Department of Cardiology, The First Hospital of Lanzhou University,
Lanzhou, China
(Yu) Department of Cardiology, The Second Affiliated Hospital of Harbin
Medical University, Harbin, China
(Cheng) Department of Cardiology, Union Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan, China
(Peng) Department of Cardiology, The First Affiliated Hospital of Nanchang
University, Nanchang, China
(Jilaihawi) Heart Valve Center, NYU Langone Health, New York, United
States
(Piazza) Division of Cardiology, Department of Medicine, McGill University
Health Centre, Quebec, Canada
(Modine) Hopital Cardiologique de Haut-Leveque, Bordeaux University
Hospital, Bordeaux, France
Publisher
Elsevier Inc.
Abstract
Rationale: Current guidelines and expert consensus recommend different
time thresholds of temporary pacemaker (TM) indwelling in patients with
conduction block after transcatheter aortic valve replacement (TAVR).
Accordingly, this lack of clinical evidence and effective strategies has
resulted in extensive variations in permanent pacemaker (PPM) implantation
patterns, potentially leading to over-early PPM implantation. The use of a
temporary permanent pacemaker (TPPM), which involves an active fixation
pacing lead and an external pulse generator secured to the skin surface,
may be effective and safe in these patients. TPPM may improve
postoperative mobility and facilitate early discharge, while providing
prolonged and stable pacing for the recovery of conduction block, thereby
reducing unnecessary PPM implantation. Design(s): The RECOVER trial
is a prospective, multicenter, open-label, randomized controlled study
comparing TPPM vs TM in patients with conduction block after TAVR. The
trial will enroll 160 subjects across 13 sites in China. Inclusion
criteria include patients with persistent third-degree atrioventricular
block (AVB), second-degree AVB, first-degree AVB with symptoms (PR
interval >300 ms), alternating bundle branch block or bifascicular block
with syncope/blackness related symptoms occurred during TAVR procedure or
within 1 month after TAVR. Enrolled patients will be randomized 1:1 to the
TPPM group for a 1-month bridge or the TM group for conventional 24 to 48
hours pacing. The primary effectiveness endpoint is the rate of PPM
implantation at 6 months after the occurrence of AVB. Secondary
effectiveness endpoint is the rate of PPM implantation at 1 month after
the occurrence of AVB. Safety endpoints include all-cause mortality and
TPPM/TM/PPM procedure-related complications during the 6-month follow-up.
Key data collected will include sociodemographic information, medical
history, electrocardiograph, HOLTER, echocardiography, contrast-enhanced
cardiac CT, details of procedures and pacemaker interrogation. Indication
for PPM implantation will be adjudicated by an independent pacing
electrophysiologist committee. Conclusion(s): The RECOVER trial will
evaluate whether TPPM is superior to conventional TM in reducing the rate
of PPM implantation in patients with conduction block after TAVR, with a
buffer period to distinguish whether conduction block is reversible or
persistent. Current status: The trial is still enrolling participants
(with 14 enrolled as of January 1, 2025). Trial registration: Randomized
controlled trial to compare temporary permanent pacemaker vs temporary
pacemaker in patients with conduction block after transcatheter aortic
valve replacement. Chinese Clinical Trial Registry ChiCTR2400087536.
Registered at July 30, 2024.
https://www.chictr.org.cn/showproj.html?proj=227719. Copyright ©
2025

<15>
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. 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.
 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). 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. Copyright © 2025 Sociedade Brasileira de
Anestesiologia

<16>
Accession Number
2038543697
Title
Rationale and design of the anticoagulant therapy after left atrial
appendage closure (ATLAAC) trial.
Source
American Heart Journal. 287 (pp 86-93), 2025. Date of Publication: 01 Sep
2025.
Author
Gosvig K.; Goller J.; Hansson N.H.; Brandes A.; Modrau I.; Rasmussen L.F.;
Eskesen K.; Jensen A.K.G.; Belley-Cote E.; Whitlock R.; Riber L.P.S.
Institution
(Gosvig, Goller, Riber) Department of Cardiothoracic and Vascular Surgery,
Odense University Hospital, Odense, Denmark
(Gosvig, Goller, Riber) Department of Clinical Research, Research unit for
Cardiac Surgery, University of Southern Denmark, Odense, Denmark
(Hansson) Department of Cardiology, Odense University Hospital, Odense,
Denmark
(Brandes) Department of Cardiology, Esbjerg and Grindsted Hospital,
Esbjerg, Denmark
(Brandes) Department of Regional Health Research, University of Southern
Denmark, Esbjerg, Denmark
(Modrau) Department of Cardiothoracic and Vascular Surgery, Aarhus
University Hospital, Aarhus N, Denmark
(Modrau) Department of Clinical Medicine, Aarhus University, Aarhus C,
Denmark
(Rasmussen) Department of Cardiothoracic and Vascular Surgery, Aalborg
University Hospital, Aalborg, Denmark
(Eskesen) Department of Cardiology, Gentofte Hospital, Hellerup, Denmark
(Jensen) Department of Public Health, Section of Biostatistics, University
of Copenhagen, Copenhagen, Denmark
(Belley-Cote, Whitlock) Department of Surgery, McMaster University,
Hamilton, ON, Canada
(Belley-Cote, Whitlock) Population Health Research Institute, McMaster
University and Hamilton Health Sciences, Hamilton, ON, Canada
Publisher
Elsevier Inc.
Abstract
Introduction: Left atrial appendage closure (LAAC) has become a
recommended addition to oral anticoagulation for patients with atrial
fibrillation, who undergo cardiac surgery. The procedure significantly
reduces the risk of stroke and systemic arterial embolism, potentially
making oral anticoagulation (OAC) unnecessary or even harmful, when
considering the associated increased risk of bleeding. This publication
describes the rationale and design of a randomized trial, testing the
hypothesis that stopping OAC is noninferior to continuing OAC after
surgical LAAC in terms of the primary endpoint. Method(s): The ATLAAC
trial is a multicenter, randomized, controlled trial, aiming to enroll
1,220 patients with atrial fibrillation, who have undergone surgical LAAC
and remain on OAC. A cardiac CT scan is performed to confirm success of
the LAAC. Patients with successful closure are randomized to stop or
continue OAC. The primary endpoint is the first occurrence of ischemic
stroke, systemic arterial embolism, or major bleeding over an expected
mean follow-up of 4 years. Secondary endpoints include all-cause
mortality, cardiovascular mortality, any bleeding leading to
hospitalization, blood transfusion, venous thromboembolism, myocardial
infarction, and quality of life measures. Trial status: Enrollment for the
ATLAAC trial began in March 2024. As of January 18th, 2025, 554 patients
have been enrolled in the study and 319 patients have been randomized.
Recruitment is expected to continue for approximately 12 months. Follow-up
will be stopped once 128 primary endpoints have occurred.
 Conclusion(s): The ATLAAC trial will evaluate the safety of stopping
OAC after surgical LAAC. Trial registration number: EU-CT:
2022-502986-92-00, clinicaltrials.gov ID: NCT06401616. Copyright
© 2025 The Authors

<17>
Accession Number
621210734
Title
Pulmonary artery catheter placement in patients with a history of
tricuspid ring annuloplasty, with pulmonary stenosis, and with the
transvenous pacemaker leads: is it difficult?.
Source
JA Clinical Reports. 4(1) (no pagination), 2018. Article Number: 26. Date
of Publication: 01 Dec 2018.
Author
Hamaba H.; Miyata Y.; Hayashi Y.
Institution
(Hamaba, Miyata, Hayashi) Anesthesiology Service, Sakurabashi-Watanabe
Hospital, 2-4-32 Umeda, Kita-ku, Osaka, Japan
Publisher
Springer Science and Business Media Deutschland GmbH

<18>
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. 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. 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. 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. Copyright
© 2025 by the authors.

<19>
Accession Number
2034459476
Title
Role of nicorandil in preventing contrast-induced nephropathy in patients
undergoing cardiac catheterization procedures: an updated systematic
review and meta-analysis.
Source
International Urology and Nephrology. (no pagination), 2025. Date of
Publication: 2025.
Author
Khan A.A.; Tahir M.Z.; Maryam K.U.E.; Uzair M.; Haram; Faheem M.S.B.;
Zainab; Abdullah A.; Anwer A.; Ashraf D.A.; Ahmed A.K.; Rahim S.; Arshad
M.S.
Institution
(Khan, Maryam, Ashraf) Department of Internal Medicine, Foundation
University Medical College Islamabad, Islamabad, Pakistan
(Tahir) Department of Internal Medicine, Punjab Medical College,
Faisalabad, Pakistan
(Uzair) Ziauddin Medical College, Karachi, Pakistan
(Haram) Rehman Medical College, Peshawar, Pakistan
(Faheem) Department of Internal Medicine, Karachi Institute of Medical
Sciences, KIMS, Sindh, Karachi, Pakistan
(Zainab) Allama Iqbal Medical College, Lahore, Pakistan
(Abdullah, Anwer) Amna Inayat Medical College, Sheikhupura, Pakistan
(Ahmed) Jinnah Medical and Dental College, Karachi, Pakistan
(Rahim) King Edward Medical University, Lahore, Pakistan
(Arshad) Dow University of Health Sciences, Islamabad, Pakistan
Publisher
Springer Science and Business Media B.V.
Abstract
Background: Contrast-induced nephropathy (CIN) is a major risk for
patients undergoing coronary angiography (CAG) and percutaneous coronary
intervention (PCI). Method(s): PubMed, MEDLINE, Embase, Google
Scholar, and Web of Science were searched through May 2024 to include
randomized controlled trials (RCTs) assessing the efficacy and safety of
nicorandil administration in patients following CAG or PCI. Outcomes of
interest included the CIN incidence, major adverse events, serum
creatinine, serum cystatin C, BUN and eGFR. Risk ratios (RRs) and standard
mean differences (SMDs) with 95% confidence intervals (CIs) were
calculated using random-effects model. Statistical heterogeneity was
assessed using I2 statistics. Result(s): Twelve studies (n = 2931
patients) were included in the final analysis. Nicorandil significantly
reduced the CIN incidence (RR: 0.40 [0.31,0.52]; p < 0.00001), with
consistent results for oral (RR: 0.35 [0.25,0.48]; p < 0.00001) and
intravenous administration (RR: 0.52 [0.30,0.92]; p = 0.02) (p-interaction
= 0.22). Oral nicorandil reduced the risk of major adverse events (RR:
0.71 [0.51,0.99]; p = 0.05). Among patients on nicorandil, serum
creatinine levels were significantly lower at 48 h (SMD: -0.30
[-0.52,-0.07]; p = 0.009), and 72 h post-intervention (SMD: -0.42
[-0.71,-0.13]; p = 0.004). Nicorandil significantly reduced serum cystatin
C levels at 48 h post-intervention (SMD: -0.56 [-1.01,-0.01]; p = 0.02).
However, nicorandil did not significantly affect eGFR values at 24-h (SMD:
0.12 [-0.21,0.45]; p = 0.46), 48-h (SMD: 0.08 [-0.19,0.35]; p = 0.58), and
72-h (SMD: 0.34 [-0.13,0.81]; p = 0.16). Conclusion(s): Nicorandil
administration reduces the CIN incidence and improves renal biomarkers in
patients undergoing CAG and PCI. Large-scale trials with longer follow-up
periods are warranted to confirm renoprotective effects of
nicorandil. Copyright © The Author(s), under exclusive licence to
Springer Nature B.V. 2025.

<20>
Accession Number
2038542926
Title
Perioperative dexmedetomidine for the prevention of postoperative delirium
after cardiac surgery: a systematic review, Bayesian meta-analysis, and
Bayesian re-analysis of the DECADE trial.
Source
British Journal of Anaesthesia. 134(6) (pp 1671-1682), 2025. Date of
Publication: 01 Jun 2025.
Author
Hunt T.; Payne T.; Brophy J.M.; Irons J.; Wang A.Y.; Cartwright C.; Moran
B.; Loadsman J.A.; Sanders R.D.
Institution
(Hunt, Payne, Loadsman, Sanders) Central Clinical School, Faculty of
Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
(Hunt, Payne, Irons, Wang, Cartwright, Loadsman, Sanders) Department of
Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District,
Camperdown, NSW, Australia
(Payne) Royal Melbourne Hospital, Melbourne Health, Parkville, VIC,
Australia
(Brophy) Department of Medicine, McGill University, Montreal, QC, Canada
(Brophy) Department of Epidemiology, McGill University, Montreal, QC,
Canada
(Brophy) Department of Biostatistics, McGill University, Montreal, QC,
Canada
(Moran) Department of Intensive Care, Gosford Hospital, Gosford, Australia
(Moran) Department of Anaesthesia and Pain Medicine, Gosford Hospital,
Gosford, Australia
(Moran) School of Medicine and Public Health, University of Newcastle,
Callaghan, NSW, Australia
(Sanders) Institute of Academic Surgery, Royal Prince Alfred Hospital,
Sydney Local Health District, NSW, Australia
(Sanders) NHMRC Clinical Trials Centre, The University of Sydney,
Camperdown, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background: Dexmedetomidine is seen as a promising agent for the
prevention of postoperative delirium after cardiac surgery, but the
largest study (DECADE) paradoxically suggested an increased risk of
delirium. Method(s): Studies were selected using inclusion/exclusion
criteria after conducting online database searches for randomised
controlled trials. The primary outcome was the incidence of postoperative
delirium with a minimum clinically important difference (MCID), defined as
an odds ratio >1.20 or <0.84. Publication bias was quantified using
Bayesian model averaging. A random-effects meta-analysis with weakly
informative priors was performed. Bayesian re-analysis of DECADE using
several different priors including a prior based on this meta-analysis
(excluding DECADE) was also performed. Result(s): We identified 12
eligible randomised controlled trials (3539 participants). The overall
pooled effect showed a mean benefit from dexmedetomidine in delirium
prevention (odds ratio 0.67 [95% credible interval 0.45, 0.92]), but any
definitive evidence of benefit disappeared after accounting for
publication bias (odds ratio 1.15 [95% credible interval 0.93, 2.51]).
Bayesian re-analysis of the DECADE trial under a vague prior showed a 1.5%
posterior probability of any benefit and only a 0.1% probability of an
MCID for benefit. Combining DECADE with the unadjusted
meta-analysis-derived prior increased the probability of an MCID for
benefit to 17.8%, which decreased to 0.2% using the meta-analysis-derived
prior adjusted for publication bias. Conclusion(s): Pooled evidence
suggests dexmedetomidine is associated with reduced incidence of
postoperative delirium; however, this is highly sensitive to the
possibility of publication bias. Bayesian re-analysis of the recently
published DECADE trial showed the effect of dexmedetomidine differs
markedly depending on the weight given to previous studies. Hence, any
true benefit from the use of dexmedetomidine over standard care in this
population cannot be definitively characterised at present. Systematic
review protocol: CRD42023401623 (PROSPERO). Copyright © 2025
British Journal of Anaesthesia

<21>
Accession Number
2038596146
Title
Effect of Esketamine on Postoperative Delirium and Inflammatory Response
in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting: A
Randomized Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Ju L.-Y.; Liu G.-Q.; Yuan L.; Lyu L.; Su Y.; Liu A.-J.
Institution
(Ju, Liu, Yuan, Lyu, Su, Liu) Department of Anesthesiology, The Affiliated
Hospital of Qingdao University, Qingdao, China
Publisher
W.B. Saunders
Abstract
Objectives: To investigate whether continuous intravenous infusion of
esketamine during surgery can improve postoperative delirium (POD) and
inflammatory response in patients undergoing off-pump coronary artery
bypass grafting (OPCAB). Design(s): Prospective, triple-blind,
randomized controlled trial. Setting(s): A single tertiary center.
 Participant(s): 140 adult patients undergoing elective OPCAB.
 Intervention(s): Patients in Group S (esketamine group) received an
infusion of esketamine at a dose of 0.25 mg/kg/h, while those in Group P
(placebo group) received an equal volume of saline. Measurements and
Main Results: The main outcome was the incidence of POD within the first 7
days after surgery. The incidence of POD within 7 days after surgery was
significantly lower in Group S compared with Group P (relative risk:
0.474, 95% confidence interval: 0.231-0.970, p = 0.034). Furthermore, the
levels of interleukin-6 (IL-6) at 12th and 72nd postoperative hours were
significantly lower in Group S than in Group P (Z = -2.697, p = 0.007; Z =
-2.022, p = 0.043). The C-reactive protein level at 72nd postoperative
hour was also significantly lower in Group S (Z = -2.134, p = 0.003).
 Conclusion(s): Esketamine can decrease the incidence of POD, reduce
postoperative inflammatory levels, and alleviate short-term inflammatory
responses in OPCAB patients. Copyright © 2025 Elsevier Inc.

<22>
[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. 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. 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. 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. Copyright ©
2025 American Heart Association, Inc.

<23>
Accession Number
2034454647
Title
Intravenous leiomyomatosis: A case report and narrative literature review.
Source
International Journal of Gynecology and Obstetrics. (no pagination),
2025. Date of Publication: 2025.
Author
Teixeira B.; Neves M.C.; Fonseca F.; Torres J.P.; Teixeira J.; Costa A.
Institution
(Teixeira, Neves, Costa) Gynecological Unit, Centro Hospitalar
Universitario de Sao Joao, Porto, Portugal
(Fonseca, Torres) Department of Cardiothoracic Surgery, Centro Hospitalar
Universitario de Sao Joao, Porto, Portugal
(Teixeira) Department of Vascular Surgery, Centro Hospitalar Universitario
de Sao Joao, Porto, Portugal
(Costa) Department of Obstetrics and Gynecology, Faculdade de Medicina da
Universidade do Porto, Porto, Portugal
Publisher
John Wiley and Sons Ltd
Abstract
In the present study, we report a case of intravenous leiomyomatosis with
intracardiac extension. A subsequent extensive literature review was
initiated in order to characterize this entity in terms of clinical
manifestations, diagnosis and treatment strategies. We performed a
literature search in PubMed, Webscience and Scopus using the MeSH term
"intravenous leiomyomatosis" and included case reports, case series and
retrospective studies published in the last 10 years. A total of 74
articles, with a total of 672 cases of intravenous leiomyomatosis were
included. The average age at diagnosis was 45.5 years and 92% of the cases
were reported in Asian countries. A total of 21% of the patients were
asymptomatic. The most frequent symptoms included perception of pelvic
mass, dyspnea, abnormal uterine bleeding and palpitations. In 55% of cases
there was a preoperative suspicion of the diagnosis. In 61%, the lesion
was confined to the pelvic cavity and in 35% there was extension beyond
the renal veins (including intracardiac extension). When there was a
preoperative diagnosis, the surgical team usually included elements from
gynecology, vascular surgery and/or cardiac surgery. The treatment
consisted of one-stage surgery in 86% of cases, with complete resection in
90%. The recurrence rate was 12%. Intravenous leiomyomatosis can have a
nonspecific presentation which, combined with its rarity, requires a high
degree of suspicion. The challenges in its treatment and follow-up arise
from its surgical complexity and the absence of guidelines. The objective
of this review was to compile the most recent cases reported to better
characterize this rare entity thereby achieving optimal
management. Copyright © 2025 International Federation of
Gynecology and Obstetrics.

<24>
Accession Number
2033554763
Title
The effect of colchicine on coagulation in patients with chronic coronary
disease who use vitamin K antagonists.
Source
European Journal of Clinical Pharmacology. 81(5) (pp 719-725), 2025. Date
of Publication: 01 May 2025.
Author
Houwen J.P.A.; Lalmohamed A.; Zwaan J.; Egberts T.C.G.; Duyvendak M.;
Fiolet A.T.L.; Mosterd A.
Institution
(Houwen, Lalmohamed, Egberts) Department of Clinical Pharmacy, University
Medical Center Utrecht, Utrecht, Netherlands
(Lalmohamed, Egberts) Division of Pharmacoepidemiology and Clinical
Pharmacology, Utrecht Institute for Pharmaceutical Science, Faculty of
Science, Utrecht University, Utrecht, Netherlands
(Zwaan) Pharmacy de Lindehoeve, Barendrecht, Netherlands
(Duyvendak) Antonius Hospital Sneek and Pharmacy d & a Research, Sneek,
Netherlands
(Fiolet) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Mosterd) Department of Cardiology, Meander Medical Center, Amersfoort,
Netherlands
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Low-dose (0.5 mg/day) colchicine improves cardiovascular
outcomes in patients with stable coronary disease. Around 10-15% of these
patients simultaneously use anticoagulant therapy, including vitamin-K
antagonists (VKAs). In vitro studies and case reports have described a
possible interaction between colchicine and VKAs leading to increased INR,
but controlled studies are lacking. Objective(s): The aim of this
study was to investigate if there is a drug-drug interaction between
low-dose colchicine and VKAs in patients with chronic coronary disease.
 Method(s): This study was a sub-analysis of the randomized low-dose
colchicine for secondary prevention of cardiovascular disease 2 (LoDoCo2)
trial. This placebo-controlled trial investigated efficacy of colchicine
0.5 mg once daily in patients with chronic coronary disease. For the
current study, we included a selection of Dutch patients who concomitantly
used a VKA. Following a 30 days open-label colchicine run-in phase,
patients were randomized to colchicine or placebo. The primary outcome was
the intra-patient difference in international normalized ratio (INR)
during the first month after starting or stopping colchicine as compared
to the preceding month. Secondary outcomes included changes in VKA daily
dosage, assessed in the same pattern and before and after randomization,
and time in therapeutic range (TTR), assessed before and after
randomization to reflect long-term effects. INR measurements were part of
routine clinical care. Result(s): In total, 73 patients were included
(35 colchicine and 38 in the placebo group). No significant intra-patient
change in INR was observed after starting colchicine during the open-label
run-in phase (mean INR: 2.60 before vs. 2.67 during run-in, difference
0.07, 95% CI - 0.13 to 0.26; p = 0.50). Similarly, stopping colchicine
treatment (i.e., randomization to placebo) did not significantly alter INR
levels (mean INR: 2.70 during run-in vs. 2.81 after randomization,
difference 0.11, 95% CI - 0.12 to 0.33; p = 0.34). The change in mean VKA
daily dosage was - 0.01 mg (95% CI - 0.03 to 0.01; p = 0.35) when starting
colchicine and - 0.01 mg (95% CI - 0.03 to 0.01; p = 0.41) when switching
to placebo. TTR in patients allocated to active treatment was 65.8% in the
year prior to the start of colchicine and 73.4% in the year after
randomization to colchicine (change in TTR 7.56%, 95% CI - 0.14 to 15.26%;
p = 0.05). Mean VKA dosage remained similar (change in VKA dosage of 0.01
mg; 95% CI - 0.11 to 0.13 mg; p = 0.84). Conclusion(s): No
significant changes in INR, VKA dosage, or TTR in patients using VKAs
after starting or stopping colchicine were observed. These results suggest
that there is no need for additional INR monitoring beyond the standard of
care when using low-dose colchicine, though further studies in larger
populations would help to confirm this conclusion. Copyright ©
The Author(s) 2025.

<25>
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. 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). 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. 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. Copyright © 2025 The Author(s). Clinical Cardiology
published by Wiley Periodicals, LLC.

<26>
Accession Number
2038613243
Title
At the heart of couple conflict: Emotion regulation and cardiac
reactivity.
Source
International Journal of Psychophysiology. 212 (no pagination), 2025.
Article Number: 112581. Date of Publication: 01 Jun 2025.
Author
Salo K.I.; Pauw L.S.; Schubotz R.I.; Milek A.
Institution
(Salo, Milek) Witten/Herdecke University, Alfred-Herrhausen-Strase 44,
Witten, Germany
(Pauw) Utrecht University, Heidelberglaan 1, CS, Utrecht, Netherlands
(Schubotz) University of Munster, Fliednerstrase 21, Munster, Germany
Publisher
Elsevier B.V.
Abstract
Adaptive emotion regulation can buffer against cardiac reactivity under
acute stress. However, research on the effectiveness of emotion regulation
in the face of interpersonal stress is scarce. We therefore conducted an
experiment investigating whether emotion regulation might buffer against
parasympathetically mediated cardiac reactivity during conflict. Couples
engaged in a 10-min conflict discussion (N = 253 participants included in
the final analyses). Prior to the discussion, one partner per couple was
randomly assigned to one of three experimental conditions (acceptance,
cognitive reappraisal, control group). In both emotion regulation groups,
the manipulated partner was instructed to apply either acceptance or
cognitive reappraisal during the following conflict. Vagal (i.e.,
parasympathetic) activity as indexed by the heart rate variability (HRV)
parameter RMSSD was assessed at baseline and during conflict. Cardiac
reactivity was operationalized as the difference between baseline vagal
activity and vagal activity during conflict. Both emotion regulation
strategies significantly reduced cardiac reactivity in the manipulated
partner as compared to the control group. We thus found preliminary
support that emotion regulation may beneficially alter parasympathetically
mediated cardiac reactivity during acute interpersonal
stress. Copyright © 2025

<27>
Accession Number
2034470092
Title
The effects of del Nido cardioplegia combined with dexmedetomidine on
cardiac surgery with cardiopulmonary bypass.
Source
Perfusion (United Kingdom). (no pagination), 2025. Article Number:
02676591251340971. Date of Publication: 2025.
Author
Jiang X.; Zhou X.; Yao L.; Li L.; Gu T.
Institution
(Jiang, Yao, Li, Gu) Department of Anesthesiology, Affiliated Hospital 2
of Nantong University, Nantong, China
(Zhou) Department of Cardiovascular Surgery, Shanghai Chest Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
Publisher
SAGE Publications Ltd
Abstract
Objective: To evaluate the effects of dexmedetomidine administration and
the use of del Nido cardioplegia in reducing the incidence of atrial
fibrillation (AF) and delirium during the perioperative period.
 Method(s): 448 patients were randomized into two groups: the
treatment group received dexmedetomidine combined with del Nido
cardioplegia, and the control group received normal saline placebo
combined with Buckberg traditional cardioplegia. Each group included 224
patients. The occurrence of AF and delirium within 5 days after surgery,
as well as other intraoperative and postoperative indicators, were noted.
 Result(s): There were no significant differences in preoperative
indicators between the two groups. The incidences of AF and delirium
events were significantly higher in the control group than in the
treatment group. Conclusion(s): We found that del Nido cardioplegia
combined with dexmedetomidine was safe in cardiac surgery with CPB and
effectively reduced the incidence of postoperative AF and
delirium. Copyright © The Author(s) 2025.

<28>
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. 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.
 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. 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. Copyright © The Author(s) 2025.

<29>
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. 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. 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. Copyright ©
2025 Saudi Heart Association.

<30>
Accession Number
2038380759
Title
Efficacy of ultrasound-guided, single-level, pectointercostal facial block
(PIFB) for postoperative analgesia after sternotomy in paediatric cardiac
surgery: A randomised controlled trial.
Source
Indian Journal of Anaesthesia. 69(5) (pp 483-488), 2025. Date of
Publication: 01 May 2025.
Author
Elhaddad A.M.M.; Hassan P.F.
Institution
(Elhaddad, Hassan) Department of Anaesthesia, ICU, and Pain Management,
Kasr Alainy Medical School, Cairo University, Cairo, Egypt
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Children undergoing median sternotomy often face
moderate to severe postoperative discomfort, along with various other
complications. Under ultrasound guidance, a pectointercostal fascial block
(PIFB) might relieve this pain. This research aimed to assess the
effectiveness of a single-level PIFB for poststernotomy analgesia in
children. Method(s): Sixty children scheduled for elective open-heart
surgery through a midline sternotomy were randomly assigned to a
pectointercostal group (PI) that was administered bilateral PIFB or a
control group (C) that did not receive any intervention. The primary
outcome was the postoperative Face, Legs, Activity, Cry, and Consolability
(FLACC) pain scale score at 6 h. The analysis employed Student's t-test
for variables with a normal distribution and Chi-squared test/Fisher's
exact test for categorical data, with a significance threshold established
at a P value < 0.05. Result(s): Intraoperative PIFB decreased the
total dose of fentanyl (P < 0.001) while maintaining a favourable
haemodynamic profile. Postoperative PIFB reduced pain scores (P < 0.001),
as evidenced by a delayed initial request for rescue analgesia (P <
0.001), reduced morphine consumption (P < 0.001) and improved predictive
indicators such as extubation time (P < 0.001) and intensive care unit
stay (P = 0.008) without complications. Conclusion(s): Single-level,
ultrasound-guided PIFB provides good analgesia and hastens recovery in
children's open-heart surgery through a midline sternotomy. Copyright
© 2025 Indian Journal of Anaesthesia.

<31>
Accession Number
2037511583
Title
Outcomes of aortic stenosis in patients with cardiac amyloidosis: A
systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. 73 (pp 98-106), 2025. Date of
Publication: 01 Apr 2025.
Author
Ahmad S.; Ahsan M.J.; Newlun M.; Sand M.; Rmilah A.A.; Yousaf A.; Shabbir
M.A.; Malik S.A.; Goldsweig A.M.
Institution
(Ahmad, Shabbir, Malik, Goldsweig) Division of Cardiovascular Medicine,
University of Nebraska Medical Center, Omaha, NE, United States
(Ahsan) Department of Cardiovascular Medicine, Baylor University Medical
Center, Dallas, TX, United States
(Newlun, Sand) Department of Medicine, University of Nebraska Medical
Center, Omaha, NE, United States
(Rmilah) Department of Medicine, Magnolia Regional Health Center, Corinth,
MS, United States
(Yousaf) Department of Medicine, McLaren Flint-Michigan State University,
Flint, MI, United States
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center
and University of Massachusetts-Baystate, Springfield, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Cardiac amyloidosis (CA) results from the deposition of
abnormally folded protein fibrils, leading to restrictive cardiomyopathy,
valvular heart disease, and arrhythmias. Up to 15 % of patients with
severe aortic stenosis (AS) have concomitant CA (AS-CA). We conducted this
systematic review and meta-analysis to compare medical management,
transcatheter aortic valve replacement (TAVR), and surgical AVR (SAVR) in
AS-CA. Method(s): A comprehensive literature search was conducted for
relevant studies from inception through January 20, 2024. Studies
exploring outcomes in adult AS patients with and without CA receiving
medical therapy, TAVR, or SAVR were included in this analysis.
 Result(s): Fifteen studies including 253,334 patients (AS-CA 6704; AS
alone 246,630) were identified. AS-CA patients had significantly higher
all-cause mortality (RR = 2.60, 95 % CI 1.48-4.57, P = 0.0009) compared to
AS alone. Among patients with AS-CA, TAVR was associated with lower
all-cause mortality compared to both medical therapy (RR = 0.50, 95 % CI
0.29-0.89, P = 0.02) and SAVR (RR = 0.41, 95 % CI 0.22-0.78, P = 0.007).
AS-CA patients undergoing TAVR were more likely to have paradoxical
low-flow, low-gradient AS (RR = 1.56, 95 % CI 1.15-2.12, P = 0.04) at
baseline and had a higher risk of post-TAVR acute kidney injury (RR =
1.95, 95 % CI 1.35-2.80, P = 0.0003) compared to patients undergoing TAVR
for AS alone. There were similar risks of other post-TAVR complications,
including major bleeding, vascular complications, stroke, and new
pacemaker implantation between AS-CA and AS alone. Conclusion(s): CA
is associated with a higher mortality in patients with severe AS. In
patients with concomitant AS and CA, TAVR is safe and associated with
better survival than medical therapy or SAVR. Social media abstract:
#Meta-Analysis: Cardiac amyloidosis is associated with increased mortality
in severe AS. #TAVR is safe in amyloidosis & improves survival more than
medical therapy or SAVR. Copyright © 2025 Elsevier Inc.

<32>
Accession Number
2034461951
Title
Maintaining ventilation with very low tidal volume and positive-end
expiratory pressure versus no ventilation during cardiopulmonary bypass
for cardiac surgery in adults: a randomized clinical trial.
Source
Intensive Care Medicine. (no pagination), 2025. Date of Publication:
2025.
Author
Tadie J.-M.; Ouattara A.; Laviolle B.; Lesouhaitier M.; Esvan M.; Rousseau
C.; Gregoire M.; Gaudriot B.; Nesseler N.; Labaste F.; Sanchez P.;
Marcheix B.; Beurton A.; Dureau P.; Demondion P.; Fouquet O.; Rineau E.;
Amour J.; Verhoye J.-P.; Mercat A.; Terzi N.; Tarte K.; Bougle A.; Flecher
E.
Institution
(Tadie, Lesouhaitier, Terzi) Department of Infectious Diseases and
Intensive Care Unit, Centre Hospitalier Universitaire Rennes, Universite
de Rennes 1, Rennes, France
(Tadie, Lesouhaitier, Gregoire, Tarte) SITI Laboratory, UMR U1236, INSERM,
University of Rennes, EFS, Rennes University Hospital, Rennes, France
(Tadie, Lesouhaitier, Esvan, Rousseau, Terzi) Centre d'investigation
Clinique de Rennes (CIC1414), Inserm, Centre Hospitalier Universitaire
Rennes, Universite de Rennes 1, Rennes, France
(Ouattara, Beurton) Department of Cardiovascular Anaesthesia and Critical
Care, CHU Bordeaux, Magellan Medico-Surgical Centre, Bordeaux, France
(Laviolle) CHU Rennes, Univ Rennes, Inserm, UMR_S 1085 (IRSET), CIC 1414,
Rennes, France
(Gaudriot, Nesseler) Department of Anesthesia and Critical Care,
Pontchaillou, Rennes University Hospital, Rennes, France
(Labaste, Sanchez) Anesthesiology and Intensive Care Department, Centre
Hospitalier Universitaire de Toulouse, Toulouse, France
(Marcheix) Department of Cardiovascular Surgery, Centre Hospitalier
Universitaire de Toulouse, Toulouse, France
(Dureau, Bougle) Department of Anesthesiology and Critical Care Medicine,
Sorbonne University, Cardiology Institute, GRC 29, Assistance Publique -
Hopitaux de Paris, Pitie-Salpetriere Hospital, Paris, France
(Demondion) Thoracic and Cardiovascular Surgery Department, Groupe
Hospitalier Pitie-Salpetriere, Institute of Cardiology, Sorbonne
Universite, APHP, Paris, France
(Fouquet) Department of Cardiac Surgery, University Hospital of Angers,
Angers, France
(Rineau) Department of Anesthesiology and Critical Care, Angers
University, Angers, France
(Amour) Institute of Perfusion, Critical Care Medicine and Anesthesiology
in Cardiac Surgery Paris Sud (IPRA), Hopital Prive Jacques Cartier, Ramsay
Health Care, Massy, France
(Verhoye, Flecher) Department of Vascular and Cardio-Thoracic Surgery,
Rennes University Hospital, Rennes, France
(Mercat) Medical Intensive Care Unit, Vent'Lab, Angers University
Hospital, University of Angers, 4 Rue Larrey, Angers, France
(Ouattara, Beurton) UMR 1034, Biology of Cardiovascular Diseases, Univ.
Bordeaux, INSERM, Pessac, France
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Cardiopulmonary bypass (CPB) during cardiac surgery mechanically
circulates and oxygenates the blood, bypassing the heart and lungs.
Despite limited evidence, maintaining mechanical ventilation (MV) during
CPB is recommended, as ventilator strategies during surgery may reduce the
occurrence of postoperative infections. We aimed to determine whether
maintaining MV for cardiac surgery would decrease postoperative infections
compared with stopping MV during CPB. Method(s): We conducted a
multicenter, single-blind, randomized trial among adult patients
undergoing scheduled cardiac surgery with CPB in six hospitals in France.
During CPB, the tracheal tube was disconnected from the ventilator in the
control group (MV- group). In the MV + group, ventilation was maintained
during CPB with very low tidal volume ventilation, using a tidal volume of
2.5 mL/kg of predicted body weight, with 5-7 cmH<inf>2</inf>O positive end
expiratory pressure. The primary outcome was the occurrence of all types
of postoperative infections within the first 28 days after surgery. There
were six secondary evaluation criteria including the number of days of
exposure to antibiotics. Result(s): A total of 1362 patients were
enrolled in the study. Postoperative infection occurred in 74 out of 680
patients (10.9%) in the MV- group, compared to 68 out of 682 patients
(10.0%) in the MV + group (relative risk, 0.92; 95% confidence interval
[CI] 0.67-1.25; p = 0.58). Antibiotic use was higher in the MV + group
than in the MV- group (incidence risk ratio, 1.08; 95% CI 1.02-1.15; p =
0.02). There were no significant differences between the groups for all
other secondary outcomes or for the incidence of adverse events.
 Conclusion(s): Maintaining very low tidal volume ventilation with
positive end-expiratory pressure during CPB did not reduce postoperative
infections at 28 days compared to when mechanical ventilation was stopped
during CPB. An unexpectedly higher use of antibiotics was observed when
ventilation was maintained. Trial registration: ClinicalTrials.gov
(NCT03372174). Copyright © The Author(s) 2025.

<33>
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. 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. 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). 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). Copyright © The Author(s) 2025.

<34>
Accession Number
2033639537
Title
Transcatheter aortic valve replacement outcomes in patients with high
gradient versus low ejection fraction low gradient severe aortic stenosis:
A meta-analysis of randomized controlled trials.
Source
Cardiovascular Revascularization Medicine. 73 (pp 1-7), 2025. Date of
Publication: 01 Apr 2025.
Author
Al-Bayati A.; Alrifai A.; Darmoch F.; Alkhaimy H.; Fanari Z.
Institution
(Al-Bayati, Fanari) University of California San Francisco, Fresno, CA,
United States
(Alrifai) Advocate Aurora Health, Chicago, IL, United States
(Darmoch) Northside Hospital Cardiovascular Institute, Cumming, GA, United
States
(Alkhaimy) University of Arkansas for Medical Sciences, Little Rock, AR,
United States
Publisher
Elsevier Inc.
Abstract
Background: The outcome of Low Flow-Low Gradient (LF-LG) severe aortic
stenosis (AS) patients who underwent Transcatheter Aortic Valve
Replacement (TAVR) procedure is not well defined. We conducted a
systematic review of the literature to compare the outcomes of TAVR in
LF-LG AS patients to the more traditional high gradient (HG) aortic
stenosis. Method(s): We comprehensively searched for controlled
randomized and non-randomized studies from 4 online databases. We are
presenting the data using risk ratios (95 % confidence intervals) and
measuring heterogeneity using Higgins' I2 index.
 Result(s): Our analysis included 4380 patients with 3425 HG patients
and 955 LF-LG patients from 6 cohort (5 retrospective and 1 prospective)
studies. When compared to LFLG; TAVR was associated with significantly
lower 30 days mortality in HG patients (5.1 % vs 7.4 %; relative risk
[RR]: 0.55; 95 % confidence interval [CI]: 0.35 to 0.86; p < 0.01).
Similar findings were also observed in 12-month cardiovascular (CV)
mortality (5.5 % vs. 10.4 %; RR: 0.47; 95 % CI: 0.38 to 0.60; p < 0.01 and
12-month all-cause mortality (15.9 % vs 20.9 %; RR: 0.70; 95 % CI: 0.49 to
1.00; p < 0.05). There was no significant difference in myocardial
infarction (MI) after TAVR between HG and LF-LG at 30 days (0.16 % vs.
0.95 %; p < 0.09) or 12 months (0.43 % vs. 0.95 %; p = 0.20). Similarly,
there was no difference in stroke rates at 30 days (2.9 % vs. 2.86 %) or
at 12 months (3.6 % vs. 3.06 %). Conclusions and relevance: Patients with
LF-LG severe AS who underwent TAVR had worse 1-year all-cause mortality,
30-day all-cause, and 1-year CV mortality when compared to TAVR in HG
severe AS. There was no difference in MI or stroke rates. Therefore, with
heart team discussion and informed patient decision regarding the risk and
benefit, TAVR would still offer better outcomes in LFLG AS compared to
conservative medical management. Copyright © 2024 The Authors

<35>
Accession Number
2033384849
Title
Comparative Efficacy and Safety of Low-Dose Direct Oral Anticoagulants
Versus Dual Antiplatelet Therapy Following Left Atrial Appendage Occlusion
in Patients With Nonvalvular Atrial Fibrillation: A Systematic Review and
Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 105(6) (pp 1311-1319),
2025. Date of Publication: 01 May 2025.
Author
Ibrahim A.; Shalabi L.; Zreigh S.; Ramadan S.; Mourad S.; Eljadid G.;
Beshr M.; Abdelaziz A.; Elhadi M.; Sabouret P.; Mamas M.
Institution
(Ibrahim, Mourad, Abdelaziz) Faculty of Medicine, Alexandria University,
Alexandria, Egypt
(Shalabi) Faculty of Medicine, Gharyan University, Gharyan, Libyan Arab
Jamahiriya
(Zreigh) Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara,
Turkey
(Ramadan, Eljadid) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Beshr) Faculty of Medicine and Health Sciences, Sana'a University,
Sana'a, Yemen
(Elhadi) Korea University College of Medicine, Seoul, Seongbuk-gu, South
Korea
(Sabouret) National College of French Cardiologists, Paris, France
(Sabouret) ACTION Study Group, Pitie-Salpetriere Hospital, Sorbonne
University, Paris, France
(Mamas) Keele Cardiovascular Research Group, Keele University,
Stoke-on-Trent, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Left atrial appendage occlusion (LAAO) is an alternative to
chronic oral anticoagulation (OAT) for stroke prevention in nonvalvular
atrial fibrillation (NVAF) patients with contraindications to OAT.
Postprocedure antithrombotic therapy (ATT) is essential to reduce the risk
of device-related thrombosis (DRT), but the optimal regimen remains
uncertain. Aim(s): This study aims to compare the safety and efficacy
of low-dose direct oral anticoagulants (DOACs) versus dual antiplatelet
therapy (DAPT) following LAAO. Method(s): A comprehensive search of
PubMed, Scopus, Cochrane, and Web of Science was conducted in August 2024.
Studies comparing low-dose DOACs and DAPT post-LAAO were included. The
primary outcomes were a composite efficacy endpoint (DRT, strokes, and
systemic embolism [SE]) and major bleeding events as the safety endpoint.
Secondary outcomes included all bleeding events, all-cause mortality, and
a composite of efficacy and safety endpoints. Result(s): Four studies
with 727 patients were included. Low-dose DOACs were associated with lower
rates of the primary composite efficacy endpoint compared to DAPT (OR =
0.36; 95% CI [0.16, 0.85], p = 0.01). No significant difference in major
bleeding events was observed (OR = 0.36; 95% CI [0.11, 1.18]; p = 0.091;
I2 = 0%). Compared to DAPT, low-dose DOACs were also associated with lower
rates of DRT events (OR = 0.36; 95% CI [0.16, 0.79], p = 0.011).
 Conclusion(s): Low-dose DOACs effectively reduce thromboembolic
events post-LAAO without increasing bleeding risk. These findings support
their use as a viable ATT option, but larger trials are needed to confirm
optimal regimens. Copyright © 2025 Wiley Periodicals LLC.

<36>
Accession Number
2038588211
Title
No-touch versus conventional vein in coronary artery bypass grafting:
three year follow-up of multicentre randomised PATENCY trial.
Source
BMJ. (no pagination), 2025. Article Number: e082883. Date of Publication:
2025.
Author
Tian M.; Wang X.; Feng W.; Wang H.; Liu S.; Liu Z.; Chen Y.; Miao Q.; Su
P.; Li X.; Wang Y.; Lu B.; Chen K.; Zhang C.; Hu S.
Institution
(Tian, Wang, Feng, Chen, Zhang, Hu) Department of Surgery, National Center
for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of
Medical Sciences, Peking Union Medical College, Beijing, China
(Wang) Beijing Hospital, Beijing, China
(Liu) The Second Hospital of Hebei Medical University, Hebei Province,
Shijiazhuang, China
(Liu) TEDA International Cardiovascular Hospital, Chinese Academy of
Medical Sciences, Peking Union Medical College, Tianjin, China
(Chen) The Second People's Hospital of Anhui Province, Anhui Province,
Hefei, China
(Miao) Peking Union Medical College Hospital, Chinese Academy of Medical
Sciences, Peking Union Medical College, Beijing, China
(Su) Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
(Li) National Clinical Research Center for Cardiovascular Diseases,
National Center for Cardiovascular Disease, China & Fuwai Hospital,
Chinese Academy of Medical Sciences, Peking Union Medical College,
Beijing, China
(Wang) Medical Research & Biometrics Center, National Center for
Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical
Sciences, Peking Union Medical College, Beijing, China
(Lu) Department of Radiology, National Center for Cardiovascular Disease,
China & Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union
Medical College, Beijing, China
Publisher
BMJ Publishing Group
Abstract
Objective: To assess the three year outcomes of the no-touch vein
harvesting technique in coronary artery bypass grafting surgery compared
with the conventional approach. Design(s): Three year extended
follow-up of the randomised PATENCY (graft patency between the no-touch
vein harvesting technique and conventional approach in coronary artery
bypass graft surgery) trial. Setting(s): Seven cardiac surgery
centres in China; enrolment between April 2017 and June 2019.
 Participant(s): 2655 participants aged 18 and older undergoing
isolated coronary artery bypass grafting surgery. Intervention(s):
Patients were randomly assigned 1:1 to the no-touch vein harvesting
technique group or the conventional approach group during surgery and
followed up. Main Outcome Measure(s): Vein graft occlusion (based on
computed tomography angiography) at three years. Result(s): Mean age
of participants was 61 years (standard deviation +/-8 years) and 22% were
women. 99.4% (2621) attended the three year follow-up visit, while 86.5%
(2281) received computed tomography angiography. At three years, the
no-touch group showed a significantly lower vein graft occlusion rate
(5.7% v 9.0%, P<0.001) than the conventional group (odds ratio 0.62, 95%
confidence interval 0.48 to 0.80), with absolute risk difference of -3.2%
(95% confidence interval -5.0% to -1.4%). The intention-to-treat analysis,
including all 2655 randomised patients with multiple imputations for
missing data, showed consistent findings, with occlusion rates of 6.1% in
the no-touch group versus 9.3% in the conventional group (odds ratio 0.63,
95% confidence interval 0.51 to 0.81; absolute risk difference-3.1%, 95%
confidence interval -4.9% to -1.4%; P<0.001). These results confirm the
robustness of the no-touch technique in reducing vein graft occlusion.
 Conclusion(s): The no-touch technique consistently and robustly
reduced the risk of vein graft occlusion and several cardiac events by one
third to one half within three years after coronary artery bypass grafting
surgery. Trial registration: ClinicalTrials.gov NCT03126409. Copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC
BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

<37>
Accession Number
2034437178
Title
Risk factors for postoperative hypothermia in non-cardiac surgery
patients: a systematic review and meta-analysis.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 223. Date
of Publication: 01 Dec 2025.
Author
Tan R.; Chen Y.; Yang D.; Long X.; Ma H.; Yang C.
Institution
(Tan, Yang, Ma, Yang) Anesthesiology Department, Chongqing University
Cancer Hospital, Chongqing, China
(Chen) School of Nursing, Guangxi University of Chinese Medicine, Nanning,
China
(Long) Nursing Department, Ruikang Hospital Affiliated to Guangxi
University of Chinese Medicine, Nanning, China
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative hypothermia seems to be a common problem in
surgical patients but is easily ignored. This study aimed to identify risk
factors for postoperative hypothermia in non-cardiac surgery patients.
 Method(s): We searched databases including PubMed, Embase, Web of
Science, Cochrane Library, CINAHL, VIP, Wan Fang, CNKI, and CBM from
inception to April 2025. The studies were selected using inclusion and
exclusion criteria. Two reviewers screened studies, extracted data, and
independently evaluated the risk of bias. The quality of the study was
assessed with the Newcastle-Ottawa Scale, and a meta-analysis was carried
out with Revman 5.4 software. Result(s): A total of 17 studies were
included. Age >= 60 (odds ratio [OR] = 1.80), BMI < 18.5 kg/m2
(OR = 1.83), ASA III-IV (OR = 1.87), endoscopic surgery (OR = 1.93),
intraoperative blood loss >= 100ml (OR = 2.35), intravenous fluid >=
1000ml (OR = 1.87), blood transfusion (OR = 1.80), duration of anesthesia
> 1 h (OR = 1.99) and duration of surgery > 1 h (OR = 2.34) were
significant risk factors that contributed to postoperative hypothermia in
non-cardiac surgery patients. Conclusion(s): There are many risk
factors for postoperative hypothermia in patients undergoing non-cardiac
surgery. The results of this research may improve clinician awareness,
risk stratification, and prevention of postoperative hypothermia in
non-cardiac surgery patients. Copyright © The Author(s) 2025.

<38>
Accession Number
2033339788
Title
Myocardial Infarction and All-Cause Mortality Following Percutaneous
Coronary Intervention Versus Conservative Treatment of Chronic Total
Occlusions: A West Denmark Heart Registry Study.
Source
Catheterization and Cardiovascular Interventions. 105(6) (pp 1296-1303),
2025. Date of Publication: 01 May 2025.
Author
Sondergaard M.M.; Gunnarstein S.; Christensen M.K.; Christiansen E.H.;
Jensen L.O.; Veien K.T.; Holck E.N.; Kragholm K.; Thuesen L.; Eftekhari A.
Institution
(Sondergaard, Gunnarstein, Christensen, Kragholm, Thuesen, Eftekhari)
Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
(Christiansen, Holck) Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark
(Jensen, Veien) Department of Cardiology, Odense University Hospital,
Odense, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: Chronic coronary total occlusions (CTO) represent a
therapeutic challenge, and results of randomized clinical trials and
observational studies comparing conservative treatment versus percutaneous
coronary intervention (PCI) are underpowered. Aim(s): To assess
myocardial infarction (MI) and all-cause mortality in consecutive patients
with CTO lesions. Method(s): Using data from the West Denmark Heart
Registry, patients with chronic coronary syndrome and a 100% occluded
vessel by invasive coronary angiography (ICA) were identified. Patients
were stratified according to PCI within 90 days. Five-year risk of MI and
all-cause mortality was calculated using cause-specific Cox-models and
g-formula methods. Subsequently, models were stratified on sex, diabetes,
estimated glomerular filtration rate above 60 mL/min, procedure before
2012, and history of cardiac surgery. The risk was calculated for patients
who did not experience MI or death within 30 days of the initial ICA.
 Result(s): A total of 7675 patients were included in the study, of
whom 3129 patients underwent PCI, and 4546 patients were treated
conservatively. PCI- and conservatively treated patients had comparable
risks of MI (13.1% [95% confidence interval [CI] 12.0%-14.3%] for patients
who underwent PCI vs. 13.4% [95% CI 12.4%-13.4%] for patients who received
conservative treatment). For all-cause mortality, results were 14.4% (95%
CI 13.3%-15.5%) versus 18.9% (95% CI 17.8%-20.0%), respectively. Results
were consistent across subgroups. However, CTO-PCI-treated patients with
previous heart surgery were at higher risk of MI. Conclusion(s):
Patients who underwent CTO-PCI had a comparable 5-year risk of MI and
lower all-cause mortality as compared to conservatively treated
patients. Copyright © 2025 The Author(s). Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<39>
Accession Number
2034065399
Title
A Current Perspective on Left Atrial Appendage Closure Device Infections:
A Systematic Review.
Source
PACE - Pacing and Clinical Electrophysiology. 48(5) (pp 492-499), 2025.
Date of Publication: 01 May 2025.
Author
Sener Y.Z.; Ozer S.F.; Karahan G.
Institution
(Sener) Department of Cardiology, Thoraxcentrum, Erasmus MC, Rotterdam,
Netherlands
(Ozer) Department of Cardiology, Karaman Training and Research Hospital,
Karaman, Turkey
(Karahan) Department of Infectious Diseases and Clinical Microbiology,
University of Health Sciences Gaziosmanpasa Training and Research
Hospital, Istanbul, Turkey
Publisher
John Wiley and Sons Inc
Abstract
Purpose: Left atrial appendage (LAA) closure has become the standard of
care for patients with atrial fibrillation (AF) at high risk of
thromboembolism who are intolerant or unwilling to take anticoagulants.
LAA occlusion device infection is a challenging complication, and there is
a paucity of data on the management and outcomes of LAA occlusion device
infection. We aimed to summarize the existing literature and highlight the
knowledge gap in this area. Method(s): A detailed search was
conducted through the databases PubMed/MEDLINE, EMBASE, Web of Science,
CINAHL, and Cochrane Central using the relevant keywords. All cases with
presented data regarding diagnosis, treatment, and outcome were included
from the reports. Result(s): The analysis included 12 case reports
encompassing a total of 12 patients. The mean age was 73.6 +/- 11.0 years,
and 50% of the cases were male. The most commonly implanted device was the
Watchman (in eight of the 12 cases). The median time between LAA closure
and infection was 6.6 (0.2-36) months. Transesophageal echocardiography
was diagnostic in all cases, and positron emission tomography/computed
tomography (PET/CT) was useful in diagnosis in three cases. The most
common pathogen was Staphylococcus aureus (n = 7). The LAAC device was
removed in seven cases; one patient refused surgery, and in the other
three cases, removal of the device was not considered appropriate due to
the patient's poor condition. Data on whether the device was removed could
not be retrieved for one patient. Mortality occurred in three cases (25%),
and all deaths occurred during hospitalization. Conclusion(s): LAA
closure device infections are rare but carry a high risk of complications
and mortality. Treatment should include device removal in appropriate
cases, and antibiotherapy alone should be considered only in selected
cases. Further studies are needed to clarify diagnostic and treatment
strategies based on the causative pathogens and patient
status. Copyright © 2025 Wiley Periodicals LLC.

<40>
Accession Number
2034451415
Title
Reexploring the STRESS Trial: Subgroup Postoperative Outcomes Following
Methylprednisolone for Infant Heart Surgery.
Source
Pediatric Cardiology. (no pagination), 2025. Date of Publication: 2025.
Author
Sunthankar S.D.; Hill K.D.; Jacobs J.P.; Baldwin H.S.; Jacobs M.L.; Li
J.S.; Graham E.M.; Resheidat A.M.; Amula V.; Bleiweis M.S.; Wald E.L.;
Eghtesady P.; Scott J.P.; Anderson B.R.; Swartz M.F.; Benscoter A.;
Ravekes W.; Kannankeril P.J.
Institution
(Sunthankar, Baldwin, Kannankeril) Division of Pediatric Cardiology and
Center for Pediatric Precision Medicine, Department of Pediatrics,
Vanderbilt University Medical Center, 2220 Children's Way; Suite 5230,
Nashville, TN, United States
(Hill, Li) Division of Pediatric Cardiology, Duke University Medical
Center, Durham, NC, United States
(Jacobs, Bleiweis) Division of Cardiac Surgery, University of Florida,
Gainesville, FL, United States
(Jacobs) Division of Cardiac Surgery, Johns Hopkins School of Medicine,
Baltimore, MD, United States
(Graham) Division of Pediatric Cardiology, Medical University of South
Carolina, Charleston, SC, United States
(Resheidat) Division of Pediatric Cardiac Anesthesiology, Texas Children's
Hospital, Baylor College of Medicine, Houston, TX, United States
(Amula) Division of Critical Care, Department of Pediatrics, Primary
Children's Hospital, Salt Lake City, UT, United States
(Wald) Division of Pediatric Cardiology, Northwestern University Feinberg
School of Medicine, Chicago, IL, United States
(Eghtesady) Division of Cardiac Surgery, Washington University School of
Medicine, St. Louis, MO, United States
(Scott) Division of Pediatric Cardiology, Medical College of Wisconsin,
Madison, WI, United States
(Anderson) Division of Pediatric Cardiology, Icahn School of Medicine at
Mt Sinai, New York, NY, United States
(Swartz) Division of Cardiac Surgery, University of Rochester, Rochester,
NY, United States
(Benscoter) Division of Pediatric Cardiology, Cincinnati Children's
Hospital, Cincinnati, OH, United States
(Ravekes) Division of Pediatric Cardiology, Johns Hopkins School of
Medicine, Baltimore, MD, United States
Publisher
Springer
Abstract
Objective Assess the association between intraoperative methylprednisolone
and specific postoperative outcomes among subgroups undergoing infant
heart surgery. Design(s): Subpopulation analyses of The Steroids to
Reduce Systemic Inflammation after Infant Heart Surgery trial, a
double-blind randomized placebo-controlled trial. Setting(s): 24
congenital heart centers. Patient(s): Infants (< 1 year old)
undergoing heart surgery with cardiopulmonary bypass. Patients stratified
by Society of Thoracic Surgeons-European Association for Cardio-Thoracic
Surgery Congenital Heart Surgery (STAT) Mortality Category, age,
gestational age, and presence of chromosomal or syndromic diagnosis (CSD).
 Intervention(s): Methylprednisolone (30 mg/kg) versus placebo
administered into cardiopulmonary bypass pump-priming fluid.
 Measurements and Main Results: Outcomes included death, heart
transplantation, mechanical circulatory support, reinterventions, and
hospital length of stay. Ranked composite outcome (death, transplant, or
one of 13 major complications) was compared between placebo and
methylprednisolone for each subgroup using the win ratio.
Methylprednisolone did not reduce odds of death, transplant, or mechanical
circulatory support for any subgroup. Those receiving methylprednisolone
had fewer catheterization or surgical reinterventions after STAT Category
1-3 operations [OR 0.50 (0.29-0.86)]; and fewer reoperations for bleeding
among patients undergoing STAT Category 1-3 operations [OR 0.28
(0.09-0.87)], term infants [OR 0.30 (0.12-0.76)], and those without CSD
[OR 0.22 (0.07-0.68)]. Length of stay was no different between
methylprednisolone versus placebo. Those without chromosomal or syndromic
diagnosis demonstrated a favorable association for methylprednisolone [win
ratio 1.28 (1.01-1.61)] for the composite outcome. Conclusion(s):
Exploratory subpopulation analyses, although underpowered, suggest that
methylprednisolone is not associated with significant harm and may benefit
certain subpopulations Copyright © The Author(s) 2025.

<41>
Accession Number
2031568089
Title
Isolated Tricuspid Valve Surgery for Functional Tricuspid Regurgitation.
Source
Thoracic and Cardiovascular Surgeon. 73(2) (pp 111-116), 2024. Date of
Publication: 03 May 2024.
Author
Kaneyuki D.; Jordan A.M.; Rosen J.L.; Macmillan T.R.; Morris R.J.;
Tchantchaleishvili V.
Institution
(Kaneyuki, Jordan, Rosen, Macmillan, Morris, Tchantchaleishvili) Division
of Cardiac Surgery, Thomas Jefferson University Hospital, Philadelphia,
PA, United States
Publisher
Georg Thieme Verlag
Abstract
Background Severe tricuspid regurgitation (TR) adversely affects long-term
survival; however, isolated tricuspid valve (TV) surgery has been rarely
performed due to high operative mortality. In addition, the previous
literature included heterogeneous TR etiologies. Therefore, we aimed to
elucidate early and long-term outcomes of isolated TV surgery for
functional TR. Methods An electronic search was performed to identify all
relevant studies. Baseline characteristics, perioperative variables, and
clinical outcomes were extracted and pooled for meta-analysis. Results
This meta-analysis included seven studies. Pooled analyses showed that 68%
(35, 89) of patients had preoperative atrial fibrillation or flutter, and
58% (11, 94) had a history of left-sided valve surgery. Seventy-three
percent (65, 80) of patients had at least one physical exam finding of
right-sided heart failure, and 57% (44, 69) were in New York Heart
Association class III or IV. TV replacement was more common than repair.
In TV replacement, bioprosthetic valve (39%, 13, 74) was more common than
mechanical prosthesis (22%, 18, 26). The early mortality rate was 7%.
Twenty percent of patients required a permanent pacemaker postoperatively.
The overall 1- and 5-year survival rates were 84.5 and 69.1%,
respectively. Conclusion More than half of the patients who underwent
isolated TV surgery for functional TR had undergone left-sided valve
surgery and had significant heart failure symptoms at the time of surgery.
Further studies on the surgical indication for concomitant TV surgery at
the time of left-sided valve surgery and the appropriate timing of surgery
for isolated functional TR are needed to improve survival. Copyright
© 2024. Thieme. All rights reserved.

<42>
Accession Number
2030550767
Title
Intentional coronary revascularization versus conservative therapy in
patients after peripheral artery revascularization due to critical limb
ischemia: the INCORPORATE trial.
Source
Clinical Research in Cardiology. (no pagination), 2024. Date of
Publication: 2024.
Author
Toth G.G.; Brodmann M.; Kanoun Schnur S.S.; Bartus S.; Vrsalovic M.;
Krestianinov O.; Kala P.; Bil J.; Gil R.; Kanovsky J.; Di Serafino L.;
Paolucci L.; Barbato E.; Mangiacapra F.; Ruzsa Z.
Institution
(Toth, Kanoun Schnur) Department of Cardiology, University Heart Center
Graz, Medical University Graz, Graz, Austria
(Brodmann) Division of Angiology, Department of Internal Medicine, Medical
University Graz, Graz, Austria
(Kanoun Schnur, Ruzsa) Department of Cardiology, Faculty of Medicine,
Doctoral School of Clinical Medicine, University of Szeged, Szeged,
Hungary
(Kanoun Schnur) Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom
(Bartus) II Dept of Cardiology, Medical College, Jagiellonian University,
Krakow, Poland
(Vrsalovic) Department of Cardiology, University of Zagreb School of
Medicine, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
(Krestianinov) E. Meshalkin National Medical Research Center of the
Ministry of Health of the Russian Federation, Novosibirsk, Russian
Federation
(Kala, Kanovsky) University Hospital Brno and Medical Faculty of Masaryk
University, Brno, Czechia
(Bil) Department of Invasive Cardiology, Centre of Postgraduate Medical
Education, Warsaw, Poland
(Gil) National Medical Institute of the Internal Affairs and
Administration Ministry, Warsaw, Poland
(Di Serafino) Department of Advanced Biomedical Sciences, University of
Naples Federico II, Naples, Italy
(Paolucci, Mangiacapra) Department of Medicine and Surgery, Research Unit
of Cardiovascular Science, Universita Campus Bio-Medico Di Roma and
Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
(Barbato) Department of Clinical and Molecular Medicine, Sapienza
University of Rome, Rome, Italy
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objectives: INCORPORATE trial was designed to evaluate whether default
coronary-angiography (CA) and ischemia-targeted revascularization is
superior compared to a conservative approach for patients with treated
critical limb ischemia (CLI). Registered at clinicaltrials.gov
(NCT03712644) on October 19, 2018. Background(s): Severe peripheral
artery disease is associated with increased cardiovascular risk and poor
outcomes. Method(s): INCORPORATE was an open-label, prospective 1:1
randomized multicentric trial that recruited patients who had undergone
successful CLI treatment. Patients were randomized to either a
conservative or invasive approach regarding potential coronary artery
disease (CAD). The conservative group received optimal medical therapy
alone, while the invasive group had routine CA and fractional flow
reserve-guided revascularization. The primary endpoint was myocardial
infarction (MI) and 12-month mortality. Result(s): Due to COVID-19
pandemic burdens, recruitment was halted prematurely. One hundred
eighty-five patients were enrolled. Baseline cardiac symptoms were scarce
with 92% being asymptomatic. Eighty-nine patients were randomized to the
invasive approach of whom 73 underwent CA. Thirty-four percent had
functional single-vessel disease, 26% had functional multi-vessel disease,
and 90% achieved complete revascularization. Conservative and invasive
groups had similar incidences of death and MI at 1 year (11% vs 10%;
hazard ratio 1.21 [0.49-2.98]). Major adverse cardiac and cerebrovascular
events (MACCE) trended for hazard in the Conservative group (20 vs 10%;
hazard ratio 1.94 [0.90-4.19]). In the per-protocol analysis, the primary
endpoint remained insignificantly different (11% vs 7%; hazard ratio 2.01
[0.72-5.57]), but the conservative approach had a higher MACCE risk (20%
vs 7%; hazard ratio 2.88 [1.24-6.68]). Conclusion(s): This trial
found no significant difference in the primary endpoint but observed a
trend of higher MACCE in the conservative arm. Graphical Abstract: A
graphical abstract illustrating the key highlights of the design and
comparisons (Figure presented.) Copyright © The Author(s) 2024.

<43>
Accession Number
2037646302
Title
Assessment of quitting versus using aspirin therapy in patients with
stabilized coronary artery disease after stenting who require long-term
oral anticoagulation: Rationale for and design of the AQUATIC double-blind
randomized trial.
Source
Archives of Cardiovascular Diseases. 118(5) (pp 296-303), 2025. Date of
Publication: 01 May 2025.
Author
Didier R.; Lemesle G.; Montalescot G.; Steg P.H.G.; Vicaut E.; Mottier D.;
Bauters C.; Mabo P.; Simon T.; Bouleti C.; Andrieu S.; Angoulvant D.;
Vanzetto G.; Kerneis M.; Cayla G.; Gilard M.
Institution
(Didier, Gilard) Department of Cardiology, Inserm UMR 1304 (GETBO), Brest
University Hospital, Western Brittany Study Group, Brest, France
(Lemesle) Heart and Lung Institute, Inserm U1011, Institut Pasteur de
Lille, University Hospital of Lille, Lille, France
(Montalescot, Kerneis) Allies in Cardiovascular Trials Initiatives and
Organized Networks (ACTION) Study Group, Inserm UMRS 1166, hopital
Pitie-Salpetriere, AP-HP, Sorbonne universite, Paris, France
(Steg) Inserm U1148/LVTS, French Alliance for Cardiovascular Trials
(FACT), AP-HP, universite Paris-Cite, Bobigny, France
(Vicaut) Clinical Research Unit, Fernand-Widal Hospital, Paris, France
(Mottier) Department of Internal Medicine and Pneumology, Inserm UMR 1304
(GETBO), CIC Inserm 1412, F-CRIN INNOVTE, universite de Bretagne
Occidentale, Brest University Hospital, Brest, France
(Bauters) Inserm 1167, Institut Pasteur de Lille, University Hospital of
Lille, universite de Lille, Lille, France
(Mabo) Department of Cardiology, CHU de Rennes, Rennes, France
(Simon) Department of Clinical Pharmacology and Clinical Research Platform
of East of Paris, AP-HP, Sorbonne universite, Paris, France
(Simon) Inserm U 1148/LVTS, French Alliance for Cardiovascular Trials
(FACT), AP-HP, Paris, France
(Bouleti) CIC Inserm 1402, Department of Cardiology, University of
Poitiers, Poitiers, France
(Andrieu) Department of Cardiology, hopital Henri-Duffaut, Avignon, France
(Angoulvant) Department of Cardiology, CHRU de Tours, Tours, France
(Angoulvant) Inserm UMR 1327 - ISCHEMIA, universite de Tours, Tours,
France
(Vanzetto) Department of Cardiology, Grenoble University Hospital, La
Tronche, France
(Cayla) Department of Cardiology, Nimes University Hospital, Montpellier
University, ACTION Study Group, Nimes, France
Publisher
Elsevier Masson s.r.l.
Abstract
Background: Antithrombotic management in patients with chronic coronary
syndrome and previous stent implantation who require long-term oral
anticoagulation is highly challenging in daily practice, especially in
those at high residual risk of coronary and vascular events. Dual therapy
with oral anticoagulation and aspirin may lead to a higher risk of
bleeding, whereas stopping aspirin in high-risk patients with coronary
artery disease after percutaneous coronary intervention may lead to
recurrent ischaemic events. Aim(s): To assess the optimal
antithrombotic regimen that should be pursued long term (often lifelong)
in these patients. Method(s): The AQUATIC study is a prospective,
randomized, double-blind, placebo-controlled, parallel-group, multicentre
study conducted in patients with chronic coronary syndrome at high risk of
ischaemic events (i.e., stent implantation [> 6 months before inclusion]
in a context of previous acute coronary syndrome and/or with high-risk
features of ischaemic event recurrences) and requiring long-term oral
anticoagulation. For superiority, we ensure 80% power at level alpha =
0.05 to detect a 25% reduction in hazard in the experimental group
relative to the control group. Overall, 2000 patients will be randomized
in a 1:1 ratio to receive either oral anticoagulation and aspirin or oral
anticoagulation and placebo. The primary efficacy endpoint is a composite
of cardiovascular death, myocardial infarction, stroke, systemic embolism,
coronary revascularization and acute limb ischaemia. Major bleeding
according to the International Society on Thrombosis and Haemostasis
definition is a secondary safety endpoint that will be assessed as a
priority. Conclusion(s): The AQUATIC trial will test the efficacy and
safety of adding aspirin to long-term oral anticoagulation in patients
with chronic coronary syndrome and previous coronary stenting who are at
high residual risk of recurrent ischaemic events and require oral
anticoagulation. Copyright © 2025

<44>
Accession Number
2034340725
Title
Non-Severe Hypophosphatemia in Older Patients: A Systematic Review.
Source
Nutrients. 17(8) (no pagination), 2025. Article Number: 1354. Date of
Publication: 01 Apr 2025.
Author
Barbarossa L.; Zandona M.; Garo M.L.; Mjahed R.B.; D'Amelio P.
Institution
(Barbarossa) Geriatric Service, Clinica Luganese di Moncucco, Lugano,
Switzerland
(Zandona) Family Medicine Institute, Ente Ospedaliero Cantonale, Lugano,
Switzerland
(Garo) Biostatistic Unit, Mathsly Research, Rome, Italy
(Mjahed, D'Amelio) Service of Geriatric Medicine and Geriatric
Rehabilitation, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne,
Switzerland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Phosphorus plays a fundamental role in cellular and
extracellular metabolism, contributing to nucleic acid synthesis,
enzymatic activity, neurologic function, and skeletal mineralization.
Despite its significance, non-severe hypophosphatemia (HP) remains largely
asymptomatic and underdiagnosed, with limited data on its prevalence in
the general population. Most studies focus on specific subgroups, such as
critically ill or dialysis patients, while the impact of mild HP in older
adults, a potentially vulnerable demographic, is not well understood. The
objective of this systematic review is to investigate the prevalence and
clinical implications of non-severe HP in older adults. Method(s):
The study followed PRISMA guidelines to assess HP in patients aged >= 65
years without critical illnesses or genetic disorders. A systematic search
was conducted in PubMed, Web of Science, and Scopus (March 2024). Eligible
studies included RCTs and prospective/retrospective studies, excluding
cancer-related studies or insufficient phosphate data. Result(s): We
identified 1350 articles, with 26 meeting eligibility criteria.
Ultimately, eight studies involving 26,548 patients were included, with an
HP prevalence of 12.5%. Studies reveal a higher prevalence of HP in frail
individuals, particularly those with increased frailty scores, and an
association between HP and cognitive decline, depressed mood, falls, and
chronic comorbidities. HP was also prevalent in infectious diseases,
especially bacterial pneumonia, with longer hospital stays and increased
mortality rates. Malnutrition was significantly more common in HP
patients, characterized by weight loss and poor nutritional status.
Furthermore, HP increased fall risk during hospitalization and worsened
outcomes after coronary artery bypass graft surgery, including higher
mortality and graft failure rates, underscoring its clinical importance.
 Discussion(s): This review identified that non-severe
hypophosphatemia (HP) is associated with conditions such as frailty,
cognitive decline, and an increased risk of falls. The evidence suggests
that low phosphate levels may negatively impact health, increasing
mortality and the risk of adverse clinical outcomes. Despite limitations
in diagnostic criteria and sample variability, the findings indicate that
HP can be a useful marker for identifying patients at risk of health
deterioration. Further research is needed to clearly define the management
and treatment of HP in this vulnerable population. Copyright ©
2025 by the authors.

<45>
Accession Number
2038606045
Title
Age and sex-related outcomes in cardiovascular magnetic resonance versus
computed tomography-guided transcatheter aortic valve replacement: a
secondary analysis of a randomized clinical trial.
Source
Journal of Cardiovascular Magnetic Resonance. 27(1) (no pagination), 2025.
Article Number: 101882. Date of Publication: 01 Jun 2025.
Author
Lechner I.; Oberhollenzer F.; Tiller C.; Holzknecht M.; Kaser A.; Binder
R.K.; Gollmann-Tepekoylu C.; Klug G.; Mayr A.; Bauer A.; Metzler B.;
Reindl M.; Reinstadler S.J.
Institution
(Lechner, Oberhollenzer, Tiller, Holzknecht, Kaser, Bauer, Metzler,
Reindl, Reinstadler) University Clinic of Internal Medicine III,
Cardiology and Angiology, Medical University of Innsbruck, Innsbruck,
Austria
(Binder) Department of Cardiology and Intensive Care, University Teaching
Hospital Klinikum Wels-Grieskirchen, Wels, Austria
(Gollmann-Tepekoylu) University Clinic of Cardiac Surgery, Medical
University of Innsbruck, Innsbruck, Austria
(Klug) Department of Internal Medicine, County Hospital Bruck an der Mur,
Bruck an der Mur, Austria
(Mayr) University Clinic of Radiology, Medical University of Innsbruck,
Innsbruck, Austria
Publisher
Elsevier B.V.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is the preferred
treatment for older patients with severe aortic stenosis with outcomes
influenced by age and sex. Computed tomography (CT) is the reference
imaging modality for TAVR planning, while cardiovascular magnetic
resonance (CMR) is an emerging alternative for this indication. The aim of
this study was to evaluate the impact of age and sex on implantation
success in patients undergoing CT- or CMR-guided TAVR. Method(s):
This was a secondary analysis of the randomized TAVR-CMR trial comparing
TAVR planning by CT or CMR (NCT03831087). Patients were categorized
according to the median age (82 years) and sex. Implantation success,
defined using the Valve Academic Research Consortium-2 definition (absence
of procedural mortality, correct positioning of a single prosthetic valve,
and proper prosthetic valve performance), was compared at hospital
discharge between age groups and sex for each imaging strategy. All-cause
mortality at 6 months was compared between imaging strategies across age
groups and sex. Result(s): A total of 267 patients (median age 82
[IQR 80-85] years, 50% (133/267) female) underwent TAVR at two heart
centers in Austria between September 2017 and December 2022. Implantation
success did not differ significantly between imaging strategies across age
and sex subgroups. For patients <=82 years, success rates were 92.1%
(58/63) (CT) vs. 94.7% (72/76) (CMR) (p = 0.524), and for those >82 years,
89.4% (59/66) (CT) vs. 91.9% (57/62) (CMR) (p = 0.622). Among female
patients, success rates were 84.7% (50/59) (CT) vs. 93.2% (69/74) (CMR) (p
= 0.113), and among male patients, 95.7% (67/70) (CT) vs. 93.8% (60/64)
(CMR) (p = 0.610). All-cause mortality at 6 months did not differ
significantly between imaging strategies across age and sex subgroups.
Mortality rates for patients <=82 and >82 years were 4.8% (3/63) vs. 5.3%
(4/76) (p = 0.839) and 9.1% (6/66) vs. 12.9% (8/62) (p = 0.490) for CT and
CMR, respectively. Similarly, female and male patients had comparable
mortality rates (10.2% (6/59) vs. 8.1% (6/74), p = 0.680; 4.3% (3/70) vs.
9.4% (6/64), p = 0.240). Conclusion(s): In this secondary analysis of
the TAVR-CMR trial, CMR-guided TAVR was associated with similar outcomes
compared with CT-guided TAVR irrespective of age and sex. Copyright
© 2025 The Author(s)

<46>
Accession Number
2037453363
Title
Benzodiazepine-Free Cardiac Anesthesia for Reduction of Postoperative
Delirium: A Cluster Randomized Crossover Trial.
Source
JAMA Surgery. 160(3) (pp 286-294), 2025. Date of Publication: 12 Mar 2025.
Author
Spence J.; Devereaux P.J.; Lee S.-F.; D'Aragon F.; Avidan M.S.; Whitlock
R.P.; Mazer C.D.; Rousseau-Saine N.; Rajamohan R.R.; Pryor K.O.; Klein R.;
Tan E.; Cameron M.J.; Di Sante E.; Deborba E.; Mustard M.E.; Couture E.J.;
Zamper R.P.C.; Law M.W.Y.; Djaiani G.; Saha T.; Choi S.; Hedlin P.;
Pikaluk D.R.; Lam W.; Deschamps A.; Ramasundarahettige C.F.; Vincent J.;
McIntyre W.F.; Oczkowski S.J.W.; Dulong B.J.; Beaver C.; Kloppenburg S.A.;
Lamy A.; Jacobsohn E.; Belley-Cote E.P.
Institution
(Spence, Devereaux, Lee, Whitlock, Di Sante, Deborba, Ramasundarahettige,
Vincent, McIntyre, Beaver, Kloppenburg, Lamy, Belley-Cote) Population
Health Research Institute, Hamilton, ON, Canada
(Spence) Department of Anesthesia and Critical Care, McMaster University,
Hamilton, ON, Canada
(Spence, Devereaux, Lee, Whitlock, Oczkowski, Belley-Cote) Department of
Health Research Methods, Evidence, and Impact, McMaster University,
Hamilton, ON, Canada
(Spence, Devereaux, Whitlock, McIntyre, Lamy, Belley-Cote) World Health
Research Trust, Hamilton, ON, Canada
(Devereaux, McIntyre, Lamy) Department of Medicine, Cardiology, McMaster
University, Hamilton, ON, Canada
(D'Aragon) Departement d'Anesthesiologie, Universite de Sherbrooke,
Sherbrooke, QC, Canada
(Avidan) Department of Anesthesia, Washington University, St Louis School
of Medicine, St Louis, MO, United States
(Whitlock) Department of Surgery, Cardiac Surgery, McMaster University,
Hamilton, ON, Canada
(Mazer) Department of Anesthesia, Li Ka Shing Knowledge Institute, St.
Michael's Hospital, Toronto, ON, Canada
(Mazer) Departments of Anesthesiology and Pain Medicine, Physiology, and
Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
(Rousseau-Saine, Deschamps) Departement d'Anesthesie, Institut de
Cardiologie de Montreal, Universite de Montreal, Montreal, QC, Canada
(Rajamohan) Department of Anesthesia, St Paul's Hospital, University of
British Columbia, Vancouver, BC, Canada
(Pryor) Department of Anesthesiology, Weill Cornell Medical College, New
York, NY, United States
(Klein) Department of Anesthesia, Vancouver General Hospital, University
of British Columbia, Vancouver, BC, Canada
(Tan, Dulong) Department of Anesthesia and Critical Care Medicine, Queen
Elizabeth II Health Sciences, Dalhousie University, Halifax, NS, Canada
(Cameron) Department of Anesthesia, Jewish General Hospital, McGill
University, Montreal, QC, Canada
(Mustard) St Michael's Hospital, Toronto, ON, Canada
(Couture) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Universite Laval, Quebec, QC, Canada
(Zamper) Department of Anesthesia, University of Western Ontario, London,
ON, Canada
(Law) Department of Anesthesiology, Royal Columbian Hospital, Department
of Anesthesiology, Pharmacology & Therapeutics, University of British
Columbia, Vancouver, BC, Canada
(Djaiani, Choi) Department of Anesthesiology and Pain Medicine, University
of Toronto, Toronto, ON, Canada
(Saha) Department of Anesthesia, Queen's University, Kingston, ON, Canada
(Choi) Department of Anesthesia, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Hedlin, Pikaluk) Department of Anesthesia, University of Saskatchewan,
Saskatoon, SK, Canada
(Lam) Department of Anesthesia, University of Alberta, Mazankowski Alberta
Heart Institute, Edmonton, AB, Canada
(Oczkowski) Department of Medicine, Critical Care, McMaster University,
Hamilton, ON, Canada
(Lamy, Belley-Cote) Department of Medicine, Cardiology and Critical Care,
McMaster University, Hamilton, ON, Canada
(Jacobsohn) Departments of Anesthesia and Perioperative Medicine and
Medicine, Critical Care, University of Manitoba, Winnipeg, MB, Canada
Publisher
American Medical Association
Abstract
Importance: Delirium is common after cardiac surgery and associated with
adverse outcomes. Intraoperative benzodiazepines may increase
postoperative delirium but restricting intraoperative benzodiazepines has
not yet been evaluated in a randomized trial. Objective(s): To
determine whether an institutional policy of restricted intraoperative
benzodiazepine administration reduced the incidence of postoperative
delirium. Design, Setting, and Participant(s): This pragmatic,
multiperiod, patient- and assessor-blinded, cluster randomized crossover
trial took place at 20 North American cardiac surgical centers. All adults
undergoing open cardiac surgery at participating centers during the trial
period were included through a waiver of individual patient consent
between November 2019 and December 2022. Intervention(s):
Institutional policies of restrictive vs liberal intraoperative
benzodiazepine administration were compared. Hospitals (clusters) were
randomized to cross between the restricted and liberal benzodiazepine
policies 12 to 18 times over 4-week periods. Main Outcomes and
Measures: The primary outcome was the incidence of delirium within 72
hours of surgery as detected in routine clinical care, using either the
Confusion Assessment Method-Intensive Care Unit or the Intensive Care
Delirium Screening Checklist. Intraoperative awareness by patient report
was assessed as an adverse event. Result(s): During the trial, 19768
patients (mean [SD] age, 65 [12] years; 14528 [73.5%] male) underwent
cardiac surgery, 9827 during restricted benzodiazepine periods and 9941
during liberal benzodiazepine periods. During restricted periods,
clinicians adhered to assigned policy in 8928 patients (90.9%), compared
to 9268 patients (93.2%) during liberal periods. Delirium occurred in 1373
patients (14.0%) during restricted periods and 1485 (14.9%) during liberal
periods (adjusted odds ratio [aOR], 0.92; 95% CI, 0.84-1.01; P =.07). No
patient spontaneously reported intraoperative awareness. Conclusions
and Relevance: In intention-to-treat analyses, restricting benzodiazepines
during cardiac surgery did not reduce delirium incidence but was also not
associated with an increase in the incidence of patient-reported
intraoperative awareness. Given that smaller effect sizes cannot be ruled
out, restriction of benzodiazepines during cardiac surgery may be
considered. Research is required to determine whether restricting
intraoperative benzodiazepines at the patient level can reduce the
incidence of postoperative delirium. Trial Registration:
ClinicalTrials.gov Identifier: NCT03928236. Copyright © 2025
American Medical Association. All rights reserved, including those for
text and data mining, AI training, and similar technologies.

<47>
Accession Number
2038562474
Title
A systematic review on deep learning-enabled coronary CT angiography for
plaque and stenosis quantification and cardiac risk prediction.
Source
European Journal of Radiology Open. 14 (no pagination), 2025. Article
Number: 100652. Date of Publication: 01 Jun 2025.
Author
Kashikar S.; Parihar P.H.; Kasat P.; Bhangale P.; Shrivastava P.
Institution
(Shrivastava, Kashikar, Parihar, Kasat, Bhangale) Department of
Radio-Diagnosis, Jawaharlal Nehru Medical College Wardha, Datta Meghe
Institute of Higher Education and Research (DU), Sawangi (Meghe), Wardha,
India
(Shrivastava) Jawaharlal Nehru Medical College Wardha, Datta Meghe
Institute of Higher Education and Research (DU), Sawangi (Meghe), Wardha,
India
Publisher
Elsevier Ltd
Abstract
Background: Coronary artery disease (CAD) is a major worldwide health
concern, contributing significantly to the global burden of cardiovascular
diseases (CVDs). According to the 2023 World Health Organization (WHO)
report, CVDs account for approximately 17.9 million deaths annually. This
emphasizies the need for advanced diagnostic tools such as coronary
computed tomography angiography (CCTA). The incorporation of deep learning
(DL) technologies could significantly improve CCTA analysis by automating
the quantification of plaque and stenosis, thus enhancing the precision of
cardiac risk assessments. A recent meta-analysis highlights the evolving
role of CCTA in patient management, showing that CCTA-guided diagnosis and
management reduced adverse cardiac events and improved event-free survival
in patients with stable and acute coronary syndromes. Method(s): An
extensive literature search was carried out across various electronic
databases, such as MEDLINE, Embase, and the Cochrane Library. This search
utilized a specific strategy that included both Medical Subject Headings
(MeSH) terms and pertinent keywords. The review adhered to PRISMA
guidelines and focused on studies published between 2019 and 2024 that
employed deep learning (DL) for coronary computed tomography angiography
(CCTA) in patients aged 18 years or older. After implementing specific
inclusion and exclusion criteria, a total of 10 articles were selected for
systematic evaluation regarding quality and bias. Result(s): This
systematic review included a total of 10 studies, demonstrating the high
diagnostic performance and predictive capabilities of various deep
learning models compared to different imaging modalities. This analysis
highlights the effectiveness of these models in enhancing diagnostic
accuracy in imaging techniques. Notably, strong correlations were observed
between DL-derived measurements and intravascular ultrasound findings,
enhancing clinical decision-making and risk stratification for CAD.
 Conclusion(s): Deep learning-enabled CCTA represents a promising
advancement in the quantification of coronary plaques and stenosis,
facilitating improved cardiac risk prediction and enhancing clinical
workflow efficiency. Despite variability in study designs and potential
biases, the findings support the integration of DL technologies into
routine clinical practice for better patient outcomes in CAD
management. Copyright © 2025 The Authors

<48>
Accession Number
2034025714
Title
Effect of Combined Vitamin C and Thiamine Therapy on Myocardial and
Inflammatory Markers in Cardiac Surgery: A Randomized Controlled Clinical
Trial.
Source
Nutrients. 17(6) (no pagination), 2025. Article Number: 1006. Date of
Publication: 01 Mar 2025.
Author
Saetang M.; Wasinwong W.; Oofuvong M.; Tanasansutthiporn J.;
Rattanapittayaporn L.; Petsakul S.; Duangpakdee P.; Rodneam P.; Boonthum
P.; Khunakanan S.; Churuangsuk C.; Sriwimol W.; Chantarokon A.; Nuanjun
K.; Yongsata D.
Institution
(Saetang, Wasinwong, Oofuvong, Tanasansutthiporn, Rattanapittayaporn,
Petsakul, Chantarokon, Nuanjun, Yongsata) Department of Anesthesiology,
Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
(Duangpakdee, Rodneam, Boonthum, Khunakanan) Department of Surgery,
Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
(Churuangsuk) Department of Internal Medicine, Faculty of Medicine, Prince
of Songkla University, Songkhla, Thailand
(Sriwimol) Department of Pathology, Faculty of Medicine, Prince of Songkla
University, Songkhla, Thailand
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Oxidative stress and systemic inflammation during cardiac
surgery can lead to postoperative complications. Although vitamin C and
thiamine (vitamin B1) have individually demonstrated protective effects,
their combined effects remain underexplored. This study aimed to evaluate
the efficacy of combined vitamin C and B1 therapy versus that of vitamin C
alone in reducing inflammatory and cardiac biomarkers and improving
postoperative outcomes in patients undergoing cardiac surgery.
 Method(s): In this prospective, double-blind, randomized controlled
trial, 64 patients scheduled for elective cardiac surgery at a tertiary
care center were randomized to receive either 1000 mg vitamin C or a
combination of 1000 mg vitamin C and 100 mg vitamin B1 at four
perioperative time points. Primary outcomes included changes in
inflammatory biomarkers [C-reactive protein, interleukin-6 (IL-6), and
white blood cells], and cardiac biomarkers [creatine kinase-MB,
Troponin-I, and lactate dehydrogenase]. Secondary outcomes included
hemodynamic parameters and left ventricular function. Result(s):
Compared with vitamin C alone, combined vitamin B1 and vitamin C
significantly reduced postoperative cardiac biomarker levels. IL-6 levels
were significantly lower immediately in the combined group; however, this
effect was not sustained at 24 h post-surgery. Up to 24 h after surgery,
no significant differences in hemodynamic stability or left ventricular
ejection were observed between the groups. Notably, the combined therapy
group demonstrated a lower incidence of postoperative arrhythmias and
shorter dobutamine duration within 24 postoperatively. Conclusion(s):
Combined vitamin C and B1 therapy significantly reduced markers of
myocardial injury and early inflammatory responses (IL-6) in patients
undergoing cardiac surgery, suggesting its potential as a protective
agent. Copyright © 2025 by the authors.

<49>
Accession Number
2038543385
Title
Predictive Effect of GDF-15 on Adverse Outcomes After Cardiovascular
Interventions: A Systematic Review and Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 26(4) (no pagination), 2025. Article
Number: 28279. Date of Publication: 01 Apr 2025.
Author
Jia X.; Gao J.; Qi Z.; Ma J.
Institution
(Jia, Gao, Qi, Ma) Department of Anesthesiology, Beijing Anzhen Hospital,
Capital Medical University, Beijing, China
Publisher
IMR Press Limited
Abstract
Background: This systematic review and meta-analysis aimed to evaluate the
predictive effect of Growth Differentiation Factor-15 (GDF-15) on adverse
outcomes in patients undergoing cardiovascular interventions.
 Method(s): A comprehensive literature search was performed across
PubMed, EMBASE, Cochrane Library, and Web of Science databases. The
meta-analysis used hazard ratios (HR) and odds ratios (OR) to compare
outcomes such as all-cause mortality, cardiovascular death, postoperative
atrial fibrillation (AF), acute kidney injury (AKI), and spontaneous
myocardial infarction (MI) between high GDF-15 levels and control groups.
Subgroup analyses were conducted based on study design and GDF-15 cutoff
levels. Publication bias was evaluated using funnel plot and Egger's test.
 Result(s): A total of 13 studies were included in the meta-analysis.
The study revealed a significant association between elevated GDF-15
levels and increased all-cause mortality. Subgroup analysis showed a
significant association in retrospective studies but not in prospective
studies. Higher GDF-15 cutoff levels (>2 ng/mL) were more strongly
associated with increased mortality than lower cutoff levels (<=2 ng/mL).
Elevated GDF-15 levels were found to be significantly associated with
increased risks of cardiovascular death, AKI, and spontaneous MI. No
significant difference was observed in the incidence of postoperative AF.
The overall adverse outcomes analysis showed no significant difference.
Subgroup analyses suggested significant associations primarily observed in
studies with higher GDF-15 cutoffs. Conclusion(s): Elevated GDF-15
levels are associated with increased risks of all-cause mortality,
cardiovascular death, AKI, and spontaneous MI in patients undergoing
cardiovascular interventions. Due to the heterogeneity of the studies,
including variations in surgical techniques, the conclusions should be
interpreted with caution. The PROSPERO Registration: CRD42024582279,
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024582279. Copyright
© 2025 The Author(s).

<50>
Accession Number
2035743727
Title
The influence of antiplatelet drugs on outcomes of spinal surgery: a
systematic review and meta-analysis.
Source
Orthopaedics and Traumatology: Surgery and Research. 111(3) (no
pagination), 2025. Article Number: 104035. Date of Publication: 01 May
2025.
Author
Yu J.; Hou L.; Fan L.; Wang H.; Jin X.; Zhou H.
Institution
(Yu, Hou, Fan, Wang, Jin, Zhou) Department of Orthopedics, Zhejiang Jinhua
Guangfu Cancer Hospital, Zhejiang Province, Jinhua City, China
Publisher
Elsevier Masson s.r.l.
Abstract
Introduction: The management of antiplatelet therapy (APT) in patients
undergoing spinal surgery is complex, requiring balancing the risks of
thromboembolic events against those of potential perioperative bleeding.
This review evaluates the effects of continuing versus discontinuing APT
on the surgical outcomes of spinal surgery. Hypothesis: The hypothesis is
that continuing antiplatelet therapy (APT) in patients undergoing spinal
surgery will not significantly increase intraoperative blood loss,
operative time, or postoperative complications compared to discontinuing
APT, but may lead to a higher need for postoperative transfusions.
 Material(s) and Method(s): Systematic search was done in EMBASE,
Scopus, PubMed Central, Google Scholar, and ScienceDirect databases for
studies comparing the continuation of APT to its discontinuation in terms
of estimated blood loss, operative time, hospital stay length,
postoperative transfusion units, postoperative complications,
postoperative hematoma, readmission rate, cardiovascular events amongst
patients undergoing spinal surgery. Risk of bias was assessed with the
Newcastle Ottawa scale and synthesized the data using random-effects
meta-analyses, summarizing outcome results as either standardized mean
differences (SMDs) or odds ratios (ORs) as appropriate. Result(s): 13
studies were included in meta-analysis. Similar estimated blood losses
(SMD = 0.125; 95%CI, -0.087 to 0.337) and operative times (SMD = 0.231;
95%CI, -0.225 to 0.687) were found between the patients who continued and
those who discontinued the APT. However, patients who continued APT had a
slightly higher chance of requiring postoperative transfusions (SMD =
0.244; 95%CI, 0.030 to 0.458). Similar hospital stay lengths, and
postoperative complication or cardiovascular event rates were found.
 Discussion(s): Continuing APT during spinal surgery does not
significantly increase the risks of intraoperative blood loss or increase
the operative time, however; it may increase the need for postoperative
transfusions. These findings suggest that for patients at risk of
thromboembolic events, the benefits of continuing APT outweigh the risks.
 Level of Evidence: III; Systematic Review and
Meta-analysis Copyright © 2024 Elsevier Masson SAS

<51>
[Use Link to view the full text]
Accession Number
2038244062
Title
Effect of Disclosing a Polygenic Risk Score for Coronary Heart Disease on
Adverse Cardiovascular Events.
Source
Circulation: Genomic and Precision Medicine. 18(2) (pp e004968), 2025.
Date of Publication: 01 Apr 2025.
Author
Naderian M.; Hamed M.E.; Vaseem A.A.; Norland K.; Dikilitas O.;
Teymourzadeh A.; Bailey K.R.; Kullo I.J.
Institution
(Naderian, Hamed, Vaseem, Norland, Teymourzadeh, Kullo) Department of
Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
(Dikilitas) Department of Internal Medicine, Mayo Clinic, Rochester, MN,
United States
(Bailey) Department of Quantitative Health Sciences, Mayo Clinic,
Rochester, MN, United States
(Kullo) Gonda Vascular Center, Mayo Clinic, Rochester, MN, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: In the Myocardial Infarction Genes clinical trial (URL:
https://www.clinicaltrials.gov; Unique identifier: NCT01936675),
participants at intermediate risk of coronary heart disease (CHD) were
randomized to receive a Framingham risk score (Framingham risk score
group, n=103) or an integrated risk score (integrated risk score group
[IRSg], n=104) that additionally included a polygenic risk score. After 6
months, IRSg participants had higher statin initiation and lower
low-density lipoprotein cholesterol. We conducted a post hoc 10-year
follow-up analysis to investigate whether disclosure of a polygenic risk
score for CHD was associated with a reduction in major adverse
cardiovascular events (MACE). METHOD(S): Participants were followed
from randomization in October 2013 to September 2023 to ascertain MACE,
testing for CHD, and changes in risk factors. The primary outcome was time
to first MACE, defined as cardiovascular death, nonfatal myocardial
infarction, coronary revascularization, and nonfatal stroke. Statistical
analyses included Cox proportional hazards regression and linear
mixed-effects models. RESULT(S): We followed all participants who
completed the trial, 100 in Framingham risk score group and 103 in IRSg
(mean age at the end of follow-up, 68.2+/-5.2; 48% male). During a median
follow-up of 9.5 years, 9 MACEs occurred in Framingham risk score group
and 2 in IRSg (hazard ratio, 0.20 [95% CI, 0.04-0.94]; P=0.042). In
Framingham risk score group, 47 (47%) underwent at least 1 diagnostic test
for CHD, compared with 30 (29%) in IRSg (hazard ratio, 0.51 [95% CI,
0.32-0.81]; P=0.004). A higher proportion of IRSg participants were on
statin therapy during the first 4 years postrandomization and had a
greater reduction in low-density lipoprotein cholesterol for up to 3 years
postrandomization. No significant differences were observed between 2
groups in other traditional cardiovascular risk factors during follow-up.
 CONCLUSION(S): Disclosure of an integrated risk score that included a
polygenic risk score to individuals at intermediate risk for CHD was
associated with lower MACE incidence after 10 years, likely due to higher
statin initiation, leading to lower low-density lipoprotein cholesterol
levels. Copyright © 2025 American Heart Association, Inc.

<52>
Accession Number
2034333632
Title
Frailty in Cardiac Surgery-Assessment Tools, Impact on Outcomes, and
Optimisation Strategies: A Narrative Review.
Source
Journal of Cardiovascular Development and Disease. 12(4) (no pagination),
2025. Article Number: 127. Date of Publication: 01 Apr 2025.
Author
Chandiramani A.; Ali J.M.
Institution
(Chandiramani) Department of Cardiology, Royal Papworth Hospital,
Cambridge, United Kingdom
(Ali) Department of Cardiac Surgery, Royal Papworth Hospital, Cambridge,
United Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Advancements in surgical care have made it possible to offer
cardiac surgery to an older and frailer patient cohort. Frailty has been
recognised as a prognostic indicator that impacts post-operative recovery
and patient outcomes. The aim of this study is to identify frailty
assessment tools, evaluate the impact of frailty on post-operative
outcomes, and explore strategies to optimise care for frail patients
undergoing cardiac surgery. Method(s): A comprehensive literature
search was performed across PubMed, MEDLINE, and SCOPUS to identify
articles reporting post-operative outcomes related to frail patients
undergoing cardiac surgery. Result(s): Measurement tools such as gait
speed, the Clinical Frailty Scale, Fried frailty phenotype, deficit
accumulation frailty index and the Short Physical Performance Battery can
be used to assess frailty. Frailty has been reported to increase the risk
of post-operative morbidity and mortality. Multiple studies have also
reported the association between frailty and an increased length of
intensive care unit and hospital stays, as well as an increased risk of
post-operative delirium. It is important to perform a comprehensive
frailty assessment and implement perioperative optimisation strategies to
improve outcomes in this patient population. Pre-operative strategies that
can be considered include adequate nutritional support, cardiac
prehabilitation, and assessing patients using a multidisciplinary team
approach with geriatric involvement. Post-operatively, interventions such
as early recognition and treatment of post-operative delirium, nutrition
optimisation, early planning for cardiac rehabilitation, and occupational
therapy can support patients' recovery and reintegration into daily
activities. Conclusion(s): The early identification of frail patients
during the perioperative period is essential for risk stratification and
tailored management strategies to minimise the impact of frailty on
outcomes following cardiac surgery. Copyright © 2025 by the
authors.

<53>
Accession Number
2038543148
Title
Economic Evaluations in Electrophysiology in the Last 15 Years: A
Systematic Review of the Literature.
Source
Reviews in Cardiovascular Medicine. 26(4) (no pagination), 2025. Article
Number: 36206. Date of Publication: 01 Apr 2025.
Author
Mei D.A.; Imberti J.F.; Vitolo M.; Bonini N.; Casali E.; Osoro L.;
Casado-Arroyo R.; Boriani G.
Institution
(Mei, Imberti, Vitolo, Bonini, Casali, Boriani) Cardiology Division,
Department of Biomedical, Metabolic and Neural Sciences, University of
Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
(Mei) Clinical and Experimental Medicine PhD Program, University of Modena
and Reggio Emilia, Modena, Italy
(Mei, Osoro, Casado-Arroyo) Advocacy, Quality Improvement and Health
Economics (AQIHEC) Committee, EHRA, Sophia Antipolis, France
(Osoro, Casado-Arroyo) Department of Cardiology, H.U.B.-Hopital Erasme,
Universite Libre de Bruxelles, Bruxelles, Belgium
Publisher
IMR Press Limited
Abstract
Background: Electrophysiology (EP) procedures, including cardiac
implantable electronic devices (CIEDs) and ablations, are widely used to
manage arrhythmias and heart failure. These interventions, though
effective, require substantial resources, prompting the need for
systematic economic evaluations to inform healthcare decision-making.
 Method(s): A systematic review of studies from 2007 to 2024 was
conducted in two phases. Phase one assessed trends in economic evaluations
of EP procedures, analyzing 129 studies across regions and timeframes.
Phase two focused on cost-effectiveness analyses of implantable
cardioverter defibrillators (ICDs), cardiac resynchronization therapy
defibrillators (CRT-Ds), and atrial fibrillation (AF) ablation, examining
outcomes like quality-adjusted life years (QALYs) and incremental
cost-effectiveness ratios (ICERs), while identifying factors influencing
economic results. Result(s): EP procedures generally demonstrated
favorable cost-effectiveness, particularly in high-income regions. Studies
on ICDs and CRT-Ds consistently supported their economic value for
patients with arrhythmias or heart failure, while AF ablation showed
potential for long-term benefits, particularly when compared to medical
therapies. However, results varied by region, reflecting differences in
healthcare systems, costs, and patient populations. Conclusion(s):
The review highlights the overall cost-effectiveness of EP procedures in
many settings but underscores the need for tailored economic evaluations
in low- and middle-income countries. Simplified methodologies and greater
attention to regional contexts are recommended to guide resource
allocation and policy development globally. Copyright © 2025 The
Author(s).

<54>
Accession Number
2034368399
Title
Vascular Closure Devices for Large Bore Femoral Access After Transfemoral
Transcatheter Aortic Valve Replacement: A Network Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Upadhaya S.; Upreti A.; Gupta K.; Gonzalez-Perez B.; Ksayer R.; Cox-Alomar
P.; Sanina C.; Irimpen A.; Farhan S.; Wiley J.
Institution
(Upadhaya, Gonzalez-Perez, Ksayer, Sanina, Wiley) Department of Internal
Medicine, Section of Cardiology, Tulane University School of Medicine, New
Orleans, LA, United States
(Upreti) Department of Biomedical Sciences, Tulane University School of
Medicine, New Orleans, LA, United States
(Gupta, Irimpen) Department of Internal Medicine, Case Western Reserve
University, Cleveland, OH, United States
(Cox-Alomar) Department of Medicine, Section of Cardiology, University of
Miami, Miami, FL, United States
(Farhan) Department of Medicine, Division of Cardiology, Lenox Hill
Hospital, Northwell Health, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background and Aims: Large-bore femoral access is commonly required in
transfemoral transcatheter aortic valve replacement (TF-TAVR), but
vascular access complications remain prevalent, impacting patient
outcomes. Various vascular closure devices (VCDs) are used for hemostasis,
including the suture-based Prostar XL, Perclose ProGlide, and ProStyle,
and the plug-based MANTA device. However, comprehensive comparative
evidence on these VCDs, particularly single Perclose strategies, is
lacking. Method(s): A systematic review and network meta-analysis
were conducted according to PRISMA guidelines. We included randomized and
observational studies comparing the safety and efficacy of VCDs for
large-bore femoral access closure in TF-TAVR patients. Primary outcomes
included major vascular complications; secondary outcomes included major
and minor bleeding, minor vascular complications, VCD failure, and
all-cause mortality. Frequentist and Bayesian analyses were performed
using a random-effects model, with additional subgroup analyses of single
Perclose strategies. Result(s): Thirty-five studies comprising 16,503
patients met inclusion criteria. The single Perclose strategy, with or
without adjunct Angio-Seal or FemoSeal, significantly reduced major
vascular complications compared to dual Perclose (RR: 1.9, 95% CI
[1.2-3.01]), MANTA (RR: 1.89, 95% CI [1.03-3.48]), and Prostar XL (RR:
3.46, 95% CI [1.94-6.18]). Among secondary outcomes, single Perclose also
ranked highest in reducing minor complications and bleeding.
 Conclusion(s): Single Perclose strategies, especially when combined
with Angio-Seal, demonstrated superior safety and efficacy for large-bore
femoral access closure following TF-TAVR. These findings support the need
for further randomized trials to validate single Perclose as a primary
approach in TF-TAVR vascular closure. Copyright © 2025 Wiley
Periodicals LLC.

<55>
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. 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. 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.
 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. Copyright © The Author(s) 2025.

<56>
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. 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. 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.
 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. 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. Copyright © 2025 Wiley Periodicals LLC.

<57>
Accession Number
2034368011
Title
Combined Use of Dexmedetomidine and Hydrocortisone to Prevent New-Onset
Atrial Fibrillation After Coronary Artery Bypass Grafting Surgery: A
Randomized Clinical Trial.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination),
2025. Date of Publication: 2025.
Author
Alhadidy M.A.; Alansary A.M.; Elghareeb S.H.
Institution
(Alhadidy, Alansary, Elghareeb) Department of Anesthesiology, ICU and Pain
Management, Ain Shams University, Cairo, Egypt
Publisher
SAGE Publications Inc.
Abstract
Objective: Postoperative atrial fibrillation (POAF) occurs in 20%-40% of
patients following coronary artery bypass grafting (CABG), contributing to
significant morbidity. POAF is linked to elevated catecholamines,
oxidative stress, and inflammatory mediators. Dexmedetomidine, a centrally
acting alpha-2 agonist with sympatholytic and anti-inflammatory effects,
and hydrocortisone, which suppresses inflammatory mediators, may reduce
the incidence of POAF. Method(s): A prospective, double-blind
randomized controlled trial was conducted on 248 patients undergoing
elective on-pump CABG at Ain Shams University Hospital. Patients were
randomized into 2 groups: the Treatment Group received dexmedetomidine and
hydrocortisone, and the Placebo Group received standard care. The primary
endpoint was the occurrence of POAF within 7 days postoperatively.
 Result(s): All 248 patients (124 per group) completed the study. The
combined use of dexmedetomidine and hydrocortisone reduced POAF incidence
(4.8% vs 12.9%). ICU and hospital length of stay were also shorter in the
Treatment Group (2.77 +/- 1.12 vs 3.16 +/- 1.34 days, P =.012, and 6.63
+/- 1.56 vs 7.11 +/- 2 days, P =.035, respectively). No differences in
hypotension, bradycardia, or wound infections were observed.
Hyperglycemia, defined as blood glucose >180 mg/dl, occurred in 8.1% of
the Treatment Group and 6.5% of the Placebo Group. Conclusion(s):
Combining dexmedetomidine and hydrocortisone effectively reduces POAF
incidence after CABG, with manageable side effects. Multicenter trials are
warranted to confirm these findings. Date and Number of IRB Approval and
Clinical Trial Registry Number. Ain Shams University Protocol Record
(FMASU R 261/2022), ClinicalTrials.gov Identifier:
NCT05674253. Copyright © The Author(s) 2025.

<58>
Accession Number
2038074236
Title
Mitral Valve Surgery After Failed Transcatheter Edge-to-Edge Repair: A
Meta-Analysis.
Source
Canadian Journal of Cardiology. 41(5) (pp 813-828), 2025. Date of
Publication: 01 May 2025.
Author
Cabrucci F.; Baudo M.; Magouliotis D.E.; Yamashita Y.; Kjelstrom S.;
Bacchi B.; Bonacchi M.; Dokollari A.; Sicouri S.; Ramlawi B.
Institution
(Cabrucci, Baudo, Magouliotis, Yamashita, Kjelstrom, Dokollari, Sicouri,
Ramlawi) Department of Cardiac Surgery Research, Lankenau Institute for
Medical Research, Main Line Health, Wynnewood, PA, United States
(Yamashita, Ramlawi) Department of Cardiac Surgery, Lankenau Heart
Institute, Main Line Health, Wynnewood, PA, United States
(Bacchi, Bonacchi) Department of Cardiac Surgery, AOU Careggi University
Hospital, Firenze, Italy
(Dokollari) Department of Cardiac Surgery, St Boniface Hospital,
University of Manitoba, Winnipeg, Canada
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter edge-to-edge repair (TEER) is increasingly used
for mitral regurgitation (MR), particularly in high-risk patients.
However, when TEER fails, patients often require mitral valve surgery,
which remains challenging because of patients' compromised condition. This
study aims to evaluate short- and long-term surgical outcomes following
failed TEER. Method(s): This meta-analysis included observational
studies with reported outcomes of mitral valve surgery after failed TEER
published until September 2024. Multivariable meta-regressions were
performed to predict short- and long-term mortality. Kaplan-Meier function
was reconstructed from individual studies. Result(s): Sixteen studies
were included with a total sample of 892 patients. The mean age was 74.8
years (55% males), with most patients (87.8%) in New York Heart
Association class III or IV before surgery. Pooled mean Society of
Thoracic Surgeons (STS) predicted risk of mortality score before index
TEER was 6.3%. Surgical indications were recurrent MR >=3+ (93%), mitral
stenosis (17%), and endocarditis (2.7%). The average time between TEER and
surgery was 6.4 months. Mitral valve replacement was performed in 83.8% of
cases. Thirty-day all-cause mortality was 12.2% but significantly lower
for elective cases (2.5%). At a mean follow-up of 14.7 months, mortality
was 28.3%. Preoperative incidence of coronary artery disease, lower left
ventricle ejection fraction (LVEF), rate of concomitant procedures, and
functional mitral regurgitation were predictors of short- and long-term
outcomes. Conclusion(s): Mitral valve surgery after failed TEER
presents significant challenges, yet acceptable outcomes are achievable,
particularly in elective cases. Complete treatment of concomitant lesions
may improve outcomes in patients with preserved LVEF. Future research
should stratify outcomes based on emergent vs elective surgery and MR
etiology to guide tailored surgical strategies. Copyright © 2025
Canadian Cardiovascular Society

<59>
Accession Number
2038499255
Title
Efficacy of enhanced recovery programmes for cardiac surgery: a systematic
review and meta-analysis.
Source
British Journal of Anaesthesia. (no pagination), 2025. Date of
Publication: 2025.
Author
Hoogma D.F.; Meeusen I.; Coppens S.; Verbrugghe P.; van den Eynde J.;
Engelman D.T.; Grant M.C.; Stoppe C.; Rex S.
Institution
(Hoogma, Coppens, Rex) Department of Anesthesiology, University Hospitals
Leuven, KU Leuven, Leuven, Belgium
(Hoogma, Coppens, Verbrugghe, van den Eynde, Rex) Biomedical Sciences
Group, Department of Cardiovascular Sciences, University of Leuven, KU
Leuven, Leuven, Belgium
(Meeusen) Biomedical Sciences, University of Leuven, KU Leuven, Leuven,
Belgium
(Verbrugghe) Department of Cardiac Surgery, University Hospitals Leuven,
KU Leuven, Leuven, Belgium
(Engelman) Heart and Vascular Program, Baystate Medical Center,
Springfield, MA, United States
(Grant) Department of Anesthesiology and Critical Care Medicine, Johns
Hopkins University School of Medicine, Baltimore, MD, United States
(Stoppe) Department of Anaesthesiology, Intensive Care, Emergency and Pain
Medicine, University Hospital Wurzburg, Wurzburg, Germany
(Stoppe) Department of Cardiac Anesthesiology and Intensive Care Medicine,
Charite Berlin, Berlin, Germany
Publisher
Elsevier Ltd
Abstract
Background: The terms fast-track (FT) and enhanced recovery after surgery
(ERAS) are often mistakenly used interchangeably. Fast-track cardiac
anaesthesia focuses on perioperative strategies, whereas ERAS (or enhanced
recovery programme [ERP]) encompasses a wider range of strategies designed
to enhance overall recovery. Evidence is needed to demonstrate the
additive value of ERP above FT in cardiac surgery. We conducted a
meta-analysis to investigate the comparative efficacy of ERP and FT
programmes in cardiac surgery. Method(s): We systematically searched
PubMed, Embase, and Web of Science for randomised trials and prospective
observational trials investigating ERP or FT programmes in cardiac surgery
(up to November 16, 2024). Following PRISMA guidelines, two reviewers
independently selected studies, extracted data, and assessed risk of bias.
Data were pooled using a random-effects model. The primary efficacy
outcome was hospital length of stay (LOS). Result(s): A total of 6368
articles were identified, of which 18 studies, with 2625 patients, were
included. Compared with control, a significant reduction in hospital LOS
(mean difference [95% confidence interval (CI)] -1.40 days [-2.19 to
-0.61], P=0.001), ICU LOS (-13.22 h [-21.75 to -4.68], P=0.006), and
ventilation time (-4.68 h [-7.85 to -1.52], P=0.008) was identified when
ERP or FT programmes were implemented. ERP demonstrated an additive value
above FT for hospital LOS (2.11 days [-3.52 to 0.71] vs -0.30 days [-0.88
to 0.27], respectively; P=0.003). Conclusion(s): In cardiac surgery,
ERP can reduce LOS in the ICU and hospital and ventilatory time. Moreover,
it is suggested that ERPs, including preoperative, intraoperative, and
postoperative interventions, are preferred above only intraoperative FT
strategies. Systematic review protocol: PROSPERO
(CRD42022382409). Copyright © 2025 British Journal of Anaesthesia

<60>
Accession Number
2038643600
Title
Comparison of single and double chest drains following pulmonary
lobectomy.
Source
PLoS ONE. 20(5 May) (no pagination), 2025. Article Number: e0319077. Date
of Publication: 01 May 2025.
Author
Elmezayen A.; Osama A.; Elbendary A.S.; Abdelbar A.
Institution
(Elmezayen) Cardiothoracic Surgery Department, Faculty of Medicine, Tanta
University, Tanta, Egypt
(Elmezayen) Basildon University Hospital, London, United Kingdom
(Osama) Pediatrics Department, Mabara Hospital, Ministry of Health, Tanta,
Egypt
(Elbendary) Clinical Pathology Department, Faculty of Medicine, Tanta
University, Tanta, Egypt
(Abdelbar) Cardiothoracic Surgery Department, Manchester University NHS
Foundation Trust, Manchester, United Kingdom
Publisher
Public Library of Science
Abstract
Background Chest tubes are commonly used to empty the chest cavity after
pulmonary lobectomy. Although two drains have traditionally been used to
guarantee proper air and fluid evacuation, they frequently cause patients
more pain and lengthen their hospital stays. This study set out to compare
the effectiveness of using a single chest drain versus using two chest
drains after a pulmonary lobectomy. Methods This retrospective trial was
performed on 50 patients aged >=18 years, both sexes, scheduled for
Video-Assisted Thoracic Surgery (VATS) lobectomy. Patients were divided
into two equal groups: Group S: single chest tube was used and Group D:
double chest tubes were used. Results The duration of drainage was 3.32
+/- 0.69 days in group S and was 4.2 +/- 1.29 days in group D (P < 0.05).
The amount of drainage was 593.64 +/- 45.94 ml in group S and was 910.04
+/- 71.42 ml in group D (P < 0.05). Assessment of the pain using the
visual analog scale on second day was insignificantly different between
both groups and was significantly lower at the second postoperative week
in group S than in group D (P = 0.005). Length of hospital stays and
complications (pneumonia, re-drainage, and persistent air leak (> 7 days))
were insignificantly different between both groups. Conclusions The
effectiveness of inserting one chest tube following a pulmonary lobectomy
is comparable to that of inserting two tubes. Furthermore, employing a
single tube is more advantageous than two tubes, as it is associated with
lower postoperative pain, duration and amount of drainage. Copyright
© 2025 Elmezayen et al.

<61>
Accession Number
2038644425
Title
Achieving Neuroprotection in the Setting of Early Extubation During Infant
Cardiac Surgery: A Prospective, Randomized, and Blinded Study.
Source
Cardiology Research. 16(3) (pp 178-188), 2025. Date of Publication: 2025.
Author
Naguib A.N.; Bozych M.; McNally K.; Galantowicz M.; Tobias J.
Institution
(Naguib, Bozych, Tobias) Departments of Anesthesiology and Pediatrics,
Nationwide Children's Hospital, The Ohio State University College of
Medicine, Columbus, OH, United States
(Naguib, Galantowicz) The Heart Center, Nationwide Children's Hospital,
The Ohio State University College of Medicine, Columbus, OH, United States
(McNally) Department of Pediatric Psychology and Neuropsychology,
Nationwide Children's Hospital, The Ohio State University College of
Medicine, Columbus, OH, United States
Publisher
Elmer Press
Abstract
Background: This study aimed to investigate the impact of early extubation
on stress response and neurodevelopmental outcomes after pediatric cardiac
surgery utilizing cardiopulmonary bypass (CPB). Method(s): In this
single-center prospective pilot study, we attempted to study the impact of
using dexmedetomidine as an adjunct to facilitate early extubation after
pediatric cardiac surgery requiring CPB during the first year of life. The
study was conducted between May 2014 and January 2020. Perioperative data
and stress hormone levels were collected at different points during the
perioperative period. In addition, neurodevelopmental outcome measures
including cognitive composite score, language (expressive and receptive)
and motor (fine and gross) composites were evaluated at five time points
including prior to surgery and up to 1 year after the procedure.
Two-sample ttests and Kruskal-Wallis tests were used to compare continuous
parametric and non-parametric outcomes, respectively. Fisher's exact or
Chi-squared tests were used to compare categorical outcomes.
 Result(s): A total of 30 subjects were included in the final cohort
of patients. Of the 30 subjects, 14 patients were randomized to the
dexmedetomidine group (dexmedetomidine plus fentanyl) (DEX group) and 16
patients were randomized to the no dexmedetomidine group (fentanyl only)
(no DEX group). With few exceptions, both groups demonstrated appropriate
blunting of the stress response. There was a significant increase in the
ratio of the pro-inflammatory interleukin-10 (IL-10) to the
anti-inflammatory interleukin-6 (IL-6) for the no DEX group at the end of
the procedure when compared to the DEX group (10 +/- 9 vs. 5 +/- 4, P =
0.04). When looking at the Bayley cognitive composite score, the DEX group
scored better than the no DEX group during the second visit (102 +/- 11
vs. 88 +/- 17, P = 0.023). By the fifth visit, the two groups scored
similarly (94 +/- 12 vs. 94 +/- 12, P = 0.9 for the no DEX and DEX groups,
respectively). Conclusion(s): When looking at the neurodevelopmental
outcome, both groups had no significant changes in their Bayley scores
from baseline with blunting of most stress markers. This study offers
possible evidence of the safety of early extubation after pediatric
cardiac surgery while maintaining the goal of
neuroprotection. Copyright © The authors

<62>
Accession Number
2038687282
Title
Lung isolation with a bronchial blocker placed in the lateral position for
patients undergoing thoracic surgery: A multicenter, randomized clinical
trial.
Source
Journal of Clinical Anesthesia. 104 (no pagination), 2025. Article Number:
111869. Date of Publication: 01 Jun 2025.
Author
Li H.; Chu L.; Ye H.; Zhang Y.; Li M.; Hua Y.; Zhang J.; Hu H.; Wen T.;
Zhao J.; Wan H.; Huang L.; Lou Y.; Tang J.; Yan Z.; Duan G.; Wu J.; Wang
C.; Lu Y.; Shen X.; Huang C.; Song C.; Wang Y.; Zeng C.; Xie G.; Fang X.
Institution
(Li, Chu, Ye, Zhang, Li, Hua, Zhang, Hu, Wen, Zhao, Wan, Huang, Lou, Wang,
Xie, Fang) Department of Anesthesiology, The First Affiliated Hospital,
Zhejiang University School of Medicine, Hangzhou, China
(Zhang, Wan) Department of Anesthesiology, Hangzhou Red Cross Hospital,
Hangzhou, China
(Li) Department of Anesthesiology, The First Hospital of Fuyang, Hangzhou,
China
(Zhao) Department of Anesthesiology, Sir Run Run Shaw Hospital, School of
Medicine, Zhejiang University, Hangzhou, China
(Tang, Yan) Department of Anesthesiology, Affiliated Hospital of Guangdong
Medical University, Zhanjiang, China
(Duan, Wu) Department of Anesthesiology, Lishui People's Hospital, Lishui,
China
(Wang) Department of Anesthesiology, Lishui Central Hospital, Lishui,
China
(Lu, Shen) Department of Anesthesiology, The First Hospital of Jiaxing;
Jiaxing, China
(Huang, Song) Department of Anesthesiology, Affiliated Hospital of
Shaoxing University, Shaoxing, China
(Zeng) Department of Anesthesiology, Vagelos College of Physicians and
Surgeons, Columbia University, New York, United States
Publisher
Elsevier Inc.
Abstract
Study objective Accurate bronchial blocker placement is essential for
effective lung isolation during thoracic surgery. Approximately one-third
of patients experience bronchial blocker malposition during the transition
from the supine to lateral decubitus position. It has been unclear whether
bronchial blocker placement directly in the lateral position can reduce
the incidence of malposition. This study investigated the incidence of
bronchial blocker malposition in the lateral versus supine position and
evaluated the effectiveness of lateral placement. Patient(s): Adults
aged >=18 years scheduled for thoracic surgery were enrolled.
 Setting(s): Seven tertiary hospitals in China. Intervention(s):
Bronchial blockers were placed either in the lateral or supine position.
Measurements: The primary outcome was the incidence of bronchial blocker
malposition. Secondary outcomes included the times of bronchial blocker
reposition, perioperative complications, intubation duration, and
satisfaction scores. Main Result(s): Among 324 patients who underwent
randomization, 306 completed the study (152 in the lateral group and 154
in the supine group). The incidence of bronchial blocker malposition was
significantly lower in the lateral group (1/152 (0.7 %)) than in the
supine group 39/154 (25.3 %), P < 0.001). The times of bronchial blocker
reposition was also lower in the lateral group (median [interquartile
range]: 0 [0,0]) than in the supine group (1.0 [1.0, 2.0], P < 0.001).
Lateral bronchial blocker placement was associated with lower incidences
of postural injury (P < 0.001). The median intubation duration
(single-lumen tube intubation plus bronchial blocker placement) was
similar between the two groups (P = 0.089). Patients and surgeons reported
higher satisfaction scores in the lateral group (P < 0.001).
 Conclusion(s): Lateral bronchial blocker placement reduced the
incidence of malposition in patients undergoing thoracic surgery; it was
associated with fewer complications and higher satisfaction scores. These
findings indicate that lateral placement is an effective approach with
substantial advantages over conventional supine placement. Clinial trial
registration: NCT05482230. Copyright © 2025

<63>
Accession Number
2038630043
Title
No-touch vein grafts in coronary artery bypass surgery: a registry-based
randomized clinical trial.
Source
European Heart Journal. 46(18) (pp 1720-1729), 2025. Date of Publication:
07 May 2025.
Author
Thelin S.; Modrau I.S.; Duvernoy O.; Daln M.; Dreifaldt M.; Ericsson A.;
Friberg O.; Holmgren A.; Hostrup Nielsen P.; Hultkvist H.; Jensevik
Eriksson K.; Jeppsson A.; Lidn M.; Nozohoor S.; Ragnarsson S.; Sartipy U.;
Ternstrom L.; Themudo R.; Vikholm P.; James S.
Institution
(Thelin, Vikholm) Department of Thoracic Surgery, Uppsala University
Hospital, Uppsala, Sweden
(Thelin, Vikholm) Department of Surgical Sciences,Thoracic Surgery,
Uppsala University, Sweden
(Modrau, Hostrup Nielsen) Department of Cardiothoracic and Vascular
Surgery, Aarhus University Hospital, Aarhus, Denmark
(Modrau) Department of Clinical Medicine, Aarhus University, Aarhus,
Denmark
(Duvernoy) Department of Surgical Sciences, Radiology, Uppsala University
, Sweden
(Daln, Sartipy) Department of Cardiothoracic Surgery, Karolinska
University Hospital, Stockholm, Sweden
(Daln, Sartipy) Department of Molecular Medicine and Surgery, Karolinska
Institutet, Stockholm, Sweden
(Dreifaldt, Friberg) Department of Cardiovascular and Thoracic Surgery,
ORebro University, Sweden
(Ericsson) Department of Thoracic Surgery, Blekinge Hospital, Karlskrona,
Sweden
(Holmgren) Department of Public Health and Clinical Medicine, Umea
University, Umea, Sweden
(Hultkvist) Department of Cardiothoracic and Vascular Surgery, Linkoping
University Hospital, Linkoping, Sweden
(Hultkvist) Department of Health, Medicine and Caring Sciences, Unit of
Cardiovascular Medicine, Linkoping University, Linkoping, Sweden
(Jensevik Eriksson, James) Uppsala Clinical Research Center, Uppsala
University, Dag Hammarskjolds vag , Uppsala, Sweden
(Jeppsson, Ternstrom) Department of Cardiothoracic Surgery, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Jeppsson) Department of Molecular and Clinical Medicine, Sahlgrenska
Academy, Institute of Medicine, University of Gothenburg, Gothenburg,
Sweden
(Lidn) Department of Radiology, Faculty of Medicine and Health, ORebro
University, Orebro, Sweden
(Nozohoor, Ragnarsson) Department of Cardiothoracic and Vascular Surgery,
Skane University Hospital, Lund, Sweden
(Nozohoor, Ragnarsson) Department of Clinical Sciences, Lund University,
Lund, Sweden
(Themudo) Department of Clinical Science, Intervention and Technology,
Karolinska Institutet, Stockholm, Sweden
(James) Department of Medical Sciences, Cardiology, Uppsala University
Hospital, Uppsala, Sweden
Publisher
Oxford University Press
Abstract
Background and Aims: No-touch saphenous vein harvesting may enhance graft
patency and improve clinical outcomes after coronary artery bypass
grafting (CABG). Method(s): In this registry-based, randomized trial,
patients undergoing CABG were randomly assigned to no-touch or
conventional harvesting. The primary composite outcome was the proportion
of patients with occluded/stenosed >50% vein graft on coronary computed
tomography angiography, or who underwent percutaneous coronary
intervention to a vein graft, or died. Secondary outcomes included
clinical outcomes and leg wound complications. Result(s): A total of
902 patients were enrolled with a mean total number of distal vein
anastomoses of 2.0 (SD 0.87). The primary endpoint occurred in 90/454
(19.8%) of patients randomized to no-touch and in 107/446 (24.0%) of
patients randomized to the conventional technique [difference, -4.3
percentage points; 95% confidence interval (CI) -10.1-1.6; P =. 15] at a
mean follow-up time of 3.5 (SD 0.1) years. The composite of death,
myocardial infarction, or repeat revascularization at 4.4 (SD 1.3) years
occurred in 57/454 (12.6%) and 44/446 (9.9%) in the no-touch and
conventional groups, respectively (hazard ratio 1.3; 95% CI, 0.87-1.93).
Leg wound complications were more common in patients assigned to no-touch
harvesting at 3 months [107/433 (24.7%) vs. 59/427 (13.8%); difference,
10.9 percentage points; 95% CI 5.7-16.1]. At 2 years, 189/381 (49.6%) vs.
91/361 (25.2%) had remaining leg symptoms (difference, 24.4 percentage
points; 95% CI 17.7-31.1). Conclusion(s): No-touch vein graft
harvesting for CABG was not superior to conventional open harvesting in
reducing vein graft failure or clinical events after CABG but increased
leg wound complications. The primary outcome requires cautious
interpretation due to a lower-than-expected number of primary
events. Copyright © The Author(s) 2025.

<64>
Accession Number
2034475039
Title
Valve-in-valve transcatheter aortic valve replacement (TAVR) leads to
lower device success compared to TAVR in native stenosis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1465409. Date of Publication: 2025.
Author
Paukovitsch M.; Dilaver B.; Felbel D.; Krohn-Grimberghe M.; Buckert D.;
Moerike J.; Schneider L.M.; Liewald C.; Rottbauer W.; Gonska B.
Institution
(Paukovitsch, Dilaver, Felbel, Krohn-Grimberghe, Buckert, Moerike,
Schneider, Rottbauer, Gonska) Department of Cardiology, Ulm University
Heart Center, Ulm, Germany
(Liewald) Department of Cardiothoracic and Vascular Surgery, Ulm
University Heart Center, Ulm, Germany
Publisher
Frontiers Media SA
Abstract
Background: Despite the lack of randomized-controlled trials in patients
with failed bioprosthetic valves, valve-in-valve transcatheter aortic
valve replacement (ViV-TAVR) is increasingly used. Method(s):
Outcomes of consecutive patients treated with ViV-TAVR (N = 100) at our
tertiary heart center between 2014 and 2022 were compared to TAVR (N =
2216) in native valves. Result(s): Patients median age was 78.5 years
(IQR 70.0-84.0) in ViV-TAVR compared to 81.0 (IQR 77.0-85.0) in patients
with native aortic stenosis (p < 0.01) with a similar percentage of
females in both groups (42% vs. 49.3%, p = 0.18). The median Society of
Thoracic Surgeons score for mortality was significantly higher in patients
undergoing ViV-TAVR [5.1% {IQR 2.6%-8.6%} vs. 3.8% {IQR 2.4%-6.3%}, p <
0.01]. ViV-TAVR was performed in degenerated surgical bioprostheses in 88%
and in degenerated transcatheter bioprostheses in 12%. Stenosis was the
main mechanism of bioprosthetic valve failure (70%), whereas severe
regurgitation was the leading cause in 30%. The overall rate of device
success amounted to 66% in ViV-TAVR, compared to 96.1% in TAVR (p < 0.01)
and ViV-TAVR was independently associated with reduced device success (OR:
0.07, 95%CI: 0.045-0.12, p < 0.01) in multivariate regression. While
ViV-TAVR decreased peak and mean gradients significantly, in 31% of
patients elevated mean gradients (>=20 mmHg) were observed at discharge.
Small native prosthesis diameter (<20 mm) was the strongest predictor (OR
3.8, 95%CI: 1.5-9.2, p = 0.01) independently associated with elevated
gradients after ViV-TAVR. Conclusion(s): ViV-TAVR for treatment of
degenerated bioprostheses improves aortic valve function. However, device
success is lower compared to TAVR in native aortic valve disease, mainly
due to elevated postprocedural mean gradients, especially in small
bioprostheses. Copyright 2025 Paukovitsch, Dilaver, Felbel,
Krohn-Grimberghe, Buckert, Moerike, Schneider, Liewald, Rottbauer and
Gonska.

<65>
Accession Number
2034520329
Title
Programmed intermittent bolus for erector spinae plane block versus
intercostal nerve block in minimally invasive direct coronary artery
bypass surgery: a randomized controlled trial.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 239. Date
of Publication: 01 Dec 2025.
Author
Wang T.; Wang X.; Yu Z.; Lyu Y.; Yang J.; Jiang Y.; Yang D.; Ling Y.; Li
M.
Institution
(Wang, Wang, Yu, Lyu, Yang, Jiang, Yang, Li) Department of Anesthesiology,
Peking University Third Hospital, Beijing, China
(Ling) Department of Cardiac Surgery, Peking University Third Hospital,
Beijing, China
Publisher
BioMed Central Ltd
Abstract
Objective: Continuous intercostal nerve block (ICNB) has been shown to
offer effective pain relief after minimally invasive direct coronary
artery bypass (MIDCAB). The erector spinae plane block (ESPB) could
represent a viable alternative approach. This study aimed to compare the
analgesic effect of programmed intermittent bolus(PIB) for ESPB to ICNB in
patients undergoing MIDCAB. Method(s): A prospective, open-label,
randomized controlled trial was conducted. Eighty patients scheduled for
MIDCAB were randomized into two groups (n = 40 per group). ESPB using a
PIB injection was performed in the ESPB group, while ICNB was performed in
the ICNB group. The primary outcome was numerical rating scale (NRS) pain
scores at movement immediately after extubation. Secondary outcomes
included the cumulative area under the curve (AUC) of the pain scores,
perioperative analgesic consumption, adverse events and recovery data.
 Result(s): A total of 73 patients were included in the modified
intention-to-treat analysis and 71 patients in the per-protocol analysis.
There was no significant difference in numeric rating scale (NRS) scores
at rest or movement between the two groups immediately after extubation,
at 8, 24 and 48 h. The cumulative area under the curve (AUC) of the time
NRS curve until 48 h after extubation and the necessity of rescue
analgesics did not differ to a statistically significant degree between
the two groups. Compared with the ICNB group, the ESPB group had
significantly lower usage of intraoperative sufentanil (93.8 +/- 33.6 vs.
128.9 +/- 48.4 microg; p = 0.001). Conclusion(s): Postoperative
analgesic effect between ESPB and ICNB did not differ in patients after
MIDCAB. Trial registration: Chinese Clinical Trial Registry
(ChiCTR1900022388, retrospectively registered on Apr 09,
2019). Copyright © The Author(s) 2025.

<66>
Accession Number
2034492030
Title
Meta-Analysis on Coronary Artery Bypass Grafting With Single Versus
Bilateral Internal Mammary Artery Grafts in Patients With End-Stage Renal
Disease.
Source
Journal of Cardiac Surgery. 2025(1) (no pagination), 2025. Article Number:
2709364. Date of Publication: 2025.
Author
Mastroiacovo G.; Izumi A.; Fileccia D.; Kawaguchi Y.; Yanagawa B.;
Biancari F.; Pirola S.; Capra N.; Alice B.; Polvani G.
Institution
(Mastroiacovo, Fileccia, Biancari, Pirola, Polvani) Department of
Cardiovascular Surgery, IRCCS Centro Cardiologico Monzino, Milan, Italy
(Izumi) Institute of Medical Science, Temerty Faculty of Medicine,
University of Toronto, Toronto, ON, Canada
(Kawaguchi, Yanagawa) Division of Cardiac Surgery, St. Michael's Hospital,
Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
(Capra, Alice) Unit of Biostatistics, IRCCS Centro Cardiologico Monzino,
Milan, Italy
(Polvani) Department of Surgical and Dental Biomedical Sciences,
University of Milan, Milan, Italy
Publisher
John Wiley and Sons Inc
Abstract
Patients with end-stage renal disease (ESRD) and concomitant coronary
artery disease (CAD) present unique challenges for coronary
revascularization. While coronary artery bypass grafting (CABG) is
recommended over percutaneous coronary intervention in this population,
the optimal surgical strategy remains controversial. This meta-analysis
provides an updated comparison of outcomes for ESRD patients undergoing
CABG with either bilateral internal thoracic artery (BITA) or single
internal thoracic artery (SITA) grafting. A total of nine studies
involving 911 patients were included. Our findings revealed no significant
differences in perioperative mortality (p = 0.57), deep sternal wound
infection (p = 0.41), or major adverse cardiac and cerebrovascular events
(p = 0.54) between groups. Long-term survival rates were also comparable
at one, three, five, and seven years postoperatively. The pooled hazard
ratio for all-cause mortality was 0.82 (95% CI: 0.61-1.12; p = 0.21),
indicating no explicit survival advantage for either grafting strategy.
These results are consistent with existing literature and suggest that
both BITA and SITA grafting are safe and effective in this high-risk
group. As medical advances continue to extend the life expectancy of
patients with ESRD, additional research focused on optimizing the
management of ESRD-related CAD will be essential to improving
perioperative and long-term outcomes for these high-risk
patients. Copyright © 2025 Giorgio Mastroiacovo et al. Journal of
Cardiac Surgery published by John Wiley & Sons Ltd.

<67>
Accession Number
2038631320
Title
Evaluation of the efficacy of angiotensin receptor-neprilysin inhibitor in
patients with aortic stenosis undergoing transcatheter aortic valve
implantation: Protocol for a randomised, open-label, controlled study.
Source
BMJ Open. 15(4) (no pagination), 2025. Article Number: e095105. Date of
Publication: 28 Apr 2025.
Author
Kitahara H.; Okita S.; Sugawara T.; Yaginuma H.; Goto H.; Yamamoto H.;
Kanda T.; Matsuura K.; Inaba Y.; Hanaoka H.; Matsumiya G.; Kobayashi Y.
Institution
(Kitahara, Okita, Yaginuma, Goto, Kobayashi) Department of Cardiovascular
Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
(Sugawara) Ophthalmology, Chiba University Hospital, Chiba, Japan
(Yamamoto, Kanda, Matsuura, Matsumiya) Department of Cardiovascular
Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
(Inaba, Hanaoka) Clinical Research Center, Chiba University Hospital,
Chiba, Japan
Publisher
BMJ Publishing Group
Abstract
Introduction There are a substantial number of patients developing heart
failure after transcatheter aortic valve implantation (TAVI) for severe
aortic stenosis (AS), even though AS has been successfully treated. The
purpose of this randomised controlled trial was to determine whether the
addition of an angiotensin receptor-neprilysin inhibitor (ARNI),
sacubitril/valsartan, is superior to conventional medications in lowering
N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in patients
undergoing TAVI for AS. Methods and analysis The study design is a
prospective, single-centre, open-label, randomised, parallel-group,
two-arm study, in which participants will be randomised in a 1:1 ratio to
receive either conventional medications plus ARNI or conventional
medications only. In the ARNI group, if a patient was on an ACE inhibitor
or angiotensin II receptor blocker before TAVI, it will be switched to
ARNI 100 mg/day (50 mg two times per day) on the first postoperative day.
If not, candesartan 4 mg/day will be started 1-2 days before TAVI, and
switched to ARNI 100 mg/day on the first postoperative day. As the patient
has tolerability to ARNI, dosage will be increased stepwise to 400 mg/day
2-4 weeks apart. ARNI will be continued until at least 6-month follow-up.
In the control group, the patient will receive conventional medications.
The primary endpoint is the serum NT-proBNP value at 6-month follow-up
after TAVI. Each group includes 42 patients (84 total patients). Ethics
and dissemination Ethical approval for this study has been obtained from
the Chiba University Hospital Certified Clinical Research Review Board
(CRB3180015). The study is ongoing. Findings from this study will be
disseminated through peer-reviewed publications and conference
presentations. Trial registration number This trial has been registered on
the Japan Registry of Clinical Trials: jRCT1031220344. Copyright
© 2025 BMJ Publishing Group. All rights reserved.

<68>
Accession Number
647287924
Title
Navigating Family Leave in Cardiothoracic Surgery Training.
Source
The Annals of thoracic surgery. (no pagination), 2025. Date of
Publication: 02 May 2025.
Author
Russo M.G.; Tompkins A.K.; Akinade O.; Woodard G.A.; Cooke D.T.; Antonoff
M.B.; Erkmen C.P.
Institution
(Russo, Akinade) Lewis Katz School of Medicine at Temple University,
Philadelphia, PA, United States
(Tompkins) Center for Asian Health, Lewis Katz School of Medicine at
Temple University, Philadelphia, PA, United States
(Woodard) Division of Thoracic Surgery, Department of Surgery, Yale
University School of Medicine, New Haven, CT, United States
(Cooke) Division of General Thoracic Surgery. University of California,
Davis Health, Sacramento, CA, United States
(Antonoff) Thoracic & Cardiovascular Surgery, UT MD Anderson Cancer
Center, Houston, TX, United States
(Erkmen) Lewis Katz School of Medicine at Temple University, Philadelphia,
PA; Department of Thoracic Medicine and Surgery, Temple University
Hospital, Philadelphia, PA
Abstract
BACKGROUND: Cardiothoracic surgery training may coincide with family needs
including pregnancy, illness, birth/adoption/fostering of a child and care
for family members. Certifying bodies sets requirements and limits on
family leave, complicating the navigation of family needs during training.
Our goal is to examine policies of medical boards and their alignment with
the 2022 Accreditation Council for Graduate Medical Education (ACGME)
policy, and.to develop a practical tool to help trainees and program
directors navigate family leave. METHOD(S): A literature review was
conducted using PubMed of publications published from July 2022 to
September 2024 focusing on family leave within surgical specialties. This
study reviews family leave policies, requirements, and benefits of
certifying bodies. Data from the American Association of Medical Colleges,
American Boards of Surgery and Thoracic Surgery, and ACGME were analyzed
to understand gender distribution and policy variations among surgical
specialties. RESULT(S): There was no publications discussing family
leave in cardiothoracic surgery. 12 out of 40 reviewed publications
concluded that parental leave policies are unclear or insufficient,
Publications were found to focus on perspectives and experiences but lack
actionable solutions. Family leave policies vary with inconsistencies in
duration and flexibility. The duration of leave was not linked with gender
representation in specialty. CONCLUSION(S): Comprehensive family
leave policies are needed to assist programs and trainees navigate family
leave in cardiothoracic surgery. Copyright © 2025. Published by
Elsevier Inc.

<69>
Accession Number
2038463650
Title
Revascularization strategies for coronary artery aneurysms: A systematic
review.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Zordok M.; Buda K.G.; Etiwy M.; Basir M.B.; Alaswad K.; Beckmann E.;
Brilakis E.S.; Megaly M.
Institution
(Zordok) Department of Medicine, Catholic Medical Center, Manchester, NH,
United States
(Buda, Beckmann, Brilakis) Minneapolis Heart Institute at Abbott
Northwestern Hospital, United States
(Buda) Cardiology Division, Department of Internal Medicine, Hennepin
Healthcare, United States
(Etiwy) Department of Medicine, Dartmouth Hitchcock, Lebanon, NH, United
States
(Basir, Alaswad) Division of Cardiology, Henry Ford Hospital, Detroit, MI,
United States
(Megaly) Department of Cardiology, Ascension St John Medical Center,
Tulsa, OK, United States
Publisher
Elsevier Inc.

<70>
Accession Number
2038684863
Title
Impact of Noninvasive Ventilation Before and After Cardiac Surgery for
Preventing Cardiac and Pulmonary Complications: A Clinical Randomized
Trial.
Source
Chest. (no pagination), 2025. Date of Publication: 2025.
Author
Goret M.; Pluchon K.; Le Mao R.; Badra A.; Oilleau J.-F.; Morvan Y.;
Beaumont M.; Desanglois G.; Guegan M.; Barnier A.; Gut-Gobert C.; Tromeur
C.; Leroyer C.; Choplain J.-N.; Khalifa A.; Bezon E.; Couturaud F.
Institution
(Goret, Le Mao, Beaumont, Barnier, Gut-Gobert, Tromeur, Leroyer,
Couturaud) Institut National de la Sante et de la Recherche Medicale
U1304, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO),
Univ_Brest, Brest, France
(Badra, Bezon) Institut National de la Sante et de la Recherche Medicale
1078, Univ_Brest, Brest, France
(Goret, Le Mao, Beaumont, Desanglois, Guegan, Barnier, Gut-Gobert,
Tromeur, Leroyer, Couturaud) Department of Internal Medicine, Vascular
Medicine and Chest Diseases, CHU_Brest, Brest, France
(Goret, Le Mao, Beaumont, Desanglois, Guegan, Barnier, Gut-Gobert,
Tromeur, Leroyer, Couturaud) Institut National de la Sante et de la
Recherche Medicale CIC1412, CHU_Brest, Brest, France
(Pluchon, Badra, Oilleau, Morvan, Choplain, Khalifa, Bezon) Department of
Cardio-thoracic and Vascular Surgery, CHU_Brest, Brest, France
(Le Mao, Tromeur, Leroyer, Couturaud) F-CRIN INNOVTE, Saint-Etienne,
France
Publisher
Elsevier Inc.
Abstract
Background: The immediate postoperative period after heart surgery poses a
substantial risk of life-threatening complications, notably acute
pulmonary and cardiac failure. Use of noninvasive ventilation (NIV) may
reduce the incidence of pulmonary or heart failure, or both. Research
Question: Is the use of NIV before and after cardiac surgery associated
with a lower rate of acute pulmonary and heart failure in patients at risk
of postoperative complications? Study Design and Methods: We designed a
prospective, randomized, monocentric trial comparing preoperative and
postoperative NIV in cardiac surgery with standard care. Adult patients
classified as being at risk of postoperative cardiac or pulmonary failure
were allocated to receive NIV for 5 days before and 5 days after surgery
in addition to usual care vs usual care alone. The primary outcome was the
composite of predefined and adjudicated cardiorespiratory failure at 1
month after cardiac surgery. Result(s): Two hundred sixteen patients
were included. During the 1-month follow-up period after surgery, the
composite outcome occurred in 59 of 107 patients (55.1%) in the NIV group
and in 87 of 109 patients (79.8%) in the no NIV group (relative risk,
0.69; 95% CI, 0.57-0.84; P < .001). The benefit persisted at 3 months. No
difference between the 2 groups was found in terms of intubation need and
length of hospital stay in cardiac and pulmonary surgery ICUs and in
cardiac and pulmonary surgery units. Interpretation(s): Our results
indicate that the use of NIV before and after cardiac surgery reduces the
rate of cardiopulmonary failure after high-risk cardiac surgery. Clinical
Trial Registry: ClinicalTrials.gov; No.: NCT02302300; URL:
www.clinicaltrials.gov Copyright © 2025 American College of Chest
Physicians

<71>
Accession Number
2034499330
Title
Cardiac surgery-associated acute kidney injury: a decade of research
trends and developments.
Source
Frontiers in Medicine. 12 (no pagination), 2025. Article Number: 1572338.
Date of Publication: 2025.
Author
Qiao C.; Zhou J.; Wei C.; Cao J.; Zheng K.; Lv M.
Institution
(Qiao, Wei, Cao) Department of Anesthesiology, Shandong Provincial
Clinical Research Center for Anesthesiology, The First Affiliated Hospital
of Shandong First Medical University, Shandong Provincial Qianfoshan
Hospital, Shandong Institute of Anesthesia and Respiratory Critical
Medicine, Shandong, Jinan, China
(Zhou) Laboratory of Laparoscopic Technology, Department of Obstetrics and
Gynecology, The First Affiliated Hospital of Shandong First Medical
University, Shandong Provincial Qianfoshan Hospital, The First Affiliated
Hospital of Shandong First Medical University, Shandong, Jinan, China
(Zheng) Graduate School, Shandong First Medical University & Shandong
Academy of Medical Sciences, Shandong, Jinan, China
(Lv) Department of Anesthesiology, Shandong Provincial Hospital of
Shandong First Medical University, Shandong, Jinan, China
Publisher
Frontiers Media SA
Abstract
Background: Cardiac surgery-associated acute kidney injury (CSA-AKI)
significantly increases postoperative mortality and healthcare costs.
Despite the growing volume of CSA-AKI research, the field remains
fragmented, with challenges in identifying high-impact studies,
collaborative networks, and emerging trends. Bibliometric analysis
addresses these gaps by systematically mapping knowledge structures,
revealing research priorities, and guiding resource allocation for both
researchers and clinicians. Method(s): We analyzed 4,474
CSA-AKI-related publications (2014-2023) from the Web of Science Core
Collection (WoSCC) using VOSviewer, CiteSpace, the Bibliometrix Package in
R, and the bibliometric online analysis platform. Result(s): Annual
publications increased steadily, with the USA and China leading
productivity. The Journal of Cardiothoracic and Vascular Anesthesia serves
as the foremost preferred journal within this domain. Critical Care (IF =
15.1) has the highest impact factor. Yunjie Li published the most papers.
John A Kellum has the highest H-index. The definition, pathogenesis or
etiology, diagnosis, prediction, prevention and treatment, which are the
research basis in CSA-AKI. Machine learning (ML) and prediction models
emerged as dominant frontiers (2021-2023), reflecting a shift toward
personalized risk stratification and real-time perioperative
decision-making. These advancements align with clinical demands for early
AKI detection and precision prevention. Conclusion(s): This study not
only maps the evolution of CSA-AKI research but also identifies priority
areas for innovation: multicenter validation of predictive models to
strengthen generalizability, preventive nephrology frameworks for
long-term AKI survivor monitoring, and randomized controlled trials to
confirm efficacy of machine learning-based CSA-AKI prediction
tools. Copyright © 2025 Qiao, Zhou, Wei, Cao, Zheng and Lv.

<72>
Accession Number
2034524148
Title
Cerebral embolic protection in transcatheter aortic valve implantation
(TAVI): a pooled analysis of 4091 patients.
Source
Cardiovascular Intervention and Therapeutics. (no pagination), 2025.
Article Number: 106605. Date of Publication: 2025.
Author
Balata M.; Gbreel M.I.; Elkasaby M.H.; Badran A.S.; Hassan M.; Westenfeld
R.; Pfister R.; Zimmer S.; Becher M.U.; Nickenig G.; Sugiura A.
Institution
(Balata, Becher) Department of Internal Medicine and Cardiology,
Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
(Gbreel) Faculty of Medicine, October 6 University, Giza, Egypt
(Elkasaby) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Badran) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Hassan) Department of Immunology, Theodor Bilharz Research Institute,
Giza, Egypt
(Westenfeld) Department of Internal Medicine and Cardiology, University
Hospital Duesseldorf, Dusseldorf, Germany
(Pfister) Department of Internal Medicine and Cardiology, University
Hospital Cologne, Cologne, Germany
(Zimmer, Nickenig, Sugiura) Department of Internal Medicine and Polyclinic
II, University Hospital Bonn, Bonn, Germany
Publisher
Springer
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is increasingly
used for severe aortic stenosis, but debris embolization during the
procedure can lead to strokes, impacting survival and quality of life. The
role of cerebral embolic protection devices (CEPDs) in mitigating stroke
risk remains debated. We aim to evaluate the impact of CEPDs on the risk
of stroke and neurocognitive outcomes after TAVI. Method(s): Six
databases (PubMed, Scopus, Web of Science, Cochrane, Embase, and Ovid)
were searched until 20 January 2023. Original randomized controlled trials
(RCTs) were only included and critically appraised using the Cochrane risk
of bias (ROB) tool. Result(s): Seven RCTs (4091 patients) were
analyzed. CEPDs significantly reduced the risk of disabling stroke within
2-5 days post-TAVI (relative risk = 0.455, 95% CI: [0.214, 0.967]; p =
0.041). However, there was no significant difference in disabling stroke
risk between the two groups at the 30-day follow-up (relative risk =
1.295, 95% CI: [0.373, 4.493]; p = 0.684). No significant differences were
observed in non-disabling or overall stroke rates at 2-5 days, 30 days, or
90 days. Additionally, CEPDs did not significantly affect risks of
life-threatening bleeding, major vascular complications, mortality, or
acute kidney injury. Conclusion(s): CEPDs are effective in reducing
disabling stroke risk in the immediate post-TAVI period (2-5 days) but did
not significantly affect the rates of non-disabling stroke, overall
stroke, or disabling stroke after 30 days when compared to non-CEPD use.
These findings suggest that CEPDs may offer short-term
neuroprotection. Copyright © The Author(s) under exclusive
licence to Japanese Association of Cardiovascular Intervention and
Therapeutics 2025.

<73>
Accession Number
2038647665
Title
Exploring the influence of extra-corporeal membrane oxygenation (ECMO)
support on neurodevelopmental outcomes in paediatric cardiac patients: a
systematic review.
Source
Cardiology in the Young. (no pagination), 2025. Date of Publication:
2025.
Author
Francis J.; Chandiramani A.; George A.; George J.; Jones T.
Institution
(Francis) Department of Cardiothoracic Surgery, Aberdeen Royal Infirmary,
Aberdeen, United Kingdom
(Chandiramani) Department of Cardiothoracic Surgery, Royal Papworth
Hospital, Cambridge, United Kingdom
(George) Department of Anaesthesia, Aberdeen Royal Infirmary, Aberdeen,
United Kingdom
(George, Jones) Department of Paediatric Cardiac Surgery, Birmingham
Women's and Children's Hospital, Birmingham, United Kingdom
Publisher
Cambridge University Press
Abstract
Background: Mechanical circulatory support, and specifically
extra-corporeal membrane oxygenation, plays a critical role in managing
paediatric cardiac patients with severe heart failure. Whilst these
technologies are vital for bridging patients to recovery or heart
transplantation, it is imperative to study the influence of
extra-corporeal membrane oxygenation on neurodevelopmental outcomes.
 Objective(s): This systematic review aimed to evaluate the influence
of extra-corporeal membrane oxygenation on neurodevelopmental outcomes in
paediatric cardiac patients, both post-cardiotomy and non-cardiotomy
patients were included. Methodology: A comprehensive search was conducted
using PubMed, EMBASE, and PsychInfo to identify primary research articles
exploring the effects of extra-corporeal membrane oxygenation on
neurodevelopmental outcomes in paediatric heart patients from inception to
June 2024. Result(s): Our search yielded 5488 papers of which eight
papers were included featuring 302 patients. Conclusion(s): The
discussion highlights the considerable variability in neurodevelopmental
outcomes and how they are measured among extra-corporeal membrane
oxygenation survivors. Outcomes vary by patient factors, with recovery
potential influenced by the duration and timing of follow-up. We
emphasised the importance of standardised assessment tools and extended
follow-ups to gain a clearer understanding of these
outcomes. Copyright © 2025 The Author(s). Published by Cambridge
University Press.

<74>
[Use Link to view the full text]
Accession Number
2038616140
Title
Mental Health Sequelae of Cardiac Events: A Comprehensive Review of
Biological Mechanisms, Prevalence, and Interdisciplinary Care Approaches.
Source
Cardiology in Review. (no pagination), 2025. Article Number:
10.1097/CRD.0000000000000924. Date of Publication: 2025.
Author
Fardeen Oishe O.; Islam S.; Pakrad P.; Chikatimalla R.; Jain R.
Institution
(Fardeen Oishe) Sylhet MAG Osmani Medical College and Hospital, Sylhet,
Bangladesh
(Islam) Washington University of Health and Science, San Pedro, Belize
(Pakrad) Islamic Azad University of Medical Science, Tehran, Iran, Islamic
Republic of
(Chikatimalla) Kamineni Institute of Medical Sciences, Narketpally, India
(Jain) Department of Internal Medicine, Penn State Health Milton S.
Hershey Medical Center, Hershey, PA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Cardiovascular diseases are the leading cause of mortality worldwide, with
postcardiac events such as myocardial infarction, acute coronary syndrome,
and sudden cardiac arrest causing significant physiological trauma and
psychological effects. This study explores the complex interplay between
cardiac events and mental health disorders, focusing on the biological and
psychological pathways that connect these conditions in at-risk
populations. The acute stress response following a cardiac event involves
the activation of the sympathetic nervous system and the
hypothalamic-pituitary-adrenal axis, leading to the release of stress
hormones and inflammatory cytokines. Prolonged activation of these systems
can result in neurotransmitter imbalances, neuroinflammation, and
epigenetic modifications, increasing the susceptibility to mental health
disorders such as depression, anxiety, and posttraumatic stress disorder
(PTSD). Women exhibit a higher vulnerability to these conditions due to
hormonal fluctuations and a more pronounced stress response. The
prevalence of mental health disorders following cardiac events is
substantial, with PTSD rates being particularly high among survivors of
myocardial infarction and out-of-hospital cardiac arrest. These
psychological conditions are associated with poor physical recovery,
reduced quality of life, and an increased risk of recurrent cardiac events
and mortality. Resilience and adaptive coping mechanisms serve as
protective factors, highlighting the importance of integrating mental
health care within cardiac rehabilitation programs. This study emphasizes
the need for early detection, targeted interventions, and an
interdisciplinary approach to improve mental health outcomes in patients
recovering from cardiac incidents. Understanding the psychiatric sequelae
of cardiac events is crucial for cardiologists, particularly in the
management of postmyocardial infarction patients, ischemic attack
survivors, and individuals undergoing open-heart surgery. Early detection
and interdisciplinary interventions can improve long-term
outcomes. Copyright © 2025 Wolters Kluwer Health, Inc. All rights
reserved.

<75>
[Use Link to view the full text]
Accession Number
2038640118
Title
Impact of Point-of-care allogeneic red blood cell washing on markers of
transfusion-related respiratory complications: A phase II randomized
clinical trial.
Source
Anesthesiology. (no pagination), 2025. Article Number:
10.1097/ALN.0000000000005505. Date of Publication: 2025.
Author
Kor D.J.; Warner M.A.; Norris P.J.; Armour S.; Wittwer E.D.; Santrach
P.J.; Meade L.A.; Conn C.M.; Schulte P.J.; Pendegraft R.S.; Di Germanio
C.; Podgoreanu M.; Welsby I.J.
Institution
(Kor) Department of Anesthesiology and Perioperative Medicine, Mayo
Clinic, Rochester, MN, United States
(Warner) Division of Critical Care, Department of Anesthesiology and
Perioperative Medicine, Mayo Clinic, Rochester, MN, United States
(Norris) Vitalant Research Institute, San Francisco, CA, United States
(Armour) Department of Anesthesiology and Perioperative Medicine, Mayo
Clinic, Rochester, MN, United States
(Wittwer) Department of Anesthesiology and Perioperative Medicine, Mayo
Clinic, Rochester, MN, United States
(Santrach) Associate Professor of Laboratory Medicine and Pathology,
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester,
MN, United States
(Meade) Department of Anesthesiology and Perioperative Medicine, Mayo
Clinic, Rochester, MN, United States
(Conn) Department of Laboratory Medicine and Pathology, Mayo Clinic,
Rochester, MN, United States
(Schulte) Department of Quantitative Health Sciences, Mayo Clinic,
Rochester, MN, United States
(Pendegraft) Department of Quantitative Health Sciences, Mayo Clinic,
Rochester, MN, United States
(Di Germanio) Immunology Core, Vitalant Research Institute, San Francisco,
CA, United States
(Podgoreanu) Department of Anesthesiology, Duke University Medical Center,
Raleigh, NC, United States
(Welsby) Tenured Professor of Anesthesiology and Critical Care, Professor
of Medicine (Hematology), Cardiothoracic Surgical ICU, Duke University
Medical Center, Erwin Road, Durham, NC, United States
(Norris) University of California, San Francisco, United States
(Di Germanio) Laboratory Medicine, University of California, San
Francisco, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Transfusion-related acute lung injury (TRALI) and
transfusion-associated circulatory overload (TACO) are leading causes of
transfusion-related morbidity and mortality. Soluble factors in red blood
cell (RBC) supernatant may increase risk for these complications. We
hypothesized that point-of-care allogeneic RBC washing may be an effective
intervention to mitigate elevations in soluble factors as well as
physiologic responses associated with transfusion-associated respiratory
complications in the setting of cardiac surgery. Method(s): This is a
two-center, non-blinded, randomized clinical trial evaluating
point-of-care washed versus standard-issue allogeneic RBC transfusions
administered during or on the day of cardiac surgery. The primary analysis
was performed via modified intention-to-treat. The primary outcomes
assessed were changes in intermediate markers of lung injury as well as
cardiopulmonary physiologic responses to RBC transfusion. Secondary
outcomes included the duration of intensive care unit and hospital stay,
durations of mechanical ventilation and oxygen supplementation, presence
of TRALI or TACO, and mortality. Result(s): Among 154 analyzed
patients (81 washed, 73 standard issue), median age was 66 years and 77
(50.0%) were women. The median (IQR) number of allogeneic RBC units
transfused on the day of surgery was 3.0 (2.0 - 5.0) in the washed RBC
group and 3.0 (2.0 - 4.0) in the standard issue group (p = 0.13). No
between-group differences were identified in any of the assessed recipient
lung injury biomarkers (all p-values > adjusted alpha). Durations of
intensive care unit stay (median [interquartile range]; 3.0 [2.0-5.0]
versus 3.0 [2.0-4.0] days; p = 0.117) and hospital length of stay (12.0
[9.0-17.0] versus 12.0 [9.0-17.0] days; p = 0.801) were similar, as were
the number of ventilator-free days at day 28 (27.0 [27.0-27.0] versus 27.0
[26.0-27.0]; p = 0.699) and oxygen free days at day 28 (24.0 [19.0-26.0]
versus 24.0 [22.0-26.0]; p = 0.400). No significant differences were noted
in mortality rate nor in incidence rates for TRALI, TACO, and acute kidney
injury. Conclusion(s): Among patients undergoing cardiovascular
surgery with high risk of RBC transfusion, point-of-care washing of
allogeneic RBC transfusions did not mitigate changes in intermediate
markers of lung injury or cardiopulmonary physiologic responses to RBC
transfusion and was not associated with improved clinical
outcomes. Copyright © 2025 American Society of Anesthesiologists.
All Rights Reserved.

<76>
Accession Number
2034499488
Title
Assessing heart failure after surgical occlusion of the left atrial
appendage. Letter regarding the article 'Heart failure after left atrial
appendage occlusion: Insights from the LAAOS III randomized trial'.
Source
European Journal of Heart Failure. (no pagination), 2025. Date of
Publication: 2025.
Author
Stollberger C.; Finsterer J.; Schneider B.
Institution
(Stollberger) Institut Gesunder Leben, Vienna, Austria
(Finsterer) Neurology & Neurophysiology Center, Vienna, Austria
(Schneider) Sana Kliniken Lubeck, Lubeck, Germany
Publisher
John Wiley and Sons Ltd

<77>
Accession Number
2038681795
Title
Percutaneous Coronary Intervention or Minimally Invasive Coronary Bypass
for Isolated Left Anterior Descending Artery Disease.
Source
American Journal of Cardiology. 249 (pp 36-42), 2025. Date of Publication:
15 Aug 2025.
Author
Gallingani A.; Pampuri G.; Diab N.; Grassa G.; Hernandez-Vaquero D.;
Tuttolomondo D.; Carino D.; Singh G.; Nicolini F.; Formica F.
Institution
(Gallingani, Pampuri, Diab, Grassa, Carino, Nicolini) Cardiac Surgery
Unit, University Hospital of Parma, Parma, Italy
(Pampuri, Diab, Grassa, Carino, Nicolini) Cardiac Surgery Unit, Department
of Medicine and Surgery, University of Parma, University Hospital of
Parma, Parma, Italy
(Hernandez-Vaquero) Cardiac Surgery Department, Hospital Universitario
Central de Asturias, Oviedo, Spain
(Tuttolomondo) Cardiology Unit, University Hospital of Parma, Parma, Italy
(Singh) Department of Critical Care Medicine and Division of Cardiac
Surgery, Mazankowski Alberta Heart Institute, University of Alberta,
Edmonton, Canada
(Formica) Department of Experimental Medicine, University of Salento,
Lecce, Italy
Publisher
Elsevier Inc.
Abstract
The optimal revascularization strategy for isolated left anterior
descending (LAD) artery disease, minimally invasive direct coronary artery
bypass (MIDCAB) and percutaneous coronary intervention (PCI), remains a
subject of debate. This updated meta-analysis aimed to compare the
long-term outcomes of MIDCAB versus PCI for patients with isolated LAD
artery disease. Three databases were systematically searched to identify
randomized controlled trials (RCTs) and adjusted studies. Primary outcomes
included long-term survival and repeat target vessel revascularization
(TVR). The secondary endpoint was long-term major adverse cardiovascular
events (MACEs). Hazards ratios (HR) and Confidence Intervals (CI) were
calculated for long-term outcomes and a random effects model was used.
Sensitivity analyses included subgroups analysis of stent-type. Nine
articles, comprising 4 RCTs, totaling 2,168 patients (MIDCAB = 1,086 and
PCI = 1,080) were included. The weighted mean follow-up was 4.35 +/- 4.9
years. Long-term survival was comparable between MIDCAB and PCI (HR =
0.76; 95% CI, 0.58 to 1.00; p = 0.05). MIDCAB was associated with a
significantly lower rate of repeat TVR (HR = 0.35; 95% CI, 0.25 to 0.49; p
<0.0001) and a reduced risk of MACEs (HR = 0.59; 95% CI, 0.43 to 0.81; p
<0.0001), although the difference was not evident in subgroup analysis
comparing MIDCAB and PCI with drug-eluting stent (HR = 0.66; 95% CI, 0.46
to 1.06; p = 0.09). In conclusion, this meta-analysis of RCTs and adjusted
studies shows that in patients with isolated LAD lesion, MIDCAB and PCI
exhibit comparable long-term survival. However, MIDCAB is associated with
a significantly reduced risk of long-term repeat TVR and MACEs compared to
PCI. Copyright © 2025 Elsevier Inc.

<78>
Accession Number
2038643171
Title
Sex-based outcomes of mitral surgery for ischaemic mitral regurgitation:
Protocol for a systematic review and meta-analysis.
Source
BMJ Open. 15(5) (no pagination), 2025. Article Number: e097759. Date of
Publication: 07 May 2025.
Author
Rahmouni K.; Gauthier N.M.; Kang N.; Voisine P.; Edwards J.; Ramsay T.;
Chan V.
Institution
(Rahmouni, Voisine, Edwards, Chan) University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Rahmouni, Edwards, Ramsay) School of Epidemiology and Public Health,
University of Ottawa, Ottawa, ON, Canada
(Gauthier, Kang, Voisine, Chan) Faculty of Medicine, University of Ottawa,
Ottawa, ON, Canada
(Ramsay) Ottawa Methods Center, Ottawa Hospital Research Institute,
Ottawa, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Introduction Patients with ischaemic mitral regurgitation (MR) have
markedly increased cardiovascular mortality compared with those with
primary MR. The sex-based prognosis of patients with ischaemic MR
undergoing mitral surgery remains unclear. The goal of this systematic
review is to evaluate long-term mortality, reoperation, heart failure
rehospitalisation and MR recurrence in women who undergo mitral valve
surgery for chronic ischaemic MR, compared with men. Methods and analysis
The MEDLINE, EMBASE, Scopus and Cochrane Central Register of Controlled
Trials databases will be searched for studies reporting surgical outcomes
for ischaemic MR. Studies published before 10 June 2024 and those
stratifying outcomes by sex will be included. The primary outcome of this
systematic review is long-term (>=1 year) mortality following mitral
surgery. Secondary outcomes include operative mortality, mitral valve
reintervention, heart failure rehospitalisation and MR recurrence, as
assessed by echocardiography. Risk of bias will be ascertained with the
Newcastle-Ottawa scale. Heterogeneity will be assessed using Higgin's I 2
statistic. If the included studies demonstrate adequate homogeneity in
their design and comparator, meta-analyses with a random-effects model
will be conducted to combine estimates. Ethics and dissemination This
systematic review uses data from previously published studies and does not
involve interaction with human subjects or access to individual patient
data. Therefore, ethical approval is not required for this study. The
findings from this review will be disseminated through publication in a
peer-reviewed journal and various media, including but not limited to,
conferences, congresses and symposia. Trial registration number In
accordance with the guidelines, our systematic review protocol was
registered with the International Prospective Register of Systematic
Reviews on 5 July 2024 and was last updated on 4 April 2025 (Registration
number: CRD42024560892). Copyright © Author(s) (or their
employer(s)) 2025.

<79>
Accession Number
2034491663
Title
Anaesthetic Techniques for Cardiac Ablation-A Scoping Review Protocol.
Source
Acta Anaesthesiologica Scandinavica. 69(6) (no pagination), 2025. Article
Number: e70054. Date of Publication: 01 Jul 2025.
Author
Fredensborg M.B.; Fiege S.B.; Moller A.M.
Institution
(Fredensborg, Moller) Department of Anaesthesiology, Herlev Anaesthesia
Critical and Emergency Care Science Unit (ACES), Copenhagen University
Hospital-Herlev Hospital, Herlev, Denmark
(Fredensborg, Moller) Department of Clinical Medicine, Faculty of Health
Sciences, University of Copenhagen, Copenhagen, Denmark
(Fiege) Department of Anaesthesiology, Herlev and Gentofte Hospital,
Gentofte, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: Cardiac arrhythmias, particularly atrial fibrillation, are
highly prevalent and represent a growing global health burden. Cardiac
ablation is a commonly used procedure for the treatment of cardiac
arrhythmias, often requiring anaesthesia to ensure patient safety and
procedural success. Despite its widespread use, there is no consensus on
the optimal anaesthetic strategy, and existing literature mainly addresses
isolated techniques or specific populations. The aim of this scoping
review is to systematically map the current evidence on anaesthetic
methods used during cardiac ablation procedures. Method(s): A scoping
review will be conducted in accordance with the Preferred Reporting Items
for Systematic Reviews and Meta-Analyses extension for scoping reviews
(PRISMA-ScR) guidelines. A comprehensive search strategy will be applied
across multiple databases, including Medline, EMBASE, Cochrane, Scopus and
Google Scholar. Eligible studies will include all research on adult
patients undergoing cardiac ablation, focusing on any anaesthetic or
sedative techniques used. Study selection and data extraction will be
performed by independent reviewers, and results will be summarized
descriptively. Result(s): In the final review, findings will be
presented through a descriptive and narrative summary, supplemented by
tables, figures and graphs where applicable. Conclusion(s): This
scoping review will provide a structured overview of the landscape of
anaesthesia methods in cardiac ablations. The findings will help uncover
knowledge gaps and inform future research and clinical decision-making
regarding anaesthesia strategies in the management of cardiac
arrhythmias. Copyright © 2025 The Author(s). Acta
Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on
behalf of Acta Anaesthesiologica Scandinavica Foundation.

<80>
Accession Number
2038672148
Title
Intranasal insulin enhances postoperative sleep quality and delirium in
middle-aged cardiac surgery patients: A randomized controlled trial.
Source
Sleep Medicine. 132 (no pagination), 2025. Article Number: 106560. Date of
Publication: 01 Aug 2025.
Author
Yang M.; Lu T.; Cao L.; Xiao C.; Liang Y.; Ding J.; Jiang X.; Wang W.;
Chen F.; Du Z.; Yang G.; Li H.
Institution
(Yang, Lu, Cao, Xiao, Liang, Ding, Jiang, Wang, Chen, Du, Yang, Li)
Department of Anesthesiology, Xinqiao Hospital of Chongqing, Second
Affiliated Hospital of Army Medical University, PLA, Chongqing, China
Publisher
Elsevier B.V.
Abstract
Background: Postoperative delirium (POD) remains a significant
complication following cardiopulmonary bypass (CPB) surgery, particularly
in middle-aged patients who constitute the majority of this surgical
population. While intranasal insulin (INI) has shown neuroprotective
potential in aging cohorts, its efficacy in younger surgical patients and
its underlying mechanisms remain under explored. This study investigates
whether INI mitigates POD through sleep-wake cycle modulation.
 Method(s): It is a single-center prospective randomized,
double-blinded controlled trial from March 4, 2024 to October 18, 2024. 76
middle-aged patients (45-65 years) undergoing elective CPB surgery were
randomized to receive INI (20 IU) or placebo preoperatively and on
postoperative days 1-2. The primary outcome was POD incidence (CAM-ICU
criteria). Secondary outcomes included Mini-Mental State Examination
(MMSE) scores, actigraphy-derived sleep metrics (sleep efficiency [SE],
total sleep time [TST]). Analyses followed intention-to-treat principles.
 Result(s): INI significantly reduced POD incidence (17.1 % vs. 38.9
%, RR = 3.45, p = 0.037) and improved cognitive recovery, as evidenced by
higher MMSE scores at postoperative day 5 with a difference of 1.71 (95 %
CI, 0.19 to 3.23; p = 0.027). Sleep analysis revealed robust improvements
in the INI group: SE increased by 21.3 % (78.2 +/- 12.1 % vs. 64.5 +/-
15.3 %, p = 0.031), and TST extended by 27.1 % (6.1 +/- 1.2h vs. 4.8 +/-
1.5h, p = 0.033) on postoperative day 1. No significant differences were
observed in hospital length of stay (p = 0.893), highlighting the
specificity of INI's sleep-mediated effects. Conclusion(s): This
trial demonstrates that INI stabilizes postoperative sleep architecture,
leading to reduced POD incidence and enhanced cognitive recovery in
middle-aged CPB patients. These findings position INI as a targeted
intervention for perioperative neurocognitive protection, particularly in
populations vulnerable to circadian disruption. Clinical trial
registration: ChiCTR 2400081444. Registered March 1, 2024,
http://www.chictr.org.cn. Copyright © 2025 Elsevier B.V.

<81>
Accession Number
647282801
Title
2025 American Association for Thoracic Surgery (AATS) Expert Consensus
Document: Surgical Management of Acute Myocardial Infarction and
Associated Complications.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2025. Date of Publication: 16 Apr 2025.
Author
Kaczorowski D.J.; Takeda K.; Atluri P.; Cevasco M.; Cogswell R.;
D'Allesandro D.; Daneshmand M.; Jeevanandam V.; Kapur N.; Milano C.; Ono
M.; Potapov E.; Ramzy D.; Silvestry S.; Soltesz E.
Institution
(Kaczorowski) Department of Cardiothoracic Surgery, University of
Pittsburgh Medical Center, Pittsburgh, PA, United States
(Takeda) Department of Surgery, Columbia University Medical Center, New
York, NY
(Atluri, Cevasco) Department of Surgery, Hospital of the University of
Pennsylvania, Philadelphia, PA, United States
(Cogswell) Cardiovascular Division, University of Minnesota, Minneapolis,
MN, United States
(D'Allesandro) Department of Surgery, Massachusetts General Hospital,
Boston, MA, United States
(Daneshmand) Department of Surgery, Emory University, Atlanta, GA, United
States
(Jeevanandam) Department of Surgery, University of Chicago Medicine,
Chicago, IL, United States
(Kapur) Division of Cardiology, Tufts Medicine, Boston, MA, United States
(Milano) Department of Surgery, Duke University, Durham, NC, United States
(Ono) Department of Surgery, University of Tokyo Hospital, Tokyo, Japan
(Potapov) Department of Thoracic and Cardiovascular Surgery, Deutsches
Herzzentrum der Charite, Berlin, Germany
(Ramzy) Department of Cardiothoracic and Vascular Surgery, UT Health
Houston McGovern School of Medicine, Houston, TX, United States
(Silvestry) Department of Surgery, University of Arizona College of
Medicine, Tucson, AZ, United States
(Soltesz) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
Abstract
OBJECTIVE: Complications of acute myocardial infarction (AMI) can result
in significant morbidity and mortality. The aim of this document is to
report findings and recommendations of a multidisciplinary group of
experts on the management of patients with complications of AMI, with
particular focus on the use of mechanical circulatory support in this
context. METHOD(S): Through the American Association of Thoracic
Surgery (AATS) Clinical Practice Standards Committee, a committee of
multi-disciplinary experts, including both cardiologists and
cardiothoracic surgeons, was established. A list of topics was developed.
Committee members were divided into subgroups and developed relevant
questions. A systematic literature review was then performed, and the
results were synthesized into clinical recommendations. Expert consensus
was then established using the Delphi process. RESULT(S): Based on
the results of the systematic review of the literature as well as the
clinical expertise of the committee, clinical recommendations were
developed. Each of these recommendations, the strength of each
recommendation, and the level or quality of evidence that the
recommendation was based upon are presented here. Topics addressed include
general considerations, revascularization strategies, cardiogenic shock,
papillary muscle rupture, post-infarction ventricular septal defect, free
wall rupture, arrhythmias, and the use of durable therapies in this
context. CONCLUSION(S): AMI may result in cardiogenic shock,
malignant arrhythmias, or mechanical complications, and each of these is
associated with high mortality. Prompt management of these complications,
including consideration for mechanical circulatory support, is
warranted. Copyright © 2025. Published by Elsevier Inc.

<82>
Accession Number
647284943
Title
The prognosis of moderate in stent restenosis detected at third month
control coronary angiography after stent implantation.
Source
Anatolian Journal of Cardiology. Conference: 31st Turkish Cardiology
Congress. Antalya Turkey. 15(Supplement 1) (pp 30), 2015. Date of
Publication: 01 Oct 2015.
Author
Haqmal H.; Yuksel U.C.; Ozturk C.; Demir M.; Yildirim A.O.; Iyisoy A.
Institution
(Haqmal, Yuksel, Ozturk, Demir, Yildirim, Iyisoy) Gulhane Military Medical
Academy (GMMA) Ankara, Ankara, Turkey
Publisher
Turkish Society of Cardiology
Abstract
Introduction: Stent restenosis is a yet unsolved problem, so there were
few reports of prospective randomized clinical studies about comparing the
efficacy of third month control angiographic results to detect the
prognosis of moderate ISR after BMS implantation. The aim of this study
was to evaluate the prognosis of moderate ISR and compare the sixth and
third month control coronary angiographic results after bare metal stent
(BMS) implantation. Material(s) and Method(s): This study is a
retrospectivet study included patients undergone bare metal stent
implantation in coronary angiography (CAG) laboratory in our centre. 248
patients who had procedural success of coronary stenting with BMS due to
of any indication of percutanous intervention (PCI) were enrolled and
moderate degree ISR in the 3th month angiographic follow-up from January
2012 to march 2013 were determined. The baseline characteristics,
angiographic and procedural parameters of these patients were determined.
Diagnosis of severity of in-stent restenosis was done by two blind
interventional cardiologists. Result(s): >70% ISR were accepted as
severe restenosis at third month control angiography. The patients who did
not come back were excluded from the study. Patients were grouped into two
groups. 'No restenosis' (n=188) group consisted of patients having less
then 50% restenosis and 'moderate restenosis group' consisted of patients
having restenosis 50-70% (n=60) based on the results of third month
control coronary angiogram. All patients had exercise treadmill test at
sixth months. 49 patients (%19.8) had positive test results. 47 of the 49
patients (95.9%) belonged to restenosis group. All of those 49 patients
had coronary angiograms and 45 (%91,8) of those patients required
revascularization due to severe restenosis at sixth months. Instent
restenosis rates were higher in hypertensive and diabetic patients (%54,
p<0.005 and %37 p<0.005 respectively). Correlation analysis revealed
lesion type, length, target vessel diameter, implanted number of stents
were all related with instent restenosis (p<0.005). Discussion and
 Conclusion(s): We found that restenosis detected at third month
control coronary angiography frequently progressed to severe restenosis
which required reintervention at sixth months. Meticulous follow up is
required in such patients to prevent adverse cardiac events. Our study
showed the most powerful predictors of angiographic restenosis of
bare-metal stents were the post-procedure minimal luminal diameter,
presence of diabetes mellitus, hypertension, lesion type, length, target
vessel diameter and number of stents. Thus, all patients with these risk
factors may need more aggressive risk modification and aggressive
angiographic follow-up.

<83>
Accession Number
647285183
Title
Nebivolol compared with metoprolol for erectile function in males
undergoing coronary artery bypass graft.
Source
Anatolian Journal of Cardiology. Conference: 31st Turkish Cardiology
Congress. Antalya Turkey. 15(Supplement 1) (pp 34), 2015. Date of
Publication: 01 Oct 2015.
Author
Tecer E.; Aldemir M.; Keles I.; Karalar M.; Adali F.; Pektas M.B.; Parlar
A.I.; Darcin O.T.
Institution
(Tecer, Aldemir, Keles, Karalar, Adali, Pektas, Darcin) Afyon Kocatepe
University, Faculty of Medicine, Afyon, Turkey
(Parlar) Private Acute Heart Hospital, Izmir, Turkey
Publisher
Turkish Society of Cardiology
Abstract
Introduction: The aim of this study was to evaluate the effects of two
widely used adrenoceptor betablockers, namely nebivolol and metoprolol on
erectile function in males undergoing coronary artery bypass grafting.
 Material(s) and Method(s): Sixty patients scheduled for coronary
artery bypass grafting surgery were randomly assigned into two groups: The
N group, which received 5 mg of nebivolol orally for 2 weeks before
surgery plus 12 weeks after surgery or the M group, which received 50 mg
of metoprolol orally for the same period. All patients were evaluated by
the erectile function domain of the International Index of Erectile
Function (IIEF) at time of admission (before starting beta blocker) and
three months after surgery. Result(s): In the metoprolol group, the
mean IIEF-5 score decreased significantly from a baseline of 15.2+/-5.8 to
12.9+/-5.8 (p<0.001), but in the nebivolol group this difference was not
statistically significant (from baseline 12.9+/-5.5 to 12.4+/-5.5 and
p=0.053). For all patients the mean IIEF-5 score decreased significantly
from a baseline of 14.0+/-5.7 to 12.6+/-5.6 (p<0.001). Discussion and
 Conclusion(s): While the selective beta1-blocker metoprolol
significantly affects erectile function, the vasodilating selective
beta1-blocker nebivolol exerts protective effects on erectile function
against the disruptive effects of CPB in patients undergoing CABG.

<84>
Accession Number
647285632
Title
Prospective observational comparison of TTR in patients followed by
specialized INR outpatient clinic and by the general cardiology outpatient
clinic.
Source
Anatolian Journal of Cardiology. Conference: 31st Turkish Cardiology
Congress. Antalya Turkey. 15(Supplement 1) (pp 41), 2015. Date of
Publication: 01 Oct 2015.
Author
Kilic S.; Yuce E.I.; Simsek E.; Yagmur B.; Soner Kemal H.; Memisoglu Akgul
N.; Cinar C.S.; Zoghi M.; Gurgun C.
Institution
(Kilic, Yuce, Simsek, Yagmur, Soner Kemal, Memisoglu Akgul, Cinar, Zoghi,
Gurgun) Ege University, Faculty of Medicine, Izmir, Turkey
Publisher
Turkish Society of Cardiology
Abstract
Introduction: The comparison of target therapeutic range (TTR) period of
INR in one-year warfarin users followed in the same centre by educated,
single health personnel and by general cardiology outpatient clinic
 Material(s) and Method(s): One-year individual TTR percentage of INR
values in patients followed in our tertiary centre, by specialized INR
outpatient clinic (Group A, n=233) and by general cardiology outpatient
clinic (Group B, n=148) was calculated by Roosendaal formula. Target INR
values for atrial fibrillation (AF) and other reasons for warfarin use was
defined as 2-3 and for prosthetic valve as 2.5-3.5. Result(s): There
was no significant difference between groups in basal characteristics of
the patients such as, sex, age, heart failure, hypertension, diabetes
mellitus, smoke, renal failure and anti-inflammatory use. The mean age of
patients was 62+/-12.3 years and 43.8% (n=167) were male. All of the
patients were using warfarin for a long time and 64.8% for more than 3
years. In Group A warfarin was used for AF more often (59.1%) and Group B
the use for AF and prosthetic valve was equal. There was no significant
difference between groups in terms of factors effecting on reaching target
INR level, such as gender, educational degree, antiplatelet use, advanced
age (>75, n=67) and lifestyle. The average number of INR control in a-year
was 14.1+/-3.6 and was similar in both groups. There were no significant
difference between HAS-BLED score and CHADS2-VASc2 score of the groups.
Group B had high risk of embolism with an average CHADS2-VASc2 score of
3.5, while a relatively low risk of bleeding with an average HAS-BLED
score of 2.09+/-1.3. The average TTR of the whole study group was
62.1+/-20.7% and there was a significant difference between groups (Group
A, 68.8%+/-15.8% vs. Group 51.6%+/-23%, p<0.001). Bleeding complications
occurred in 93 patients and 26.8% of them (n = 25) had a major bleeding
(The Bleeding Academic Research Consortium [BARC 3 and above]) and no
significant difference between the groups. Discussion and
 Conclusion(s): Despite tight controls of INR levels, most randomized
controlled trials' TTR percentages do not surpass 70%. In real life
experiences, these rates fall further. In our study, the real-life
experience shows that, while TTR percentage of general outpatient
follow-up is 51.6%, it is 68.8% in specialized outpatient follow-up,
revealing the importance of specialized clinics. In conclusion, our study
shows that with similar INR level controls in a year, specialized
outpatient clinics are more effective in reaching TTR rates than general
cardiology outpatient clinics.

<85>
Accession Number
647285250
Title
The effects of NAC on renal functions evaluated by NGAL blood levels in
geriatric patients undergoing CABG.
Source
Anatolian Journal of Cardiology. Conference: 31st Turkish Cardiology
Congress. Antalya Turkey. 15(Supplement 1) (pp 75), 2015. Date of
Publication: 01 Oct 2015.
Author
Carsanba G.; Aldemir M.; Koca H.B.; Baki E.D.; Kavrut N.O.; Kavakli A.S.;
Adali F.; Emmiler M.; Darcin O.T.
Institution
(Carsanba, Aldemir, Koca, Baki, Adali, Darcin) Afyon Kocatepe University,
Faculty of Medicine, Afyon, Turkey
(Kavrut, Kavakli, Emmiler) Antalya Education and Research Hospital,
Antalya, Turkey
Publisher
Turkish Society of Cardiology
Abstract
Introduction: Recent conflicting studies on the renal effects of N-acetyl
cysteine (NAC) after cardiac surgery have been published. The aim of this
study was to evaluate the renal effects of NAC using neutrophil
gelatinase-associated lipocalin (NGAL) blood levels in elderly patients
undergoing coronary artery bypass surgery. Material(s) and Method(s):
This randomized, double-blinded, placebo-controlled study was conducted
among geriatric patients (>65 years) scheduled for CABG. A total of 60
consecutive patients were randomly assigned into two groups. The first
group received I.V. NAC (n=30) and the second group received placebo
(n=30) at induction of anaesthesia and then for 20 hrs. NGAL values were
determined and conventional renal function tests were performed.
 Result(s): Plasma creatinine level at the P.O. 24th hr was
significantly higher in the placebo group than the NAC group (1.41+/-0.63
vs 1.13+/-0.35, p<0.05). The mean serum NGAL level in the third
postoperative hour was higher in the placebo group than in the NAC group
(104.94+/-30.51 vs 87.82+/-25.18, p<0.05). Its level was similar at all
other measurement times for the two groups. The number of patients (%)
with increased plasma creatinine >=1.5 mg/dL or >25% of the baseline value
at any time of the study period was 27% in the NAC group and 37% in the
placebo group, which was statistically significant (p<0.05). Discussion
and Conclusion(s): In the present study, we found that I.V.
N-acetylcysteine infusion in elderly patients undergoing coronary artery
by-pass surgery reduced the incidence of acute kidney injury as determined
by blood NGAL and creatinine levels. (Figure Presented).

<86>
Accession Number
2038643366
Title
Morphologic changes of the no-touch saphenous vein as Y-composite versus
aortocoronary grafts (CONFIG Trial).
Source
PLoS ONE. 20(5 MAY) (no pagination), 2025. Article Number: e0322176. Date
of Publication: 01 May 2025.
Author
Sohn S.H.; Kang Y.; Kim J.S.; Kang J.; Hwang H.Y.
Institution
(Sohn, Kang, Kim, Hwang) Department of Thoracic and Cardiovascular
Surgery, Seoul National University Hospital, Seoul National University
College of Medicine, Seoul, South Korea
(Kang) Department of Internal Medicine and Cardiovascular Center, Seoul
National University Hospital, Seoul National University College of
Medicine, Seoul, South Korea
Publisher
Public Library of Science
Abstract
Objective This randomized controlled trial was aimed to compare 1-year
morphologic changes of the no-touch saphenous vein graft as Y-composite
(Composite group) versus aortocoronary (Aorta group) configurations in
coronary artery bypass grafting. Methods The primary endpoint was
intima-media thickness of the saphenous vein graft as measured by
intravascular ultrasound (IVUS) at the 1-year angiographic evaluation.
Recruitment of 25 patients in each group was necessary based on a
superiority design. Among the 50 patients, IVUS data were obtained in 22
and 24 patients from the Composite and Aorta groups, respectively. Results
Mean age was 64.8 +/- 9.2 years, and the proportion of females was 20.0%.
The numbers of distal anastomoses per saphenous vein graft were 2.7 +/-
1.1 and 2.6 +/- 0.8 in the Composite and Aorta groups, respectively. The
intima-media thickness of the saphenous vein graft 1 year after surgery
were 0.25 +/- 0.04 mm and 0.24 +/- 0.06 mm in the Composite and Aorta
groups, respectively (P for superiority = .99). Other IVUS parameters of
saphenous vein grafts, including vessel diameter, luminal diameter, and
the ratio of intima-media thickness to vessel diameter, also demonstrated
no differences between the groups. No neointimal hyperplasia or plaque
formation was detected using IVUS. All study patients underwent 1-year
angiographic evaluation, and the patency rates were 94.7%(89 out of 94
anastomoses) and 100.0%(90 out of 90 anastomoses) in the Composite and
Aorta groups, respectively. Conclusions The intima-media thickness of the
saphenous vein graft 1 year after surgery demonstrated no significant
difference between the Y-composite and aortocoronary configurations
(NCT04782492). Copyright © 2025 Sohn et al.

<87>
Accession Number
2038631853
Title
Effects of pre-CABG program on discharge readiness and surgery outcomes
for patients undergoing elective CABG surgery: A study protocol for a
randomised control trial.
Source
BMJ Open. 15(4) (no pagination), 2025. Article Number: e090256. Date of
Publication: 30 Apr 2025.
Author
Abadi P.D.; Zakerimoghadam M.; Abadi Z.A.D.; Rahmanian M.; Riahi S.M.;
Khanipour-Kencha A.
Institution
(Abadi, Zakerimoghadam, Abadi, Khanipour-Kencha) Department of
Medical-Surgical Nursing, Tehran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Rahmanian) Imam Khomeini Hospital Complex, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Riahi) Department of Community Medicine, School of Medicine,
Cardiovascular Diseases Research Center, Birjand University of Medical
Sciences, Birjand, Iran, Islamic Republic of
Publisher
BMJ Publishing Group
Abstract
Introduction Cardiovascular diseases, a leading cause of death globally,
impose significant health and economic burdens, particularly in countries
like Iran. Coronary artery bypass grafting (CABG) is a common intervention
for ischaemic heart disease, yet it entails a long recovery process with
potential complications and psychological impacts. This study aims to
evaluate the effectiveness of a prehabilitation programme (pre-CABG) on
postoperative outcomes and discharge readiness in patients undergoing
elective CABG. Methods and analysis This randomised controlled trial
involves 60 patients diagnosed with coronary artery disease at Imam
Khomeini Hospital Complex, Tehran. Participants will be randomly assigned
to either the intervention group, receiving the pre-CABG programme, or the
control group, receiving standard care. The pre-CABG programme includes
patient education, stress management techniques, respiratory muscle
training and nutritional guidance. Primary outcomes include discharge
readiness, duration of intubation, Intensive Care Uniy (ICU) stay,
occurrence of atelectasis, onset of mobility, hospital stay and levels of
anxiety and depression. Secondary outcomes include the rate of 30-day
readmissions. Data collection will involve standardised scales and
checklists administered at various stages preoperation and postoperation.
Ethics and dissemination The research study has received approval from the
Research Ethics Committee at Tehran University of Medical Sciences' School
of Nursing and Midwifery and Rehabilitation. All participants must provide
written consent for their involvement in this study. The findings will be
shared with appropriate groups and published in peer-reviewed journals.
Trial registration number The study is registered with the Iranian
Registry of Clinical Trials under the ID
IRCT20231019059768N1. Copyright © Author(s) (or their
employer(s)) 2025.

<88>
Accession Number
2038634761
Title
Comparison of Magnesium Sulphate and Esmolol for Attenuation of
Hemodynamic Stress Response to Laryngoscopy and Intubation in Elective ENT
Procedures.
Source
European Journal of Cardiovascular Medicine. 15(5) (pp 99-102), 2025. Date
of Publication: 01 May 2025.
Author
Sree K.U.; Vegiraju B.V.V.; Nagaraju C.H.
Institution
(Sree) Department of Anaesthesiology, Alluri Sitarama Raju Academy of
Medical Sciences, West Godavari District, Andhra Pradesh, Eluru, India
(Vegiraju) Department of Anaesthesiology, Government Medical College,
Andhra Pradesh, Anantapuramu, India
(Nagaraju) Department of Anaesthesiology, Government medical college,
Nizamabad, India
Publisher
Healthcare Bulletin
Abstract
Background: The induction of anaesthesia, laryngoscopy, tracheal
intubation and surgical stimulation evoke cardiovascular responses leading
to alteration in heart rate, cardiac rhythm and blood pressure. The
response starts in 5 seconds, peaks within 1-2 minutes and returns to
baseline in 5 minutes. The goal is to compare the effectiveness of Esmolol
and Magnesium Sulphate for attenuation of haemodynamic stress response to
laryngoscopy and intubation. Material(s) and Method(s): After
approval from the ASRAMS Institutional Ethics Committee, the procedure was
clearly explained to patients and informed written consent was obtained.
The study was conducted during the period, April 2024- March 2025 at ASRAM
General and Super-Specialty Hospital, Eluru, Andhra Pradesh. 90 patients
of age group 15 to 60 yrs of ASA physical status I and II who underwent
elective ENT surgery under general anesthesia were selected and randomly
allocated into 3 groups. Baseline heart rate and blood pressure was
measured. They were premedicated with Inj. Glycopyrrolate 0.2mg and Inj.
Midazolam 0.04mg/kg intramuscular 45 minutes before surgery. Patients were
then shifted into the theatre. Inj. Fentanyl 2microg/kg was given 5
minutes before intubation to all patients. They were induced with Inj.
Propofol 2mg/kg and Vecuronium 0.1mg/kg. Group M received Inj. Magnesium
Sulphate 50mg/kg in 100ml of normal saline infusion over 10 minutes before
induction. Group P received 15ml of normal saline 5 minutes before
induction. Group E received Esmolol 1.5mg/kg in 15ml normal saline over
15-20 seconds one minute after vecuronium and intubation was done after 2
minutes. Group P received 15ml of normal saline 5 minutes before
induction. The heart rate, systolic and diastolic blood pressure and mean
arterial pressure were recorded baseline, after premedication, one min
after test drug, after induction, immediately after intubation, thereafter
1, 3 and 5 minutes following intubation. Laryngoscopy duration was noted.
 Result(s): 1) Group E showed maximum attenuation of heart rate and
blood pressure. 2) Group M also showed significant attenuation of blood
pressure response but produced tachycardia on infusion of the drug. Heart
rate response was not statistically significant compared to group E. 3)
All patients recovered well. 4) Incidence of side effects was not
significant between the groups. Conclusion(s): From this study, it is
concluded that hemodynamic changes to laryngoscopy and intubation can be
attenuated by giving intravenous Esmolol 1.5mg/kg. Esmolol is effective in
blunting the response followed by Magnesium Sulphate which blunts the
hypertensive response but produces tachycardia during infusion of the
drug. Placebo was ineffective in blunting hemodynamic stress response to
laryngoscopy and intubation.. Copyright © 2025 Healthcare
Bulletin. All rights reserved.

<89>
Accession Number
2038636220
Title
SAVR and TAVI comparison across the globe based on current regional
registry evidence - A meta-analysis of reconstructed time-to-event data.
Source
IJC Heart and Vasculature. 59 (no pagination), 2025. Article Number:
101703. Date of Publication: 01 Aug 2025.
Author
Caldonazo T.; Kirov H.; Vogel A.; Runkel A.; Mukharyamov M.; Fischer J.;
Dadashzadeh A.; Doenst T.
Institution
(Caldonazo, Kirov, Vogel, Runkel, Mukharyamov, Fischer, Dadashzadeh,
Doenst) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, Germany
Publisher
Elsevier Ireland Ltd
Abstract
Background: There is debate whether surgical aortic valve replacement
(SAVR) or transcatheter implantation (TAVI) provide better results for
treatment of aortic valve stenosis. While randomized clinical trials
(RCTs) are considered to compare the average treatment effect of two
methods in a selected patient population, registry data, although biased,
reflect every day clinical practice and provide external validation of
RCTs. We evaluated the impact of SAVR or TAVI on long-term survival based
on local reports from all available regions in the world. Method(s):
We systematically searched three databases selecting risk-adjusted
registry studies comparing outcomes for SAVR and TAVI with at least five
years of follow-up. Reports without all-cause mortality were excluded. One
time-to-event curve was reconstructed from survival curves. Cox regression
model and sensitivity analysis were performed. Result(s): From 10,399
screened studies, 13 met the inclusion criteria with 28,344 patients in
the final analysis (follow-up: 5-9 years). In ten studies, survival rates
favored SAVR, three showed no difference and none favored TAVI. Hazard
ratio (HR) for overall survival was 0.58 (95 %CI: 0.54-0.61, p < 0.01 -
favors SAVR). A landmark analysis with a 6-months split showed no
significant survival difference in the first 6 months (HR: 0.94, 95 %CI:
0.86-1.02, p = 0.14) and better survival for SAVR compared to TAVI
thereafter (HR: 0.43, 95 %CI: 0.40-0.46, p < 0.01). All sensitivity
analyses supported this outcome. Conclusion(s): This systematic
regional registry-type comparison revealed that SAVR is associated with
increased long-term survival compared to TAVI, which appears to be
independent of the world region in which the study was
performed. Copyright © 2025 The Author(s)

<90>
Accession Number
2038664654
Title
Anticoagulation vs No Anticoagulation for Postoperative Atrial
Fibrillation After Isolated Coronary Artery Bypass Graft: A Meta-Analysis.
Source
American Journal of Cardiology. 249 (pp 16-17), 2025. Date of Publication:
15 Aug 2025.
Author
Shariff M.; Kumar A.; Bagameri G.; Kowlgi N.G.; Deshmukh A.; Stulak J.
Institution
(Shariff, Bagameri, Stulak) Department of Surgery, Mayo Clinic, Rochester,
Minneapolis
(Kumar, Kowlgi, Deshmukh) Department of Cardiovascular Medicine, Mayo
Clinic, Rochester, Minnesota
(Bagameri, Stulak) Department of Cardiovascular Surgery, Mayo Clinic,
Rochester, Minnesota
Publisher
Elsevier Inc.

<91>
Accession Number
2038632918
Title
Iron deficiency in patients with cardiogenic shock: Protocol for a scoping
review.
Source
BMJ Open. 15(4) (no pagination), 2025. Article Number: e092891. Date of
Publication: 19 Apr 2025.
Author
Germinario L.; Catena D.; Ott S.; Roeschl T.; Ghamri Y.; Meyer A.; O'Brien
B.; Schoenrath F.
Institution
(Germinario, Catena, Ott, Ghamri, O'Brien) Department of Cardiac
Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der
Charite - Medical Heart Center of Charite, German Heart Institute Berlin,
Berlin, Germany
(Germinario, Catena, Ott, Roeschl, Ghamri, Meyer, O'Brien, Schoenrath)
Charite - Universitatsmedizin Berlin, Corporate member of Freie
Universitat Berlin, Humboldt-Universitat zu Berlin, Campus
Virchow-Klinikum, Augustenburger Platz 1, Berlin, Germany
(Ott, Schoenrath) Dzhk (German Centre for Cardiovascular Research),
Partner Site Berlin, Berlin, Germany
(Ott) Department of Anesthesiology, Outcomes Research Consortium,
Cleveland Clinic, Cleveland, OH, United States
(Roeschl, Meyer, Schoenrath) Department of Cardiothoracic and Vascular
Surgery, Deutsches Herzzentrum der Charite - Medical Heart Center of
Charite, German Heart Institute Berlin, Berlin, Germany
(Roeschl, Meyer) Berlin Institute of Health, Charite-Universitatsmedizin
Berlin, Institute of Medical Informatics, Invalidenstrase 90, Berlin,
Germany
(O'Brien) Department of Perioperative Medicine, St Bartholomew's Hospital
and Barts Heart Centre, London, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Cardiogenic shock (CS) is a severe condition characterised by
low cardiac output and often hypotension, which results in organ
hypoperfusion due to cardiac failure. As a form of acute heart failure,
this condition seems to share similar underlying pathological mechanisms.
It is well established that iron deficiency is correlated with chronic and
acute heart failure, causing worsening of the symptoms, reduction of
quality of life and survival and simultaneously increasing the
rehospitalisation rates for all causes in these patients. It remains
unclear whether there is an association between iron deficiency and CS.
The objective of this scoping review will be to determine the actual state
of the art regarding the significance of iron deficiency in patients
affected by CS. Methods and analysis We will conduct a systematic review
of the literature using MEDLINE and EMBASE via 'Ovid' (Elsevier) and Web
of Science (2024 Clarivate). The goal is to analyse the incidence and
clinical significance of iron deficiency in patients affected by
cardiogenic shock. To gain a deeper insight into the underlying
pathophysiological mechanisms, the review will include basic research
conducted on both human subjects and on animal models as well as
observational, randomised controlled studies and systematic reviews and
meta-analysis. To maximise the identification of relevant reports and
reduce loss of information, a systematic search of the literature will be
performed from inception until January 2025 using the terms "iron
deficiency"as well as "iron", "ferritin", "transferrin", "transferrin
saturation", "hepcidin"and "soluble transferrin receptor"matching these
terms with the keywords "cardiogenic shock", "acute heart failure",
"advanced heart failure", "decompensated heart failure", "lvad", "left
ventricular assist device", "mechanical circulatory support", "VA-ECMO"and
"Extracorporeal Life Support". We will also use the corresponding MeSH and
Emtree terms. In order to find grey literature, we will use the OADT.org
internet-based database. Ethics and dissemination No additional ethics
approval is required, as this review is based on existing research without
new data collection. Only studies with ethics approval will be included.
We plan to publish our findings in a peer-reviewed journal and present
them at international conferences on cardiology, intensive and acute
cardiovascular care, cardiac surgery and
cardioanaesthesiology. Copyright © Author(s) (or their
employer(s)) 2025.

<92>
Accession Number
2038627546
Title
Valve thrombosis and antithrombotic therapy after bioprosthetic mitral
valve replacement: a systematic review and meta-analysis.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 11(3) (pp
251-263), 2025. Date of Publication: 01 May 2025.
Author
Zorman M.J.; Vibhishanan J.; Dangas K.; Castle J.; Li K.H.C.; Coronelli
M.; Eastwick-Jones K.; Swan A.; Johnson N.; Choksey A.; Yan H.; Scott
S.G.C.; Henry M.; Cassar M.P.; Barnes C.; Ferreira-Martins J.; Newton J.;
Dawkins S.; Alkhouli M.; Rihal C.; Eleid M.F.; Pislaru S.V.; Guerrero
M.E.; Ordonez-Mena J.; Cahill T.J.
Institution
(Zorman, Vibhishanan, Dangas, Castle, Li, Coronelli, Eastwick-Jones, Swan,
Johnson, Choksey, Yan, Scott, Cassar, Barnes, Ferreira-Martins, Newton,
Dawkins, Cahill) Oxford Heart Centre, Oxford University Hospitals NHS
Trust, Headley Way, Oxford, United Kingdom
(Zorman, Alkhouli, Rihal, Eleid, Pislaru, Guerrero) Department of
Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN,
United States
(Henry) Health Care Libraries, University of Oxford, John Radcliffe
Hospital, Headley Way, Oxford, United Kingdom
(Ordonez-Mena) Nuffield Department of Primary Care Sciences, University of
Oxford, Radcliffe Observatory Quarter, Woodstock Road, United Kingdom
Publisher
Oxford University Press
Abstract
Aims: Transcatheter mitral valve replacement (TMVR) has become a feasible
alternative to surgical mitral valve replacement (SMVR) in selected
patients at high surgical risk. The risk of valve thrombosis following
SMVR and TMVR, and the optimal antithrombotic therapy following these
procedures, remains uncertain. We aimed to compare the incidence of
bioprosthetic mitral valve thrombosis (bMVT) after SMVR and TMVR, and the
incidence of bMVT between patients on different antithrombotic regimens.
 Methods and Results: A literature search of Medline, Embase, and
Cochrane Library was performed between January 2000 and August 2024.
Random-effects models were used to derive pooled estimates of the
incidence of bMVT in the absence of prior or active endocarditis and valve
thrombosis. A total of 47 studies (6170 patients, total follow-up 9541.8
patient-years) were eligible for inclusion. The overall incidence of bMVT
was 5.05 [95% confidence interval (CI) 3.18-8.01, I2 = 82%] per
100-patient-years. Subclinical bMVT was more common than clinically
significant bMVT: incidence 19.11 vs. 7.91 per 100-patient-years, adjusted
incidence rate ratio (aIRR) 4.62 (95% CI 1.39-15.36), P = 0.012. bMVT was
numerically more common after TMVR than SMVR, but the comparison was not
statistically significant: incidence 7.03 vs. 0.58 per 100-patient-years,
aIRR 2.19 (95% CI 0.72-6.72), P = 0.170. Patients on vitamin-K antagonists
(VKA) had a lower incidence of bMVT than patients on direct oral
anticoagulants (DOAC; incidence 5.72 vs. 17.08, aIRR 0.31, 95% CI
0.13-0.73, P = 0.007). Conclusion(s): bMVT is not uncommon, with
numerically higher incidence in transcatheter compared to surgical valves,
but the comparison was not statistically significant. VKAs are associated
with a lower incidence of bMVT compared to DOACs. Copyright ©
2025 The Author(s).

<93>
Accession Number
2038642759
Title
Cryopreserved platelets compared with liquid-stored platelets for the
treatment of surgical bleeding: protocol for two multicentre randomised
controlled blinded non-inferiority trials (the CLIP-II and CLIPNZ-II
trials).
Source
BMJ Open. 12(12) (no pagination), 2022. Article Number: e068933. Date of
Publication: 20 Dec 2022.
Author
Reade M.C.; Marks D.C.; Howe B.; McGuinness S.; Parke R.; Navarra L.;
Charlewood R.; Johnson L.; McQuilten Z.; Marks D.; French C.; Weinberg L.;
Irving D.; Wood E.; Bannon P.; Gattas D.; Eastwood G.; Royse A.; Smith J.;
Hu R.; Holley A.; Higgins A.; Gilder E.; Byrne K.; Galvin S.; Hayes K.;
Moore J.; Morley S.; Walker C.
Institution
(Reade) Faculty of Medicine, University of Queensland, Herston, QLD,
Australia
(Reade, Howe, McQuilten) Australian and New Zealand Intensive Care
Research Centre, Monash University, Melbourne, VIC, Australia
(Marks, Johnson) Australian Red Cross Lifeblood, Alexandria, NSW,
Australia
(McGuinness, Parke) Cardiothoracic and Vascular Intensive Care Unit,
Auckland City Hospital, Auckland, New Zealand
(McGuinness, Navarra) Medical Research Institute of New Zealand,
Wellington, New Zealand
(Parke) School of Nursing, University of Auckland, Auckland, New Zealand
(Charlewood) New Zealand Blood Service, Auckland, New Zealand
Publisher
BMJ Publishing Group
Abstract
Introduction Cryopreservation at -80degreeC in dimethylsulphoxide extends
platelet shelf-life from 7 days to 2 years. Only limited comparative trial
data supports the safety and effectiveness of cryopreserved platelets as a
treatment for surgical bleeding. Cryopreserved platelets are not currently
registered for civilian use in most countries. Methods and analysis
CLIP-II and CLIPNZ-II are harmonised, blinded, multicentre, randomised,
controlled clinical non-inferiority trials comparing bleeding,
transfusion, safety and cost outcomes associated with cryopreserved
platelets versus conventional liquid platelets as treatment for bleeding
in cardiac surgery. CLIP-II is planning to enrol patients in 12 tertiary
hospitals in Australia; CLIPNZ-II will recruit in five tertiary hospitals
in New Zealand. The trials use near-identical protocols aside from details
of cryopreserved platelet preparation. Patients identified preoperatively
as being at high risk of requiring a platelet transfusion receive up to
three units of study platelets if their treating doctor considers platelet
transfusion is indicated. The primary endpoint is blood loss through the
surgical drains in the 24 hours following intensive care unit (ICU)
admission after surgery. Other endpoints are blood loss at other time
points, potential complications, adverse reactions, transfusion and fluid
requirement, requirement for procoagulant treatments, time to commencement
of postoperative anticoagulants, delay between platelet order and
commencement of infusion, need for reoperation, laboratory and
point-of-care clotting indices, cost, length of mechanical ventilation,
ICU and hospital stay, and mortality. Transfusing 202 (CLIP-II) or 228
(CLIPNZ-II) patients with study platelets will provide 90% power to
exclude the possibility of greater than 20% inferiority in the primary
endpoint. If cryopreserved platelets are not inferior to liquid-stored
platelets, the advantages of longer shelf-life would justify rapid change
in clinical practice. Cost-effectiveness analyses will be incorporated
into each study such that, should clinical non-inferiority compared with
standard care be demonstrated, the hospitals in each country that would
benefit most from changing to a cryopreserved platelet blood bank will be
known. Ethics and dissemination CLIP-II was approved by the Austin Health
Human Research Ethics Committee (HREC/54406/ Austin-2019) and by the
Australian Red Cross Lifeblood Ethics Committee (2019#23). CLIPNZ-II was
approved by the New Zealand Southern Health and Disability Ethics
Committee (21/ STH/66). Eligible patients are approached for informed
consent at least 1 day prior to surgery. There is no provision for consent
provided by a substitute decision-maker. The results of the two trials
will be submitted separately for publication in peer-reviewed
journals. Copyright © Author(s) (or their employer(s)) 2022.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<94>
Accession Number
647270938
Title
Long-term trials of colchicine for secondary prevention of vascular
events: a meta-analysis.
Source
European heart journal. (no pagination), 2025. Date of Publication: 02
May 2025.
Author
Samuel M.; Berry C.; Dube M.-P.; Koenig W.; Lopez-Sendon J.; Maggioni
A.P.; Pinto F.J.; Roubille F.; Tardif J.-C.
Institution
(Samuel) University Medical Center Groningen, University of Groningen,
Groningen, Netherlands
(Samuel) Dalhousie University, Halifax, Canada
(Berry) School of Cardiovascular and Metabolic Health, University of
Glasgow and Golden Jubilee National Hospital, Clydebank, United Kingdom
(Dube, Tardif) Montreal Heart Institute, Universite de Montreal ,5000
Belanger Street, Montreal, Canada
(Koenig) Technical University of Munich, School of Medicine and Health,
German Heart Centre, TUM University Hospital, Munich, Germany
(Koenig) German Centre for Cardiovascular Research (DZHK), partner site
Munich Heart Alliance, Munich, Germany
(Koenig) Institute of Epidemiology and Medical Biometry, University of
Ulm, Ulm, Germany
(Lopez-Sendon) IdiPaz Research Institute, Hospital La Paz, Universidad
Autonoma de Madrid, Madrid, Spain
(Maggioni) ANMCO Research Center-Heart Care Foundation, Florence, Italy
(Pinto) Santa Maria University Hospital, Center of Cardiology of the
University of Lisbon, Lisbon School of Medicine, Lisbon Academic Medical
Center, Lisboa, Portugal
(Roubille) PhyMedExp, Cardiology Department, University of Montpellier,
INSERM, CNRS UMR, Montpellier, France
Abstract
BACKGROUND AND AIMS: Colchicine has emerged as a safe and inexpensive
anti-inflammatory medication to target the residual risk of cardiovascular
events in the secondary prevention of coronary artery disease. Two
recently published randomized controlled trials (RCTs) investigating
colchicine in the post-stroke and post-myocardial infarction (MI)
populations warrant a re-evaluation of colchicine. New evidence was
synthesized in a systematic review and meta-analysis to determine the
long-term efficacy and safety of colchicine for the secondary prevention
of vascular disease. METHOD(S): Randomized controlled trials
comparing the incidence of cardiovascular events between patients with
clinically manifest vascular disease randomized to colchicine vs. placebo
and >=12-month follow-up were included. The primary efficacy endpoint is
major adverse cardiovascular events (MACE) and includes cardiovascular
mortality, MI, ischaemic stroke, and urgent coronary revascularization.
The DerSimonian and Laird random effects model was used to calculate
pooled effect estimates. RESULT(S): Six RCTs, with a pooled sample
size of 21 800 patients, were included (colchicine n = 10 871; placebo n =
10 929). Over a follow-up of 12-34 months, colchicine reduced the
incidence of MACE compared with placebo [pooled hazard ratio .75, 95%
confidence interval (CI) .56-.93]. The reduction in cardiovascular events
among colchicine patients was driven by reductions in MIs, ischaemic
strokes, and urgent coronary revascularizations (P < .05 for all). No
differences were detected for safety outcomes (P > .05 for all), including
non-cardiovascular deaths (risk ratio 1.08, 95% CI .76-1.54).
 CONCLUSION(S): This updated meta-analysis of RCTs demonstrated a
substantial reduction in MACE, MI, ischaemic stroke, and recurrent
coronary revascularization with colchicine compared with placebo.
Therefore, the results support the use of colchicine to reduce recurrent
cardiovascular events. Copyright © The Author(s) 2025. Published
by Oxford University Press on behalf of the European Society of
Cardiology.

<95>
Accession Number
2037913052
Title
Transformative effects of fluorescence imaging technologies on current
vascular surgical practices: An updated review.
Source
SLAS Technology. 32 (no pagination), 2025. Article Number: 100270. Date of
Publication: 01 Jun 2025.
Author
Fang T.; Dong J.; Xie Z.
Institution
(Fang, Dong, Xie) Department of Vascular Surgery, Yantai Mountain
Hospital, Yantai, China
Publisher
Elsevier B.V.
Abstract
Fluorescence imaging technologies have revolutionized vascular surgery by
enabling real-time visualization of vascular anatomy, blood circulation,
and tissue perfusion, thus improving intraoperative decision-making. This
review provides a comprehensive analysis of key fluorescence modalities,
including Fluorescence-Guided Surgery (FGS), Near-Infrared (NIR)
fluorescence imaging, and Indocyanine Green (ICG) angiography,
highlighting their roles in optimizing tissue perfusion assessment, vessel
patency evaluation, and identifying anatomical variations. Unlike existing
literature, this review addresses critical gaps in current practices by
comparing these technologies and exploring their applications across a
range of vascular procedures such as peripheral vascular surgery, coronary
artery bypass grafting, and oncological operations. The review further
delves into the potential future directions for fluorescence imaging in
vascular surgery, emphasizing emerging technologies, challenges in
clinical implementation, and how these advancements can enhance surgical
precision, patient outcomes, and intraoperative guidance. By synthesizing
the latest developments, this review offers valuable insights into the
evolving role of fluorescence imaging in vascular surgery and its
potential to transform surgical practices. Copyright © 2025

<96>
Accession Number
647264909
Title
Cardiorespiratory Fitness in Children with Surgically Corrected Congenital
Heart Disease: A Meta-analysis and Meta-regression.
Source
Trends in cardiovascular medicine. (no pagination), 2025. Date of
Publication: 28 Apr 2025.
Author
Haas S.D.; van der Hulst A.E.; Adel C.; Malekzadeh A.; Blom N.A.; Konigs
M.; van den Aardweg J.G.; Kuipers I.M.; Oosterlaan J.
Institution
(Haas, Adel) Department of Pediatrics, Emma Children's Hospital, Amsterdam
UMC location University of Amsterdam, Amsterdam, The Netherlands;
Department of Pediatric Cardiology, Emma Children's Hospital, Amsterdam
UMC location University of Amsterdam, Amsterdam, The Netherlands
(van der Hulst, Kuipers) Department of Pediatric Cardiology, Emma
Children's Hospital, Amsterdam UMC location University of Amsterdam,
Amsterdam, Netherlands
(Malekzadeh) Medical Library, Amsterdam UMC location University of
Amsterdam, Amsterdam, Netherlands
(Blom) Department of Pediatric Cardiology, Emma Children's Hospital,
Amsterdam UMC location University of Amsterdam, Amsterdam, The
Netherlands; Department of Pediatric Cardiology, Willem-Alexander's
Children's Hospital, Leiden UMC, Leiden, The Netherlands
(Konigs) Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC
location University of Amsterdam, Amsterdam, The Netherlands; Emma
Neuroscience Group, Department of Pediatrics, Emma Children's Hospital,
Amsterdam UMC location University of Amsterdam, Amsterdam, The
Netherlands; Amsterdam Reproduction and Development research institute,
Amsterdam, The Netherlands
(van den Aardweg) Department of Pulmonology, Amsterdam UMC location
University of Amsterdam, Amsterdam, Netherlands
(Oosterlaan) Department of Pediatrics, Emma Children's Hospital, Amsterdam
UMC location University of Amsterdam, Amsterdam, The Netherlands;
Amsterdam Reproduction and Development research institute, Amsterdam, The
Netherlands
Abstract
Congenital heart disease (CHD) is the most common birth defect, and
despite advancements in medical care, children with surgically corrected
CHD often experience reduced cardiorespiratory fitness, which is
associated with negative long-term health outcomes. This meta-analysis
aimed to quantify peak oxygen consumption (VO2peak) impairments in
children with surgically corrected CHD, examine isolated
diagnosis-specific impairments, and explore the relationship between
clinical variables and cardiorespiratory fitness. A total of 45 studies
encompassing 2,536 children with CHD and 3,108 healthy controls were
included in the meta-analysis, revealing that children with CHD had
significantly lower VO2peak (standardized mean difference = 1.13, 95%CI
0.98-1.28), with those having univentricular hearts being most affected
(standardized mean difference = 1.61, 95%CI 1.34-1.87). Reduced saturation
during exercise, chronotropic impairment and early onset of anaerobic
threshold are likely to play a role in this impairment. Copyright
© 2025. Published by Elsevier Inc.

<97>
Accession Number
647267928
Title
Perioperative Normoxia versus Hyperoxia in Neonates with Cyanotic Heart
Disease Undergoing Cardiac Surgery: A Randomized Controlled Trial.
Source
The Annals of thoracic surgery. (no pagination), 2025. Date of
Publication: 29 Apr 2025.
Author
Sznycer-Taub N.; Peng Y.-W.; Yu S.; Batazzi A.; Les A.; Lowery R.;
Griffith K.; Sturmer D.; Ohye R.G.; Russell M.W.; Pasquali S.K.; Charpie
J.
Institution
(Sznycer-Taub) Division of Pediatric Cardiology, Department of Pediatrics,
University of Michigan, Ann Arbor, MI, United States
(Peng, Yu, Batazzi, Lowery, Russell, Pasquali, Charpie) Division of
Pediatric Cardiology, Department of Pediatrics, University of Michigan,
Ann Arbor, MI, United States
(Les, Griffith, Sturmer) Department of Perfusion, Department of Cardiac
Surgery, University of Michigan, Ann Arbor, MI, United States
(Ohye) Section of Pediatric Cardiovascular Surgery, Department of Cardiac
Surgery, University of Michigan, Ann Arbor, MI, United States
Abstract
BACKGROUND: Exposure to supra-physiologic levels of oxygen has been
associated with end-organ damage and worse outcomes across multiple
populations related to oxidative stress and inflammation. There is limited
evidence to guide practice in children undergoing surgery with
cardiopulmonary bypass, including neonates with cyanotic congenital heart
disease, who are particularly vulnerable to oxidative stress due to
immature and depleted antioxidant defenses. METHOD(S): We conducted
the first randomized trial of perioperative normoxia (goal PaO2 60-100
mmHg during cardiopulmonary bypass and for the first 24 hours) versus
hyperoxia (goal PaO2 200-300 mmHg during cardiopulmonary bypass)
exclusively in cyanotic neonates to examine feasibility, systemic
oxidative stress response, and safety. The primary outcome was a serum
measure of oxidative stress: thiobarbituric acid reactive substances
(TBARS). Additional biomarkers and clinical outcomes were collected.
 RESULT(S): Twenty-nine neonates (median age 5 days) were enrolled.
Mean PaO2 in the normoxia arm (n=15) during cardiopulmonary bypass was
106+/-27 mmHg (vs hyperoxia 256+/-29 mmHg, p<0.0001). Mean post-operative
TBARS expressed as fold-change from baseline was lower in the normoxia arm
at 2 hours (1.21+/-0.26 vs 1.93+/-0.63), 6 hours (1.09+/-0.25 vs
1.77+/-0.7), and 24 hours (0.96+/-0.16 vs 1.41+/-0.29); all p<0.01. Other
biomarkers of oxidative stress were significantly lower in the normoxia
arm (all time points p<0.01). Safety outcomes including in-hospital
mortality and morbidities were similar between arms. CONCLUSION(S):
Controlled normoxia during cardiopulmonary bypass in cyanotic neonates is
feasible, safe, and associated with significant improvement in measures of
oxidative stress. These data are critical in informing larger-scale
studies of end-organ injury and clinical outcomes. Copyright ©
2025. Published by Elsevier Inc.

<98>
Accession Number
647270134
Title
Colchicine for secondary prevention of vascular events: a meta-analysis of
trials.
Source
European heart journal. (no pagination), 2025. Date of Publication: 02
May 2025.
Author
d'Entremont M.-A.; Poorthuis M.H.F.; Fiolet A.T.L.; Amarenco P.; Boczar
K.E.; Buysschaert I.; Chan N.C.; Cornel J.H.; Jannink J.; Jansen S.; Kedev
S.; Keech A.C.; Layland J.; Mewton N.; Montalescot G.; Pascual-Figal D.A.;
Rodriguez A.E.; Shah B.; Teraa M.; van Zelm A.; Wang Y.; Mosterd A.; Kelly
P.; Eikelboom J.; Jolly S.S.
Institution
(d'Entremont, Amarenco, Eikelboom, Jolly) Population Health Research
Institute, 237 Barton Street East, Hamilton L8L 2X2, Ontario, Canada
(d'Entremont, Jolly) Department of Cardiology, Hamilton General Hospital,
McMaster University, 237 Barton Street East, Hamilton L8L 2X2, Ontario,
Canada
(d'Entremont) Departement de Medecine, Centre Hospitalier Universitaire de
Sherbrooke, Sherbrooke, QC, Canada
(Poorthuis) Department of Neurology, University Medical Center Utrecht,
Utrecht, Netherlands
(Fiolet) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Fiolet, Cornel, Mosterd) Dutch Network for Cardiovascular Research (WCN),
Utrecht, Netherlands
(Amarenco) Department of Neurology, Bichat University Hospital, Paris,
France
(Boczar) Department of Cardiology, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Buysschaert) Department of Cardiology, Sint-Jan Hospital, Brugge, Belgium
(Chan) Department of Medicine, Division of Haematology and
Thromboembolism, McMaster University, Hamilton, ON, Canada
(Cornel) Department of Cardiology, Northwest Clinics, Alkmaar, Netherlands
(Cornel) Department of Cardiology, Radboud University Medical Centre,
Nijmegen, Netherlands
(Jannink, Mosterd) Department of Cardiology, Meander Medical Center,
Amersfoort, Netherlands
(Jansen) Heart and Vascular Research Institute, Harry Perkins Institute
for Medical Research, Perth, Australia
(Kedev) Department of Cardiology, University Ss. Cyril and Methodius,
Skopje, North Macedonia
(Keech) NHMRC Clinical Trials Centre, Faculty of Medicine and Health,
University of Sydney, Sydney, Australia
(Keech) Department of Cardiology, Royal Prince Alfred Hospital, Sydney,
Australia
(Layland) Department of Cardiology, Peninsula Health, Peninsula Clinical
School, Central Clinical School, Monash University, Frankston, VIC,
Australia
(Mewton) Department of Cardiology, Institut de Cardiologie des Hospices
Civils de Lyon, Lyon, France
(Montalescot) Sorbonne University, ACTION Study Group, Centre Hospitalier
Universitaire Pitie-Salpetriere Assistance Publique-Hopitaux de Paris,
Paris, France
(Pascual-Figal) Department of Cardiology, Hospital Virgen de la Arrixaca,
University of Murcia, Murcia, Spain
(Pascual-Figal) Department of Cardiology, Centro Nacional de
Investigaciones Cardiovasculares (CNIC), Madrid, Spain
(Rodriguez) Department of Cardiology, Otamendi Hospital, Argentina
(Shah) Department of Cardiology, VA New York Harbor Healthcare System, NY,
United States
(Shah) Leon H Charney Division of Cardiology, NYU Grossman School of
Medicine, New York, NY, USA
(Teraa, van Zelm) Department of Vascular Surgery, University Medical
Center Utrecht, Utrecht, Netherlands
(Wang) Department of Neurology, Beijing Tiantan Hospital, Capital Medical
University, Beijing, China
(Kelly) Department of Neurology, Mater Misericordiae University Hospital
and School of Medicine, University College Dublin, Dublin, Ireland
(Kelly) Health Research Board Stroke Clinical Trials Network Dublin
Ireland, Dublin, Ireland
(Eikelboom) Department of Medicine, McMaster University, Hamilton, ON,
Canada
Abstract
BACKGROUND AND AIMS: Randomized trials of colchicine in secondary
prevention of atherosclerotic cardiovascular disease have shown mixed
results. METHOD(S): A systematic review and study-level meta-analysis
of randomized controlled trials was performed comparing colchicine vs no
colchicine in a secondary-prevention atherosclerotic cardiovascular
disease population. A fixed-effect inverse variance model was applied
using the intention-to-treat population from the included trials. The
primary outcome was the composite of cardiovascular death, myocardial
infarction, or stroke. RESULT(S): Nine trials, including 30 659
patients (colchicine 15 255, no colchicine 15 404) with known coronary
artery disease or stroke, were included. Compared with no colchicine,
patients randomized to colchicine had a relative risk (RR) of 0.88 [95%
confidence interval (CI) 0.81-0.95, P = .002] for the primary composite
outcome, including a RR of 0.94 for cardiovascular death (95% CI
0.78-1.13, P = .5), a RR of 0.84 for myocardial infarction (95% CI
0.73-0.97, P = .016), and a RR of 0.90 for stroke (95% CI 0.80-1.02, P =
.09). Colchicine was associated with a RR of 1.35 for hospitalization for
gastrointestinal events (95% CI 1.10-1.66, P = .004) with no increase in
hospitalization for pneumonia, newly diagnosed cancers, or
non-cardiovascular death. CONCLUSION(S): In patients with prior
coronary disease or stroke, colchicine reduced the composite of
cardiovascular death, myocardial infarction, or stroke by
12%. Copyright © The Author(s) 2025. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved. For commercial re-use, please contact reprints@oup.com
for reprints and translation rights for reprints. All other permissions
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<99>
Accession Number
2038600881
Title
Mitral Transcatheter Edge-to-edge Repair: British Cardiovascular
Intervention Society Position Statement.
Source
Interventional Cardiology: Reviews, Research, Resources. 20 (no
pagination), 2025. Article Number: e14. Date of Publication: 2025.
Author
Byrne J.; Buch M.; Mullen M.; Duncan A.; Dawkins S.; Nadir A.; Newton J.;
Patterson T.; Smith R.; Ghattas A.; Blackman D.J.; Hildick-Smith D.
Institution
(Byrne) King's College Hospital NHS Foundation Trust, London, United
Kingdom
(Buch) Manchester University Hospital NHS Foundation Trust, Manchester,
United Kingdom
(Mullen) St Bartholomew's Hospital NHS Foundation Trust, London, United
Kingdom
(Duncan, Smith) Royal Brompton and Harefield NHS Foundation Trust, London,
United Kingdom
(Dawkins, Newton) John Radcliffe Hospital, Oxford, United Kingdom
(Nadir) Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
(Patterson) Guy's and St Thomas' NHS Foundation Trust, London, United
Kingdom
(Ghattas) Golden Jubilee Hospital, Glasgow, United Kingdom
(Blackman) Leeds Teaching Hospitals NHS Trust, University of Leeds, Leeds,
United Kingdom
(Hildick-Smith) University Hospitals Sussex NHS Foundation Trust,
Brighton, United Kingdom
Publisher
Radcliffe Medical Media
Abstract
Transcatheter mitral leaflet repair is a non-surgical technique used to
treat severe mitral regurgitation. The technique has matured significantly
since its commercial introduction, and with device iteration and
increasing operator experience, it is now an important treatment option
for patients at higher risk for conventional mitral valve surgery.
Randomised clinical trials have established the safety and efficacy of the
technique in the treatment of primary and secondary mitral regurgitation,
and its use was approved by the National Institute for Health and Care
Excellence in 2019. This position statement summarises the clinical
evidence and indications for the procedure and provides expert consensus
on best practice in terms of patient selection, the procedure and
post-procedure care. Standards are also described with respect to team
composition, minimum case volume and collection of procedural and outcome
data. Copyright © The Author(s) 2025.

<100>
Accession Number
2034501698
Title
Vancomycin Antibiotic Prophylaxis Compared to Cefazolin Increases Risk of
Surgical Site Infection Following Spine Surgery.
Source
Global Spine Journal. (no pagination), 2025. Article Number:
21925682251341833. Date of Publication: 2025.
Author
Herrington B.J.; Urquhart J.C.; Rasoulinejad P.; Siddiqi F.; Gurr K.;
Bailey C.S.
Institution
(Herrington, Urquhart, Rasoulinejad, Siddiqi, Gurr, Bailey) Combined
Orthopaedic and Neurosurgical Spine Program, London Health Sciences
Centre, London, ON, Canada
(Herrington, Urquhart, Rasoulinejad, Siddiqi, Gurr, Bailey) London Health
Sciences Centre Research Institute, London, ON, Canada
(Herrington, Rasoulinejad, Siddiqi, Gurr, Bailey) Department of Surgery,
Division of Orthopaedics, Schulich School of Medicine and Dentistry,
University of Western Ontario, London, ON, Canada
Publisher
SAGE Publications Ltd
Abstract
Study Design: Retrospective analysis of randomized controlled trial.
 Objective(s): Surgical site infection (SSI) after spine surgery has
severe negative health and financial consequences. Surgical antibiotic
prophylaxis (SAP) is a routinely used method to prevent SSIs in the spine
patient population. The most commonly used antibiotic is cefazolin, with
vancomycin often being substituted in the case of penicillin or
cephalosporin allergy. Vancomycin as SAP has been associated with
increased SSI in the joint replacement literature, but this is not yet
well defined in the spinal surgery population. The purpose of this study
was to determine whether vancomycin SAP compared to cefazolin SAP is
associated with increased risk of SSI. Method(s): 535 patients, aged
16 years or older, underwent elective multi-level open posterior spinal
fusion surgery at the thoracic, thoracolumbar, or lumbar levels.
Demographic and operative characteristics as well as post-operative
outcomes were compared between the following groups: (1)
noninfected-cefazolin, (2) noninfected-vancomycin, (3) infected-cefazolin,
and (4) infected-vancomycin. Primary outcomes were superficial and
complicated (deep and organ/space) infections. Result(s): The
following risk factors for SSI were identified in a logistic regression
analysis: vancomycin (OR 2.498, 95% CI, 1.085-5.73, P = 0.031), increasing
operating time (OR 1.006, 95% CI, 1.001-1.010 P = 0.010), weight (OR
1.020, 95% CI 1.006-1.034, P = 0.005), revision procedure (OR 2.343, 95%
CI 1.283-4.277, P = 0.006), and depression (OR 2.366, 95% CI 1.284-4.360,
P = 0.006). Conclusion(s): In open posterior approach spinal fusion
surgery, vancomycin SAP is associated with increased risk of infection
compared to cefazolin SAP. Copyright © The Author(s) 2025.

<101>
[Use Link to view the full text]
Accession Number
2038616074
Title
Outcomes of Cardiac Surgery in Patients with Liver Cirrhosis: A Systematic
Review and Meta-Analysis.
Source
Cardiology in Review. (no pagination), 2025. Article Number:
10.1097/CRD.0000000000000917. Date of Publication: 2025.
Author
Saxena A.; Tatum R.; Chen H.; Ahmad D.; Rahimov D.; Curran J.; Kagarise
T.; Plestis K.A.; Rajagopal K.; Entwistle J.W.; Tchantchaleishvili V.
Institution
(Saxena) The Department of Medicine, Rutgers Health Robert Wood Johnson,
New Brunswick, NJ, United States
(Saxena, Tatum, Chen, Ahmad, Rahimov, Curran, Kagarise, Plestis,
Rajagopal, Entwistle, Tchantchaleishvili) Department of Cardiac Surgery,
Thomas Jefferson University, Philadelphia, PA, United States
(Tatum) Department of Surgery, University of Vermont, Burlington, VT,
United States
(Chen) Sidney Kimmel Medical College, Thomas Jefferson University,
Philadelphia, PA, United States
(Ahmad) Division of Cardiac Surgery, Department of Surgery, University of
Pittsburgh, Pittsburgh, PA, United States
(Curran) Department of Psychiatry, Perelman School of Medicine, The
University of Pennsylvania, Philadelphia, PA, United States
(Kagarise) Shippensburg University, Shippensburg, PA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Cirrhosis is a progressive form of liver disease associated with
significant patient morbidity and mortality. Model for End-Stage Liver
Disease (MELD) and Child-Pugh scores are disease severity classification
systems that carry predictive value for patients undergoing various
procedures. Missing is a granular analysis exploring the association
between liver disease severity and clinical outcomes among patients who
require cardiac surgery. Our study extracted demographic, periprocedural,
and postoperative clinical data for patients with liver cirrhosis
undergoing cardiac surgery between 2000 and 2023. Continuous variables
were pooled by meta-analysis utilizing a random effects model, and
categorical variables were studied using meta-analysis of proportions with
logit transformations. The most frequently observed Child-Pugh
classification was class A in 60% of patients (95% confidence interval
[CI]: 53-67), followed by class B in 33% (95% CI: 27-39) and class C in 4%
(95% CI: 2-6). Notably, 30% of patients developed renal failure in the
postoperative period (95% CI: 21-39), and overall in-patient mortality
occurred in 11% of patients (95% CI: 9-14). There was a significant
association between Child-Pugh classification and overall patient survival
for 3 years in the postoperative period. No significant relationship was
observed between preoperative MELD score and postoperative clinical
outcomes. Preoperative Child-Pugh classification is associated with
postoperative clinical outcomes among patients undergoing cardiac surgery.
More granular data are required to understand the association between MELD
scores and postoperative outcomes within the cardiac surgery
population. Copyright © 2025 Wolters Kluwer Health, Inc. All
rights reserved.

<102>
Accession Number
2034475181
Title
Efficacy and safety of Tongxinluo capsules combined with conventional
therapy for acute myocardial infarction: a systematic review and
meta-analysis.
Source
Frontiers in Pharmacology. 16 (no pagination), 2025. Article Number:
1555859. Date of Publication: 2025.
Author
Ouyang D.; Jiang X.; Wang H.; Xu M.L.; Qi H.; Li X.H.; Cao J.Z.
Institution
(Ouyang, Wang, Xu, Li) The Second Affiliated Hospital, Hunan University of
Chinese Medicine, Changsha, China
(Ouyang, Jiang, Wang, Xu, Qi, Li, Cao) College of Traditional Chinese
Medicine, Hunan University of Chinese Medicine, Changsha, China
Publisher
Frontiers Media SA
Abstract
Background: Tongxinluo capsule, a formally classical commercial Chinese
polyherbal preparation, has been utilized to treat patients with acute
myocardial infarction for decades. Purpose(s): This meta-analysis
aimed to comprehensively evaluate the clinical outcomes of tongxinluo
capsule treated acute myocardial infarction. Method(s): Randomized
controlled trials evaluating the effectiveness of tongxinluo capsule alone
or in combination with conventional therapy in patients with acute
myocardial infarction were identified from eight major databases: Chinese
Biomedical Medicine, China National Knowledge Infrastructure, Wanfang Med
Database, China Science and Technology Journal Database, PubMed, and
Cochrane Central Register of Controlled Trials. In addition, two clinical
trial registry platforms (clinicalTrials.gov and the WHO International
Clinical Trials) were also searched for relevant studies, with the search
extending to all published literature until December 2024. The initial
screening and evaluation of the studies were carried out by two
independent reviewers who assessed each study according to predefined
eligibility criteria. The risk of bias in the research was evaluated using
the Cochrane Collaboration's methodology for assessing methodology.
Meta-analysis was carried out using RevMan 5.3 software, and publication
bias was assessed utilizing StataMP 14.0. The evidence's quality was
determined by the Grading of Recommendations Assessment, Development, and
Evaluation process. Result(s): This research included a total of 36
randomized controlled trials with 7002 patients. The meta-analysis
revealed that Tongxinluo capsule combined with conventional treatment
significantly decreased the 1-month MACCE rate (RR = 0.62, 95% CI 0.47 to
0.81; p = 0.0007), along with the individual risks of 1-month MACCE,
including cardiac death (RR = 0.68, 95% CI 0.50 to 0.93; p = 0.02) and
myocardial reinfarction (RR = 0.11, 95% CI 0.01 to 0.94; p = 0.04). After
12 months of treatment, the MACCE rate (RR = 0.61, 95% CI 0.49 to 0.75; p
< 0.00001), cardiac death (RR = 0.69, 95% CI 0.50 to 0.96; p = 0.03),
myocardial reinfarction (RR = 0.32, 95% CI 0.13 to 0.75; p = 0.009), and
stroke (RR = 0.42, 95% CI 0.20 to 0.87; p = 0.02) were also reduced. The
remaining secondary outcomes-1-month stroke (RR = 0.44, 95% CI 0.44 to
1.44; p = 0.18), 12-month (RR = 0.12, 95% CI 0.01 to 2.14; p = 0.15)
emergent coronary revascularization, 12-month all-cause mortality (RR =
0.78, 95% CI 0.60 to 1.01; p = 0.06)-showed no differences. Furthermore,
the combination of Tongxinluo capsule and conventional therapy increased
the incidence of the adverse drug reaction, mainly gastrointestinal
discomfort (RR = 1.80, 95% CI 1.14 to 2.84; p = 0.01). However, there were
no differences in the liver function levels of aspartate transaminase (SMD
= -0.24, 95% CI -0.54 to -0.07; p = 0.12) and alanine aminotransferase
(SMD = -0.25, 95% CI -0.55 to 0.05; p = 0.11), or the kidney function
levels of blood urea nitrogen (SMD = 0.32, 95% CI -0.21 to 0.86; p = 0.23)
and creatinine (SMD = 0.10, 95% CI -0.20 to 0.40; p = 0.52).
 Conclusion(s): Current data indicates that Tongxinluo capsule, used
as an adjuvant treatment, may enhance clinical outcomes for AMI patients
at 1- and 12-month. Moreover, it may enhance heart function, regulate
lipid peroxidation, and suppress inflammatory levels. Copyright ©
2025 Ouyang, Jiang, Wang, Xu, Qi, Li and Cao.

<103>
Accession Number
647266914
Title
Impact of psycho-educational interventions on patients undergoing Coronary
Artery Bypass Grafting Surgery.
Source
Journal of cardiothoracic surgery. 20(1) (pp 223), 2025. Date of
Publication: 30 Apr 2025.
Author
Bagheri S.; Dadashpouromrani Z.; Setoodeh G.; Shirazi Z.H.; Amiri A.;
Ghobadimoghaddam R.
Institution
(Bagheri, Shirazi) Community Based Psychiatric Care Research Center,
Department of Nursing, School of Nursing and Midwifery, Shiraz University
of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Dadashpouromrani, Amiri) Student Research Committee, School of Nursing
and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran,
Islamic Republic of
(Setoodeh) Mental Health and Psychiatric Nursing Department, School of
Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz,
Iran, Islamic Republic of
(Amiri) Department of Surgical Technologists, School of Nursing and
Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic
Republic of
(Ghobadimoghaddam) Department of Biological Sciences, Middle East
Technical University, Ankara, Turkey
Abstract
BACKGROUND: Postoperative period of Coronary Artery Bypass Grafting can be
challenging, with physical and psychological problems and symptoms. We
conducted this study to explore the effect of a psycho-educational
intervention on anxiety, pain and physiological parameters among Coronary
Artery Bypass Grafting surgery patients. METHOD(S): A randomized
clinical trial design included one experimental and control group. Data
were collected from 56 candidates for coronary artery bypass surgery (n =
28) in the intervention and (n = 28) in the usual care groups. Settings
were the cardiac centers of the three teaching, specialty, and
subspecialty Nemazee, Faghihi, and Al-Zahra hospitals affiliated with
Shiraz University of Medical Sciences (SUMS). The data were collected
using a demographic information form, the Short-Form McGill Pain
Questionnaire, the Spielberger State-Trait Anxiety Inventory, and the
physiological parameters form (systolic and diastolic blood pressure,
heart rate, respiratory rate, and peripheral oxygen saturation).
Psycho-educational interventions were performed individually through
face-to-face sessions. All tests were two-tailed, and the statistical
level was considered 0.05. RESULT(S): The mean scores of state
anxiety and pain decreased significantly after the intervention (p <
0.05). Also, psycho-educational interventions affected peripheral oxygen
saturation percentage, and breathing rate mean scores (P < 0.05). But,
they did not affect the blood pressure and pulse rate (P > 0.05). At the
same time, there was no significant difference in the control group.
 CONCLUSION(S): This study indicated that the pre-operative
psycho-educational interventions facilitated intrapersonal caring, reduce
state anxiety, relieve pain and stabilize physiological parameters such as
peripheral oxygen saturation percentage and breathing rate after surgery
among Coronary Artery Bypass Grafting surgery patients. Hence, this
intervention is recommended for developing care programs in same
population. TRIAL REGISTRATION: https://www.irct.ir/trial/55652 :
IRCT20090908002432N8 (2021-09-17). Copyright © 2025. The
Author(s).

<104>
Accession Number
647268516
Title
Strain on the surgeon: a systematic review of the methods of measuring
strain in abdominal and thoracic surgery.
Source
The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and
Ireland. (no pagination), 2025. Date of Publication: 30 Apr 2025.
Author
Menon N.; Guidozzi N.; Kamarajah S.K.; Gujjuri R.; Markar S.R.
Institution
(Menon, Markar) Surgical Intervention Trials Unit, Nuffield Department of
Surgical Sciences, University of Oxford, Oxford, United Kingdom
(Guidozzi) Department of General Surgery, University of Witwatersrand,
Johannesburg, South Africa
(Kamarajah) NIHR Global Health Research Unit on Global Surgery, School of
Health Science, University of Birmingham, United Kingdom
(Gujjuri) College of Medical and Dental Sciences, University of
Birmingham, Birmingham, United Kingdom
Abstract
INTRODUCTION: Surgery can be arduous to the operating surgeon - both in
terms of cognitive and physical strain. Ergonomic strain has been
recognised to drive absenteeism, reduce career longevity and cause
injuries. This systematic review aims to 1. Outline the nature of
ergonomic strain in the context of abdominal and thoracic surgery,
regardless of surgical approach 2. Identify the qualitative and
quantitative measures of surgical strain. METHOD(S): A systematic
review was conducted using Pubmed, MEDLINE and Ovid EMBASE databases (date
range: 1990 to Sep 2024). Of the initial 1288 articles identified, a final
71 studies were included in this review (quantitative measures = 36,
qualitative measures = 49, of which 14 studies overlapped with the papers
reviewed in the quantitative measures section). RESULT(S): The
quantitative measures used to measure ergonomic strain included
electromyography, electrocardiography, gravimetric position sensors, skin
conductance and inertial measurement units. Laparoscopic surgery caused
less physical strain than open surgery, however more cognitive strain
during the learning curve. Robotic surgery yielded conflicting data in
terms of muscle activation when compared to laparoscopic surgery however
reported less cognitive and cardiovascular strain. The qualitative
measures of strain included a range of self-reported questionnaires,
demonstrating important gender differences and scores that typically
correlated with objective physical strain. DISCUSSION(S): The studies
show wide variation in measuring ergonomic strain. Avenues for further
research include measuring the impact of learning curves, patient factors
on ergonomic strain and the impact of gender. Copyright © 2025
The Authors. Published by Elsevier Ltd.. All rights reserved.

<105>
Accession Number
2034067065
Title
Chest Tube Clearance Strategies Versus Conventional Chest Tubes After
Cardiac Surgery.
Source
Journal of Cardiac Surgery. 2024(1) (no pagination), 2024. Article Number:
2207185. Date of Publication: 2024.
Author
Chan V.F.; Vervoort D.; Tam D.Y.; Fremes S.E.
Institution
(Chan) Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
(Chan, Vervoort, Tam, Fremes) Division of Cardiac Surgery, Department of
Surgery, Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Vervoort, Tam, Fremes) Institute of Health Policy, Management and
Evaluation, University of Toronto, Toronto, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Standard chest tubes (CTs) used to drain retained blood can become
occluded from blood clots, leading to ineffective drainage and
postoperative complications such as cardiac tamponade. Chest tube
clearance strategies (CTCSs) were developed to improve CT patency. Our
meta-analysis compared the safety and efficacy of CTCS versus CT following
cardiac surgery. The PubMed/MEDLINE, Embase, Web of Science, and Scopus
databases were searched from 1946 to 2023 for studies that compared CTCS
to CT. Two investigators independently reviewed, screened, extracted, and
assessed the data prior to performing a random effects meta-analysis using
R. The primary outcome was re-exploration and the secondary outcomes were
retained blood syndrome, mortality, blood products, stroke, cardiac
arrest, atrial fibrillation, ventilation time, intensive care unit (ICU)
time, hospital length of stay, and chest drainage. Five studies (2288
patients) were included. There were two clinical trials (n = 620) and
three observational studies (1668 patients). Compared to CT, CTCS had a
significant reduction of postoperative atrial fibrillation (risk ratio
(RR) 0.80, 95% CI 0.70 to 0.92, I2 = 17%, p < 0.01). There was
no significant difference in re-exploration, retained blood syndrome,
hospital length of stay, and ICU length of stay. However, with the
addition of four unmatched studies (n = 2583), CTCS was associated with a
significant reduction in re-exploration (RR 0.52, 95% CI 0.37 to 0.73,
I2 = 34%, p < 0.01), retained blood syndrome (RR 0.71, 95% CI
0.53 to 0.95, I2 = 72%, p = 0.02), hospital length of stay
(mean difference (MD) -0.40, 95% CI -0.78 to -0.01, I2 = 49%, p
= 0.04), and chest drainage (MD 0.80, 95% CI 0.70 to 0.92, I2 =
17%, p < 0.01). Drawing from results including the unmatched studies,
CTCSs are associated with fewer postoperative complications compared to
CT. This was achieved without major differences in chest drainage,
supporting the important role of preventing even small accumulations of
blood in the pericardial space. Copyright © 2024 Veronica F. Chan
et al.

<106>
Accession Number
2038610454
Title
Improving the performance of the Cleveland Clinic Score for predicting
acute kidney injury after cardiac surgery: a prospective multicenter
cohort study.
Source
Minerva Anestesiologica. 90(4) (pp 245-253), 2024. Date of Publication: 01
Apr 2024.
Author
Wijeysundera D.N.; Alvarez J.; Aparicio R.; Blanco V.; Bravo B.; Callejas
R.; Calderon E.; Candela A.; Carmona P.; Echarri G.; Esteva C.; Garcia A.;
Garcia E.; Garcia-Fernandez N.; Gomez L.; Gragera I.; Hernandez A.; Lopez
M.; Marcos J.M.; Matilla A.; Medina A.; Mendez E.; Mon T.; Monedero P.;
Montesinos S.; Mora J.M.; Morales L.; Munoz P.; Nagore D.; Nunez J.;
Pajares A.; Pasqualetto A.; Pereira M.A.; Pita R.; Rodriguez J.M.;
Rodriguez M.A.; Sanchez J.; Santana L.; Tamayo E.; Varela M.A.; Vicente
R.; Villa D.; Vives M.
Institution
(Vives, Monedero) Department of Anesthesiology and Critical Care Medicine,
Clinica Universidad de Navarra, Pamplona, Spain
(Candela) Department of Anesthesiology and Perioperative Medicine, Ramon y
Cajal University Hospital, Madrid, Spain
(Tamayo) Department of Anesthesiology and Perioperative Medicine,
Valladolid University Hospital, Valladolid, Spain
(Hernandez) Department of Anesthesiology and Perioperative Medicine,
Policlinica Ibiza Hospital, Ibiza, Spain
(Wijeysundera) Institute of Health Policy Management and Evaluation,
University of Toronto, Toronto, ON, Canada
(Wijeysundera) Department of Anesthesia, St. Michael's Hospital, Toronto,
ON, Canada
(Wijeysundera) Li Ka Shing Knowledge Institute of St. Michael's Hospital,
Toronto, ON, Canada
(Nagore) Department of Anesthesia and Perioperative Medicine, Barts Heart
Centre, St. Bartholomew's Hospital, London, United Kingdom
Publisher
Edizioni Minerva Medica
Abstract
BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is
associated with high short- and long-term mortality rates. The prediction
of CSA-AKI is crucial for early detection and treatment. Current
predictive models may be improved by potentially useful preoperative and
intraoperative information. METHOD(S): This multicenter prospective
cohort study recruited 261 consecutive patients at high risk for
developing CSA-AKI, based on a Cleveland Clinical Score (CCS) of >=4
points from July to December 2017 in 14 hospitals in Spain and the UK.
Postoperative AKI occurred in 145 (55.5%) patients. The receiver operating
characteristics curve (AUC) of a base model including only the CCS was
compared with models including additional preoperative and intraoperative
variables such as the estimated glomerular filtration rate (eGFR) instead
of plasmatic creatinine, intraoperative urine output, baseline hemoglobin,
nadir hemoglobin, and glycosylated hemoglobin (HbA<inf>1c</inf>) instead
of diabetes mellitus. The performance of each model for AKI was compared.
 RESULT(S): The CCS alone gave an AUC of 0.67 (95% CI, 0.56-0.78) for
postoperative AKI. None of the single variables added to the base model
CCS improve discrimination. The AUC for postoperative AKI was improved
when baseline hemoglobin, eGFR instead of plasmatic creatinine,
HbA<inf>1c</inf>, and nadir hemoglobin were added to the CCS (AUC=0.77;
95% CI, 0.67-0.87; P=0.02). CONCLUSION(S): The addition of baseline
hemoglobin, eGFR, HbA<inf>1c</inf>, and nadir intraoperative hemoglobin
may be useful for improving the discrimination of the clinical predictive
risk scores for AKI. Copyright © 2023 EDIZIONI MINERVA MEDICA.

<107>
Accession Number
2038618538
Title
Impact of perioperative dexmedetomidine on postoperative delirium in adult
undergoing cardiac surgery: A comprehensive bibliometrix and
meta-analysis.
Source
Asian Journal of Psychiatry. 108 (no pagination), 2025. Article Number:
104522. Date of Publication: 01 Jun 2025.
Author
Fu Q.; Sandeep B.; Li H.; Wang B.S.; Huang X.
Institution
(Fu, Huang) Department of Anesthesiology, The Third People's Hospital of
Chengdu, Sichuan Province, China
(Sandeep) Department of Cardio-Thoracic Surgery, Chengdu Second People's
Hospital, Sichuan Province, Chengdu, China
(Li, Wang) Department of Anesthesiology, No. 363 Hospital, Sichuan
province, Chengdu, China
Publisher
Elsevier B.V.
Abstract
This bibliometrix and meta-analysis aimed to evaluate the efficacy of
perioperative dexmedetomidine (DEX) on postoperative delirium (POD) in
adult patients undergoing cardiac surgery. A comprehensive search of
electronic databases identified 21 randomized controlled trials involving
5210 patients. The primary outcome was the incidence of POD from the first
day to seven days post-surgery. The meta-analysis revealed that DEX
significantly reduced POD incidence compared to various controls (RR 0.70;
95 % CI 0.54-0.89; P = 0.004). Subgroup analyses showed that DEX was
particularly effective when compared to propofol (RR 0.48; 95 % CI
0.30-0.78; P = 0.003). However, no significant differences were observed
in the duration of anesthesia, surgery, or ICU/hospital stay. Notably, DEX
was associated with a higher incidence of hypotension (RR 1.90; 95 % CI
1.16-3.10; P = 0.01). The study highlights the potential neuroprotective
benefits of DEX but underscores the need for careful monitoring of
hemodynamic stability. Future research should focus on optimizing DEX
dosing protocols and exploring its broader impact on postoperative
recovery and patient outcomes. Copyright © 2025 Elsevier B.V.

<108>
Accession Number
647236172
Title
Comparative Effectiveness and Safety of Self-Expanding Versus
Balloon-Expandable Transcatheter Aortic Valve Replacement: A Systematic
Review and Meta-Analysis.
Source
The American journal of the medical sciences. (no pagination), 2025. Date
of Publication: 25 Apr 2025.
Author
Elkholy M.; Akkawi M.; Kidess G.G.; Abdulelah Z.; Rayyan A.; Al-Dqour
M.R.; Damlakhy A.; Bahar Y.; Alraies M.C.
Institution
(Elkholy, Akkawi) Wayne State University School of Medicine, Detroit
Medical Center, Detroit, MI, United States
(Kidess) Wayne State University School of Medicine, Detroit, MI, United
States
(Abdulelah) Department of Cardiology, Royal Papworth Hospital, Cambridge,
United Kingdom
(Rayyan) School of Medicine, University of Jordan, Amman, Jordan
(Al-Dqour) Department of Internal Medicine, East Tennessee State
University, United States
(Damlakhy) Wayne State University School of Medicine, Detroit Medical
Center, Detroit, MI, United States
(Bahar) Wayne State University, Detroit, MI, United States
(Alraies) Cardiovascular Institute, Detroit Medical Center, Detroit, MI,
United States
Abstract
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a safe
alternative to surgical aortic valve replacement for patients with
symptomatic severe aortic stenosis at increased surgical risk. However,
comparative data on self-expanding valves (SEV) versus balloon-expanding
valves (BEV) remain limited. METHOD(S): A comprehensive review of
PubMed and Embase was conducted through April 2024, identifying eight
studies (five randomized controlled trials and three propensity-matched
observational studies) comparing SEV and BEV in TAVR. Primary outcomes
included all-cause mortality, cardiovascular mortality, and device success
per Valve Academic Research Consortium criteria, while secondary outcomes
assessed bioprosthetic valve dysfunction and adverse events (annulus
rupture/dissection, coronary artery occlusion, valve
dislocation/embolization, valve thrombosis, moderate and severe
paravalvular aortic regurgitation, endocarditis, permanent pacemaker
implantation, major or life-threatening bleeding, acute kidney injury, and
stroke). RESULT(S): The analysis included 4,032 patients (SEV =
2,006; BEV = 2,017). SEV was associated with higher rates of
moderate-to-severe paravalvular aortic regurgitation [OR, 1.76; CI
1.13-2.74; P = 0.01] and permanent pacemaker placement [OR, 1.57; CI,
1.23-2.00; P = 0.0002] compared to BEV. No significant differences were
observed in 30-day or 1-year all-cause mortality, cardiovascular
mortality, device success, bioprosthetic valve dysfunction, valve
dislocation/embolization, valve thrombosis, endocarditis, major or
life-threatening bleeding, coronary artery occlusion, stroke,
rehospitalization, or acute kidney injury. CONCLUSION(S): SEV and BEV
demonstrated comparable outcomes in mortality and device success. However,
the higher risk of moderate-to-severe paravalvular aortic regurgitation
and permanent pacemaker placement with SEV should be considered when
selecting the optimal TAVR valve for individual patients. Copyright
© 2025. Published by Elsevier Inc.

<109>
Accession Number
647234274
Title
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. (no pagination), 2025. Date of Publication: 18 Apr 2025.
Author
Saliba W.; Nair D.; Swarup V.; Hall T.; Iyer V.; Calle Perez G.; Weiner
S.; Shah M.; Islam N.; Grygier M.; Schuler B.; Ibanez Criado J.L.; Duthoit
G.; Reddy Y.M.; Reddy V.Y.; Mansour M.; Natale A.; Leger K.; Christen T.;
Stein K.; Sutton B.; Wazni O.
Institution
(Saliba, Wazni) Cleveland Clinic, Cleveland, OH, United States
(Nair) St. Bernards Medical Center & Arrhythmia Research Group, Jonesboro,
AR, United States
(Swarup) Arizona Arrhythmia Research Center, Phoenix, AZ, United States
(Hall) Cardiology, East Brisbane
(Iyer) MarinHealth Medical Center, CA, United States
(Calle Perez) H. Puerta Del Mar, Cadiz, Spain
(Weiner) Christus Trinity Mother Frances Health System, Tyler, TX, United
States
(Shah) Washington Hospital Center, WA, United States
(Islam) University of Maryland St. Joseph Medical Group
(Grygier) Chair and 1(st) Department of Cardiology, Poznan University of
Medical Sciences, Poznan, Poland
(Schuler) York Hospital, York PA
(Ibanez Criado) Arrhythmia Unit, Cardiology Department. Hospital
Universitario Doctor Balmis, Alicante; Instituto de Investigacion
Sanitaria y Biomedica de Alicante (ISABIAL). Spain
(Duthoit) Hopital Pitie-Salpetriere, APHP, Paris, France
(Reddy) University of Kansas Hospital, Kansas City, KS, United States
(Reddy) Cardiac Electrophysiology, Mount Sinai Fuster Heart Hospital
School of Medicine, NY, United States
(Mansour) Massachusetts General Hospital, Boston, MA, United States
(Natale) Texas Cardiac Arrhythmia Institute, St. David's Medical Center,
Austin, TX, USA; Department of Biomedicine and Prevention, Division of
Cardiology, University of Tor Vergata, Rome, Italy; Metro Health Medical
Center, Case Western Reserve University, Cleveland, Ohio, USA
(Leger, Christen, Stein, Sutton) Boston Scientific Corporation,
Marlborough, MA, USA
Abstract
BACKGROUND: LAAC can be performed in separate procedures with cardiac
ablation (sequentially) or concomitantly in the same operative session.
 OBJECTIVE(S): The OPTION trial aims to compare the efficacy and
safety of LAAC with OAC in patients who have undergone catheter ablation
for AF. The objective of this; sub-analysis is to evaluate LAAC versus OAC
within concomitant and sequential ablation timings. METHOD(S): OPTION
is a multicenter, prospective randomized clinical trial. Patients with AF
and an elevated CHA2DS2-VASc score undergoing catheter ablation were
randomly assigned (1:1) to catheter-based LAAC (Device) versus oral
anticoagulation (Control). Randomization was stratified by AF catheter
ablation procedure timing: Sequential (90 to 180 days prior to
randomization) or Concomitant (within 10 days of; randomization, 99% of
procedures happened same day). 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. RESULT(S): In both the Concomitant
(n=654) and Sequential (n=946) groups, the Device arm compared to Control
had fewer primary safety endpoint events, and similar rates of primary
efficacy events and secondary safety events. Rates of acute safety events
were low and similar between Device and Control arms within the
Concomitant group; the addition of LAAC to cardiac ablation sessions did
not result in increased procedural events. CONCLUSION(S): For both
Concomitant and Sequential ablation timing strategies, LAAC has similar
efficacy compared with OAC and a lower risk of clinically important
postprocedure bleeding in high-risk patients following AF
ablation. Copyright © 2025. Published by Elsevier Inc.

<110>
Accession Number
647243098
Title
Outcomes after DCD Cardiac Transplantation: An international, multicenter
retrospective study.
Source
JACC. Heart failure. (no pagination), 2025. Date of Publication: 24 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.R.H.; Park S.Y.;
Cain M.T.; Fetten K.; Meyer D.; Xu A.; Gonzalez-Vilchez F.; Dominguez-Gil
B.; Royo-Villanova M.; Garrido I.; Brouckaert J.; Rega F.; Tchana-Sato V.;
Berman M.; Bae J.; Sinha S.; Pettit S.; Messer S.; Large S.
Institution
(Louca) University of Cambridge, Cambridge Stem Cell Institute, Cambridge,
United Kingdom,; Royal Papworth Hospital, Cambridge, United Kingdom,;
University of Oxford, Nuffield Department of Population Health, Oxford,
United Kingdom,. Electronic address: jol20@cantab.ac.uk
(Ochsner) Royal Papworth Hospital, Cambridge, United Kingdom,; LMU
University Hospital Munich, Germany
(Bhagra, Berman, Bae, 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, Luikart, Ashley) Stanford University, Palo Alto, CA, United
States
(Moazami, James) NYU Langone Health, New York, NY, United States
(Dar) Harefield Hospital (a division of Guys and St Thomas' NHS Foundation
Trust), London, United Kingdom,; School of Cardiovascular Medicine &
Sciences Kings College London, United Kingdom
(Konicoff) Harefield Hospital (a division of Guys and St Thomas' NHS
Foundation Trust), London, United Kingdom
(Urban, Um, Castleberry) Medical Center, Omaha, NE, United States
(Hoffman, Park, Cain) University of Colorado, Anschutz Medical Center,
Aurora, CO, United States
(Fetten, Meyer, Xu) Baylor Scott and White Health, Baylor University
Medical Center, Dallas, TX, United States
(Gonzalez-Vilchez) Hosp Marques de Valdecilla, Santander, Spain
(Dominguez-Gil) Organizacion Nacional de Trasplantes, Madrid, Spain
(Royo-Villanova, Garrido) Hospital Universitario Virgen de la Arrixaca,
Murcia, Spain
(Brouckaert, Rega) University Hospitals Leuven, Leuven, Belgium
(Tchana-Sato) CHU Liege, Liege, Belgium
(Sinha) University of Cambridge, Cambridge Stem Cell Institute, Cambridge,
United Kingdom
(Messer) Golden Jubilee National Hospital, Glasgow, United Kingdom
Abstract
BACKGROUND: As donation after circulatory determination of death (DCD)
heart transplantation (HT) becomes more widely adopted, there is a need to
establish the most clinically effective method of organ procurement.
 OBJECTIVE(S): This international, multicenter study compares outcomes
of DCD-HT across Europe and the United States (US) between recipients
whose donor hearts were retrieved using thoraco-abdominal normothermic
regional perfusion (taNRP) to those whose hearts were recovered using
direct procurement and perfusion (DPP). METHOD(S): This was a
retrospective observational study across 20 heart transplant centers in
Belgium, Spain, the United Kingdom (UK) and the US. This study included
all patients undergoing DCD-HT at participating centers, from the start of
each center's DCD program through 01/01/2023. DCD-HT with recovery using
either taNRP or DPP were compared to one-another. Post-transplant outcomes
included (i)survival at 1-year, (ii)incidence of severe primary graft
dysfunction (PGD), (iii)episodes of treated, biopsy-proven acute-cellular
rejection (ACR) in the first year following transplantation.
 RESULT(S): 504 DCD-HT took place in the study period. Survival at one
year was similar for taNRP and DPP recipients (91% vs 88%, p=0.1). taNRP
recipients had a lower rate of severe PGD (7.6% vs 19.2%, p<0.001) and
fewer episodes of biopsy-proven, ACR requiring treatment in the first-year
post-transplantation (13% vs 25%,p<0.001). CONCLUSION(S): In an
international study of DCD-HT, recipients of hearts retrieved by taNRP
technique had lower rates of severe PGD and fewer episodes of
biopsy-proven ACR in the first year when compared with those retrieved
utilizing DPP. These results should be further investigated with
randomized control trials. Copyright © 2025. Published by
Elsevier Inc.

<111>
Accession Number
647246270
Title
Perioperative interdisciplinary optimisation of patients with heart
failure undergoing non-cardiac surgery with intermediate or high surgical
risk: the rationale and study protocol for the multicentre, randomised
interventional PeriOP-CARE HF trial.
Source
Clinical research in cardiology : official journal of the German Cardiac
Society. (no pagination), 2025. Date of Publication: 29 Apr 2025.
Abstract
AIM: Chronic heart failure (HF) is a frequent comorbidity in elderly
patients undergoing major non-cardiac surgery with increasing prevalence.
This trial aims to evaluate a new interdisciplinary, multimodal and
individually optimised treatment strategy in patients with established or
at risk for HF throughout the entire perioperative period. METHOD(S):
The PeriOP-CARE HF trial is a prospective, multicentre, randomised,
controlled and interventional trial. The primary hypothesis is that an
interdisciplinary, intersectoral and standardised approach to the
preoperative evaluation, optimisation and perioperative management of
patients aged >= 65 years undergoing non-cardiac surgery with intermediate
or high surgical risk and preoperative N-terminal pro-brain natriuretic
peptide levels >= 450 pg/mL, will reduce postoperative morbidity. The
preoperative evaluation includes clinical evaluations by
anaesthesiologists and cardiologists, electrocardiography and
echocardiography, as well as a discussion of these findings by a
perioperative management team, where all involved specialities, including
the speciality surgeon, will decide the perioperative treatment strategy
for each patient. Intraoperative strategies include individualised
haemodynamic optimisation. The interdisciplinary team and specialised HF
nurses will screen patients for HF-related postoperative complications.
The primary end point will be a composite morbidity end point, comprising
any rehospitalisation, acute kidney injury, suspected or proven bacterial
infection requiring treatment and acute decompensated HF at postoperative
day 90. CONCLUSION(S): The new treatment form can potentially reduce
the morbidity burden after major non-cardiac surgery in patients with
known or unknown HF. If the PeriOP-CARE HF trial yields positive results,
the treatment of patients with HF undergoing major non-cardiac surgery
could be considerably improved. TRIAL REGISTRATION: clinicaltrials.gov:
NCT06381427, registered April 24, 2024. Copyright © 2025. The
Author(s).

<112>
Accession Number
2038631627
Title
- Evidence-based recommendations for lung cancer surgery: first results
form a systematic review of guidelines.
Source
Journal of epidemiology and population health. Conference: EPICLIN 2025
Conference. Bordeaux France. 73(Supplement 2) (no pagination), 2025.
Article Number: 203054. Date of Publication: 01 May 2025.
Author
Belaroussi Y.; Frasca M.; Poiseuil M.; Potenza I.; Delva F.;
Mathoulin-Pelissier S.
Institution
(Belaroussi, Frasca, Poiseuil, Delva, Mathoulin-Pelissier) Universite de
Bordeaux - Centre Bordeaux Population Health, UMR1219-Epicene, Bordeaux,
France
(Belaroussi) CHU de Bordeaux, Palliative Medicine Department, Bordeaux,
France
(Belaroussi, Potenza) CHU de Bordeaux, Chirurgie thoracique, Pessac,
France
Publisher
Elsevier Masson s.r.l.
Abstract
Background and objective(s): Lung cancer remains a leading cause of
cancer-related mortality worldwide. Early detection through lung cancer
screening programs has demonstrated promise in improving survival rates by
identifying malignancies at earlier, more treatable stages. However, a
critical limitation of these programs lies in the heterogeneity of care
following diagnosis, particularly in lung cancer surgery. Variability in
surgical approaches, perioperative management, and adherence to
evidence-based clinical practice guidelines (CPGs) significantly impacts
patient outcomes. Understanding and implementing high-quality CPGs is
essential to address these disparities and ensure standardized,
high-quality care across institutions. This systematic review aims to
evaluate existing CPGs in thoracic surgery, focusing on their role in
standardizing care for patients diagnosed through lung cancer screening
programs. By identifying gaps and inconsistencies in current
recommendations, this review seeks to inform future efforts to improve the
quality and uniformity of surgical management in lung cancer.
 Material(s) and Method(s): A systematic search was conducted across
major databases (PubMed, Embase, Cochrane Library) and relevant
professional society websites to identify CPGs published since 2000 in
French or English. Guidelines addressing surgical management-including
diagnosis, staging, indications, and techniques-were included. Data
extraction focused on key recommendations, evidence grading, areas of
consensus or variation, and their alignment with lung cancer screening
programs. The AGREE II tool was used to assess guideline quality across
six domains, with scores calculated as percentages (0-100%) and an overall
assessment rated on a 7-point scale. Result(s): Among 82 included
guidelines, 36 originated from European countries or societies. AGREE II
scores varied, with higher scores in scope and purpose (67.6%) and clarity
of presentation (67.6%), while stakeholder involvement (60.8%), rigor of
development (64.1%), applicability (50.9%; only 34.1% scoring above 70%),
and editorial independence (62.3%) showed more variability. The mean
overall assessment score was 5.8. Of the guidelines, 43 (52.4%) were
recommended, 39 (47.6%) recommended with modifications, and none were not
recommended. Notably, many guidelines lacked explicit integration with
lung cancer screening programs, despite the need for standardized
approaches to managing early-stage cancers detected through screening.
Harmonizing surgical practices through high-quality guidelines could
address the heterogeneity of care outcomes and enhance clinical pathways.
 Conclusion(s): The variability in clinical practice guidelines for
lung cancer surgery, combined with the heterogeneity of care in lung
cancer screening programs, underscores the urgent need for standardized
and evidence-based recommendations. High-quality CPGs are pivotal in
bridging the gap between screening and surgical care, ensuring consistent
practices, improving patient outcomes, and enhancing the overall
effectiveness of lung cancer screening programs. Copyright © 2025

<113>
Accession Number
2038586955
Title
Statistical primer: an introduction into the principles of Bayesian
statistical analyses in clinical trials.
Source
European Journal of Cardio-thoracic Surgery. 67(4) (no pagination), 2025.
Article Number: ezaf139. Date of Publication: 01 Apr 2025.
Author
Heuts S.; Kawczynski M.J.; Velders B.J.J.; Brophy J.M.; Hickey G.L.;
Kowalewski M.
Institution
(Heuts, Kawczynski, Kowalewski) Department of Cardiothoracic Surgery,
Maastricht University Medical Centre (MUMC), Maastricht, Netherlands
(Heuts, Kawczynski) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht University, Maastricht, Netherlands
(Velders) Department of Cardiothoracic Surgery, Leiden University Medical
Centre, Leiden, Netherlands
(Brophy) McGill University Health Centre, Centre for Health Outcome
Research (CORE), Montreal, QC, Canada
(Hickey) Structural Heart and Aortic, Medtronic, Minneapolis, MN, United
States
(Kowalewski) Department of Cardiac Surgery and Transplantology, National
Medical Institute, the Ministry of Interior and Administration, Warsaw,
Poland
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Trials in cardiac surgery are often hampered at the design level by small
sample sizes and ethical considerations. The conventional analytical
approach, combining frequentist statistics with null hypothesis
significance testing, has known limitations and its associated P-values
are often misinterpreted, leading to dichotomous conclusions of trial
results. The Bayesian statistical framework may overcome these limitations
through probabilistic reasoning and is subsequently introduced in this
Primer. The Bayesian framework combines prior beliefs and currently
obtained data (the likelihood), resulting in updated beliefs, also known
as posterior distributions. These distributions subsequently facilitate
probabilistic interpretations. Several previous cardiac surgery trials
have been performed under a Bayesian framework and this Primer enhances
the understanding of their basic concepts by linking results to graphical
presentations. Furthermore, contemporary trials that were initially
analysed under a frequentist framework, are re-analysed within a Bayesian
framework to demonstrate several interpretative advantages. Copyright
© The Author(s) 2025.

<114>
Accession Number
647228884
Title
Custodiol-N Versus Custodiol: Results from A Prospective Noninferiority
Randomised Single Blind, Multicenter Phase 3 Trial In Patients Undergoing
Heart Transplantation.
Source
The Journal of heart and lung transplantation : the official publication
of the International Society for Heart Transplantation. (no pagination),
2025. Date of Publication: 23 Apr 2025.
Author
Aliabadi-Zuckermann A.; Osorio-Jaramillo E.; Knosalla C.; Gummert J.;
Szabo G.; Wittmann F.; Yeter R.; Schramm R.; Goekler J.; Hennig F.;
Morshuis M.; Zuckermann A.
Institution
(Aliabadi-Zuckermann, Osorio-Jaramillo, Zuckermann) Department of Cardiac
Surgery, Medical University of Vienna; A-1090 Vienna, Austria Medical
University of Vienna; A-1090 Vienna, Austria
(Knosalla, Hennig) Department of Cardiothoracic and Vascular Surgery,
Deutsches Herzzentrum der Charite (DHZC); 13353 Berlin, Germany;
Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat
Berlin and Humboldt-Universitat zu Berlin; 10117 Berlin, Germany; German
Center for Cardiovascular Research (DZHK), Partner Site Berlin; Berlin,
Germany
(Gummert, Schramm, Morshuis) Herz und Diabeteszentrum NRW; 32545 Bad
Oeynhausen, Germany
(Szabo) Department of Cardiac Surgery, University of Heidelberg; 69120
Heidelberg, Germany
(Wittmann, Goekler) Medical University of Vienna; A-1090 Vienna, Austria
(Yeter) Department of Cardiothoracic and Vascular Surgery, Deutsches
Herzzentrum der Charite (DHZC); 13353 Berlin, Germany;
Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat
Berlin and Humboldt-Universitat zu Berlin; 10117 Berlin, Germany
Abstract
BACKGROUND: Custodiol is a well-established preservation solution for
organ transplantation and was the basis for the development of Custodiol-N
to improve graft preservation. Previous results in coronary artery bypass
graft surgery have shown effective cardiac protection without safety
concerns. This study aimed to evaluate the safety and ability of
Custodiol-N to preserve cardiac grafts for heart transplantation.
 METHOD(S): This prospective, randomized, single-blind, multicenter,
non-inferiority study was conducted at three centers in Austria and
Germany. The primary endpoint was creatine kinase (CK-MB) peak value from
4-168 hours after opening of the aortic cross-clamp, with a 30%
non-inferiority margin. Key secondary efficacy endpoints include patient
and graft survival, incidence of primary graft failure, or length of stay
in the intensive care unit. The primary and secondary endpoints were
analyzed in both the treated and per protocol populations. RESULT(S):
A total of 105 randomized patients received Custodiol (n=52) or
Custodiol-N (n=53) preserved hearts. Average donor age and ischemic times
were comparable. Average CK-MB peak values were 176.94+/-189.61 U/L for
the Custodiol vs. 130.51+/-69.60 U/L for the Custodiol-N group (p-value
for non-inferiority of Custodiol-N by 30% <.0001). Patient survival was
comparable 1-year post-transplantation (90.4% for Custodiol vs 88.7% for
Custodiol-N). The incidence of primary graft failure and median length of
intensive care unit stay were higher for Custodiol group. Safety
assessment showed evenly distributed adverse events. CONCLUSION(S):
This study shows that Custodiol-N is safe, non-inferior, and provides
similar cardiac graft protection as the established Custodiol
solution. Copyright © 2025. Published by Elsevier Inc.

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