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<1>
Accession Number
2038673566
Title
Defining centres of expertise for minimally invasive mitral valve surgery:
a systematic review and volume-outcome meta-analysis.
Source
Heart. (no pagination), 2025. Article Number: heartjnl-2024-325048. Date
of Publication: 2025.
Author
Heuts S.; Hjij W.; Kawczynski M.J.; Olsthoorn J.R.; Tjon Joek Tjien A.;
Van Kuijk S.M.J.; Maessen J.G.; Sardari Nia P.
Institution
(Heuts, Hjij, Kawczynski, Maessen, Sardari Nia) Cardiothoracic Surgery,
Maastricht University Medical Centre (MUMC+), Maastricht, Netherlands
(Heuts, Kawczynski, Maessen) Cardiovascular Research Institute Maastricht
(CARIM), Maastricht University, Maastricht, Netherlands
(Olsthoorn, Tjon Joek Tjien) Catharina Hospital, Eindhoven, Netherlands
(Olsthoorn) Isala Hospital Zwolle, Zwolle, Netherlands
(Van Kuijk) Clinical Epidemiology and Medical Technology Assessment,
Maastricht University Medical Centre (MUMC+), Maastricht, Netherlands
Publisher
BMJ Publishing Group
Abstract
Background: Minimally invasive mitral valve surgery (MIMVS) is
increasingly performed, but outcomes such as repair rate, mortality and
survival likely depend on expertise. Still, the definition of a
high-volume centre varies in the literature and lacks an evidence-based
substantiation. Consequently, this study aims to determine the
volume-outcome relation in MIMVS in conjunction with a volume threshold,
in order to define 'high-volume centres', applying a novel statistical
concept. Method(s): The study was preregistered in PROSPERO
(CRD42022376293, registered 26 November 2022). A systematic search was
applied to three databases, including consecutive patients undergoing
MIMVS. Studies describing patients undergoing transcatheter procedures
were excluded. Restricted cubic spline analyses were applied and the elbow
method was used to retrieve the threshold volume. Long-term outcomes were
analysed using reconstructed Kaplan-Meier curves and a novel statistical
concept to assess the volume-outcome relation for time-to-event outcomes
was applied. The primary outcome was early mortality, secondary outcomes
were repair rate, stroke, and long-term survival, freedom from
reoperation, and freedom from more than moderate mitral regurgitation.
Leave-one-out analyses were performed for sensitivity purposes.
 Result(s): Data from 68 unique centres were included (n=23 495
patients). Early mortality was 1.3% (95% CI 1.1% to 1.6%), without a
statistically significant non-linear relation for this endpoint, nor for
stroke. There was a statistically significant volume-outcome relation for
mitral valve repair rate (p=0.018). Based on the repair rate, the
threshold to define a high-volume centre was 60 cases/year (number needed
to treat to prevent a replacement <=7). A significant volume-outcome
relation was observed for long-term outcomes as well, with a threshold of
53 and 54 cases/year for long-term survival and freedom from reoperation,
respectively. These results were robust across the sensitivity analyses
for the various endpoints. Conclusion(s): The threshold to define a
high-volume centre ranges between 53 and 60 cases/year based on repair
rate, long-term survival and freedom-from reoperation. These findings have
the potential to facilitate centralisation of MIMVS. Copyright ©
2025 Author(s) (or their employer(s)). No commercial re-use. See rights
and permissions. Published by BMJ Group.

<2>
Accession Number
2034538863
Title
Ischemic outcomes after left atrial appendage closure following
intracerebral hemorrhage: a retrospective inverse probability weighting
analysis from the HANSE-LAAC registry.
Source
Clinical Research in Cardiology. (no pagination), 2025. Article Number:
961000. Date of Publication: 2025.
Author
Jurczyk D.; Mezger M.; Lemmer F.; Fatum C.; Gradaus R.; Drochner-Brocks
N.-K.; Saraei R.; Frerker C.; Stiermaier T.; Paitazoglou C.; Eitel I.
Institution
(Jurczyk, Mezger, Lemmer, Fatum, Gradaus, Drochner-Brocks, Saraei,
Frerker, Stiermaier, Paitazoglou, Eitel) Medical Clinic II (Cardiology,
Angiology, Intensive Care Medicine), University Hospital
Schleswig-Holstein, University Heart Center Lubeck, University
Schleswig-Holstein (UKSH), Ratzeburger Allee 160, Luebeck, Germany
(Jurczyk, Mezger, Lemmer, Fatum, Saraei, Frerker, Stiermaier, Paitazoglou,
Eitel) German Center for Cardiovascular Research,
Hamburg/Kiel/Lubeck/Greifswald, Partner Site Lubeck, Luebeck, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Intracerebral hemorrhage (ICH) is associated with worse
outcomes and subsequent high risk for acute arterial ischemic events.
Percutaneous left atrial appendage closure (LAAC) is an established
procedure in case of atrial fibrillation and adverse events, such as
severe bleeding. Clinical benefits of LAAC in patients with ICH are
currently unclear. Method(s): The single-center registry HANSE-LAAC
included consecutively treated patients from 2014 to 2022. Index-procedure
and standardized follow-ups at 3 and 12 months were analyzed regarding
safety and efficacy retrospectively. Mortality, major adverse
cardiovascular, and bleeding events were compared between patients with or
without ICH. We used Cox proportional hazard models and inverse
probability weights to adjust confounders. Result(s): 401 patients
received percutaneous LAAC (ICH 15.2%, n = 61 and non-ICH 84.8%, n = 340).
The composite endpoint of death, MACE, and bleeding was significantly
lower in the ICH group (HR 0.35, confidence interval [CI] 0.05-4.62, p =
0.0044). This clinical benefit was mainly driven by a significant
reduction in bleeding events (HR 0.27; CI 0.06-1.15, p = 0.04).
Re-hospitalization was significantly lower as well (HR 0.36; CI 0.20-0.64,
p < 0.0001). Adjustment for confounders and inverse probability weighting
for the probability of ICH showed no statistically significant difference
in mortality (HR 0.53, CI 0.15-1.92, p = 0.33), stroke (HR 0.32 CI
0.03-3.13, p = 0.33), bleeding (HR 0.26; CI 0.05-1.29, p = 0.02), and MACE
(HR 0.29; CI 0.04-2.36, p = 0.002). Conclusion(s): LAAC in ICH was
safe and associated with less MACE, bleeding, and re-hospitalization.
Randomized-controlled trials are needed to confirm these first positive
signs. Copyright © Springer-Verlag GmbH Germany, part of Springer
Nature 2025.

<3>
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

<4>
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.

<5>
Accession Number
2038587529
Title
Design and rationale of the drug-coated balloon coronary angioplasty
versus stenting for treatment of disease adjacent to a chronic total
occlusion (Co-CTO) trial.
Source
American Heart Journal. 288 (pp 65-76), 2025. Date of Publication: 01 Oct
2025.
Author
Somsen Y.B.O.; de Winter R.W.; Wu J.; Hoek R.; Sprengers R.W.; Verouden
N.J.; Claessen B.E.P.M.; Kleijn S.A.; Twisk J.W.R.; Henriques J.P.; Spratt
J.C.; Rissanen T.T.; McEntegart M.B.; Maehara A.; Nap A.; Knaapen P.
Institution
(Somsen, de Winter, Hoek, Verouden, Kleijn, Nap, Knaapen) Department of
Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam,
Netherlands
(Wu, McEntegart, Maehara) Department of Cardiology, New York-Presbyterian
Hospital and Columbia University Medical Center, New York, United States
(Sprengers) Radiology & Nuclear Medicine, Amsterdam UMC, Vrije
Universiteit Amsterdam, Amsterdam, Netherlands
(Claessen, Henriques) Department of Cardiology Amsterdam UMC, AMC,
Amsterdam, Netherlands
(Twisk) Department of Epidemiology & Data Science, Amsterdam UMC, Vrije
Universiteit Amsterdam, Amsterdam, Netherlands
(Spratt) Department of Cardiology, St. George's University Hospital,
London, United Kingdom
(Rissanen) Department of Cardiology, North Karelia Central Hospital,
Joensuu, Finland
Publisher
Elsevier Inc.
Abstract
Background: Percutaneous coronary intervention (PCI) of chronic total
coronary occlusions (CTOs) typically involves extensive drug-eluting stent
(DES) implantation. As a result, patients undergoing CTO PCI are exposed
to a relatively high risk of in-stent restenosis and target lesion
revascularization. While the application of drug-coated balloons (DCBs)
may improve patient outcome by reducing stent burden, randomized
controlled trials investigating the use of DCB in CTO PCI are lacking.
 Method(s): The Co-CTO trial (NCT04881812) is a single-blind,
noninferiority randomized controlled trial enrolling 144 patients
undergoing CTO PCI. A hybrid strategy (stenting of the CTO body and DCB
treatment of adjacent disease) will be compared to a complete stenting
strategy. The primary study endpoint is in-segment percentage diameter
stenosis at 1 year follow-up determined by intravascular ultrasound.
Secondary endpoints include major adverse cardiovascular events (a
composite of cardiac death, nonfatal myocardial infarction, and
ischemia-driven target lesion revascularization) at 1 year, angiographic
outcomes, and cardiac symptoms (Canadian Cardiovascular Society Grading
Scale, New York Heart Association Classification of Dyspnea).
 Conclusion(s): The Co-CTO trial is the first randomized controlled
trial exploring a hybrid strategy (DES + DCB) in patients undergoing CTO
PCI. Trial registration: Registered at ClinicalTrials.Gov under
registration number: NCT04881812
(https://clinicaltrials.gov/study/NCT04881812?cond=cto&intr=drug-coated%20
balloon&rank=1). Copyright © 2025 The Authors

<6>
Accession Number
2038670452
Title
The German Registry of Acute Aortic Dissection Type A score for 30-day
mortality prediction in Type A Acute Aortic Dissection surgery: a
systematic review and meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 67(5) (no pagination), 2025.
Article Number: ezaf138. Date of Publication: 01 May 2025.
Author
Gemelli M.; Rojanathagoon T.; van den Eynde J.; Italiano E.G.; Lena T.; Sa
M.P.; Bruno V.D.; Sandhu M.; Pruna-Guillen R.; Oo A.Y.; Czerny M.; Gallo
M.; Slaughter M.S.; Tarzia V.; Ahmed E.M.; Rajakaruna C.; Gerosa G.
Institution
(Gemelli, Italiano, Lena, Tarzia, Gerosa) Cardiac Surgery Unit, Department
of Cardiac, Thoracic, Vascular and Public Health Sciences, University of
Padova, Padova, Italy
(Gemelli, Sandhu, Ahmed, Rajakaruna) Bristol Heart Institute, University
Hospitals Bristol, Weston NHS Foundation Trust, Bristol, United Kingdom
(Rojanathagoon) School of Medicine, University of Nottingham, Nottingham,
United Kingdom
(van den Eynde) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Sa) Division of Cardiac Surgery, Department of Surgery, Massachusetts
General Hospital, Harvard Medical School, Boston, MA, United States
(Bruno) Minimally Invasive Cardiac Surgery Unit, IRCCS Ospedale
Galeazzi-Sant'Ambrogio, Milan, Italy
(Pruna-Guillen, Oo) Department of Cardiothoracic Surgery, Barts Heart
Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United
Kingdom
(Czerny) Clinic for Cardiovascular Surgery, University Heart Center
Freiburg Bad Krozingen, Bad Krozingen, Germany
(Czerny) Faculty of Medicine, Albert-Ludwigs-UniversityFreiburg, Freiburg,
Germany
(Gallo, Slaughter) Department of Cardiovascular and Thoracic Surgery,
University of Louisville, Louisville, KY, United States
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The German Registry of Acute Aortic Dissection Type A
(GERAADA) score is a risk score for predicting 30-day mortality after an
operation for type A acute aortic dissection (TAAAD). This meta-analysis
sought to assess the performance of the GERAADA model and compare it to
the performance of the European System for Cardiac Operative Risk
Evaluation II (EuroSCORE II). METHOD(S): A systematic search of 3
online databases was conducted to identify studies that externally
validated the GERAADA score. A random-effect meta-analysis was conducted,
pooling area under the curve (AUC) data, operative mortality
observed/expected (O/E) ratios and observed-expected (O-E) differences-of
the GERAADA model in all studies and of the EuroSCORE II when available.
 RESULT(S): Eleven studies were selected, including a total of 10 360
patients. The observed in-hospital mortality rate was 12.2%. Pooled
expected mortality rates estimated by the GERAADA score and the EuroSCORE
II were 18.4% and 5.8%, respectively. The pooled analyses for the GERAADA
scores showed moderate discrimination [AUC 0.70, 95% confidence interval
(CI) 0.66-0.73] and good calibration [observed-expected (O-E) differences
-12.3, 95% CI -27.1 to 2.58; O/E ratio 0.81, 95% CI 0.57-1.05]. Results
from 5 studies (2133 patients) investigating both scores simultaneously
revealed similar AUC results (P 1/4 0.50), significantly lower O-E
differences (P 1/4 0.03) and a trend towards O/E ratios closer to 1 (P 1/4
0.08) with the GERAADA score compared to the EuroSCORE II.
 CONCLUSION(S): The GERAADA score seemed to offer a better calibration
for predicting 30-day postoperative death following TAAAD operations, even
though further studies are needed to confirm these findings. The moderate
discriminatory capacity of both scores highlights the challenges of
predicting outcomes in complex cardiovascular conditions like
TAAAD. Copyright © The Author(s) 2025. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<7>
Accession Number
2038685861
Title
Five-Year Mortality of Surgical and Transcatheter Aortic Valve Replacement
in the Real-World Scenario: A Systematic Review and Meta-Analysis of
Propensity Score Matching Studies.
Source
Brazilian Journal of Cardiovascular Surgery. 40(4) (no pagination), 2025.
Article Number: e20240048. Date of Publication: 2025.
Author
Marin-Cuartas M.; Dalbesio B.; Pollari F.; Scarpanti M.; Anselmi A.; de la
Cuesta M.; Uva M.S.; Verhoye J.-P.; Musumeci F.; Barili F.; Parolari A.
Institution
(Marin-Cuartas, de la Cuesta) University Department of Cardiac Surgery,
Leipzig Heart Center, Leipzig, Germany
(Dalbesio) Department of Cardiac Surgery, S. Croce Hospital, Cuneo, Italy
(Pollari) Cardiac Surgery, Klinikum Nurnberg-Paracelsus Medical
University, Nuremberg, Germany
(Scarpanti, Parolari) University Cardiac Surgery Unit, IRCCS Policlinico
San Donato, San Donato, Italy
(Anselmi, Verhoye) Department of Thoracic and Cardiovascular Surgery,
University Hospital of Rennes, Rennes, France
(Uva) Department of Cardiac Surgery, Hospital Santa Cruz, Carnaxide,
Portugal
(Uva) Department of Cardiac Surgery and Physiology, Porto University
Medical School, Porto, Portugal
(Musumeci) Department of Cardiac Surgery, ISMETT, Palermo, Italy
(Barili) University Cardiac Surgery Unit, IRCCS Ospedale Galeazzi
Sant'Ambrogio, Milan, Italy
(Barili) Department of Epidemiology, Harvard T.H. Chan School of Public
Health, Boston, MA, United States
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Randomized controlled trials (RCTs) provide evidence of
efficacy, while real-world data (RWD) demonstrate effectiveness in
real-world practice. We designed a systematic review and meta-analysis of
reconstructed time-to-event (RTE) data from propensity score matching
studies comparing transcatheter aortic valve implantation (TAVI) and
surgical aortic valve replacement (SAVR) to compare their effectiveness
and evaluate the generalizability of TAVI indications. Method(s):
Systematic review of literature between 2007 and 2023 including propensity
score matching studies comparing TAVI or SAVR that reported at least
one-year Kaplan-Meier curves of endpoints. Result(s): Twenty-one
studies were included (39538 participants). TAVI shows a higher all-cause
mortality (hazard ratio [HR] 1.41; 95% confidence interval [CI] 1.34-1.47,
P-value < 0.001), with a significant heterogeneity. The analysis of HR
trend over time shows that TAVI superiority is limited to the first month
with a steep reversal afterwards, when SAVR becomes clearly superior.
All-cause mortality is significantly higher in TAVI in low-risk (HR 1.35;
95% CI 1.08-1.69, P-value < 0.001) as well as in intermediate (HR 1.73;
95% CI 1.35-2.22, P-value < 0.001) and high-risk (HR 1.61; 95% CI
1.38-1.88, P-value < 0.001) patients. The HR trend in the subgroups of
risk confirms the data from the whole mixed population.
 Conclusion(s): In a real-word setting, TAVI is associated with higher
incidence of all-cause death and maintains a survival benefit only in the
first month after implantation. These results show that TAVI effectiveness
may not reflect the efficacy demonstrated by RCTs and pose a threat to
their external validity. Copyright © 2025, Sociedade Brasileira
de Cirurgia Cardiovascular. All rights reserved.

<8>
Accession Number
2038523869
Title
Randomized study assessing the effectiveness and safety of a novel scoring
balloon for percutaneous coronary intervention: the Wedge NC trial.
Source
Journal of Thoracic Disease. 17(4) (pp 2101-2112), 2025. Date of
Publication: 30 Apr 2025.
Author
Chen H.; Xu J.; Chen D.; Gao F.; Liu Y.; Cui H.; Wang J.; Guo S.; Du Z.;
Huang J.; Zhang X.; Jiang W.; Cheng Z.; Jiang J.
Institution
(Chen, Xu, Chen, Gao, Liu, Jiang) Department of Cardiology, The Second
Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou,
China
(Cui) Department of Cardiology, The First Affiliated Hospital of Ningbo
University, Ningbo, China
(Wang) Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun
Yat-sen University, Guangzhou, China
(Guo) Department of Cardiology, Dongguan People's Hospital, The Tenth
Affiliated Hospital of Southern Medical University, Dongguan, China
(Du) Department of Cardiology, Dongguan Songshan Lake Tungwah Hospital,
Dongguan, China
(Huang) Department of Cardiology, Affiliated Hangzhou First People's
Hospital, Westlake University School of Medicine, Hangzhou, China
(Zhang) Department of Cardiology, The Affiliated Hospital of Hangzhou
Normal University, Hangzhou, China
(Jiang) Department of Cardiology, Wenzhou Hospital of Integrated
Traditional Chinese, Western Medicine Affiliated to Zhejiang Chinese
Medicine University, Wenzhou, China
(Jiang) Department of Cardiology, Wenzhou Central Hospital, The Second
Affiliated Hospital of Shanghai University, Wenzhou, China
(Cheng) Department of Cardiology, Huzhou Central Hospital, Affiliated
Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, China
Publisher
AME Publishing Company
Abstract
Background: Scoring balloon angioplasty catheters are designed to induce
high focal stress at low inflation pressure for better lesion
modification. We aimed to assess the effectiveness and safety of a newly
developed Wedge NC scoring balloon catheter compared to the ScoreFlex
coronary dilatation catheter for treating coronary artery lesions.
 Method(s): The Wedge NC trial was a prospective, multicenter,
open-label, randomized controlled noninferiority trial conducted during
August 2021 and February 2022. There were 198 patients with indication for
percutaneous coronary intervention (PCI) enrolled at nine centers in
China. Patients undergoing angioplasty were randomly assigned to treatment
with the Wedge NC scoring balloon or the ScoreFlex scoring balloon. The
primary endpoint was procedure success, defined as the residual stenosis
of the target lesion <=30% immediately after PCI procedure, without
complications (limited to death, Q-wave or non-Q-wave myocardial
infarction, or emergent coronary artery bypass grafting during
postoperative hospitalization). The secondary endpoints included rate of
clinical success, device procedural success, balloon slippage, and
angiographic traits measured by quantitative coronary analysis.
 Result(s): Baseline parameters showed no differences between the two
groups. Procedure success was achieved in 98 of 99 patients in both
groups. The mean difference between the Wedge group and the ScoreFlex
group was 0 (95% confidence interval: -2.79% to 2.79%, 1-sided P<0.001
with both Wald method and minimum risk weights method). Noninferiority at
a predefined margin of 7% was established. Immediately after the balloon
inflation, minimal lumen diameter in the Wedge group was significantly
larger than that of the ScoreFlex group (1.71+/-0.39 vs. 1.56+/-0.36 mm,
P=0.02), resulting in a lower percent diameter stenosis and a higher acute
lumen gain (36.04+/-11.43 vs. 41.14+/-10.63, P=0.004; 0.82+/-0.39 vs.
0.69+/-0.37 mm, P=0.02, respectively). There was comparable and low rate
of procedural complications for both treatment groups. Conclusion(s):
In patients undergoing PCI, the Wedge NC scoring balloon dilatation
catheter was noninferior to the ScoreFlex coronary dilatation catheter
regarding procedure success and had comparably low procedural complication
rate. (Sponsored by BrosMed Medical.) Copyright © AME Publishing
Company.

<9>
Accession Number
2038674520
Title
Digital integration of research conduct into clinical care: results of the
PROSPECTOR randomised feasibility study.
Source
BMJ Evidence-Based Medicine. (no pagination), 2025. Article Number:
bmjebm-2024-113081. Date of Publication: 2025.
Author
Wilson M.G.; Asselbergs F.W.; Saleem N.; Jeilani L.; Brealey D.; Sydes
M.R.; Harris S.
Institution
(Wilson, Asselbergs, Saleem, Jeilani, Brealey, Sydes, Harris) University
College London, London, United Kingdom
(Brealey) National Institute of Health Research Central London Patient
Safety Research Collaboration, London, United Kingdom
(Sydes) BHF Data Science Centre, London, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Objectives: To evaluate the feasibility of conducting a clinically
integrated randomised comparative effectiveness trial using digital
clinical trial infrastructure within an electronic patient record (EPR).
 Design(s): A mixed-methods, unblinded, feasibility study of digital
clinical trial system incorporating testing of two designs of electronic
point-of-care randomisation prompt. Setting(s): The study was
conducted at University College London Hospitals NHS Trust between March
and November 2022. The study used a real clinical research question for
context, comparing liberal vs restrictive strategies for magnesium
supplementation to prevent new-onset atrial fibrillation in critical care.
 Participant(s): Adult patients undergoing elective, non-cardiac
surgical procedures expecting postoperative admission to critical care
were recruited. Intervention(s): A digital trial system screened
participants continuously against eligibility criteria. Participants were
automatically randomised (1:1) to (1) magnesium supplementation strategy
and (2) one of two electronic randomisation prompt designs (nudge or
preference). Electronic point-of-care randomisation prompts displayed to
clinicians at regular intervals, inviting them to follow a randomised
magnesium supplementation suggestion. Main Outcome Measure(s): The
primary outcome measure was a composite determination of study design
feasibility (including recruitment, technical performance and concordance
between the randomised suggestion and the observed clinician action).
 Result(s): 23 patients were recruited and 11 successfully randomised.
The implemented digital systems for automated eligibility screening,
randomisation, data collection and follow-up demonstrated technical
feasibility. 47 electronic point-of-care randomisation prompts
successfully deployed across 11 patients. Clinician actions were
concordant with randomised suggestions in 32 prompts (68%). Technical and
implementational barriers to delivering the electronic point-of-care
randomisation prompts were identified. Patients were followed up to 30
days following discharge from hospital, with no serious adverse events
attributable to participation identified. There was insufficient data to
make a quantitative determination on the superiority of either prompt
design. Clinician feedback suggested the simplified design (nudge) had
greater utility. Conclusion(s): This study demonstrates that
digitally embedding clinical trial infrastructure into a site-level EPR
and integrating conduct into clinical care is safe and feasible. Future
work will focus on improving and expanding the integrated digital trial
design across multiple centres. Copyright © 2025. Author (s) (or
their employer(s)) Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ Group.

<10>
Accession Number
2038705240
Title
Impact of Preoperative STEMI on Postoperative Recovery and Complications
Following Cardiac Surgery.
Source
Heart Surgery Forum. 28(4) (pp E335-E342), 2025. Date of Publication:
2025.
Author
Li X.; Sun B.; Fu M.; Sun S.; Xu S.; Luo J.
Institution
(Li, Sun, Fu, Sun, Xu, Luo) Department of Cardiology, Guangdong Provincial
People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical
University, Guangdong, Guangzhou, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Comprehensive perioperative management strategies are advised
for patients undergoing cardiac surgery who have a history of preoperative
ST-segment elevation myocardial infarction (STEMI) because these patients
have a higher risk for adverse postoperative outcomes. This systematic
review explored the influence of preoperative STEMI on postoperative
recovery and complications in cardiac surgery patients. Method(s): A
systematic search of PubMed, MEDLINE, EMBASE, and Cochrane Library
databases was conducted following the Preferred Reporting Items for
Systemic Reviews and Meta-analyses (PRISMA) guidelines. Studies published
between 1990 and 2024 were screened for inclusion based on predefined
criteria. A total of 420 studies were initially identified, and eight
studies, encompassing 1741 patients undergoing coronary artery bypass
grafting (CABG), were included in the review. Two independent reviewers
performed data extraction, and the quality of studies was assessed using
the Newcastle-Ottawa scale. Key findings from each study were narratively
synthesized to explore common themes and outcomes related to postoperative
mortality, major adverse cardiac events (MACEs), and complications.
 Result(s): Of the 420 initially identified studies, eight met the
inclusion criteria. Across these included studies, STEMI patients
demonstrated higher postoperative mortality rates and increased incidence
of MACEs compared to other cardiac surgery patients. Complications such as
renal failure were particularly prevalent in patients with preoperative
cardiogenic shock, with up to 50% of these patients requiring intra-aortic
balloon pump (IABP) support. Recovery of left ventricular ejection
fraction (LVEF) varied, ranging from 0.36 to 0.50, depending on the extent
of preoperative myocardial dysfunction and the revascularization strategy
employed. Variability in patient demographics, surgical techniques, and
clinical settings contributed to differences in reported outcomes across
studies. Conclusion(s): These findings underscore the importance of
tailored perioperative strategies and specialized care protocols for STEMI
patients undergoing cardiac surgery. By addressing the unique challenges
posed by this high-risk group, healthcare providers can improve patient
outcomes and reduce the incidence of postoperative
complications. Copyright © 2025 The Author(s).

<11>
Accession Number
2033501313
Title
Oral vs. Outpatient Parenteral Antimicrobial Treatment for Infective
Endocarditis: Study Protocol for the Spanish OraPAT-IE GAMES Trial.
Source
Infectious Diseases and Therapy. 14(3) (pp 643-655), 2025. Article Number:
100213. Date of Publication: 01 Mar 2025.
Author
Alonso-Socas M.M.; Lopez-Lirola A.; Goikoetxea-Agirre A.J.; Ribas M.A.;
Navarro D.; Sala C.; Ambrosioni J.; Olivares P.; Lopez-Cortes L.E.;
Morales I.; Mendez I.; de Cueto M.; Calvo-Jambrina R.; Barquero J.M.;
Araji O.; Almendro-Delia M.; Brase A.; Calvo-Fernandez A.; Tauron M.;
Recasens L.; Sorli L.; Suarez M.; Silverio A.; Sanchez F.; Ribas N.;
Serrat R.; Molina L.; Mestres A.; Mas A.; Ginel A.J.; Horcajada-Gallego
J.P.; Ble M.; Lopez-Montesinos I.; Salavert-Lleti M.; Garcia-Bustos V.;
Fernandez-Navarro J.A.; Calabuig-Munoz E.; Montero-Alonso M.;
Tasias-Pitarch M.; Domingo-Valero D.; Arnau-Vives M.A.; Blanes-Hernandez
R.; Vives-Borras M.; Vidal-Bonet L.; Ruiz de Gopegui-Bordes E.;
Ribas-Blanco M.A.; Zarauza J.; Teira R.; Ruiz-Alonso N.; Parra J.A.;
Pajaron M.; Gutierrez-Diez J.; Gutierrez-Cuadra M.; Gutierrez-Fernandez
L.; Gonzalez-Rico C.; Garrido R.; Garcia I.; Fernandez-Sampedro M.;
Farinas-Alvarez C.; Farinas M.C.; Cobo-Belaustegui M.; Arnaiz de las
Revillas F.; Arminanzas-Castillo C.; Amado-Fernandez C.; Aguero-Balbin J.;
Martin-Blanco N.; Oteo J.A.; Garcia-Alvarez L.; Corral-Armas E.; Blanco
J.R.; Azcona-Gutierrez J.M.; Azcarate P.; Alonso L.J.; Saura D.;
Roura-Piloto A.; Perez-Andreu J.; Ortin A.; Oliva M.J.; Moral-Escudero E.;
Martinez-Toldos M.C.; de Gea J.H.; de la Morena Valenzuela G.; Blazquez
A.; Hernandez-Torres A.; Vazquez E.G.; Canovas S.; Albert L.;
Rivera-Martinez M.A.; Lopez-Contreras J.; Leta-Petracca R.; Grillo S.;
Ginel-Iglesias A.; Barros-Membrilla A.; Camprecios M.; Gasch O.; Monsalvez
V.; Gomila A.; Calzado S.; Diaz E.; Lozano L.; Capilla S.; Guillamon L.;
Guillaumet E.; Castaldo F.; Araujo G.; Dietl B.; Ibars S.; Xercavins M.;
Boix-Palop L.; Badia C.; Rosillo S.; Romero M.; Rial-Baston V.; Ramirez
U.; Moreno M.; Loeches B.; Antorrena I.; Ruiz S.; Rodriguez-Roda-Stuart
J.; del Rio A.; Oliva E.; Navas E.; Martin-Davila P.; Moya J.L.; Hermida
J.M.; Centella T.; Sanchez-Rodriguez I.; Gracia-Sanchez L.; Blasco A.;
Sbraga F.; Ruiz-Majoral A.; Alegre O.; Sanchez-Salado J.C.; Berbel D.;
Ardanuy C.; Grau I.; Carratala J.; Escrihuela-Vidal F.;
Gonzalez-de-la-Aleja P.; Pinargote-Celorio H.; Reus S.; Plazas J.; Merino
E.; Llamas P.; Climent V.; Carrasco R.; Goyeneche M.; Bidegain M.; Sanchez
S.; Zabalo-Arrieta M.; Villanueva-Benito I.; Vicente-Anza D.;
Unamuno-Ugartemendia I.; Solla-Ruiz I.; Sebastian-Alda R.; Sanchez-Haza
E.; Saez-Berbejillo A.; Reviejo K.; Rengel-Jimenez A.;
Perez-Moreiras-Lopez J.I.; Kortajarena-Urkola X.; Iribarren J.A.;
Granda-Bauza A.; Goyeneche del Rio M.; Goenaga M.A.; Fuentes A.;
Eizaguirre-Yarza A.; Echeverria T.; del Bosque-Martin C.;
Bustinduy-Odriozola M.J.; Berritu-Boronat E.; Azkune-Galparsoro H.; Camino
X.; Alvarez-Rodriguez I.; Voces R.; Vitoria Y.; Rodriguez R.; Rodrigo D.;
Nieto J.; Montejo M.; Lopez-Soria L.; Irurzun-Zuazabal J.; Iruretagoyena
J.R.; Ibarrola-Hierro M.; Goikoetxea A.J.; Euba-Ugarte G.; Del Alamo
Martinez de Lagos M.; Guio-Carrion L.; Crespo A.; Campana-Lazaro M.; Boado
M.V.; Blanco R.; Blanco-Vidal M.J.; Bereciartua E.; de la Villa S.;
Verde-Moreno E.; Vazquez P.; Valerio M.; Segado A.; Sanchez-Perez E.;
Rodriguez-Abella H.; Rincon C.; Pinto A.; Pinilla B.; Pedraz A.; Olmedo
M.; Monzon D.; Munoz P.; Melero R.; Martinez-Selles M.; Marin M.; Machado
M.; Hualde A.M.; Kestler-Hernandez M.; Gonzalez-Ramallo V.;
Gonzalez-Moraga F.J.; Mansilla A.G.; Garcia-Leoni M.E.; Gargallo E.;
Fortuny-Ribas R.; Estevez A.; Delgado-Montero A.; Cuerpo-Caballero G.;
Calatayud J.; Bouza E.; Bermejo J.; Alvarez-Uria A.; Alonso J.C.; Adan I.;
Rodriguez-Moreno F.; Prada-Arrondo P.; Perez-Ramirez A.; Lorenzo de la
Pena L.; Lacalzada J.; Gonzalez Gonzalez J.; Garcia-Rosado D.;
Fernandez-Sarabia J.; Delgado-Melian T.; Castro B.; Alonso M.D.M.;
Poyato-Borrego M.; Sanchez-Dominguez E.; Ortiz-Carrellan A.; Marin G.;
Luque-Marquez R.; Lopez-Haldon J.; Lepe J.A.; Gutierrez-Carretero E.;
Navarro-Amuedo D.; de Alarcon A.; Vila J.; Tuset M.; Vidal B.; Urra X.;
Tolosana J.M.; Tellez A.; Soy D.; Sitges M.; Sanchis L.; Sandoval E.;
Rovira I.; Roque M.; Roca C.; Regueiro A.; Ramirez J.; Quintana E.; Pomar
J.L.; Perissinotti A.; Pericas J.M.; Pereda D.; Pare C.; Ortiz J.; Ninot
S.; Nicolas D.; Moreno A.; Miro J.M.; Marco F.; Lopez T.; Llopis-Perez J.;
Hernandez-Meneses M.; Garcia-Pares D.; Garcia de la Maria C.; Fuster D.;
Fita G.; Fernandez-Pittol M.; Espasa M.; Falces C.; de Diego O.; Cuervo
G.; Canas M.A.; Castella M.; Cartana R.; Brunet M.; Azqueta M.; Ascaso M.;
Alcocer J.; Almela M.; Andrea R.
Institution
(Cuervo, Hernandez-Meneses, Moreno, Sala, Ambrosioni, Miro) Infectious
Diseases Department, Hospital Clinic-IDIBAPS, University of Barcelona,
Villarroel 170, Barcelona, Spain
(Nicolas) Internal Medicine-Home Hospitalization Unit, Hospital
Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
(Vidal) Cardiology Department, Hospital Clinic-IDIBAPS, University of
Barcelona, Barcelona, Spain
(Fernandez-Pittol) Microbiology Department, Hospital Clinic-IDIBAPS,
University of Barcelona, Barcelona, Spain
(Cuervo, de Alarcon, Martin-Davila, Lopez-Montesinos, Lopez-Cortes,
Ambrosioni, Miro) CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
(de Alarcon, Luque-Marquez, Navarro) Clinical Unit of Infectious Diseases,
Microbiology and Parasitology (UCEIMP), Institute of Biomedicine of
Seville (IBiS), Virgen del Rocio University Hospital/CSIC/University of
Seville, Seville, Spain
(Alonso-Socas, Lopez-Lirola) Hospital Universitario de Canarias, Tenerife,
Spain
(Gonzalez-Ramallo) Hospital General Universitario Gregorio Maranon,
Madrid, Spain
(Goikoetxea-Agirre) Hospital Universitario de Cruces, Bilbao, Spain
(Goenaga) Hospital Universitario Donosti, Instituto Investigacion
Biogipuzkoa, San Sebastian, Spain
(Merino) Unit of Infectious Diseases, Alicante General University Hospital
- Alicante Institute of Health and Biomedical Research (ISABIAL),
Alicante, Spain
(Merino) Clinical Medicine Department, Miguel Hernandez University, Elche,
Spain
(Escrihuela-Vidal) Hospital Universitario de Bellvitge, Barcelona, Spain
(Martin-Davila) Hospital Universitario Ramon y Cajal, Instituto Ramon y
Cajal de Investigacion Sanitaria (IRYCIS), Madrid, Spain
(Loeches) Hospital Universitario La Paz, Madrid, Spain
(Boix-Palop) Hospital Mutua de Terrassa, Terrassa, Spain
(Gasch) Servei de Malalties Infeccioses, Hospital Universitari Parc Tauli,
Institut d'Investigacio i Innovacio Parc Tauli (I3PT-CERCA), Universitat
Autonoma de Barcelona, Sabadell, Spain
(Camprecios) Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
(Hernandez-Torres) Hospital Virgen de la Arrixaca, Murcia, Spain
(Garcia-Alvarez) Hospital San Pedro-CIBIR, Logrono, Spain
(Pajaron) Hospital Marques de Valdecilla, Santander, Spain
(Ribas) Hospital Son Espases, Palma, Spain
(Blanes-Hernandez) Hospital de La Fe, Valencia, Spain
(Lopez-Montesinos) Hospital del Mar, Barcelona, Spain
(Lopez-Cortes) Unidad Clinica de Enfermedades Infecciosas y Microbiologia,
Hospital Universitario Virgen Macarena, Seville, Spain
(Lopez-Cortes) Departamentos de Medicina y Microbiologia, Facultad de
Medicina, Universidad de Sevilla, Seville, Spain
(Lopez-Cortes) Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Seville,
Spain
Publisher
Adis
Abstract
Introduction: The POET trial demonstrated that moving from intravenous to
oral antibiotics in stable patients with left-sided infective endocarditis
(IE) was noninferior to fully parenteral treatment. However, it did not
compare outpatient strategies. Method(s): The OraPAT-IE GAMES trial
is a noninferiority, multicenter, randomized, open-label study aimed to
compare partial oral versus outpatient parenteral antibiotic therapy
(OPAT) for consolidation of antibiotic treatment in left-sided IE. A total
of 342 stable patients with IE caused by selected micro-organisms will
eventually be included. After a minimum of 10 days of parenteral
treatment, stable patients are randomized to oral therapy or OPAT. The
primary end-point is a composite of all-cause mortality, unplanned cardiac
surgery, relapse of positive blood cultures and/or unplanned hospital
admission. Patients are followed-up for 6 months after completing
antibiotic therapy. Planned Outcome: This trial seeks to demonstrate the
equivalent efficacy of the two outpatient strategies currently available
for stable patients with IE in the consolidation phase of antibiotic
treatment. Conclusion(s): In a global context of limited healthcare
resources and a sustained increase in elderly and frail patients, it is of
great importance to demonstrate the effectiveness and safety of outpatient
management strategies that could reduce the duration of conventional
hospitalizations with their potential complications and inherent costs.
Trial Registration: EudraCT: 2020-001024-34. ClinicalTrials.gov
identifier: NCT05398679. Copyright © The Author(s) 2025.

<12>
Accession Number
2038502718
Title
De-escalating Dual Antiplatelet Therapy to Ticagrelor Monotherapy in Acute
Coronary Syndrome A Systematic Review and Individual Patient Data
Meta-analysis of Randomized Clinical Trials.
Source
Annals of Internal Medicine. 178(4) (pp 533-542), 2025. Date of
Publication: 01 Apr 2025.
Author
Lee Y.-J.; Gao X.; Lee S.-H.; Kan J.; Zhang J.-J.; Lee S.-J.; Hong S.-J.;
Ahn C.-M.; Kim J.-S.; Kim B.-K.; Ko Y.-G.; Choi D.; Jang Y.; Stone G.W.;
Chen S.-L.; Hong M.-K.
Institution
(Lee, Lee, Lee, Hong, Ahn, Kim, Kim, Ko, Choi, Hong) Division of
Cardiology, Severance Hospital, Yonsei University College of Medicine,
Seoul, South Korea
(Gao, Kan, Zhang, Jang, Chen) Department of Cardiology, Nanjing First
Hospital, Nanjing Medical University, Nanjing, China
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
Publisher
American College of Physicians
Abstract
Background: The role of transitioning from short dual antiplatelet therapy
(DAPT) to potent P2Y12 inhibitor monotherapy in patients with acute
coronary syndrome (ACS) undergoing drug-eluting stent (DES) implantation
remains inconclusive. Purpose(s): To compare the effects of
de-escalating DAPT to ticagrelor monotherapy versus standard DAPT from
randomized clinical trials in patients with ACS. Data Sources:
PubMed, EMBASE, Scopus, and ClinicalTrials.gov from inception to 12
December 2024. Study Selection: Randomized clinical trials comparing
de-escalating DAPT to ticagrelor monotherapy versus ticagrelor-based
standard DAPT for 12 months, specifically in patients with ACS undergoing
DES implantation. Data Extraction: The coprimary end points were an
ischemic end point (composite of death, nonprocedural [spontaneous]
myocardial infarction, or stroke) and a bleeding end point (Bleeding
Academic Research Consortium types 3 or 5 bleeding). Data Synthesis:
Individual patient data were obtained from 3 trials (TICO [Ticagrelor
Monotherapy After 3 Months in the Patients Treated With New Generation
Sirolimus-Eluting Stent for Acute Coronary Syndrome], T-PASS [Ticagrelor
Monotherapy in Patients Treated With New-Generation Drug-Eluting Stents
for Acute Coronary Syndrome], and ULTIMATE-DAPT [Ticagrelor alone versus
ticagrelor plus aspirin from month 1 to month 12 after percutaneous
coronary intervention in patients with acute coronary syndromes]),
including 9130 randomized patients with ACS; 3132 had ST-segment elevation
myocardial infarction (STEMI), 3023 had non-STEMI (NSTEMI), and 2975 had
unstable angina. The rate of the primary ischemic end point was not
different between the ticagrelor monotherapy and standard DAPT groups
(1.7% vs. 2.1%; hazard ratio [HR], 0.85 [95% CI, 0.63 to 1.16]). The rate
of the primary bleeding end point was lower in the ticagrelor monotherapy
group (0.8% vs. 2.5%; HR, 0.30 [CI, 0.21 to 0.45]). These findings were
consistent in patients with STEMI, NSTEMI, and unstable angina.
 Limitation(s): Other de-escalation strategies for modulating
antiplatelet therapy were not included. Conclusion(s): In patients
with ACS undergoing DES implantation, de-escalating DAPT to ticagrelor
monotherapy was associated with a lower risk for major bleeding compared
with standard DAPT, without an increase in ischemic events, regardless of
the type of ACS. Copyright © 2025 American College of Physicians.

<13>
Accession Number
2038499381
Title
Intra-aortic balloon pump in patients with heart failure-related
cardiogenic shock: the Altshock-2 trial in perspective.
Source
European Heart Journal: Acute Cardiovascular Care. 14(4) (pp 237-239),
2025. Date of Publication: 01 Apr 2025.
Author
Zeymer U.; Morrow D.A.
Institution
(Zeymer) Institut fur Herzinfarktforschung Ludwigshafen, Ludwigshafen,
Germany
(Zeymer) University Heart Center Freiburg - Bad Krozingen, Faculty of
Medicine, University of Freiburg, Bad Krozingen, Germany
(Morrow) TIMI Study Group, Critical Care Cardiology Trials Network,
Brigham and Women's Hospital, 75 Francis Street, Boston, MA, United States
Publisher
Oxford University Press

<14>
Accession Number
2038690678
Title
Immediate transcatheter aortic valve replacement versus temporizing
balloon aortic valvuloplasty in severe aortic stenosis: A systematic
review and meta-analysis immediate TAVR vs. temporizing BAV.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Doma M.; Huang W.; Hernandez S.; Fatima S.R.; Lingamsetty S.; Kritya M.;
Hemdanieh M.; Naji Z.; Gewehr D.M.; Martignoni F.V.; Goldsweig A.M.
Institution
(Doma) Alexandria Faculty of Medicine, Egypt
(Huang) University of Padjadjaran, Indonesia
(Hernandez) Universidad Xochicalco Campus Tijuana, Mexico
(Fatima) CMH Lahore Medical College and Institute of Dentistry, Pakistan
(Lingamsetty) Mamata Medical College, India
(Kritya) Armed Forces Medical College, India
(Hemdanieh) American University of Beirut, Lebanon
(Naji) Faculty of Medicine of Tunis, Al-Manar University, Tunisia
(Gewehr) Curitiba Heart Institute, Curitiba, Parana, Brazil
(Martignoni) Minneapolis Heart Institute and Foundation, MN, United States
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center
and Division of Cardiovascular Medicine, University of
Massachusetts-Baystate, Springfield, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is a first-line
therapy for severe aortic stenosis (AS). In patients with
contraindications to immediate TAVR, temporizing balloon aortic
valvuloplasty (BAV) may be performed to stabilize patients prior to TAVR.
The relative efficacy and safety of TAVR with or without temporizing BAV
remains inadequately described. Method(s): We searched PubMed,
Embase, and Cochrane databases for studies comparing TAVR with and without
temporizing BAV in patients with severe AS. Random-effects models were
used to calculate pooled odds, risk ratios (RRs) and mean differences with
95 % confidence intervals (CIs). Result(s): Nine studies (59,205
patients: 95.7 % immediate TAVR, 4.3 % BAV + TAVR) met inclusion criteria.
Mean age was 82.9 +/- 6.6 years old, and 45.9 % were males. Patients in
the TAVR group were a mean difference of 1 year younger with no difference
in gender distribution between groups. Direct TAVR was associated with a
lower risk of 30-day all-cause mortality than BAV + TAVR (RR = 0.62; 95 %
CI 0.41 to 0.93; p = 0.02). There were no significant differences in risks
of post-procedural pacemaker implantation, myocardial infarction, cardiac
tamponade, major vascular complications, ischemic stroke, major bleeding,
2+ or greater aortic regurgitation grade or acute kidney injury.
 Conclusion(s): While immediate TAVR was associated with slightly
lower short-term mortality compared to BAV + TAVR in patients with severe
AS, other binary endpoints were equivalent. This potential mortality
difference should be considered when offering BAV + TAVR in patients with
contraindications to immediate TAVR. Randomized studies are required to
confirm these results. Copyright © 2025 Elsevier Inc.

<15>
Accession Number
2037914635
Title
Contemporary risk models for transcatheter aortic valve replacement: A
narrative review.
Source
Cardiovascular Revascularization Medicine. 74 (pp 71-79), 2025. Date of
Publication: 01 May 2025.
Author
Chan N.; Agrawal A.; Arockiam A.D.; Majid M.; Haroun E.; Shah A.; Puri R.;
Griffin B.; Wang T.K.M.
Institution
(Chan) Section of Cardiovascular Medicine, Heart and Vascular Center,
Dartmouth-Hitchcock Health System, Lebanon, NH, United States
(Agrawal, Arockiam, Majid, Haroun, Shah, Puri, Griffin, Wang) Department
of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute,
Cleveland Clinic, Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Aortic stenosis (AS) is the most common form of valvular heart disease in
older adults requiring intervention. Severe symptomatic AS, if left
untreated, is typically associated with a poor prognosis. Over the past
two decades, there have been significant advances in the field of
transcatheter aortic valve replacement (TAVR), leading to its emergence as
an alternative to the well-established surgical aortic valve replacement
(SAVR) for treating severe AS. Multiple randomized clinical trials have
demonstrated comparable efficacy and safety outcomes of TAVR vs SAVR in
high, intermediate, and low-risk surgical candidates. In the process,
multiple risk scores, both traditional surgical and TAVR-specific, have
been developed to better risk stratify patients as well as guide
periprocedural management and patient counseling. This review aims to
discuss the currently available risk models for risk prediction in TAVR
patients, highlighting their strengths, limitations, and applicability to
different patient populations. Copyright © 2025 The Authors

<16>
[Use Link to view the full text]
Accession Number
2035556472
Title
Is the Use of a Buprenorphine Transdermal Patch More Effective Than Oral
Medications for Postoperative Analgesia After Arthroscopic Rotator Cuff
Repair? A Randomized Clinical Trial.
Source
Clinical Orthopaedics and Related Research. 483(5) (pp 857-865), 2025.
Date of Publication: 01 May 2025.
Author
Liu W.; Qin J.; Fang X.; Jiang G.; Wang P.; Ding M.; Xu R.
Institution
(Liu) Department of Pharmacy, Nanjing Drum Tower Hospital, Drum Tower
Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing,
China
(Qin, Jiang, Wang, Xu) Division of Sports Medicine and Adult
Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum
Tower Hospital, Affiliated Hospital of Medical School, Nanjing University,
Nanjing, China
(Fang, Ding) Department of Pharmacy, Nanjing Drum Tower Hospital, School
of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University,
Nanjing, China
(Xu) Department of Pharmacy, Nanjing Drum Tower Hospital, Affiliated
Hospital of Medical School, Nanjing University, Nanjing, China
Publisher
Wolters Kluwer Health Inc
Abstract
Background Appropriate analgesic protocols for patients following
arthroscopic rotator cuff repair remain controversial. Although
transdermal buprenorphine patches might potentially provide better pain
control and fewer side effects, it is worth noting that there is limited
evidence for this given a lack of direct comparisons with oral pain
regimens. Questions/purposes Among patients undergoing arthroscopic
rotator cuff repair, and compared with an analgesic approach using oral
tramadol plus celecoxib: (1) Does perioperative use of buprenorphine
patches provide better pain relief by a clinically important margin? (2)
Does perioperative use of buprenorphine patches improve shoulder joint
function recovery? (3) Does perioperative use of buprenorphine patches
have a lower frequency of adverse reactions? Methods This was a
prospective, single-center, randomized controlled trial. We included
patients who underwent arthroscopic rotator cuff repair for partial- or
full-thickness rotator cuff tears < 3 cm in size in the anterior to
posterior direction as estimated by preoperative MRI and excluded those
who had obesity, were pregnant, had opioid dependence, had history of
cardiac bypass surgery or ipsilateral rotator cuff repair, had allergies
to trial medications, were taking anticoagulants or antidepressants, were
being treated with other postsurgical pain management methods, or had
severe liver or kidney dysfunction. Based on these criteria, 64% (72 of
112) of patients were eligible. The patients were randomly assigned into
either the control group (oral tramadol and celecoxib) or the experimental
group (buprenorphine patches). The control group received 100 mg of
tramadol and 200 mg of celecoxib every 12 hours for 2 weeks after surgery.
The experimental group received buprenorphine patches about 48 hours
before surgery without any oral medication. A medication journal was given
to the patients to self-report their compliance in taking the drugs. The
dosage regimen adhered strictly to protocol. After enrollment, 11% (4 of
36) of patients in the control group and 17% (6 of 36) of patients in the
experimental group could not be fully analyzed because of loss to
follow-up or missing data. The surveillance period was 3 months, and there
was no crossover between groups. The groups did not differ at baseline in
terms of demographic parameters and relevant clinical characteristics,
including age, gender, BMI, American Society of Anesthesiologists
classification, tear size, concomitant procedures, and number of anchors.
The outcomes were (1) numeric rating scale (NRS) for pain score at rest or
with movement, which ranges from 0 to 10, where 0 indicates no pain, and
10 indicates the worst pain; (2) the American Shoulder and Elbow Surgeons
(ASES) score for joint function, which ranges from 0 to 100, with higher
scores indicating better shoulder joint function; and (3) the incidence of
postoperative adverse reactions. We defined the minimum clinically
important difference on the NRS as 2 of 10 points and on the ASES score as
15 of 100 points, based on anchor-based approaches reported in other
studies. Results We found no clinically important between-group
differences in NRS pain scores at any time point, either at rest or with
movement. Likewise, we found no clinically important between-group
differences in ASES scores at any time point. Postoperative dizziness or
drowsiness (20% [6 of 30 patients] versus 44% [14 of 32 patients]; p =
0.04) and nausea (10% [3 of 30 patients] versus 34% [11 of 32 patients]; p
= 0.02) during the hospital stay were slightly lower in the experimental
group compared with the control group. Conclusion In this randomized
trial, we found no clinically important advantages in pain or function to
the use of buprenorphine patches after arthroscopic rotator cuff repair,
and insufficient evidence exists to confirm whether the minor differences
in transient side effects could justify the use of a new and largely
untested analgesic approach in this context. That being so, we recommend
against the routine use of buprenorphine patches for this indication. In
general, we found that pain levels were low after the procedure in both
groups. Future studies, therefore, should focus on the efficacy of
buprenorphine patches for more invasive or more painful
procedures. Copyright © 2024 by the Association of Bone and Joint
Surgeons.

<17>
Accession Number
2034540820
Title
Lipid-Lowering Effect and Safety of Ezetimibe and Atorvastatin 5 mg in
Patients With Primary Hypercholesterolemia or Mixed Dyslipidemia: A
Randomized, Double-Blind, Parallel, Multicenter, Phase 3 Clinical Trial.
Source
Clinical Cardiology. 48(5) (no pagination), 2025. Article Number: e70138.
Date of Publication: 01 May 2025.
Author
Ki Y.-J.; Kim W.; Lee K.H.; Han S.-J.; Kim Y.-H.; Doh J.-H.; Kim T.N.;
Chung C.H.; Kim D.Y.; Cho J.-M.; Yoon H.-J.; Jeong I.-K.; Park S.; Song
K.-H.; Yu C.W.; Cho D.-K.; Choi S.H.; Oh S.-J.; Shin S.; Jeong H.; Park
Y.; Kim H.-S.
Institution
(Ki) Cardiovascular Center, Department of Internal Medicine, Uijeongbu
Eulji Medical Center, Uijeongbu, South Korea
(Kim) Cardiovascular Division, Department of Internal Medicine, Kyung Hee
University Hospital, Kyung Hee University, Seoul, South Korea
(Lee) Cardiovascular Division, Department of Internal Medicine, Chonnam
National University Medical School & Hospital, Gwangju, South Korea
(Han) Division of Cardiology, Department of Internal Medicine, Hallym
University Sacred Heart Hospital, Anyang, South Korea
(Kim) Department of Endocrinology, Bundang Jesaeng Hospital, Gyeonggido,
Bundang-gu, South Korea
(Doh) Inje University Ilsan Paik Hospital, Goyang, South Korea
(Kim) Division of Endocrinology and Metabolism, Department of Internal
Medicine, Inje University Haeundae Paik Hospital, Busan, South Korea
(Chung) Department of Internal Medicine and Research Institute of
Metabolism and Inflammation, Yonsei University Wonju College of Medicine,
Wonju, South Korea
(Kim) Division of Cardiology, Department of Internal Medicine, Ajou
University Hospital and Ajou School of Medicine, Suwon, South Korea
(Cho) Department of Cardiovascular Medicine, Kyung Hee University Hospital
at Gangdong, Seoul, South Korea
(Yoon) Cardiovascular Center, Keimyung University Dongsan Hospital, Daegu,
South Korea
(Jeong) Division of Endocrinology and Metabolism, Department of Internal
Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University
College of Medicine, Seoul, South Korea
(Park) Cardiovascular Research Institute, Yonsei University College of
Medicine, Seoul, South Korea
(Song) Division of Endocrinology and Metabolism, Konkuk University Medical
Center, Konkuk University School of Medicine, South Korea
(Yu) Department of Cardiology, Cardiovascular Center, Korea University
Anam Hospital, Seoul, South Korea
(Cho) Yongin Severance Hospital, Yonsei University College of Medicine,
South Korea
(Choi) Department of Internal Medicine, Seoul National University College
of Medicine, Seoul National University Bundang Hospital, Seongnam-City,
South Korea
(Oh) Division of Cardiology, National Health Insurance Service Ilsan
Hospital, Goyang, South Korea
(Shin) Division of Cardiology, Department of Internal Medicine, Ewha
Womans University Seoul Hospital, Seoul, South Korea
(Jeong) Division of Cardiology, Department of internal medicine, Myongji
Hospital, Hanyang University Medical Center, Goyang, South Korea
(Park) Division of Cardiology, Department of Internal Medicine, Gyeongsang
National University Changwon Hospital, Changwon, South Korea
(Kim) Cardiovascular Center, Department of Internal Medicine, Seoul
National University Hospital, Seoul, South Korea
Publisher
John Wiley and Sons Inc
Abstract
Objective: This study aimed to compare the lipid-lowering effect and
safety of low-intensity atorvastatin (5 mg) plus ezetimibe (10 mg)
combination therapy (A5E10) with monotherapy regimens-atorvastatin 5 mg
[A5], ezetimibe 10 mg [E10], and atorvastatin 10 mg [A10])-in dyslipidemia
patients. Method(s): A randomized, double-blind, placebo-controlled
trial involving 252 dyslipidemia patients was conducted at 25 centers in
South Korea (NCT05970679). Participants aged >= 19 years were randomized
into four groups: A5E10, A5, E10, and A10. The primary endpoint was the
percentage change in low-density lipoprotein cholesterol (LDL-C) levels
from baseline to 8 weeks. Secondary endpoints included changes in other
lipid parameters, lipid ratios, LDL-C goal achievement rates and safety
assessments. Result(s): The mean age of the patients was 63 years,
and 51.2% were male. The A5E10 group showed significantly greater LDL-C
reduction (47.6%) compared with A5 (33.4%), E10 (19.4%), and A10 (40.1%)
at 8 weeks (p < 0.0001). A5E10 also significantly reduced triglyceride,
non-high-density lipoprotein cholesterol, and apolipoprotein B levels. In
addition, a significant reduction in LDL-C levels was observed over the 4
weeks, with a 46.7% reduction in LDL-C levels after 4 weeks of A5E10
administration. No severe adverse events were observed in the A5E10 group.
 Conclusion(s): The combination of low-intensity atorvastatin and
ezetimibe was more effective than moderate-intensity atorvastatin
monotherapy in lowering LDL-C levels and improving other lipid parameters.
It was well-tolerated and demonstrated rapid benefits within a month,
offering a promising alternative for patients with low to moderate
cardiovascular risk who do not achieve adequate control with statin
monotherapy. Copyright © 2025 The Author(s). Clinical Cardiology
published by Wiley Periodicals LLC.

<18>
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.

<19>
Accession Number
2038620266
Title
Transcatheter Aortic Valve Implantation (TAVI) in Australia.
Source
Heart Lung and Circulation. 34(5) (pp 419-421), 2025. Date of Publication:
01 May 2025.
Author
Sarathy K.; Kushwaha V.; Nagaraja V.
Institution
(Sarathy, Kushwaha) Department of Cardiology, Prince of Wales Hospital,
University of New South Wales, Sydney, NSW, Australia
(Nagaraja) Department of Cardiovascular Diseases, Mayo Clinic College of
Medicine, Rochester, MN, United States
Publisher
Elsevier Ltd

<20>
Accession Number
2038549656
Title
Complete revascularization versus culprit-lesion only PCI in patients with
NSTEMI and multivessel disease - Design and rationale of the randomized
COMPLETE-NSTEMI trial.
Source
American Heart Journal. 287 (pp 94-106), 2025. Date of Publication: 01 Sep
2025.
Author
Feistritzer H.-J.; Jobs A.; Zeymer U.; Schneider S.; Lauten P.; Ferenc M.;
Weferling M.; Brinkmann R.; Winkler S.; Landmesser U.; Trippel T.;
Stellbrink C.; Wienbergen H.; Furnau G.; Mollmann H.; Linke A.; Jung C.;
Lauten A.; Achenbach S.; Rassaf T.; Schmitz T.; Cremer S.; Olivier C.;
Schachinger V.; Sossalla S.; Toischer K.; Templin C.; Sedding D.;
Clemmensen P.; Tigges E.; Meincke F.; Sharar H.A.; Kulenthiran S.; Schulze
P.C.; Jacobshagen C.; Frank D.; Baldus S.; Lehmann R.; Spies C.; Klein N.;
Eitel I.; Zahn R.; Schmeisser A.; Gori T.; Lurz P.; Akin I.; Chatzis G.;
Rizas K.; Kessler T.; Ademaj F.; Elsasser A.; Maier L.; Oner A.; Staudt
A.; Werner N.; Geisler T.; Kessler M.; Ferrari M.W.; Seyfarth M.; Nordbeck
P.; Ewen S.; Bietau C.; Haghikia A.; Reinstadler S.J.; Geppert A.; Hosler
N.; Toth-Gayor G.; Billmann B.; Tschierschke R.; Schmidt C.; Fichtlscherer
S.; Thiele H.
Institution
(Feistritzer, Jobs, Thiele) Department of Internal Medicine/Cardiology,
Heart Center Leipzig at Leipzig University and Leipzig Heart Science,
Leipzig, Germany
(Zeymer, Schneider) Institut fur Herzinfarktforschung, Ludwigshafen,
Germany
(Zeymer, Zahn) Klinikum Ludwigshafen, Ludwigshafen, Germany
(Lauten) Zentralklinik Bad Berka, Bad Berka, Germany
(Ferenc) Division of Cardiology and Angiology II, University Heart Center
Freiburg-Bad Krozingen, Bad Krozingen, Germany
(Weferling, Sossalla) Kerckhoff-Klinik, Department of Cardiology, Bad
Nauheim, Germany
(Brinkmann) Clinic for General and Interventional Cardiology/Angiology,
Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr-Universitat Bochum,
Bad Oeynhausen, Germany
(Winkler) Clinic for Internal Medicine and Cardiology, Unfallkrankenhaus
Berlin, Berlin, Germany
(Landmesser) Department of Cardiology, Angiology and Intensive Care
Medicine, Deutsches Herzzentrum der Charite, Campus Benjamin Franklin,
Berlin, Germany
(Trippel) Department of Cardiology, Angiology and Intensive Care Medicine,
Deutsches Herzzentrum der Charite, Campus Virchow Klinikum, Berlin,
Germany
(Stellbrink) Department of Cardiology, Klinikum Bielefeld, Bielefeld,
Germany
(Wienbergen) Klinikum Links der Weser Bremen, Bremen, Germany
(Furnau) Clinic for Internal Medicine II, Staedtisches Klinikum Dessau,
Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences
Brandenburg, Dessau-Rosslau, Germany
(Mollmann) Department of Internal Medicine, St. Johannes-Hospital,
Dortmund, Germany
(Linke) Technische Universitat Dresden, Heart Centre, Dresden, Germany
(Jung) Department of Cardiology, Pulmonology and Vascular Medicine,
University Hospital and Medical Faculty, Heinrich-Heine University,
Duesseldorf, Germany
(Lauten) Department of General and Interventional Cardiology and
Rhythmology, Helios Klinikum Erfurt, Erfurt, Germany
(Achenbach) Department of Cardiology, Friedrich-Alexander University
Erlangen-Nurnberg, Erlangen, Germany
(Rassaf) Department of Cardiology and Vascular Medicine, West German Heart
and Vascular Center, University Hospital Essen, Essen, Germany
(Schmitz) Department of Cardiology, Elisabeth Krankenhaus Essen, Essen,
Germany
(Cremer) Cardiopulmonary Institute, Goethe University, Frankfurt, Germany
(Olivier) Department of Cardiology and Angiology, University Heart Center
Freiburg-Bad Krozingen, University of Freiburg, Freiburg, Germany
(Schachinger) Medizinische Klinik I, Herz-Thorax Zentrum, Klinikum Fulda,
Fulda, Germany
(Sossalla) Department of Cardiology and Angiology, Medical Clinic I,
University Clinic of Giessen, Giessen, Germany
(Toischer) Department of Cardiology and Pneumology, University Medical
Center Gottingen, Germany
(Templin) Department of Internal Medicine B, University Medicine
Greifswald, Greifswald, Germany
(Sedding) Department of Internal Medicine III, University Hospital Halle
(Saale), Halle (Saale), Germany
(Clemmensen) Department of Cardiology, University Heart & Vascular Center
Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany and
Department of Medicine, Cardiology, Zealand University Hospital, Roskilde
and Nykobing Falster, Denmark
(Tigges) Department of Cardiology and Critical Care, Asklepios Clinic St.
Georg, Hamburg, Germany
(Meincke) Department of Cardiology, Asklepios Klinik Altona, Hamburg,
Germany
(Sharar) Department of Cardiology, Angiology and Pneumology, Heidelberg
University Hospital, Heidelberg, Germany
(Kulenthiran) Internal Medicine Clinic III, Cardiology, Angiology and
Intensive Care Medicine, Saarland University Hospital, Homburg, Germany
(Schulze) Department of Medicine, Division of Cardiology, Angiology and
Intensive Care Medicine, University Hospital Jena, Jena, Germany
(Jacobshagen) Clinic for Cardiology and Pneumology, Georg August
University Gottingen, Gottingen, Germany
(Jacobshagen) Vincentius-Diakonissen Hospital, Karlsruhe, Germany
(Frank) Department of Internal Medicine III, Cardiology and Critical Care,
University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
(Baldus) Clinic III for Internal Medicine, Faculty of Medicine and
University Hospital Cologne, University of Cologne, Cologne, Germany
(Lehmann) Asklepios Clinic Langen, Langen, Germany
(Spies) Clinic and Policlinic for Cardiology, Leipzig University Clinic,
Leipzig, Germany
(Klein) Department of Cardiology, Angiology and Internal Intensive-Care
Medicine, Klinikum St. Georg Leipzig, Leipzig, Germany
(Eitel) Medical Clinic II, Cardiology, Angiology, Intensive Care Medicine,
University Heart Center Lubeck, Lubeck, Germany
(Schmeisser) Department of Internal Medicine, Division of Cardiology and
Angiology, Magdeburg University, Magdeburg, Germany
(Gori, Lurz) Department of Cardiology, University Clinic Mainz, Mainz,
Germany
(Akin) Department of Cardiology, University of Mannheim, Mannheim, Germany
(Chatzis) Department of Cardiology, Angiology, and Intensive Care
Medicine, University Hospital, Philipps University of Marburg, Marburg,
Germany
(Rizas) Department Internal Medicine, University Hospital Munich, Campus
Grosshadern, Ludwig-Maximilians-University Munich (LMU Munich), Munich,
Germany
(Kessler) Department of Cardiology, Deutsches Herzzentrum Munchen,
Technische Universitat Munchen, Munich, Germany
(Ademaj) Department of Cardiology, Paracelsus Medical University,
Nuremberg, Germany
(Elsasser) University Clinic for Internal Medicine, Oldenburg, Cardiology,
Germany
(Maier) Department of Internal Medicine II, University Hospital
Regensburg, Regensburg, Germany
(Oner) Department of Cardiology, Rostock University Medical Centre,
Rostock, Germany
(Staudt) Department of Cardiology and Angiology, Hospital Schwerin,
Schwerin, Germany
(Werner) Department of Cardiology, Heart Centre Trier, Barmherzige Brueder
Hospital, Trier, Germany
(Geisler) Department of Cardiology and Angiology, University Hospital
Tubingen, Germany
(Kesler) Department of Cardiology, Angiology, Pneumology and Intensive
Care, Ulm University Heart Center, Ulm, Germany
(Ferrari) Division of Interventional Cardiology, Helios Dr. Horst Schmidt
Kliniken Wiesbaden, Wiesbaden, Germany
(Seyfarth) Department of Cardiology, Heart Center Wuppertal,
Witten/Herdecke University, Wuppertal, Germany
(Nordbeck) Department of Internal Medicine I, University Hospital
Wurzburg, Wurzburg, Germany
(Ewen) Schwarzwald-Baar Klinikum, Villingen-Schwenningen, Germany
(Bietau) Vogtland-Klinikum Plauen, Plauen, Germany
(Haghikia) Department of Cardiology and Rhythmology, University Hospital
St. Josef-Hospital Bochum, Cardiology and Rhythmology, Ruhr University
Bochum, Bochum, Germany
(Reinstadler) University Clinic of Internal Medicine III, Cardiology and
Angiology, Medical University of Innsbruck, Innsbruck, Austria
(Geppert) 3rd Department of Medicine, Cardiology and Intensive Care
Medicine, Clinic Ottakring, Vienna, Austria
(Hosler) Leipzig Heart Science Institute, Leipzig, Germany
(Toth-Gayor) Division of Cardiology, Department of Internal Medicine,
Medical University Graz, Graz, Austria
(Billmann) Clinic for Internal Medicine - Cardiology, Stadtisches Klinikum
Wolfenbuttel, Wolfenbuttel, Germany
(Tschierschke) Department of Cardiology, Angiology and Intensive Care
Medicine, Bruderklinikum Julia Lanz, Mannheim, Germany
(Schmidt) Medizinische Klinik I, Klinikum Neumarkt, Neumarkt, Germany
(Fichtlscherer) Heart and Vascular Center Bad Segeberg, Cardiology and
Angiology, Segeberger Kliniken, Bad Segeberg, Germany
Publisher
Elsevier Inc.
Abstract
Background: Multivessel coronary artery disease (CAD) is present in 30% to
70% of patients presenting with non-ST-segment elevation myocardial
infarction (NSTEMI) depending on varying age and risk profiles. In
contrast to the STEMI cohort, there is only limited scientific evidence
derived from randomized controlled trials directing the general decision
for or against complete revascularization in the NSTEMI population.
Primary hypothesis: The COMPLETE-NSTEMI trial aims to investigate whether
multivessel percutaneous coronary intervention (PCI) is superior over
culprit-lesion only PCI in patients with NSTEMI and multivessel CAD.
 Design(s): COMPLETE-NSTEMI is a prospective, randomized, controlled,
multicenter, parallel group, open-label trial. It will enroll 3390 NSTEMI
patients with multivessel CAD at 65 to 70 sites in Germany and Austria.
Patients will be randomized 1:1 to either complete revascularization with
PCI or culprit lesion-only PCI. Endpoints: The primary efficacy endpoint
is a composite of cardiovascular death or rehospitalization for nonfatal
myocardial infarction during follow-up. The trial is event-driven and will
be stopped as soon as 578 primary endpoint events and a minimal follow-up
duration of 12 months for each patient are reached. Current status: The
first patient was enrolled at October 27, 2023. By April 2025, 51 sites
have been activated and >500 patients have been randomized. Completion of
recruitment is expected for the first half of 2027. The final results of
the primary endpoint are expected in 2028. Outlook: COMPLETE NSTEMI will
be the first dedicated trial to answer the question about the optimal
revascularization strategy in patients with NSTEMI and multivessel CAD.
Trial registration: ClinicalTrials.gov: NCT05786131 Copyright ©
2025 Elsevier Inc.

<21>
[Use Link to view the full text]
Accession Number
2038177987
Title
Predictive Value of Platelet FcgammaRIIa in Patients Treated With PCI
Compared With Medical Therapy Alone After Myocardial Infarction.
Source
Circulation: Cardiovascular Interventions. 18(4) (pp e014939), 2025. Date
of Publication: 01 Apr 2025.
Author
Schneider D.J.; Mcmahon S.R.; Angiolillo D.J.; Fanaroff A.C.; Ibrahim H.;
Hohl P.K.; Wanamaker B.L.; Effron M.B.; Dibattiste P.M.; Fanaroff A.;
Serrano-Gomez C.; Ball K.M.; Effron M.; Shapiro T.A.; Nolan B.; Hassan A.;
Cohen M.; Rodriguez D.; Amin R.; Gurbel P.A.; French W.J.; Paul T.; Shutt
R.; Pudusseri J.; Shaheem W.; Mojares B.
Institution
(Schneider) Department of Medicine, Cardiovascular Research Institute, The
University of Vermont, Burlington, United States
(Mcmahon) Department of Medicine, Hartford Hospital, CT, United States
(Angiolillo) Division of Cardiology, Department of Medicine, University of
Florida, Jacksonville, United States
(Fanaroff) Department of Medicine, University of Pennsylvania,
Philadelphia, United States
(Ibrahim) Adventist Healthcare White Oak, Silver Spring, MD, United States
(Hohl) Division of Cardiovascular Medicine, Maine Medical Center,
Portland, ME, United States
(Wanamaker) Division of Cardiovascular Medicine, University of Michigan,
Ann Arbor, United States
(Effron) John Ochsner Heart and Vascular Institute, University of
Queensland Ochsner Clinical School, New Orleans, LA, United States
(Dibattiste) Prolocor, Inc, Philadelphia, PA, United States
(Schneider) University of Vermont Medical Center, United States
(Mcmahon) Hartford Hospital, United States
(Fanaroff) University of Pennsylvania, United States
(Serrano-Gomez) New York University, United States
(Hohl) Mane Medical Center, United States
(Angiolillo) University of Florida, United States
(Ball) Ascension St Vincent, United States
(Wanamaker) University of Michigan, United States
(Effron) John Ochsner Heart and Vascular Institute, United States
(Shapiro) Lankenau Medical Center, United States
(Nolan) St. Lukes Health System, United States
(Hassan) Prairie Education and Research Cooperative, United States
(Cohen) RWJ Barnabas Health, United States
(Rodriguez) Ascension St. John, United States
(Amin) Ascension Sacred Heart, United States
(Gurbel) Sinai Center for Thrombosis Research, United States
(French) University of California Los Angeles, United States
(Paul) Ascension St. Thomas, United States
(Shutt) Ascension Seton, United States
(Pudusseri) Our Lady of Lourdes Memorial Hospital, United States
(Shaheem) Ascension Via Christi Hospital, United States
(Mojares) Ascension Macomb, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: In patients with myocardial infarction (MI), quantifying
platelet FcRIIa (pFCG) stratifies the risk of subsequent MI, stroke, and
death. This report is a subgroup analysis of outcomes in patients treated
with percutaneous coronary intervention (PCI) or medical management alone
in an 800-patient, 25-center trial. METHOD(S): Patients were enrolled
in a prospective, noninterventional trial during hospitalization for type
1 MI (ST-segment-elevation and non-ST-segment-elevation). Inclusion
criteria included at least 2 of the following: aged >=65 years,
multivessel coronary artery disease, prior MI, chronic kidney disease, or
diabetes. Flow cytometry was used to quantify pFCG at a core laboratory.
High and low pFCG were defined by a prespecified threshold. The primary
end point was the composite of MI, stroke, and death. RESULT(S):
Patients treated with medical therapy alone (n=151) had a greater
occurrence of the primary end point (23.8%) than those treated with PCI
(n=490, 8.8%). The pFCG test discriminated to a similar extent the risk of
the primary end point in both the medical treatment group (hazard ratio,
2.29 [95% CI, 1.18-4.41]; P=0.014) and the PCI group (hazard ratio, 2.57
[95% CI, 1.41-4.69]; P=0.002). There was no significant association
between pFCG and clinically relevant bleeding in the medical treatment
group (hazard ratio, 1.22 [95% CI, 0.29-5.10]) or the PCI group (hazard
ratio, 1.56 [95% CI, 0.67-3.61]). CONCLUSION(S): Quantifying pFCG
discerned the risk of subsequent cardiovascular events among patients
treated with medical therapy alone or PCI. This prognostic information
will be useful for clinical decisions that balance ischemic and bleeding
risk. Copyright © 2025 American Heart Association, Inc.

<22>
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.

<23>
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.

<24>
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.

<25>
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

<26>
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.

<27>
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.

<28>
Accession Number
2036012508
Title
Risk of Incident Diabetes Related to Lipoprotein(a), LDL Cholesterol, and
Their Changes With Alirocumab: Post Hoc Analyses of the ODYSSEY OUTCOMES
Randomized Trial.
Source
Diabetes Care. 48(4) (pp 596-604), 2025. Date of Publication: 01 Apr 2025.
Author
Schwartz G.G.; Szarek M.; Jukema J.W.; Cobbaert C.M.; Reijnders E.;
Bittner V.A.; Schwertfeger M.; Bhatt D.L.; Fazio S.; Garon G.; Goodman
S.G.; Harrington R.A.; White H.D.; Steg P.G.
Institution
(Schwartz, Szarek) Division of Cardiology, University of Colorado School
of Medicine, Aurora, CO, United States
(Szarek) CPC Clinical Research, Aurora, CO, United States
(Szarek) State University of New York Downstate Health Sciences
University, Brooklyn, NY, United States
(Jukema) Department of Cardiology, Leiden University Medical Center,
Leiden, Netherlands
(Jukema) Netherlands Heart Institute, Utrecht, Netherlands
(Cobbaert, Reijnders) Department of Clinical Chemistry and Laboratory
Medicine, Leiden University Medical Center, Leiden, Netherlands
(Bittner) Division of Cardiovascular Disease, University of Alabama at
Birmingham, Birmingham, AL, United States
(Schwertfeger) Roche Diagnostics International, Zug, Switzerland
(Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Fazio) Regeneron Pharmaceuticals, Tarrytown, NY, United States
(Garon) Sanofi, North York, ON, Canada
(Goodman) Canadian VIGOUR Centre, University of Alberta, Edmonton, AB,
Canada
(Goodman) St. Michael's Hospital, University of Toronto, Toronto, ON,
Canada
(Harrington) Weill Cornell Medical College, New York, NY, United States
(White) Green Lane Cardiovascular Research Unit, Te Whatu Ora-Health New
Zealand, University of Auckland, Te Toka Tumai, New Zealand
(Steg) Universite Paris-Cite, INSERM-UMR1148, Assistance Publique-Hopitaux
de Paris, Hopital Bichat, French Alliance for Cardiovascular Trials,
Institu Universitaire de France, Paris, NY, United States
Publisher
American Diabetes Association Inc.
Abstract
OBJECTIVE Previous genetic and clinical analyses have associated lower
lipoprotein(a) and LDL cholesterol (LDL-C) with greater risk of new-onset
type 2 diabetes (NOD). However, PCSK9 inhibitors such as alirocumab lower
both lipoprotein(a) and LDL-C without effect on NOD. RESEARCH DESIGN AND
METHODS In a post hoc analysis of the ODYSSEY OUTCOMES trial
(NCT01663402), we examined the joint prediction of NOD by baseline
lipoprotein(a), LDL-C, and insulin (or HO MA-insulin resistance [HOMA-IR])
and their changes with alirocumab treatment. Analyses included 8,107
patients with recent acute coronary syndrome on optimized statin therapy,
without diabetes at baseline, assigned to alirocumab or placebo with
median follow-up 2.4 years. Splines were estimated from logistic
regression models. RESULTS Lower baseline lipoprotein(a) and higher
baseline insulin or HOMA-IR indepen dently predicted 782 cases of NOD;
baseline LDL-C did not predict NOD. Aliro cumab reduced lipoprotein(a) and
LDL-C without affecting insulin or NOD risk (odds ratio [OR] vs. placebo
0.998; 95%CI 0.860-1.158). However, in logistic re gression, decreased
lipoprotein(a) and LDL-C on alirocumab were independent, opposite
predictors of NOD. OR for NOD for 25% and 50%lipoprotein(a) reduc
tionsonalirocumabwere1.12(95%CI1.01-1.23) and 1.24 (1.02-1.52). OR for NOD
for 25% and 50% LDL-C reductions on alirocumab were 0.88 (95% CI
0.80-0.97) and 0.77 (0.64-0.94). CONCLUSIONS Baseline lipoprotein(a) was
inversely associated with risk of NOD. Alirocumab induced reductions of
lipoprotein(a) and LDL-C were associated with increased and decreased risk
of NOD, respectively, without net effect on NOD. Ongoing trials will
determine the impact of larger and longer lipoprotein(a) reductions on
NOD. Copyright © 2025, American Diabetes Association Inc. All
rights reserved.

<29>
Accession Number
2034507963
Title
Emerging Trends and Research Hotspots of Remote Ischemic Preconditioning
in Cardiac Surgery: A Bibliometric Analysis.
Source
Journal of Evaluation in Clinical Practice. 31(4) (no pagination), 2025.
Article Number: e70111. Date of Publication: 01 Jun 2025.
Author
Chen L.; Yao Y.
Institution
(Chen) Department of Anesthesiology, Fuwai Hospital, Chinese Academy of
Medical Sciences, Shenzhen, China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College and Chinese Academy
of Medical Sciences, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Remote ischemic preconditioning (RIPC) is a key area in
cardiovascular research, but inconsistent findings have made it hard to
fully understand. Bibliometrics, using mathematics and statistics, can
track trends and progress in research over time. This study uses
bibliometrics to assess RIPC trends and hotspots in cardiac surgery,
aiming to better understand future research. Methods and Results:
Studies on RIPC were retrieved from the Web of Science Core Collection,
with 104 studies included contributing countries, collaborative countries,
institutions, authors, journals, keywords, research topics, citation
patterns, and the current state of research. in this field were visually
analyzed by using R platform, VOS viewer, and Microsoft Excel. These
publications mainly came from 29 countries and 65 institutions. All
experiments were clinical studies, and the type of surgery involved was
cardiac surgery. A significant percentage of publications occurred during
the period from 2010 to 2020 (75; 72.11%). Germany made the most
significant contribution to this field with 27 (25.96%) papers and had the
highest total citation count (2314). J Thorac Cardiovasc Surg published
the most studies (n = 6), followed by Basic Res Cardiol (n = 5). We
identified 89 authors, among which Patrick Meybohm, Juergen Peters, and
Matthias Thielmann had the most studies (n = 10). Conclusion(s): RIPC
has significant research value and potential in cardiac surgery, mainly
focusing on organ protection during adult heart surgeries, especially
myocardial protection. Although Germany and China are leading, more
international cooperation is needed. Large-scale, standardized randomized
controlled trials on RIPC are essential to provide higher-level
evidence-based medical research. Copyright © 2025 John Wiley &
Sons Ltd.

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

<31>
Accession Number
2038345645
Title
Impact of Heart Failure Severity on Vutrisiran Efficacy in Transthyretin
Amyloidosis With Cardiomyopathy.
Source
Journal of the American College of Cardiology. 85(20) (pp 1927-1939),
2025. Date of Publication: 27 May 2025.
Author
Maurer M.S.; Witteles R.M.; Garcia-Pavia P.; Sheikh F.H.; Morbach C.;
Rodriguez Duque D.; Aldinc E.; Eraly S.A.; Gillmore J.D.
Institution
(Maurer) Division of Cardiology, Department of Medicine, Columbia
University Irving Medical Center, New York, NY, United States
(Witteles) Division of Cardiovascular Medicine, Stanford University School
of Medicine, Stanford, CA, United States
(Witteles) Stanford Amyloid Center, Stanford, CA, United States
(Garcia-Pavia) Department of Cardiology, Hospital Universitario Puerta de
Hierro Majadahonda, Health Research Institute of the Puerta de Hierro
Majadahonda-Segovia, Centro de Investigacion Biomedica en Red Enfermedades
Cardiovasculares (CIBER-CV), Madrid, Spain
(Garcia-Pavia) Centro Nacional de Investigaciones Cardiovasculares (CNIC),
Madrid, Spain
(Sheikh) MedStar Heart and Vascular Institute, Georgetown University
School of Medicine, Washington DC, United States
(Morbach) Department of Clinical Research and Epidemiology, Comprehensive
Heart Failure Center, Wurzburg, Germany
(Morbach) Department of Medicine I, University Hospital Wurzburg,
Wurzburg, Germany
(Rodriguez Duque, Aldinc, Eraly) Alnylam Pharmaceuticals, Cambridge, MA,
United States
(Gillmore) National Amyloidosis Centre, UCL, Division of Medicine, Royal
Free Hospital, London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Vutrisiran reduced the risk of all-cause mortality (ACM) and
recurrent cardiovascular (CV) events in patients with transthyretin
amyloidosis with cardiomyopathy (ATTR-CM) in HELIOS-B (A Study to Evaluate
Vutrisiran in Patients With Transthyretin Amyloidosis With Cardiomyopathy;
NCT04153149). Objective(s): This study sought to assess the effect of
vutrisiran in HELIOS-B patients with different heart failure severities.
 Method(s): HELIOS-B randomized patients with ATTR-CM with NYHA
functional class I-III (functional class IV or functional class III with
National Amyloidosis Centre [NAC] stage 3 were excluded) 1:1 to vutrisiran
25 mg or placebo every 3 months for up to 36 months. This exploratory
subgroup analysis assessed the primary composite endpoint of ACM and
recurrent CV events, ACM, and additional functional and biomarker
endpoints. Result(s): Of 654 patients, 84 (13%), 508 (78%), and 62
(9%) were in NYHA functional class I, II, and III, respectively. Median
baseline N-terminal pro-B-type natriuretic peptide (NT-proBNP) level was
1,920 ng/L. Lower risk of ACM and recurrent CV events was observed with
vutrisiran vs placebo across baseline severity subgroups: respective HRs
were 0.54 (95% CI: 0.27-1.10), 0.77 (95% CI: 0.57-1.03), and 0.68 (95% CI:
0.33-1.41) in NYHA functional classes I, II, and III, respectively; 0.52
(95% CI: 0.30-0.88), 0.61 (95% CI: 0.37-1.00), and 0.93 (95% CI:
0.64-1.35) in NT-proBNP tertiles <1,368 ng/L, >=1,368 and <2,691 ng/L, and
>=2,691 ng/L; 0.49 (95% CI: 0.34-0.72) and 1.08 (95% CI: 0.74-1.56) in NAC
stages 1 and 2/3, respectively; and 0.69 (95% CI: 0.45-1.07) and 0.74 (95%
CI: 0.53-1.02) in Columbia early and intermediate/late stages,
respectively. Similar effects were observed in the monotherapy population
(patients not on tafamidis at baseline) and across the additional
endpoints evaluated. Conclusion(s): Vutrisiran demonstrated evidence
of benefit across the range of baseline disease severities in HELIOS-B,
with the greatest benefit in earlier, less severe disease. (A Study to
Evaluate Vutrisiran in Patients With Transthyretin Amyloidosis With
Cardiomyopathy [HELIOS-B]; NCT04153149) Copyright © 2025 The
Authors

<32>
Accession Number
2034305664
Title
A Systematic Review of risk factors for major adverse cardiovascular
events in patients with coronary heart disease who underwent percutaneous
coronary intervention.
Source
Frontiers in Physiology. 16 (no pagination), 2025. Article Number:
1514585. Date of Publication: 2025.
Author
Zhai Y.; Shang H.; Li Y.; Zhang N.; Zhang J.; Wu S.
Institution
(Zhai, Li, Zhang, Zhang) Henan University of Chinese Medicine, Henan,
Zhengzhou, China
(Shang) Key Laboratory of Chinese Internal Medicine of Ministry of
Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese
Medicine, Beijing, China
(Wu) The First Affiliated Hospital of Henan University of Chinese
Medicine, Henan, Zhengzhou, China
Publisher
Frontiers Media SA
Abstract
Objective: This study aims to systematically review the risk factors for
major adverse cardiovascular events (MACE) in patients with coronary heart
disease who have undergone percutaneous coronary intervention (PCI).
 Design(s): Systematic review and meta-analysis. Data sources: The
Cochrane Library, PubMed, Web of Science, China National Knowledge
Infrastructure (CNKI), Wanfang Database, and VIP Database for Chinese
Technical Periodicals (VIP) were screened until December 2024. Eligibility
criteria for selecting studies: Case-control studies or cohort studies on
the risk factors for MACE in patients with coronary heart disease who
underwent PCI. Data extraction and synthesis: The literature review, data
extraction, and quality evaluation were conducted by two independent
researchers, and the meta-analysis was performed using RevMan 5.4
software. Main outcomes: The main outcome was that MACE occurred during
the follow-up period. Result(s): A total of 40 articles were
included. The meta-analysis erevealed that dyslipidemia (OR = 1.50; 95% CI
[1.19, 1.89], p = 0.0007), diabetes mellitus (OR = 1.70; 95% CI [1.43,
2.02], p < 0.00001), hypertension (OR = 1.62; 95% CI [1.35, 1.96], p <
0.0001), history of smoking (OR = 2.08; 95% CI [1.51, 2.85], p < 0.0001),
poorer ventricular function (OR = 2.39; 95% CI [2.17-2.64], p < 0.0001),
impaired left ventricular ejection fraction (LVEF) (OR = 1.86; 95% CI
[1.71-2.03], p < 0.0001), door to balloon (D-to-B) time (OR = 0.61; 95% CI
[0.42-0.88]; p = 0.009), thrombolysis in myocardial infarction (TIMI) (OR
= 1.41; 95% CI [1.17, 1.70], p = 0.0004), renal dysfunction (OR = 1.82;
95% CI [1.37, 2.43], p < 0.0001), and multi-vessel coronary artery disease
(OR = 0.41; 95% CI [0.37, 0.46], p < 0.0001) were significantly associated
with MACE after PCI. Conclusion(s): The independent risk factors of
MACE after PCI are dyslipidemia, hypertension, diabetes mellitus, smoking
history, Killip class > II, LVEF <=40%, D-to-B time >90 min, TIMI flow
grade <= II, renal insufficiency, and multivessel disease. Copyright
© 2025 Zhai, Shang, Li, Zhang, Zhang and Wu.

<33>
Accession Number
2036167259
Title
Comparison between Levobupivacaine and Levobupivacaine with Clonidine in
Erector Spinae Plane Block in Patients undergoing open Cholecystectomy: A
Prospective Randomized Double Blinded Study.
Source
JK Science. 27(2) (pp 113-117), 2025. Date of Publication: 01 Apr 2025.
Author
Sahoo S.; Chattopadhyay S.; Datta S.; Bhar D.; Maiti A.K.
Institution
(Sahoo, Chattopadhyay, Datta, Bhar, Maiti) Department of Anaesthesiology,
Midnapore Medical College, Vidyasagar Road, Paschim Medinipur, West
Bengal, Midnapore, Kolkata, India
Publisher
JK Science
Abstract
Background: Erector spinae plane (ESP) block is effective for
post-operative analgesia in thoracic and abdominal surgeries. There is
minimal experience with clonidine (alpha2 agonist) as an adjuvant to
levobupivacaine in ESP block. The objective of the present study is to
compare the duration of postoperative analgesia between levobupivacaine
and levobupivacaine with clonidine in open cholecystectomy following ESP
block. Method(s): One hundred patients, randomly divided into two
groups, undergoing open cholecystectomy under general anaesthesia (GA),
were given ESP block 20 min before administration of GA. Group L received
19 ml of 0.25% levobupivacaine with 1 ml of normal saline and group LC
received clonidine (1.5 mcg/ kg) prepared in 1 ml of normal saline as
adjuvant with 19 ml of 0.25% levobupivacaine for ESP block. In the
postoperative period, the duration and requirement of analgesia were
recorded. Result(s): Duration of post-operative analgesia in group LC
was 595.78+/- 71.5 min compared to 357.2+/- 18.14 min in group L.
(P<0.0001). The requirement of analgesic in the first 24 hours was also
significantly less in group LC (P<0.0001). Conclusion(s): Clonidine
as adjuvant with levobupivacaine in erector spinae plane block provides
longer duration of analgesia and reduces analgesic requirement
postoperatively without any significant adverse effects. Copyright
© 2025 JK Science.

<34>
Accession Number
2037315175
Title
Tricuspid Transcatheter Edge-to-Edge Repair in Patients With Transvalvular
CIED Leads: The TRILUMINATE Pivotal Trial.
Source
JACC: Clinical Electrophysiology. 11(5) (pp 1012-1020), 2025. Date of
Publication: 01 May 2025.
Author
Naik H.; Price M.J.; Kapadia S.; Whisenant B.K.; Tadros P.; Makkar R.;
Asgar A.W.; Fam N.; Tang G.H.L.; Mehta S.R.; Byrne T.; Singh G.; Panaich
S.S.; Peterman K.; Trusty P.M.; Hamid N.; Hahn R.T.; Adams D.H.; Sorajja
P.
Institution
(Naik) Arizona Cardiovascular Research Center, Phoenix, AZ, United States
(Price) Scripps Clinic, La Jolla, CA, United States
(Kapadia) Cleveland Clinic Foundation. Cleveland, OH, United States
(Whisenant) Intermountain Medical Center, Murray, UT, United States
(Tadros) Kansas University Medical Center, Kansas City, KS, United States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Asgar) Montreal Heart Institute, Montreal, QC, Canada
(Fam) St. Micheal's Hospital, Toronto, ON, Canada
(Tang, Adams) Mount Sinai Hospital, New York, NY, United States
(Mehta) Hamilton Health Science Centre, Hamilton, ON, Canada
(Byrne) Phoenix Cardiovascular Research Group, Phoenix, AZ, United States
(Singh) University of California, Davis Medical Center, Sacramento, CA,
United States
(Panaich) Swedish Medical Center, Seattle, WA, United States
(Peterman, Trusty) Abbott Structural Heart, Santa Clara, CA, United States
(Hamid, Sorajja) Abbott Northwestern Hospital, Minneapolis, MN, United
States
(Hahn) NewYork-Presbyterian/Columbia University Medical Center, New York,
NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Patients with tricuspid regurgitation (TR) frequently have
transvalvular cardiac implantable electronic device (CIEDs).
 Objective(s): The aim of this study was to determine the safety and
efficacy of tricuspid transcatheter edge-to-edge repair in patients with
transvalvular CIED leads. Method(s): The TRILUMINATE (Trial to
Evaluate Cardiovascular Outcomes in Patients Treated With the Tricuspid
Valve Repair System) Pivotal Trial (NCT03904147) is an international
randomized, controlled trial in symptomatic subjects with severe TR.
Subjects with CIED leads were screened by an eligibility committee prior
to inclusion into the randomized or single-arm cohorts. Safety events were
adjudicated by an independent review committee. All echocardiograms were
analyzed by an independent core laboratory. Result(s): A total of 98
subjects (of 469) with attempted TriClip procedures had transvalvular CIED
leads. CIED+ subjects were older (age 80.2 +/- 8.6 years vs 78.2 +/- 7.6
years; P = 0.02), with a higher prevalence of renal disease (46.9% vs
31.5%; P = 0.004) and lower health status (Kansas City Cardiomyopathy
Questionnaire overall summary score 51.9 +/- 21.0 vs 55.0 +/- 23.1) at
baseline compared with CIED- subjects. Slightly fewer clips were implanted
in CIED+ subjects (mean 1.9) than in CIED- subjects (mean 2.2) (P =
0.0018). Procedural times were significantly shorter in CIED+ subjects
(132.9 +/- 63.3 minutes vs 155.9 +/- 71.9 minutes; P = 0.0043) although
greater in those with lead-induced TR (149.5 +/- 87.5 minutes). Major
adverse events (1.0% vs 1.1%) and major bleeding (3.1% vs 3.0%) were
infrequent in CIED+ and CIED- subjects. At 30 days, TR reduction to
moderate or less was similar in CIED+ and CIED- subjects (88% vs 87%) and
was sustained out to 1 year in the majority of subjects (81% vs 84%).
Compared with baseline, Kansas City Cardiomyopathy Questionnaire overall
summary score significantly improved through 1 year in CIED+ subjects
(18.7 +/- 22.6; P < 0.0001) and CIED- subjects (16.8 +/- 22.6; P <
0.0001). Heart failure symptoms were reduced in both groups at 30 days,
with 85% of CIED+ subjects and 87% of CIED- subjects in NYHA functional
class I or II. There were no differences in mortality, heart failure
hospitalization, and need for tricuspid valve surgery or intervention
between groups. No lead revisions, removals, or replacements were reported
through follow-up. Conclusion(s): Tricuspid transcatheter
edge-to-edge repair with the TriClip system was safe and effective in
selected CIED+ subjects and did not affect CIED function. CIED+ subjects
experienced similar TR reduction and quality-of-life improvements as CIED-
subjects. Future work should define the treatable scope of patients with
transvalvular CIED leads. (TRILUMINATE Pivotal Trial;
NCT03904147) Copyright © 2025

<35>
Accession Number
2034183396
Title
Year in Review 2024: Noteworthy Literature in Cardiac Anesthesiology.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 29(2) (pp 134-146),
2025. Date of Publication: 01 Jun 2025.
Author
Seres T.; Wilkey B.; Weitzel N.; Clendenen N.
Institution
(Seres, Wilkey, Clendenen) Department of Anesthesiology, University of
Colorado Anschutz Medical Campus School of Medicine, Aurora, CO, United
States
(Weitzel) Department of Anesthesiology and Pain Medicine, University of
California Davis Health, Sacramento, CA, United States
Publisher
SAGE Publications Inc.
Abstract
The research findings relevant for Cardiac Anesthesiology studies
published in 2024 involved key innovations in devices and gene therapy in
addition to the expansion of transcatheter techniques for valve repair or
replacement. We reviewed 447 relevant articles and selected 21 as the most
noteworthy studies published in 2024. Themes that emerged from our review
include the etiology and prevention of delirium or outcomes after
mechanical circulatory support. Robust clinical outcome data now supports
the use of microaxial flow devices for mechanical circulatory support for
cardiogenic shock due to acute myocardial infarction. Pharmacology
development presents colchicine as anti-inflammatory medication to prevent
atrial fibrillation or intravenous amino acids for kidney protection after
cardiopulmonary bypass. Technological advances include implantable
wireless pacing-defibrillator devices, pulmonary artery pressure
monitoring in heart failure patients, extracorporeal blood purification
for preventing acute kidney injury and hypothermic oxygenated perfusion of
the donor heart in heart transplantation. Transcatheter interventions on
mitral or aortic valve were gaining advances over surgical procedures.
Novel paradigms included treatments with gene therapy for cardiac
amyloidosis or refractory angina and the emerging risk of microplastic
exposure in cardiovascular events. Copyright © The Author(s)
2025.

<36>
Accession Number
2037646126
Title
Andexanet-induced heparin resistance in cardiac surgery-a rapid review of
case reports and series.
Source
Journal of Thrombosis and Haemostasis. 23(5) (pp 1522-1530), 2025. Date of
Publication: 01 May 2025.
Author
Mishima Y.; Townsend G.; Clifton S.C.; Butt A.L.; Vandyck K.B.; Stewart
K.E.; Boylan P.M.; Tanaka K.A.
Institution
(Mishima, Townsend, Butt, Vandyck, Stewart, Tanaka) Department of
Anesthesiology, University of Oklahoma Health Sciences Center, Oklahoma
City, OK, United States
(Clifton) Reference and Instructional Services, Robert M. Bird Health
Sciences Library, University of Oklahoma Health Sciences Center, Oklahoma
City, OK, United States
(Stewart) Department of Surgery, University of Oklahoma Health Sciences
Center, Oklahoma City, OK, United States
(Boylan) College of Pharmacy, University of Oklahoma Health Sciences
Center, Oklahoma City, OK, United States
Publisher
Elsevier B.V.
Abstract
Background: Andexanet alfa, a Food and Drug Administration (FDA)-approved
antidote for apixaban and rivaroxaban, is used to manage life-threatening
or uncontrolled bleeding. In patients undergoing cardiopulmonary bypass
(CPB), preoperative exposure to andexanet can cause severe heparin
resistance, necessitating effective mitigation strategies. A comprehensive
review of such strategies remains lacking. Objective(s): This study
aimed to systematically review and characterize cases of andexanet-induced
heparin resistance in patients undergoing CPB and to evaluate management
strategies. Method(s): A systematic search was conducted across
multiple databases via the Ovid interface, Cochrane Central Register of
Controlled Trials, and the FDA Adverse Event Reporting System. Quality
appraisal was performed using a validated instrument for case reports and
series describing drug-induced adverse events. Result(s): Fourteen
discrete patient cases met inclusion criteria. After andexanet
administration, the mean initial activated clotting time (ACT) was 199.5
seconds, falling short of a target of >=400 seconds despite additional
heparin dosing (mean total, 1123 U/kg). Moreover, 35.7% of all cases
involved thrombus formation in the reservoir, 2 of which required a
circuit replacement. Antithrombin (AT) concentrate was administered to 75%
of those received an adjunct therapy. A prophylactic AT use (mean, 49.9
IU/kg) resulted in an ACT over 400 seconds, while its effects in low dose
after the occurrence of thrombosis varied on ACT values. Nafamostat
mesylate was used in some cases reported from Japan. Conclusion(s):
Heparin resistance following andexanet exposure poses significant
procoagulant risk during CPB. Pre-emptive high-dose AT therapy may improve
ACT values. Further studies are needed to understand the mechanisms and
optimize management of this condition. Copyright © 2025
International Society on Thrombosis and Haemostasis

<37>
Accession Number
2034108578
Title
A multifactorial intervention to improve cardiovascular outcomes in adults
with type 2 diabetes and current or previous diabetic foot ulcer disease:
Protocol for a multi-centre randomised control trial (MiFoot study).
Source
Diabetic Medicine. 42(6) (no pagination), 2025. Article Number: e70028.
Date of Publication: 01 Jun 2025.
Author
Onuwe T.; Highton P.J.; Batchelor D.; Brennan A.; Caba M.; Davies M.J.;
Funnell M.P.; Game F.; Gillies C.L.; Glab A.; Gray L.J.; Gregg E.;
Hadjiconstantinou M.; Hall V.; Johnson V.; Petrie J.R.; Pollard D.;
Rowntree H.; Tesfaye S.; Valabhji J.; Webb D.; Zaccardi F.; Khunti K.
Institution
(Onuwe, Highton, Caba, Davies, Funnell, Gillies, Hadjiconstantinou, Webb,
Khunti) Diabetes Research Centre, Leicester General Hospital, University
of Leicester, Leicester, United Kingdom
(Onuwe, Highton, Funnell, Gray, Hadjiconstantinou, Khunti) National
Institute for Health and Care Research Applied Research Collaboration East
Midlands, Leicester, United Kingdom
(Batchelor) Patient and Public Involvement and Engagement Representative,
Leicester, United Kingdom
(Brennan, Pollard) School of Medicine and Population Health, University of
Sheffield, Sheffield, United Kingdom
(Davies, Gray) National Institute for Health and Care Research Leicester
Biomedical Research Centre, Leicester, United Kingdom
(Game) Department of Research and Development, University Hospitals of
Derby and Burton NHS Foundation Trust, Derby, United Kingdom
(Gillies, Zaccardi) Leicester Real World Evidence Unit, Leicester Diabetes
Centre, University of Leicester, Leicester, United Kingdom
(Glab, Hall, Johnson, Rowntree) Leicester Diabetes Centre, University
Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester,
United Kingdom
(Gray) Department of Population Health Sciences, University of Leicester,
Leicester, United Kingdom
(Gray) Leicester British Heart Foundation Centre of Research Excellence,
University of Leicester, Leicester, United Kingdom
(Gregg) School of Population Health, RCSI University of Medicine and
Health Sciences, Dublin, Ireland
(Gregg) School of Public Health, Imperial College London, London, United
Kingdom
(Petrie) School of Health and Wellbeing, College of Medical Veterinary and
Life Sciences, University of Glasgow, Glasgow, United Kingdom
(Tesfaye) Diabetes Research Unit, Sheffield Teaching Hospitals NHS
Foundation Trust, Sheffield, United Kingdom
(Valabhji) Department of Metabolism, Digestion and Reproduction, Faculty
of Medicine, Imperial College London, Chelsea and Westminster Hospital
Campus, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: In the United Kingdom, the prevalence of diabetes-related foot
ulcer disease (DFUD) is 6.3%, and cardiovascular disease (CVD) is the
leading cause of mortality in people with DFUD. This study aims to
evaluate the effectiveness of a multifactorial intervention to reduce CVD
events and mortality in adults with type 2 diabetes (T2D) and DFUD.
 Method(s): The MiFoot study is a multi-centre, pragmatic randomised
controlled trial to test intervention effectiveness and cost-effectiveness
compared to usual care that will include an internal feasibility study and
a process evaluation. English-speaking adults (>=18 years; n = 392) with
T2D and current/previous (within 5 years) DFUD will be recruited from
multiple sites across the United Kingdom and randomised 1:1 to
intervention (MiFoot multifactorial intervention plus usual care) or
control (usual care), with data collected at baseline, 12- and 24-month
follow-up. The MiFoot intervention comprises an individualised assessment
with a healthcare practitioner to optimise treatment and assess the
suitability of physical activity participation; group-based disease self
management education and physical activity sessions; and a digital-based
programme, consisting of cohort-relevant topics, physical activity
guidance and peer support functionality. The primary outcome will be
extended major adverse cardiovascular events (MACE, i.e. myocardial
infarction, stroke, cardiovascular death, peripheral arterial bypass,
coronary artery bypass, coronary angioplasty or peripheral artery
angioplasty) at 24 months. DISCUSSION(S): This study will provide
evidence on the feasibility and clinical effectiveness, and
cost-effectiveness of a multifactorial intervention to prevent or slow the
progression of CVD-related complications in the extremely high-risk
population with T2D and DFUD. Copyright © 2025 The Author(s).
Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes
UK.

<38>
Accession Number
2034205104
Title
Year in Review 2024: Noteworthy Literature in Cardiothoracic Critical
Care.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 29(2) (pp 116-125),
2025. Date of Publication: 01 Jun 2025.
Author
Gilliland S.; Kim K.K.; Li X.; Tanabe K.; Hennigan A.; Alber S.
Institution
(Gilliland, Kim, Li, Tanabe, Hennigan, Alber) Department of
Anesthesiology, University of Colorado, Aurora, CO, United States
Publisher
SAGE Publications Inc.
Abstract
This article reviews noteworthy additions to the literature for the
management of critically ill cardiothoracic surgical patients published in
2024. We reviewed 8100 articles to identify 10 publications that provided
new or updated information across a diverse range of topics including
extracorporeal membrane oxygenation (ECMO), sepsis and shock, and acute
hypoxemic respiratory failure (AHRF). Additional topics within these
publications included prophylaxis guidelines and evidence for prevention
of common complications in the intensive care unit, such as bleeding,
thrombosis, and acute kidney injury (AKI). Copyright © The
Author(s) 2025.

<39>
Accession Number
2034302116
Title
Outcomes following TAVR in patients with cardiogenic shock: A systematic
review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. 74 (pp 8-13), 2025. Date of
Publication: 01 May 2025.
Author
Jabri A.; Ayyad M.; Albandak M.; Al-Abdouh A.; Madanat L.; Khalefa B.B.;
Alhuneafat L.; Ayyad A.; Lemor A.; Mhanna M.; Al Jebaje Z.; Fadel R.;
Gonzalez P.E.; O'Neill B.; Bagur R.; Hanson I.D.; Abbas A.E.; Frisoli T.;
Lee J.; Wang D.D.; Aggarwal V.; Alaswad K.; O'Neill W.W.; Aronow H.D.;
AlQarqaz M.; Villablanca P.
Institution
(Ayyad, Al Jebaje, Fadel, Gonzalez, O'Neill, Frisoli, Lee, Wang, Aggarwal,
Alaswad, O'Neill, Aronow, AlQarqaz, Villablanca) Division of
Cardiovascular Medicine, Henry Ford Hospital, Michigan State University,
College of Human Medicine, Detroit, MI, United States
(Albandak, Al-Abdouh) Division of Hospital Medicine, University of
Kentucky, Lexington, KY, United States
(Jabri, Madanat, Hanson, Abbas) Department of Cardiovascular Medicine,
William Beaumont University Hospital, Oakland University William Beaumont
School of Medicine, Royal Oak, MI, United States
(Khalefa, Alhuneafat) Cardiovascular Division, University of Minnesota,
Minneapolis, MN, United States
(Lemor) Division of Cardiovascular Disease, Department of Medicine,
University of Mississippi Medical Center, Jackson, MS, United States
(Mhanna) Division of Cardiovascular Medicine, University of Iowa, IA,
United States
(Bagur) Division of Cardiology, Department of Medicine, London Health
Sciences Centre, Western University, Canada Department of Epidemiology and
Biostatistics, Western University, London, ON, Canada
(Ayyad) Department of Internal Medicine, Rutgers New Jersey Medical
school, Newark, NJ, United States
Publisher
Elsevier Inc.
Abstract
Background: While transcatheter aortic valve replacement (TAVR) has
broadened treatment options for critically ill patients, outcomes among
those with concomitant cardiogenic shock (CS) are not well-explored.
 Method(s): We conducted a comprehensive search of major databases for
studies comparing outcomes following TAVR in patients with and without CS
since inception up to October 31, 2023. Our meta-analysis included five
non-randomized observational. Dichotomous outcomes were assessed using the
Mantel-Haenszel method (risk ratio, 95 % CI), and continuous outcomes were
evaluated using mean difference and 95 % CI with the inverse variance
method. Statistical heterogeneity was determined using the inconsistency
test (I2). Result(s): Among 26,283 patients across five
studies, 30-day mortality was higher in the CS group (7267 patients; 27.6
%) compared to those without CS (OR 3.41, 95 % CI [2.01, 5.76], p < 0.01),
as well as 30-day major vascular complications (OR 1.72, 95 % CI [1.54,
1.92], p < 0.01). At 1-year follow-up, there was no statistically
significant difference in mortality rates between the compared groups (OR
2.68, 95 % CI [0.53, 13.46], p = 0.12). No significant between-group
differences were observed in the likelihood of 30-day aortic valve
reintervention (OR 3.20, 95 % CI [0.63, 16.22], p = 0.09) or post-TAVR
aortic insufficiency (OR 0.91, 95 % CI [0.33, 2.51], p = 0.73).
Furthermore, 30-day stroke, pacemaker implantation, and in-hospital major
bleeding were comparable between both cohorts. Conclusion(s): Among
patients undergoing TAVR, short-term mortality is higher but one-year
outcomes are similar when comparing those with, to those without, CS.
Future studies should examine whether TAVR outcomes are improved when the
procedure is delayed to optimize CS and when delay is not possible,
whether particular management strategies lead to more favorable
periprocedural outcomes. Copyright © 2024 Elsevier Inc.

<40>
Accession Number
2034508115
Title
Drug-induced fever in post-surgical patients: a systematic review of case
reports.
Source
Therapeutic Advances in Drug Safety. 16 (no pagination), 2025. Article
Number: 20420986251335825. Date of Publication: 01 Jan 2025.
Author
Afra F.; Aboutalebzadeh M.; Tayefeh S.; Javankiani S.; Shahrami B.;
Arabzadeh A.A.
Institution
(Afra, Aboutalebzadeh, Tayefeh) Department of Clinical Pharmacy, School of
Pharmacy, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Afra) Clinical Pharmacist, Sina Hospital, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Javankiani) General Surgery Department, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Javankiani) International Surgical Research Association (ISRA), Universal
Scientific Education and Research Network (USERN), Tehran, Iran, Islamic
Republic of
Publisher
SAGE Publications Ltd
Abstract
Background: Fever is a common postoperative complication, typically caused
by aseptic inflammation or infection. However, drug-induced fever (DIF) is
an underdiagnosed etiology that should be considered in the differential
diagnosis, especially in patients receiving complex medication regimens
post-surgery. Objective(s): This systematic review aims to assess the
current literature on DIF in post-surgical patients to improve diagnostic
accuracy and patient care. Design(s): Systematic review of case
reports and case series. Data sources and methods: This systematic review
was conducted following the PRISMA 2020 guidelines. We included case
reports and series involving post-surgical patients with fever linked to
drug administration. Studies were retrieved from the PubMed, Scopus,
Embase, and Web of Science databases, as well as gray literature sources.
Quality and bias were assessed using the Joanna Briggs Institute (JBI)
critical appraisal tools. Result(s): A total of 16 studies (14 case
reports and 2 case series) involving 23 patients were included. The most
frequently implicated drugs were propofol, morphine, and cephalosporins.
Fever onset ranged from immediate postoperative to several days later,
with varied patterns, including intermittent, remittent, and continuous
fever. The majority of patients recovered after drug discontinuation,
although two cases resulted in death. Conclusion(s): DIF is one of
the causes of postoperative fever. Early identification and cessation of
the offending drug are crucial for resolving the fever and preventing
severe complications. Clinicians must remain vigilant in diagnosing DIF to
improve patient outcomes post-surgery. Copyright © The Author(s),
2025.

<41>
[Use Link to view the full text]
Accession Number
2038178007
Title
Early Versus Delayed Invasive Management of Female Patients with
Non-ST-Elevation Acute Coronary Syndrome: An Individual Patient Data
Meta-Analysis.
Source
Circulation: Cardiovascular Interventions. 18(3) (pp e014763), 2025. Date
of Publication: 01 Mar 2025.
Author
Mills G.B.; Kotanidis C.P.; Mehta S.; Tiong D.; Badings E.A.; Engstrom T.;
Van 'T Hof A.W.J.; Hofsten D.; Holmvang L.; Jobs A.; Kober L.; Milasinovic
D.; Milosevic A.; Stankovic G.; Thiele H.; Mehran R.; Kunadian V.
Institution
(Mills, Kotanidis, Kunadian) Faculty of Medical Sciences, Translational
and Clinical Research Institute, Newcastle University, United Kingdom
(Mills, Kotanidis, Kunadian) Cardiothoracic Centre, Freeman Hospital,
Newcastle Upon Tyne Hospitals Nhs Foundation Trust, United Kingdom
(Mehta, Tiong) Population Health Research Institute, McMaster University
and Hamilton Health Sciences, ON, Canada
(Badings) Department of Cardiology Research, Deventer Hospital,
Netherlands
(Engstrom, Hofsten, Holmvang, Kober) Department of Cardiology,
Rigshospitalet, Copenhagen University Hospital, Denmark
(Van 'T Hof, Holmvang) Department of Cardiology, Maastricht University
Medical Center, Netherlands
(Van 'T Hof) Department of Cardiology, Zuyderland Medical Center, Heerlen,
Netherlands
(Van 'T Hof) Cardiovascular Research Institute Maastricht, Netherlands
(Holmvang) Faculty of Health and Medical Sciences, University of
Copenhagen, Denmark
(Jobs, Thiele) Heart Center Leipzig, Leipzig University and Leipzig Heart
Science, Germany
(Milasinovic, Milosevic, Stankovic) Faculty of Medicine, University of
Belgrade, Serbia
(Milasinovic, Milosevic, Stankovic) Department of Cardiology, Clinical
Center of Serbia, Belgrade, Serbia
(Mehran) Mount Sinai School of Medicine, New York, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Female patients are at greater risk of adverse events
following non-ST-elevation acute coronary syndrome but less frequently
receive guideline-recommended coronary angiography and revascularization.
Routine invasive management benefits high-risk patients, but evidence
informing the optimal timing of angiography specifically in female
patients is lacking. METHOD(S): Medline, Web of Science, and Scopus
were searched up to November 2023. Randomized controlled trials
investigating early versus delayed timing of coronary angiography in
patients with non-ST-elevation acute coronary syndrome were included.
Individual patient data from female patients were extracted. The primary
end point was a composite of all-cause mortality or myocardial infarction
at 6 months. We performed a 1-stage individual patient data meta-analysis
using random-effects Cox models. RESULT(S): Six trials contributed
individual patient data from 2257 female patients. Median time to coronary
angiography was 5 hours in the early invasive group (n=1141) and 49 hours
in the delayed invasive group (n=1116). Overall, there was no significant
reduction in the risk of the primary end point in the early invasive group
compared with the delayed group (hazard ratio, 0.79 [95% CI, 0.60-1.06];
P=0.12). Early invasive management was associated with a reduction in
recurrent ischemia (hazard ratio, 0.60 [95% CI, 0.39-0.94]; P=0.025). In
the prespecified subgroup analysis, high-risk female patients with Global
Registry of Acute Coronary Events score >140 receiving early invasive
management experienced a significantly reduced hazard for all-cause
mortality or myocardial infarction at 6 months (hazard ratio, 0.65 [95%
CI, 0.45-0.94]; P=0.021; Pinteraction=0.035). Similar benefits were
observed for female patients with elevated cardiac biomarkers.
 CONCLUSION(S): Early invasive management in female patients with
non-ST-elevation acute coronary syndrome, compared with delayed invasive
management, was not associated with a significant reduction in the hazard
for the primary end point. In prespecified subgroup analysis, high-risk
female patients as assessed with Global Registry of Acute Coronary Events
score >140 or elevated cardiac biomarkers experienced significant
reductions in all-cause mortality or myocardial infarction at 6 months
following early invasive management. Copyright © 2025 American
Heart Association, Inc.

<42>
[Use Link to view the full text]
Accession Number
2037942441
Title
Stenting Versus Medical Therapy for Symptomatic Intracranial Artery
Stenosis: Long-Term Follow-Up of a Randomized Trial.
Source
Stroke. 56(5) (pp 1128-1137), 2025. Date of Publication: 01 May 2025.
Author
Gao P.; He X.; Wang H.; Wang T.; Wang D.; Shi H.; Li T.; Zhao Z.; Cai Y.;
Wu W.; He W.; Yu J.; Zheng B.; Feng X.; Derdeyn C.P.; Dmytriw A.A.; Wu Y.;
Zhao G.; Jiao L.
Institution
(Gao, He, Wang, Feng, Zhao, Jiao) Departments of Neurosurgery and
Interventional Neuroradiology, Xuanwu Hospital, Capital Medical
University, Beijing, China
(Wang, Wu) Clinical Research Institute, Institute of Advanced Clinical
Medicine, Peking University, Beijing, China
(Wang) Department of Neurosurgery, Beijing Hospital, National Center of
Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical
Sciences, China
(Shi, Zheng) Department of Neurosurgery, First Affiliated Hospital of
Harbin Medical University, China
(Li) Department of Cerebrovascular and Neurosurgery, Henan Provincial
People's Hospital, Zhengzhou University, China
(Zhao) Department of Neurosurgery, Tangdu Hospital of Air Force Medical
University, Xi'an, China
(Cai) Department of Neurology, Strategic Support Force Medical Center,
Beijing, China
(Wu) Department of Neurology, Qilu Hospital of Shandong University,
Ji'nan, China
(He) Department of Neurosurgery, Second Affiliated Hospital of Guangzhou
Medical University, China
(Yu) Department of Neurology, First Affiliated Hospital of Xi'an Jiaotong
University, China
(Derdeyn) Department of Radiology and Medical Imaging, University of
Virginia School of Medicine, Charlottesville, United States
(Dmytriw) Neuroendovascular Program, Massachusetts General Hospital,
Harvard Medical School, Boston, United States
Publisher
Wolters Kluwer Health
Abstract
BACKGROUND: Whether the long-term benefit of stroke prevention when
stenting is added to medical therapy (MT) over MT alone for symptomatic
severe intracranial artery stenosis offsets the perioperative risks of the
stenting has not been directly evaluated in a randomized trial. We aimed
to compare the long-term (>3 years) effect of stenting versus MT alone in
patients with symptomatic severe intracranial artery stenosis in a
randomized trial. METHOD(S): We extended the follow-up of 358
subjects enrolled in a multicenter, open-label, randomized trial conducted
at 8 centers in China. Patients with transient ischemic attack or stroke
attributed to severe intracranial stenosis (70% to 99%) were recruited
between March 5, 2014, and November 10, 2016. The primary outcome was a
composite of stroke or death within 30 days or stroke in the territory of
the qualifying artery beyond 30 days. Other secondary outcomes included
stroke in the territory of the qualifying artery, as well as disabling
stroke or death after enrollment. RESULT(S): A total of 358 patients
(stenting 176 versus MT 182) were recruited from March 5, 2014, and
followed up till January 22, 2024. The median duration of follow-up was
7.4 years (interquartile range, 6.0-8.0). The primary outcome was not
significantly different (stenting 14.8% versus MT 14.3%; hazard ratio,
1.02 [95% CI, 0.58-1.77]; P=0.97). No significant difference was found
between groups for the secondary outcomes: stroke in the territory of
qualifying artery (14.8% versus 14.3%; hazard ratio, 1.02 [95% CI,
0.58-1.77]; P=0.97), disabling stroke or death (16.5% versus 14.3%; hazard
ratio, 1.12 [95% CI, 0.66-1.91]; P=0.70), and death (9.1% versus 7.1%;
hazard ratio, 1.22 [95% CI, 0.58-2.58]; P=0.60). CONCLUSION(S): This
study provides compelling evidence that, even over prolonged observed
periods, the addition of stenting to MT does not confer additional
benefits to MT alone in patients with symptomatic severe intracranial
artery stenosis. These results underscore the importance of MT as the
cornerstone of long-term stroke prevention in this patient
population. Copyright © 2025 American Heart Association, Inc.

<43>
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.

<44>
[Use Link to view the full text]
Accession Number
2037552113
Title
Natural History, Phenotype Spectrum, and Clinical Outcomes of Desmin
(DES)-Associated Cardiomyopathy.
Source
Circulation: Genomic and Precision Medicine. 18(2) (pp e004878), 2025.
Date of Publication: 01 Apr 2025.
Author
Asatryan B.; Rieder M.; Murray B.; Muller S.A.; Tichnell C.; Gasperetti
A.; Carrick R.T.; Joseph E.; Leung D.G.; Te Riele A.S.J.M.; Zimmerman
S.L.; Calkins H.; James C.A.; Barth A.S.
Institution
(Asatryan, Murray, Muller, Tichnell, Gasperetti, Carrick, Calkins, James,
Barth) Division of Cardiology, Department of Medicine, Baltimore, MD,
United States
(Joseph) Welch Medical Library, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
(Leung) Kennedy Krieger Institute, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
(Zimmerman) The Russell H. Morgan Department of Radiology and Radiological
Sciences, Johns Hopkins University School of Medicine, Baltimore, MD,
United States
(Rieder) Department of Cardiology, Inselspital, Bern University Hospital,
University of Bern, Bern, Switzerland
(Muller, Te Riele) Division of Cardiology, University Medical Centre,
Utrecht, Netherlands
(Muller, Te Riele) European Reference Network for Rare, Low Prevalence,
and Complex Diseases of the Heart, ERN GUARD-Heart, Utrecht, Netherlands
(Te Riele) Netherlands Heart Institute, Utrecht, Netherlands
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Pathogenic/likely pathogenic (LP) desmin (DES) variants cause
heterogeneous cardiomyopathy and skeletal myopathy phenotypes. Limited
data suggest a high incidence of major adverse cardiac events (MACEs),
including cardiac conduction disease, sustained ventricular arrhythmias
(VA), and heart failure (HF) events (HF hospitalization, left ventricular
assist device/cardiac transplant, HF-related death) in patients with
pathogenic/LP DES variants. However, pleiotropic presentation and small
cohort sizes have limited clinical phenotype and outcome characterization.
We aimed to describe the natural history, phenotype spectrum, familial
penetrance and outcomes in patients with pathogenic/LP DES variants
through a systematic review and individual patient data meta-analysis
using published reports. METHOD(S): We searched Medline (PubMed) and
Embase for studies that evaluated cardiac phenotypes in patients with
pathogenic/LP DES variants. Cardiomyopathy diagnosis or occurrence of MACE
was considered evidence of cardiac involvement/penetrance. Lifetime
event-free survival from cardiac conduction disease, sustained VA, HF
events, and composite MACE was assessed. RESULT(S): Of the 4212
screened publications, 71 met the inclusion criteria. A total of 230
patients were included (52.6% men, 52.2% probands, median age: 31 years
[22.0-42.8] at first evaluation, median follow-up: 3 years [0-11.0]).
Overall, 124 (53.9%) patients were diagnosed with cardiomyopathy,
predominantly dilated cardiomyopathy (14.8%), followed by restrictive
cardiomyopathy (13.5%), whereas other forms were less common:
arrhythmogenic cardiomyopathy (7.0%), hypertrophic cardiomyopathy (6.1%),
arrhythmogenic right ventricular cardiomyopathy (5.2%), and other forms
(7.4%). Overall, 132 (57.4%) patients developed MACE, with 96 (41.7%)
having cardiac conduction disease, 36 (15.7%) sustained VA, and 43 (18.7%)
HF events. Familial penetrance of cardiac disease was 63.6% among
relatives with pathogenic/LP DES variants. Male sex was associated with an
increased risk of sustained VA (hazard ratio, 2.28; P=0.02) and HF events
(hazard ratio, 2.45; P=0.008). CONCLUSION(S): DES cardiomyopathy
exhibits heterogeneous phenotypes and a distinct natural history,
characterized by high familial penetrance and a substantial MACE burden.
Male patients face a higher risk of sustained VA events. Copyright
© 2025 American Heart Association, Inc.

<45>
[Use Link to view the full text]
Accession Number
2036051725
Title
THE EFFECT OF CATECHOLAMINE VERSUS NONCATECHOLAMINE VASOPRESSORS ON RENAL
FUNCTION AND RECOVERY IN VASODILATORY SHOCK: A SYSTEMATIC REVIEW OF
PRECLINICAL AND CLINICAL STUDIES.
Source
Shock. 63(3) (pp 351-362), 2025. Date of Publication: 01 Mar 2025.
Author
Vernon-Elliot J.; Goradia S.; Bellomo R.; Lankadeva Y.R.; Burrell L.M.;
See E.J.
Institution
(Vernon-Elliot, Goradia, Bellomo, See) Department of Intensive Care, Royal
Melbourne Hospital, Parkville, Australia
(Vernon-Elliot, Goradia) Melbourne Medical School, University of
Melbourne, Parkville, VIC, Australia
(Bellomo, Lankadeva, See) Department of Critical Care, Department of
Medicine, The University of Melbourne, Parkville, VIC, Australia
(Bellomo, See) Australian and New Zealand Intensive Care Research Centre,
Department of Epidemiology and Preventive Medicine, Monash University,
Melbourne, VIC, Australia
(Bellomo, See) Department of Intensive Care, Austin Hospital, Heidelberg,
Australia
(Bellomo, Burrell) Department of Medicine, University of Melbourne,
Parkville, VIC, Australia
(Lankadeva) Preclinical Critical Care Unit, Florey Institute of
Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC,
Australia
(Lankadeva) Department of Anaesthesia, Austin Health, Melbourne, VIC,
Australia
(Burrell) Department of General Medicine, University of Melbourne, Austin
Health, VIC, Australia
(Burrell) Institute of Breathing and Sleep, Austin Health, Melbourne, VIC,
Australia
(See) Department of Nephrology, Royal Melbourne Hospital, Melbourne, VIC,
Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Acute kidney injury (AKI) is a common complication of
vasodilatory shock. AKI is associated with an increased risk of death,
prolonged hospital stays, and subsequent transition to chronic kidney
disease. Catecholamines have historically been used as the first-line
vasopressors for vasodilatory shock; however, they may adversely affect
renal function and recovery. Objective(s): To compare the effects of
catecholamine and noncatecholamine vasopressors on AKI risk and recovery
in preclinical and clinical studies of vasodilatory shock. Method(s):
MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were
systematically searched to identify studies reporting renal outcomes
associated with catecholamine (norepinephrine, epinephrine, metaraminol,
phenylephrine, dopamine) and noncatecholamine vasopressors (vasopressin,
angiotensin II), in preclinical models or adult cohorts of vasodilatory
shock. Two independent reviewers screened studies and extracted data using
a prespecified form for qualitative synthesis and risk of bias assessment.
 Result(s): Of 3,504 citations, 90 studies were eligible for
inclusion: 41 preclinical studies, 17 nonrandomized clinical studies, 28
randomized clinical studies, and 4 post-hoc analyses. Risk of bias was
generally low in preclinical studies and low to moderate in clinical
studies. In preclinical studies, catecholamine vasopressors exacerbated
medullary hypoxia and intrarenal inflammation compared to noncatecholamine
vasopressors. In clinical studies, catecholamines were associated with
higher serum creatinine, lower urine output, and increased requirements
for renal replacement therapy compared to noncatecholamine vasopressors.
In patients on high-dose catecholamines, adjunctive angiotensin II was
associated with improved renal replacement therapy liberation.
 Conclusion(s): Preclinical and clinical studies suggest that
noncatecholamine vasopressors may confer renal benefits compared to
catecholamine vasopressors. These hypothesis-generating observations
suggest the need for comparative studies focused on renal
outcomes. Copyright © 2024 by the Shock Society.

<46>
Accession Number
2036204960
Title
The Impact of Olfactory Dysfunction on Post-Operative Cognitive
Dysfunction and Delirium: A Systematic Review.
Source
Journal of Cellular and Molecular Anesthesia. 10(1) (no pagination), 2025.
Article Number: e158956. Date of Publication: 01 Mar 2025.
Author
Amirdosara M.; Hajiesmaeili M.; Goharani R.; Mokhtari M.; Vafaei A.; Zangi
M.
Institution
(Amirdosara, Hajiesmaeili, Goharani, Mokhtari, Vafaei, Zangi) Critical
Care Quality Improvement Research Center, Loghman Hakim Hospital, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Brieflands
Abstract
Context: Post-operative cognitive dysfunction (POCD) and postoperative
delirium (POD) are common complications following major surgery,
particularly in older adults. Emerging evidence suggests that olfactory
dysfunction may significantly predispose individuals to these cognitive
disturbances, potentially serving as an early marker for post-surgical
cognitive decline. However, the relationship between olfactory impairment
and post-operative cognitive outcomes remains underexplored.
 Objective(s): The present systematic review aims to synthesize
current evidence on the impact of olfactory dysfunction on POCD and POD.
 Evidence Acquisition: The review adhered to the preferred reporting
items for systematic reviews and meta-analyses (PRISMA) guidelines. A
comprehensive search of PubMed, Scopus, and the Web of Science (WOS) was
conducted from inception until December 2024. Studies on patients
undergoing major operations that involved verified olfactory and cognitive
examinations and yielded quantitative data were included. Exclusion
criteria encompassed research focusing on non-surgical groups,
non-original studies, and studies lacking postoperative cognitive
assessments. Result(s): From an initial 389 articles, seven studies
met the inclusion criteria, comprising 1,038 participants. These studies,
conducted between 2004 and 2022, included patients undergoing major
surgeries such as cardiac, abdominal, and neurosurgery. Various olfactory
tests [e.g., sniffin' sticks, brief smell identification test (BSIT)] and
cognitive assessments [e.g., mini-mental state examination (MMSE), clock
drawing test (CDT)] were used. The findings across studies were
heterogeneous but suggested a potential link between olfactory dysfunction
and both POCD and POD. Specifically, several studies indicated that
impaired olfactory function was associated with an increased risk of
delirium (OR = 1.90; 95% CI = 1.17-3.09) and cognitive decline
post-surgery. Some studies identified olfactory impairment as an
independent predictor of worse cognitive outcomes, particularly among
frail or elderly populations. Conclusion(s): The evidence reviewed
supports the hypothesis that olfactory dysfunction may be a preoperative
marker for POCD, particularly delirium and delayed neurocognitive recovery
(dNCR). Based on the obtained results, olfactory testing could be a useful
preoperative screening tool, especially in populations at risk for
cognitive decline. Copyright © 2025, Amirdosara et al.

<47>
Accession Number
2038495686
Title
Effectiveness of intravenous administration of a combination of sufentanil
and esketamine on post-cardiac surgery pain management and depression: a
randomized controlled trial.
Source
Cardiovascular Diagnosis and Therapy. 15(2) (pp 291-301), 2025. Date of
Publication: 30 Apr 2025.
Author
Xu S.; Liang T.; Xu W.
Institution
(Xu, Xu) Center for Rehabilitation Medicine Center, Department of
Anesthesiology, Zhejiang Provincial People's Hospital, Affiliated People's
Hospital, Hangzhou Medical College, Hangzhou, China
(Xu) Second Clinical Medical School, Zhejiang Chinese Medical University,
Hangzhou, China
(Liang) Emergency and Critical Care Center, Intensive Care Unit, Zhejiang
Provincial People's Hospital, Affiliated People's Hospital, Hangzhou
Medical College, Hangzhou, China
Publisher
AME Publishing Company
Abstract
Background: Cardiac surgery often results in significant postoperative
pain, which can lead to complications and prolonged recovery. Pain and
depression are closely linked, with effective pain management potentially
reducing the risk of depression. Combining sufentanil, an opioid, with
esketamine, a medication with both analgesic and antidepressant effects,
may improve pain control and mood in postoperative patients. While
promising in other surgeries, their effects in cardiac surgery remain
unclear. This study explores how sufentanil and esketamine work together
to manage pain and reduce depression after cardiac surgery.
 Method(s): A randomized controlled clinical trial was conducted from
January 2021 to December 2023, involving 104 patients who underwent
cardiac surgery. Patients [aged 61-64 years, body mass index (BMI) <30
kg/m2, American Society of Anesthesiologists (ASA) I-II,
STOP-BANG score <3] were randomly assigned to a control group (n=52)
receiving 2.5 mug/kg sufentanil or an experimental group (n=52) receiving
2.0 mug/kg sufentanil with 2 mg/kg esketamine via a central venous
catheter for 48 h postoperatively. Exclusion criteria included allergies
to fentanyl or etomidate, central nervous system diseases, recent opioid
use, liver/kidney failure, or severe respiratory conditions. Outcome
measures included patient-controlled intravenous analgesia (PCIA) pump
usage, pain scores, clinical indicators, depressive symptoms, adverse
events, and satisfaction levels. Result(s): The experimental group
had significantly fewer PCIA pump button presses (2.41+/-0.72) than the
control group (6.20+/-1.31) (P<0.05). Visual analog pain scores were lower
in the experimental group at multiple postoperative time points (P<0.05).
Hamilton Depression Rating Scale (HAMD) scores were significantly lower in
the experimental group (7.52+/-4.24) compared to the control group
(13.84+/-2.76) (P<0.05), as were Hamilton Anxiety Rating Scale (HAMA)
scores (8.84+/-2.13 vs. 12.64+/-3.25, P<0.05). Heart rate and mean
arterial pressure were higher at postoperative time points T2, T3, and T4
in the experimental group (P<0.05), but no difference was observed at T1
(P>0.05) (T1 =4 h, T2 =8 h, T3 =24 h, T4 =48 h post-surgery). Oxygen
saturation showed no significant difference between groups (P>0.05).
Adverse reactions occurred in 13.46% of the experimental group and 19.23%
of the control group, with no statistically significant difference
(P>0.05). Patient and surgeon satisfaction scores were uniformly high on a
five-point scale (both groups had median =5). Conclusion(s): The
combined administration of sufentanil and esketamine effectively managed
pain and significantly reduced depressive symptoms in post-cardiac surgery
patients. The experimental group demonstrated reduced PCIA usage and
improved clinical indicators. These findings provide valuable insights for
enhancing postoperative recovery and addressing both pain management and
psychological well-being. Copyright © AME Publishing Company.

<48>
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.

<49>
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.

<50>
Accession Number
2034381782
Title
Update on the Clinical and Molecular Characterization of Noonan Syndrome
and Other RASopathies: A Retrospective Study and Systematic Review.
Source
International Journal of Molecular Sciences. 26(8) (no pagination), 2025.
Article Number: 3515. Date of Publication: 01 Apr 2025.
Author
Reynolds G.; Gazzin A.; Carli D.; Massuras S.; Cardaropoli S.; Luca M.;
Defilippi B.; Tartaglia M.; Ferrero G.B.; Mussa A.
Institution
(Reynolds) Department of Public Health and Pediatrics, Postgraduate School
of Pediatrics, University of Torino, Turin, Italy
(Reynolds, Gazzin, Massuras, Cardaropoli, Defilippi, Mussa) Department of
Public Health and Pediatric Sciences, University of Torino, Turin, Italy
(Gazzin, Massuras, Mussa) Clinical Pediatrics Genetics Unit, Regina
Margherita Children's Hospital, Turin, Italy
(Carli, Luca) Department of Medical Sciences, University of Turin, Turin,
Italy
(Tartaglia) Molecular Genetics and Functional Genomics, Bambino Gesu
Children's Hospital, IRCCS, Rome, Italy
(Ferrero) Department of Clinical and Biological Sciences, University of
Turin, Orbassano, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
RASopathies are a diverse group of genetic conditions caused by
hyperactivation of the RAS-MAPK signaling pathway, mainly inherited in an
autosomal dominant manner. They present with variable features such as
short stature, congenital heart defects, facial dysmorphisms, and
neurodevelopmental delays. This study retrospectively analyzed 143 cases
from 2003 to 2022, aiming to improve genotype-phenotype correlation
knowledge for personalized care. Patients with genetically confirmed
Noonan syndrome (NS) and related disorders were included, with molecular
analysis performed via Sanger or parallel sequencing. Data from 906
previously reported cases were also reviewed. Among the 143 patients, most
had NS (n = 116). PTPN11 mutations were most frequent (61%), followed by
SOS1 (10.3%) and RAF1 (8.6%). Cardiac anomalies were observed in 71%, with
pulmonary stenosis (PS) prevalent in NS (48.3%) and hypertrophic
cardiomyopathy (HCM) in NSML (40%). PTPN11 variants were linked to PS and
atrial septal defects, SOS1 to multiple cardiopathies, and RAF1 to HCM.
Additional features included facial dysmorphisms (74.1%), short stature
(62.0%), skeletal anomalies (43.1%), cryptorchidism (59.7%), and brain
abnormalities (17.2%). JMML and other malignancies were seen in eight
patients. This study emphasizes the importance of genotype-guided care,
improved diagnosis of mild cases, and the underrecognized prevalence of
neurological anomalies. Copyright © 2025 by the authors.

<51>
Accession Number
2033959488
Title
Prognostic value of baseline RV dysfunction using TAPSE and TAPSE to PASP
ratio in patients undergoing mitra-clip: a systematic review and
meta-analysis.
Source
International Journal of Cardiovascular Imaging. 41(5) (pp 827-846), 2025.
Date of Publication: 01 May 2025.
Author
Rmilah A.A.; Ghaly R.; Pfeiffer C.; Saeed M.H.; Khojah A.; Jaber S.;
Alzu'Bi H.; Tabash A.; Chib A.; Darwish R.; Prokop L.; Elajami T.K.;
Arsanjani R.
Institution
(Rmilah) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Rmilah, Pfeiffer, Tabash, Chib) Department of Internal Medicine, Magnolia
Regional Health Center, Corinth, MS, United States
(Ghaly) Department of Internal Medicine, University of Missouri-Kansas
City, Kansas City, MO, United States
(Saeed, Khojah, Jaber) Department of Internal Medicine, Al-Habib Hospital,
Riyadh, Saudi Arabia
(Alzu'Bi, Elajami) Department of Cardiovascular Medicine, Mount Sinai
Medical Center, Miami, FL, United States
(Darwish) Department of Internal Medicine, Al Salam Specialized Hospital,
Cairo, Egypt
(Prokop) Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, United States
(Arsanjani) Department of Cardiovascular Medicine, Mayo Clinic, Phoenix,
AZ, United States
Publisher
Springer Science and Business Media B.V.
Abstract
Mitra-clip is an established therapy for high-risk surgical candidates who
are refractory to optimal medical treatment. Reports have shown that right
ventricular dysfunction (RVD) has been associated with increased morbidity
and mortality in heart failure (HF) patients. Our goal of this systematic
review/meta-analysis is to assess the prognosis of baseline RV function
markers including TAPSE (tricuspid annular plane systolic excursion) and
TAPSE:PASP (pulmonary artery systolic pressure) ratio after Mitra-clip.
MEDLINE and EMBASE were searched from inception to December 20th, 2023,
for studies discussing the prognostic outcome of pre-existing RVD in
Mitra-clip patients. Definition of RV dysfunction was reported as an
abnormal TAPSE (< 15-16 mm) or RV-PA (right ventricle-pulmonary artery)
uncoupling expressed as abnormal TAPSE:PASP ratio (< 0.30-0.37 mm/mmHg).
We included all original research studies (excluding reviews,
meta-analysis, commentaries/editorials, and animal studies) that assessed
the prognostic utility of TAPSE and TAPSE:PASP ratio in patients with MR
undergoing Mitra-clip. Reviewers independently screened the studies and
extracted the pertinent data. Odds ratios (OR) were calculated using a
random-effects model. Twelve reports enrolling 3526 patients were
included. Mean age ranged from 70 to 81 years and 61.1% patients were
male. Primary, secondary, and mixed MR were reported in 36.9%, 61.4%, and
1.8% respectively. Mean LVEF ranged from 27% to 57.1% and 93.7% of
patients had MR grade >= 3 + (at least moderate to severe MR). Patients
with RVD had a reduction in the overall survival (OS) after Mitra-clip at
6 months (81.8% vs 90.5%, OR = 0.45 [0.35-0.58]; P < 0.001), 1-year (71.1%
vs 85.7%, OR = 0.40 [0.33-0.48]; P < 0.001), and 2-year (60.3% vs 76.8%,
OR = 0.37 [0.31-0.45]; P < 0.001) compared to normal RV group. Likewise,
HF re-admission free survival was minimized among RVD patients at 6 months
(76.8% vs 88.1%, OR = 0.47 [0.34-0.65]; P < 0.001), 1-year (64.5% vs
81.3%, OR = 0.44 [0.35-0.55]; P < 0.001), and 2-year (58.2% vs 78.9%, OR =
0.41 [0.30-0.56]; P < 0.001) compared to normal RV group. Decreased TAPSE:
PASP was associated with lower OS at 6-month (OR = 0.46 [0.31-0.68]; P <
0.001), 1-year (OR = 0.37 [0.29-0.47]; P < 0.001), and 2-year (OR = 0.35
[0.25-0.47]; P < 0.001) and reduced HF re-admission free survival at
6-month ((OR = 0.44 [0.31-0.62]; P < 0.001), 1-year (OR = 0.41[0.31-0.54];
P < 0.001), and 2-year (OR = 0.41 [0.31-0.58]; P < 0.001) after
Mitra-clip. Furthermore, decreased TAPSE negatively impacted the OS and HF
re-admission at 6-month (OR = 0.40 [0.21-0.77]; P = 0.006), and 1-year (OR
= 0.50 [0.31-0.80]; P = 0.004) and increased HF re-admission rate at
6-month (OR = 0.27 [0.13-0.56]; P = 0.0005), and 1-year (OR = 0.30
[0.15-0.58]; P = 0.0004). Pre-existing RVD as expressed by TAPSE < 15-16
mm or TAPSE:PASP ratio < 0.30-0.37 mmHg reduced the OS and HF readmission
free survival after Mitra-clip. Copyright © The Author(s), under
exclusive licence to Springer Nature B.V. 2025.

<52>
[Use Link to view the full text]
Accession Number
2037153437
Title
Cytokine Hemoadsorption versus Standard Care in Cardiac Surgery Using the
Oxiris Membrane: The OXICARD Single-center Randomized Trial.
Source
Anesthesiology. 142(5) (pp 874-884), 2025. Date of Publication: 01 May
2025.
Author
Abou-Arab O.; Huette P.; Ibrahima A.; Beyls C.; Bayart G.; Guilbart M.;
Coupez A.; Bennis Y.; Navarre A.; Lenglet G.; Beal R.; Touati G.; Caus T.;
Bar S.; Josse E.; Nguyen M.; Dupont H.; Gubler B.; Kamel S.; Diouf M.;
Mahjoub Y.
Institution
(Abou-Arab, Huette, Ibrahima, Beyls, Bayart, Guilbart, Coupez, Beal, Bar,
Dupont, Mahjoub) Anesthesia and Critical Care Department, Amiens
University Hospital, Amiens, France
(Abou-Arab, Bennis, Kamel) EA7517, Pathophysiological Mechanisms and
Consequences of Cardiovascular Calcifications (MP3CV), Jules Verne
University of Picardie, Amiens, France
(Navarre) Department of Clinical Pharmacology, Amiens University Hospital,
Amiens, France
(Lenglet) Department of Immunology, Amiens University Hospital, Amiens,
France
(Touati, Caus) Department of Cardiac Surgery, Amiens University Hospital,
Amiens, France
(Josse) Division of Clinical Research, Amiens University Hospital, Amiens,
France
(Nguyen) Department of Anesthesiology and Critical Care Medicine, Dijon
University Medical Centre, Dijon, France
(Gubler) Department of Molecular Oncobiology, Amiens University Hospital,
Amiens, France
(Kamel) Department of Clinical Biochemistry, Amiens University Hospital,
Amiens, France
(Diouf) Department of Statistics, Amiens University Hospital, Amiens,
France
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Cardiac surgery can lead to dysregulation with a
proinflammatory state, resulting in adverse outcomes. Hemadsorption using
the AN-69 membrane (Oxiris membrane, Baxter, USA) has the properties to
chelate inflammatory cytokines. The authors hypothesized that in patients
at high risk of inflammation, the use of the Oxiris membrane could
decrease inflammation, preserve endothelial function, and improve
postoperative outcomes. Method(s): The authors conducted a randomized
single-center study at Amiens University Hospital (Amiens, France). The
study population consisted of adult patients admitted for scheduled
cardiac surgery with an expected cardiopulmonary bypass (CPB) time greater
than 90 min. The patients were allocated to either the standard group or
the Oxiris group. The intervention consisted of using the Oxiris membrane
on a Prismaflex device (Baxter, USA) at a blood flow rate of 450 ml/min
during CPB. The primary outcome was the assessment of microcirculation on
day 1 after surgery by measuring sublingual microcirculation using the
microvascular flow index. Microvascular flow index reflects the
microcirculation flow type and is graded from 0 to 3 as follows: 0, no
flow; 1, intermittent flow; 2, sluggish flow; 3, continuous flow. The
secondary outcome was a composite adverse outcome within 30 days after
surgery. Cytokines and endothelial biomarkers were measured in all
patients at different time points. An intention-to-treat analysis was
performed. Result(s): From October 2019 to November 2022, the study
included 70 patients. Two patients were excluded from the Oxiris group:
one patient did not undergo surgery, and one procedure was performed under
deep hypothermia. The microvascular flow index did not differ between
groups on day 1 from baseline: difference (95% CI) Oxiris minus standard
at -0.17 (-0.44 to 0.10); P = 0.2. The occurrence of a composite adverse
outcome did not significantly differ between groups (14 [42%] for the
Oxiris group vs. 12 [35%] for the standard group; P = 0.7). The overall
variation in cytokines and angiopoietins did not significantly differ
between groups. Conclusion(s): In patients scheduled for a cardiac
surgery with prolonged CPB, the authors could not demonstrate the benefit
on microcirculation and major cardiovascular events. Copyright ©
2025 The Author(s).

<53>
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.

<54>
Accession Number
2036204959
Title
Effect of Dexmedetomidine on Stress-Induced Changes in Hemodynamic and
Left Ventricular Function in Coronary Artery Bypass Grafting Surgery: A
Randomized Controlled Trial.
Source
Journal of Cellular and Molecular Anesthesia. 10(1) (no pagination), 2025.
Article Number: e160218. Date of Publication: 01 Mar 2025.
Author
Hussien R.M.; El Shafei M.N.; Ahmed M.M.; Abdelmoneim W.; Ghoneim M.A.-F.;
Tolba M.A.A.
Institution
(Hussien, El Shafei, Ahmed, Abdelmoneim, Tolba) Department of Anesthesia,
Ain Shams University, Cairo, Egypt
(Ghoneim) Anesthesia and Intensive Care, Faculty of Medicine, Ain Shams
University, Cairo, Egypt
Publisher
Brieflands
Abstract
Background: Dexmedetomidine is a highly selective central adrenoceptor
agonist with a short half-life, making it an ideal intravenous drug for
blunting the stress response. Objective(s): The present study aimed
to determine the effect of dexmedetomidine on left ventricular function
and its ability to attenuate the hemodynamic response to skin incision,
sternotomy, and the postoperative period in coronary artery bypass graft
(CABG) surgery. Method(s): This randomized controlled clinical trial
included 64 patients of both sexes who underwent elective CABG surgery.
They were randomly assigned to two equal groups: Group D received a
continuous infusion of dexmedetomidine (0.5 microg/kg/h) one hour before
the induction of anesthesia until immediately before transfer to the
intensive care unit (ICU), while group C received a continuous infusion of
0.9% saline at a rate of 10 mL/h. Result(s): The heart rate (HR) and
mean arterial blood pressure in group D exhibited significant differences
starting 3 minutes following skin incision and continuing for 4 hours (P <
0.05). Although they changed postoperatively, the pre-and post-bypass
ejection fraction (EF) did not change significantly between the two
groups. The need for inotropic support was significantly higher in group
D. Additionally, the incidence of new-onset atrial fibrillation was
significantly lower in group D. Conversely, both groups showed no
significant differences in serum lactate levels, the incidence of bleeding
and reopening, pacemaker usage, mechanical ventilation, ventricular
fibrillation, and bradycardia. Conclusion(s): Using a 0.5 microg/kg/h
dexmedetomidine infusion as pretreatment is a secure and effective method
for decreasing stress-induced reactions and improving hemodynamic
stability, without any noticeable adverse effects. Copyright ©
2025, Maher Hussien et al.

<55>
Accession Number
2037230838
Title
Benefit of Systematic "Jailed Wire" Technique for Bifurcation Provisional
Stenting. A CABRIOLET Substudy.
Source
Canadian Journal of Cardiology. 41(5) (pp 871-877), 2025. Date of
Publication: 01 May 2025.
Author
Derimay F.; Mercier A.; Aminian A.; Maillard L.; Souteyrand G.; Motreff
P.; Lattuca B.; Cayla G.; Rioufol G.; Finet G.
Institution
(Derimay, Mercier, Rioufol, Finet) Cardiology Department, Cardiovascular
Hospital, Lyon, France
(Aminian) Centre Hospitalier Universitaire de Charleroi, Charleroi,
Belgium
(Maillard) GCS ES Axium Rambot, Aix-en-Provence, France
(Souteyrand, Motreff) ACTION Study Group, Cardiology Department, CHU de
Nimes, France
(Lattuca, Cayla) Cardiology Department, CHU de Clermont-Ferrand, France
Publisher
Elsevier Inc.
Abstract
Background: Jailed wire (JW) in the side branch (SB) is recommended during
coronary bifurcation provisional stenting, but there is uncertainty about
the real benefit. Our objective was to evaluate the benefit of a JW
technique in the Coronary Artery Bifurcation Revascularization Without
kIssing ballOon infLation by rEpoT (CABRIOLET) registry. Method(s):
In CABRIOLET, which included 500 patients, we compared the primary
composite end point of a poor final SB angiographic result (of
Thrombolysis in Myocardial Infarction (TIMI) flow < III, dissection grade
> B, thrombosis, residual stenosis > 70%, or additional SB stenting)
whether JW was performed or not. On the basis of the usual operator
practice, we also compared a systematic JW strategy: operators known to
place JW frequently (> 75% performed), to a conditional strategy:
selective JW practices (< 20% of JW). Result(s): JW was performed in
251 patients (50.2%), without significant baseline clinical and
angiographic differences compared with those who received no JW. JW was
associated with higher primary end point (15.1% vs 8.4%; P < 0.05), and
increased fluoroscopy time and contrast volume (15.9 +/- 7.3 minutes and
181 +/- 62 mL vs 13.3 +/- 6.5 minutes and 161 +/- 74 mL; P < 0.05). JW was
performed in 12.1% of patients (26 of 214) in the conditional JW group and
78.7% (225 of 286) in systematic group. The primary end point was similar
in both strategies (11.2% and 12.2%; P = 0.78), although with greater
fluoroscopy time and contrast volume for systematic JW (180 +/- 57 mL and
15.3 +/- 7.5 minutes vs 162 +/- 79 mL and 13.7 +/- 6.1 minutes; P < 0.05).
There was no difference in 1-year major adverse cardiovascular events
depending on whether JW was performed or not and between conditional or
systematic strategies. Conclusion(s): In a large registry, JW was
associated with poorer final SB angiographic results than no JW. Final SB
angiographic results were similar between conditional or systematic JW
strategies. Copyright © 2024 Canadian Cardiovascular Society

<56>
Accession Number
2034198882
Title
Comparison of the analgesic effects of liposomal bupivacaine in
ultrasound-guided erector spinae plane block and surgeon-administered
intercostal nerve block following video-assisted thoracoscopic lung
resection: protocol for a randomized controlled trial.
Source
Frontiers in Medicine. 12 (no pagination), 2025. Article Number: 1564738.
Date of Publication: 2025.
Author
Yan J.; Feng Y.-S.; Zheng X.-Y.; Zhang Y.; Liu H.-Y.; Yang Y.-F.; Wan
J.-J.; Peng K.; Liu H.; Ji F.-H.; Shan X.-S.
Institution
(Yan, Zheng, Zhang, Liu, Yang, Wan, Peng, Ji, Shan) Department of
Anesthesiology, First Affiliated Hospital of Soochow University, Jiangsu,
Suzhou, China
(Yan, Zheng, Zhang, Liu, Yang, Wan, Peng, Ji, Shan) Institute of
Anesthesiology, Soochow University, Jiangsu, Suzhou, China
(Feng) Suzhou Medical College, Soochow University, Jiangsu, Suzhou, China
(Liu) Ambulatory Surgery Centre, First Affiliated Hospital of Soochow
University, Jiangsu, Suzhou, China
(Liu) Department of Anesthesiology and Pain Medicine, University of
California, Davis, Sacramento, CA, United States
Publisher
Frontiers Media SA
Abstract
Background: The analgesic efficacy of liposomal bupivacaine (LB) for
ultrasound-guided erector spinae plane block (ESPB) and thoracoscopic
intercostal nerve block (ICNB) in thoracic surgery remains uncertain. This
study aims to evaluate the analgesic efficacy of
anesthesiologist-performed ESPB using LB versus surgeon-administrated ICNB
with LB in patients undergoing video-assisted thoracoscopic surgery (VATS)
lung resection. Method(s): This single-center, prospective,
randomized, double-blinded trial will include 120 adult patients scheduled
for VATS lung resection. Patients will be randomly assigned 1:1 to the
ESPB group or ICNB group. Each patient will receive either an ESPB or ICNB
at the end of the surgery, along with patients-controlled intravenous
analgesia (PCIA) as part of a postoperative multimodal analgesia. The
primary outcome is the average numeric rating scale (NRS) pain scores at
rest over 72h postoperatively (average of three 24-h time points: 24, 48,
and 72h). Secondary outcomes include NRS pain scores at rest and during
activity at 24, 48, and 72h postoperatively, Quality of Recovery 15 scores
at 24, 48, and 72h postoperatively, time to first press on the PCIA
device, total opioid consumption within 72h postoperatively, time to
initiate independent bedside mobilization, length of postoperative
hospital stay, and the incidence of chronic pain (defined as an NRS
score>=1) at 3months post-surgery. Analyses will be performed in the
modified intention-to-treat population. Discussion(s): We hypothesize
that anesthesiologist-performed ultrasound-guided ESPB with liposomal
bupivacaine will result in lower average numeric rating scale pain scores
over 72h compared to surgeon-administrated thoracoscopic ICNB in patients
undergoing VATS lung resection. The findings of this study aim to provide
evidence to optimize postoperative analgesic regimens for patients
undergoing VATS lung resection. Clinical trial registration:
http://www.chictr.org.cn, identifier ChiCTR2400092927. Copyright
© 2025 Yan, Feng, Zheng, Zhang, Liu, Yang, Wan, Peng, Liu, Ji and
Shan.

<57>
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.

<58>
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.

<59>
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

<60>
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.

<61>
Accession Number
646645226
Title
Impact of Continuation Versus Interruption of Oral Anticoagulation During
TAVI on Health-Related Quality of Life.
Source
Catheterization and cardiovascular interventions : official journal of the
Society for Cardiac Angiography & Interventions. 105(6) (pp 1329-1337),
2025. Date of Publication: 01 May 2025.
Author
van Ginkel D.J.; Bor W.L.; Aarts H.M.; Dubois C.; Backer O.; Rooijakkers
M.J.P.; Rosseel L.; Veenstra L.; Delewi R.; Ten Berg J.M.
Institution
(van Ginkel, Bor, Ten Berg) Department of Cardiology, St. Antonius
Hospital, Nieuwegein, Netherlands
(Aarts, Delewi) Department of Cardiology, Amsterdam, Netherlands
(Aarts) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Dubois) Department of Cardiovascular Medicine, University Hospital
Leuven, Leuven, Belgium
(Backer) Heart Center, Rigshospitalet, Copenhagen University Hospital,
Copenhagen, Denmark
(Rooijakkers) Department of Cardiology, Radboud University Medical Center,
Nijmegen, Netherlands
(Rosseel) Department of Cardiology, Aalst, Belgium
(Veenstra, Ten Berg) Department of Cardiology, Maastricht University
Medical Center, Maastricht, Netherlands
(Veenstra, Ten Berg) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht, Netherlands
Abstract
BACKGROUND: One-third of patients undergoing TAVR have a concomitant
indication for oral anticoagulation. The impact of continuation as
compared to interruption of oral anticoagulation during TAVR on
health-related quality of life is unknown. AIMS: To investigate the impact
of continuation as compared to interruption of oral anticoagulation on
health-related quality of life. METHOD(S): The POPular PAUSE TAVI
(Periprocedural Continuation vs. Interruption of Oral Anticoagulant Drugs
during Transcatheter Aortic Valve Implantation) trial was an
international, open-label, randomized, clinical trial performed at 22
European sites. Health-related quality of life was assessed using the
Kansas City Cardiomyopathy Questionnaire (KCCQ) and Short Form-12 (SF-12)
before, and at 1 and 3 months after TAVR. RESULT(S): A total of 8
patients were included: 431 were assigned to continuation and 427 to
interruption of oral anticoagulation. Before TAVR, the mean overall KCCQ
summary score was 53.6 (+/-26.0). At 1 month, the mean change in KCCQ
summary score as compared to baseline was +11.4 points (95% confidence
interval [CI] 8.0-14.8) in the continuation group and +12.2 points (95% CI
8.8-15.6) in the interruption group (difference -0.7 points; 95% CI -4.6
to 3.1). At 3 months, the mean change was +11.0 points (95% CI 7.3-14.6)
versus +13.8 points (95% CI 10.2-17.4), respectively (difference -2.8
points; 95% CI -7.1 to 1.5). Mean changes in SF-12 physical and mental
component summary scores showed no differences between both groups at 1
and 3 months after TAVR. CONCLUSION(S): In patients undergoing TAVR
with a concomitant indication for oral anticoagulation, continuation as
compared to interruption of oral anticoagulation during TAVR did not
significantly impact health-related quality of life up to 3 months after
TAVR. Copyright © 2025 Wiley Periodicals LLC.

<62>
Accession Number
647348035
Title
Comparative Prognostic Value of Risk Factors for Predicting Pacemaker
Implantation After Transcatheter Aortic Valve Replacement: A Systematic
Review and Network Meta-analysis.
Source
The American journal of cardiology. (no pagination), 2025. Date of
Publication: 08 May 2025.
Author
Mohammadi N.S.H.; Tavakoli K.; Taebi M.; Zafari A.; Riahi M.; Molaei M.M.;
Farooqi M.A.; Khanipour R.; Karvane H.B.; Shahrzad S.; Vaseghi M.;
Lakkirrddy G.R.; Mattumpuram J.; Tzeis S.; Jenab Y.; Hosseini K.
Institution
(Mohammadi, Tavakoli, Taebi, Jenab, Hosseini) Tehran Heart Center,
Cardiovascular Disease Research Institute, Tehran University of Medical
Sciences, Tehran, Iran; Cardiac Primary Prevention Research Center,
Cardiovascular Diseases Research Institute, Tehran University of Medical
Sciences, Tehran, Iran
(Zafari) School of Medicine, Shahid Beheshti University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Riahi, Molaei) School of Medicine, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Farooqi) Central Michigan University, Internal Medicine
(Khanipour) Department of Internal Medicine, HCA Florida Bayonet Point
Hospital - University of South Florida
(Karvane) Tehran Heart Center, Cardiovascular Disease Research Institute,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Shahrzad) Shariati Hospital, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Vaseghi) Division of Cardiology, Department of Medicine, UCLA Cardiac
Arrhythmia Center, University of California, 100 Medical Plaza ,Suite 660,
Los Angeles, CA, United States
(Lakkirrddy) Kansas City Heart Rhythm Institute and Research Foundation,
Overland Park, KS, United States
(Mattumpuram) Division of Cardiology, University of Louisville School of
Medicine, Louisville, KY, United States
(Tzeis) Department of Cardiology, Mitera Hospital, Hygeia Group, Athens,
Greece
Abstract
This study compares the prognostic value of risk factors for Permanent
pacemaker implantation (PPI) following transcatheter aortic valve
replacement (TAVR). PubMed, Embase, Scopus, and Cochrane Library databases
were searched until November 2024 for studies reporting PPI incidence
within 30 days post-TAVR. A random-effect model was used to pool risk
ratios (RR) and standardized mean differences (SDM) for binary and
continuous risk factors. Network meta-analysis estimated pooled risk
differences (DELTARR) for binary predictors with male sex as the
reference. Significant predictors were ranked based on their surface under
the cumulative ranking curve (SUCRA) values. A total of 108 studies
comprising 77,538 patients (14,560 requiring PPI) were included. Male sex
(RR: 1.13), baseline atrial fibrillation (AF) (RR: 1.12), 2nd degree
Mobitz I (RR: 5.16) and Mobitz II (RR: 2.30) atrioventricular blocks
(AVB), 3rd degree AVB (RR: 13.46), left anterior (LAHB) (RR: 1.79) and
posterior hemiblocks (LPHB) (RR: 2.57), bifascicular block (RR: 2.34),
right bundle branch block (RBBB) (RR: 3.20) and intraprocedural AVB (RR:
4.15) were identified as predictors for PPI post-TAVR. The risk of PPI was
higher with self-expandable valves (RR: 1.79), subclavian access (RR:
1.75), and 29 mm prostheses (RR: 1.33) compared to balloon-expandable
valves, transfemoral access, and 23 mm prostheses. Network meta-analysis
ranked 3rd degree AVB (SUCRA <0.01), Mobitz I AVB (SUCRA: 0.14), Mobitz II
AVB (SUCRA: 0.33), intraprocedural AVB (SUCRA: 0.42), bifascicular block
(SUCRA: 0.48), RBBB (SUCRA: 0.49) and LPHB (SUCRA: 0.54) as major
predictors of PPI in descending order of significance. In conclusion,
clinicians should closely monitor conduction abnormalities as key
predictors of PPI following TAVR. Additionally, other risk factors such as
subclavian access, self-expanding implantation, AF, large prosthesis
diameter, and male sex should not be overlooked. Copyright ©
2025. Published by Elsevier Inc.

<63>
Accession Number
2038735349
Title
L-carnitine supplementation to prevent postoperative complications after
cardiac surgery: A systematic review and meta-analysis of randomised
clinical trials.
Source
Indian Journal of Anaesthesia. 69(6) (pp 547-560), 2025. Date of
Publication: 01 Jun 2025.
Author
Shalabi L.; Ibrahim A.; Elsawy M.A.; Zreigh S.; Dervis M.; Elshabrawi
M.N.; Mourad S.; Arafa M.A.; Abuelazm M.
Institution
(Shalabi) Department of Internal Medicine, Faculty of Medicine, Gharyan
University, Gharyan, Libyan Arab Jamahiriya
(Ibrahim, Mourad) Department of Internal Medicine, Faculty of Medicine,
Alexandria University, Alexandria, Egypt
(Elsawy, Arafa) Department of Internal Medicine, Faculty of Medicine,
Al-Azhar University, Cairo, Egypt
(Zreigh, Dervis) Department of Internal Medicine, Faculty of Medicine,
Ankara Yildirim Beyazit University, Ankara, Turkey
(Elshabrawi) Deparment of Internal Medicine, Faculty of Medicine, Port
Said University, Port Said, Egypt
(Abuelazm) Department of Internal Medicine, Faculty of Medicine, Tanta
University, Tanta, Egypt
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Cardiac surgeries often lead to postoperative
complications, which affect recovery and increase morbidity and mortality.
This systematic review aims to assess L-carnitine's effect on preventing
postoperative complications across various cardiac surgeries, addressing
gaps in current literature on its potential therapeutic benefits.
 Method(s): We systematically searched Web of Science, Cochrane,
Embase, PubMed, and Scopus databases until March 2025. Statistical
analysis was performed using R version 4.3.2. Effect sizes were measured
with relative risks (RR) for dichotomous outcomes and mean differences
(MD) for continuous outcomes, while heterogeneity was evaluated using the
I2 statistic. Result(s): Thirteen randomised controlled trials(RCTs)
with 786 patients were included. L-carnitine significantly increased the
cardiac index (CI) (MD: 0.14; 95% CI: 0.07, 0.20; P < 0.01) and left
ventricular stroke work index (LVSWI) (MD: 0.42; 95% CI: 0.06, 0.78; P =
0.02). In addition, L-carnitine significantly improved the left
ventricular ejection fraction (LVEF) (MD: 7.88; 95% CI: 6.67, 9.09; P <
0.01), with a significant reduction in postoperative atrial fibrillation
(POAF) (RR: 0.53; 95% CI: 0.30, 0.95; P = 0.03). In contrast, there was no
significant reduction in in-hospital mortality (RR: 0.51; 95% CI: 0.10,
2.63; P = 1.00) and stroke incidence (RR: 0.85; 95% CI: 0.12, 5.76; P =
0.82). Conclusion(s): Preoperative administration of L-carnitine
demonstrates meaningful short-term benefits in enhancing CI, LVSWI, and
LVEF while reducing the incidence of POAF following cardiac surgery. These
findings suggest a potential role for L-carnitine supplementation in
optimising perioperative cardiac care, enhancing recovery, and reducing
complications following cardiac surgery. However, the existing studies are
limited in scope, making it challenging to draw robust
conclusions. Copyright © 2025 Indian Journal of Anaesthesia.

<64>
Accession Number
647350258
Title
Incidence Of Myocardial Injury In Patients Submitted To Abdominal Aortic
Aneurysm Repair: a systematic review and metanalysis.
Source
Annals of vascular surgery. (no pagination), 2025. Date of Publication:
09 May 2025.
Author
Azevedo J.F.; Romana-Dias L.; Ribeiro H.; Dias-Neto M.; Neves J.R.
Institution
(Azevedo) Faculty of Medicine of the University of Porto, Portugal
(Romana-Dias) Faculty of Medicine of the University of Porto, Portugal;
Department of Angiology and Vascular Surgery, Unidade Local de Saude de
Sao Joao, Porto, Portugal
(Ribeiro) Faculty of Medicine of the University of Porto, Portugal;
Community Palliative Care Support Team Gaia, Vila Nova de Gaia, Portugal;
Faculty of Medicine of University of Coimbra, Coimbra, Portugal; Centre
for Innovative Biomedicine and Biotechnology, Coimbra, Portugal
(Dias-Neto) Department of Angiology and Vascular Surgery, Unidade Local de
Saude de Sao Joao, Porto, Portugal; UnIC@RISE-Health, Department of
Surgery and Physiology, Faculty of Medicine of the University of Porto,
Porto, Portugal; RISE-Health, Departamento de Biomedicina - Unidade de
Anatomia, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
(Neves) UnIC@RISE-Health, Department of Surgery and Physiology, Faculty of
Medicine of the University of Porto, Porto, Portugal; Department of
Biomedicine, Unity of Anatomy, Faculty of Medicine of the University of
Porto, Portugal; RISE-Health, Departamento de Biomedicina - Unidade de
Anatomia, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
Abstract
BACKGROUND: Repair of abdominal aortic aneurysms (AAA) is a major vascular
surgery that carries risk of myocardial injury following non-cardiac
surgery (MINS). MINS occurs in approximately 20% of patients and affects
patient outcomes, but its incidence remains unclear in this subset of
patients. This systematic review aims to determine the incidence of MINS
in patients undergoing AAA repair. METHOD(S): MEDLINE, WOS, and
Scopus were searched for studies assessing MINS after AAA repair. The
incidence of MINS in EVAR and OAR was pooled by random-effects
meta-analysis, with sources of heterogeneity being explored. Assessment of
studies' quality was performed using NHLBI Study Quality Assessment and
RoB 2 Tool. RESULT(S): Sixteen studies were included, with a total of
25,649 participants. Two were RCTs, while the remaining were cohorts. Age
ranged from 65.8-75.5 and percentage of male participants between
78%-96.6%. The pooled incidence of MINS ranged from 0.4%-18.7% for EVAR
and 1.8%-46.8% for OAR. Meta-analytical incidence of MINS after EVAR was
12.5% [95%CI 6.2-18.7%] in cohort studies and 0.9% [95%CI 0.4-1.4%] in
multicentre database studies, both with severe heterogeneity (I2=91.0% and
79.1%). For OAR, the incidence was 30.6% [95%CI 19.5-41.7%] in cohort
studies, 3.2% [95%CI 1.8-4.6%] in multicentre database studies, and 32.4%
[95%CI 18.1-46.8%] in RCTs, all with high heterogeneity (I2=96.8%, 86.6%,
and 71.3%). CONCLUSION(S): MINS incidence was significant, and
results indicate a possible difference between EVAR and OAR, but the
significant heterogeneity found indicates a need for additional research
with consistent methodology and definitions. Copyright © 2025 The
Author(s). Published by Elsevier Inc. All rights reserved.

<65>
Accession Number
647347213
Title
Randomised trials in cardiac surgery: why and how.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2025.
Date of Publication: 10 May 2025.
Author
Gaudino M.; Siepe M.; Murphy G.J.; Williams B.; Sandner S.; Gregg A.C.;
Moskowitz A.J.; Falk V.; Gelijns A.C.
Institution
(Gaudino, Gregg) Department of Cardiothoracic Surgery, Weill Cornell
Medicine, NY, United States
(Siepe) Department of Cardiac Surgery, University of Bern, University
Hospital Bern, Bern, Switzerland
(Murphy) Department of Cardiovascular Sciences and NIHR Leicester
Biomedical Research Unit in Cardiovascular Medicine, University of
Leicester, Leicester, United Kingdom
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Moskowitz, Gelijns) Department of Population Health Science and Policy,
Icahn School of Medicine at Mount Sinai, NY, United States
(Falk) Department of Cardiothoracic and Vascular Surgery, Berlin, Germany
(Falk) Deutsches Zentrum fur Herz-Kreislauf-Forschung (DZHK), partner site
Berlin, Berlin, Germany
(Falk) Department of Health Sciences and Technology, Eidgenossische
Technische Hochschule Zurich, Zurich, Switzerland
Abstract
OBJECTIVES: Randomised clinical trials (RCTs) are the gold standard for
comparative effectiveness. However, they face unique challenges in cardiac
surgery. The objective of this work is to summarize the challenges of RCTs
in cardiac surgery, describe efforts employed in recent years to mitigate
these impediments and outline the future opportunities for increased RCT
adoption in the specialty. METHOD(S): This review was conducted as an
expert analysis on the existing state of RCTs in cardiac surgery based on
expert discussion at a dedicated session during the 2024 Annual Meeting of
the European Association for Cardio-Thoracic Surgery (EACTS). Different
trial-support infrastructures, such as the Randomized Comparison of the
Clinical Outcomes of Single versus Multiple Arterial Grafts (ROMA)
Network, the Cardiothoracic Trials Surgical Network (CTSN), the Global
Cardiovascular Research Funders Forum (GCRFF) and the United Kingdom
Model, and their respective mechanisms for overcoming RCT barriers were
described in detailed. Models were selected due to specific author
involvement and knowledge. Future directions were postulated based on
current trends. RESULT(S): Despite heterogeneous structures, the
described models largely aimed to increased cardiac RCTs through improved
trial participation, either via increased trainees, expanded stakeholders
or focused patient recruitment, facilitating funding and fostering wider
collaboration. CONCLUSION(S): RCTs are a key component for clinical
advancement yet have been underutilized in cardiac surgery. Recent
endeavors have reduced the multifactorial barriers associated with cardiac
surgery RCTs and intentional future efforts are necessary for continued
cardiac advancement. Copyright © The Author(s) 2025. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. 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 informat

<66>
Accession Number
2038805293
Title
Immediate orotracheal extubation in cardiac surgical procedures.
Systematic review and meta-analysis.
Source
REC: CardioClinics. (no pagination), 2025. Date of Publication: 2025.
Author
Aguero Martinez M.O.; Alarcon Gomez L.C.
Institution
(Aguero Martinez) Servicio de Cirugia Cardiovascular, Departamento de
Anestesiologia, Hospital Clinico Quirurgico Hermanos Ameijeiras, La
Habana, Cuba
(Alarcon Gomez) Servicio de Anestesiologia y Reanimacion, Hospital Clinico
Quirurgico Hermanos Ameijeiras, La Habana, Cuba
Publisher
Elsevier Espana S.L.U
Abstract
Introduction and objectives: The anesthesia for cardiovascular surgical
procedures has evolved along with the surgical specialty. Enhanced
recovery programs are a typical example of this advance, and within them
are actions aimed at achieving immediate orotracheal extubation in the
operating room. The objective was to estimate the effectiveness of the
implementation immediate orotracheal extubation in the perioperative
evolution of patients scheduled for cardiac surgical procedures.
 Method(s): A systematic review with meta-analysis was carried out
according to the recommendations of the manual 5.1.0 and 6.2.0 for
reviewers of the Cochrane library. Result(s): Eight studies were
evaluated, for a total of 786 patients. Their quality is not ideal.
Meta-analyses suggest that this procedure is associated with a decrease in
intensive care unit stay (mean difference: -10.46; 95%CI, -17.15 to
-3.77), hospital stay (mean difference: -1.88; 95%CI, -3.73 to -0.03), and
the incidence of reintubation (RR, 0.85; 95%CI, 0.32-2.23). However, the
influence of orotracheal extubation time on postoperative complications
(RR, 1.08; 95%CI, 0.52-2.26) could not be demonstrated.
 Conclusion(s): It is necessary to carry out and publish controlled
and randomized clinical trials, as the first level of evidence, to safely
endorse the implementation of this technique in cardiovascular surgical
procedures. Registered at PROSPERO: CRD42021281286. Copyright ©
2025 Sociedad Espanola de Cardiologia

<67>
Accession Number
647344007
Title
Comparison between low-molecular-weight heparin and apixaban for
prophylaxis against venous thromboembolism after laparoscopic sleeve
gastrectomy: a randomized controlled trial.
Source
British Journal of Surgery. Conference: 5th IBC Oxford University World
Congress 2024. Oxford United Kingdom. 112(Supplement 5) (pp v38), 2025.
Date of Publication: 01 Feb 2025.
Author
Abdelsalam A.
Publisher
Oxford University Press
Abstract
Background: Venous thromboembolism (VTE) is a possible complication after
bariatric-metabolic surgery. Low-molecular-weight heparin (LMWH) is
commonly used to prevent VTE, but there is limited data on the use of
direct oral anticoagulants (DOACs). Apixaban, which is primarily absorbed
in the proximal small bowel, may offer advantages over LMWH.
 Objective(s): This study aimed to assess the efficacy and safety of
apixaban compared to LMWH for VTE prophylaxis after laparoscopic sleeve
gastrectomy (LSG), by evaluating the incidence of VTE and bleeding.
 Method(s): This study was a randomized, single-blind, parallel-group
(1:1) controlled clinical trial that enrolled 100 adult participants of
both genders, aged 18 to 65 years who were scheduled for LSG at Cairo
University Hospitals between August 2022 and January 2024. Subjects with
severe obesity (BMI >= 40 kg/m2 or >= 35 kg/m2 with
comorbidities), normal preoperative human coagulation factor Xa serum
level, and normal preoperative mesenteric, portal, splenic, and lower limb
venous duplex were recruited. Exclusion criteria for this study included a
history of bariatric surgery other than LSG, VTE/pulmonary embolism, or
heart valve replacement, as well as pregnancy, lactation, and missed
follow-up duplex. Participants were randomly assigned to one of two groups
(50 patients each) using a computer-generated random sample table. Group A
received postoperative prophylaxis with LMWH (1 mg/kg/day, max 120 mg/day)
from day 1 to day 15, while G to day 15. Assessment of VTE was conducted
on postoperative day 15 via venous duple roup B received postoperative
prophylaxis with apixaban (2.5 mg twice daily) from day 1x of the
mesenteric, splenic, portal, and lower limb veins. Result(s): No
statistically significant differences were observed between groups in VTE
(0% incidence) or major postoperative bleeding (2% incidence).
 Conclusion(s): Apixaban is as effective and safe as LMWH in
preventing VTE after LSG, highlighting its potential role in this setting.
Poster Presentations.

<68>
Accession Number
2034605509
Title
Continuation Versus Interruption of Oral Anticoagulation During TAVI: A
Systematic Review and Meta-Analysis Oral Anticoagulation Management in
TAVI.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Borges Martins J.M.; dos Santos Borges R.; Gosch Berton G.; Ferreira
Vieira P.L.; Machado Gomes de Sousa P.A.; Chaves Vieira A.L.; Ken Fukunaga
C.; Karlinski Vizentin V.; Rodrigues Macedo E.M.; Guida C.M.
Institution
(Borges Martins, Ferreira Vieira, Chaves Vieira, Rodrigues Macedo)
Department of Medicine, Federal University of Para, Belem, Brazil
(dos Santos Borges) Department of Medicine, Federal University of Minas
Gerais, Belo Horizonte, Brazil
(Gosch Berton) School of Medicine, University of Passo Fundo, Passo Fundo,
Brazil
(Gosch Berton) Department of Neurology, Mater Misericordiae University
Hospital - University College Dublin, Dublin, Ireland
(Machado Gomes de Sousa) Department of Medicine, Federal University of
Uberlandia, Uberlandia, Brazil
(Ken Fukunaga, Guida) Department of Medicine, FMABC University Centre,
Santo Andre, Brazil
(Karlinski Vizentin) Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, MN, United States
(Guida) Department of Cardiology, Dante Pazzanese Institute of Cardiology,
Sao Paulo, Brazil
Publisher
John Wiley and Sons Inc
Abstract
Patients undergoing transcatheter aortic valve implantation (TAVI) often
require long-term oral anticoagulation (OAC), but it is unclear whether to
continue or interrupt OAC during the procedure. This meta-analysis
compares clinical outcomes of continuing versus interrupting OAC during
TAVI. PubMed, Embase, and Cochrane Central databases were searched from
inception to September 2024 for studies comparing continuation versus
interruption of OAC in patients undergoing TAVI with an indication for
OAC, including vitamin K antagonists and direct oral anticoagulants. Risk
ratios (RR) with 95% confidence intervals (CI) were pooled using a
random-effects model. Sensitivity analysis was performed using the
Hartung-Knapp-Sidik-Jonkman method. Three studies were included, one
randomized controlled trial and two cohort studies, with 2773 patients, of
whom 1314 (47.4%) continued OAC during TAVI. At a 30-day follow-up after
TAVI, there were no significant differences between groups in all-cause
mortality (RR 0.74; 95% CI 0.45-1.20; p = 0.22), any bleeding (RR 1.08;
95% CI 0.81-1.43; p = 0.60), and major bleeding (RR 0.90; 95% CI
0.67-1.21; p = 0.48). However, the continued OAC group was associated with
a lower stroke rate (RR 0.65; 95% CI 0.42-1.01; p = 0.053), also attested
after a sensitivity analysis (RR 0.65; 95% CI 0.47-0.90; p < 0.03). In
patients with an indication for OAC undergoing TAVI, uninterrupted
anticoagulation is associated with similar thrombotic and hemorrhagic
outcomes compared to interrupted OAC. Stroke risk was lower in the
continued OAC group, with a significant reduction, as demonstrated in
sensitivity analysis. Copyright © 2025 The Author(s).
Catheterization and Cardiovascular Interventions published by Wiley
Periodicals LLC.

<69>
Accession Number
2038757731
Title
Effect of Aerobika Device in Sputum Induction, Pulmonary Function and
Thoracic Expansion in Phase One Cardiac Rehabilitation for Post CABG
Subjects: A Randomized Prospective Controlled Trial.
Source
Nepalese Heart Journal. 22(1) (pp 3-9), 2025. Date of Publication: 2025.
Author
Naik V.; Paramshetti A.
Institution
(Naik, Paramshetti) Department of Cardiovascular and Pulmonary
Physiotherapy, KLE Institute of Physiotherapy, Karnataka, Belagavi, India
Publisher
Cardiac Society of Nepal
Abstract
Background: Patients who undergo coronary artery bypass graft (CABG)
surgery frequently ex-perienced pulmonary complications shortly after the
procedure due to reduced lung function and a weakened cough reflex. The
recent study aimed to determine and evaluate the effects of Aerobika
device on sputum induction, pulmonary function and thoracic expansion in
phase one cardiac rehabilitation for post CABG subjects. Method(s): A
Randomized prospective controlled trail was conducted on 36 participants
with me-dian sternotomy. Participants were assigned to either Group A
(n=18) or Group B (n=18) . The session was carried for 30 minutes twice a
day for a week. Outcome measures in the present study were sputum volume,
thoracic expansion measurements, peak expiratory flow meter and maximal
inspiratory pressure. The outcome measures were evaluated on daily basis
i.e., pre and post of every session. Statistical analysis used:Statistical
analysis was done using SPSS 23. Wilcoxon test was used for within group
pre test and post test comparison whereas Mann Whitney Test was used for
between the group comparison. The level of significance was set at 5%.
 Result(s):Within-group analysis indicated that both groups
demonstrated statistically significant improvements in all parameters
individually (p-value = 0.001< 0.05). Between group comparison
demonstrated that the experimental group was more effective in enhancing
secretion clearance, thoracic expansion, maximal inspiratory pressure and
peak expiratory flow meter as evidenced by significant differences
(p-value = 0.001<0.05). Conclusion(s): The study concluded that phase
one cardiac rehabilitation along with the use of Aerobika device are
effective in improving the sputum induction, pulmonary function and
tho-racic expansion of the lung. Copyright © 2025 Cardiac Society
of Nepal. All rights reserved.

<70>
Accession Number
2038767145
Title
Perioperative Oral decontamination and ImmunoNuTrition (POINT) to prevent
postoperative pulmonary complications in elderly patients scheduled for
elective non-cardiac surgeries: Protocol for a multicentre, randomised
controlled trial.
Source
BMJ Open. 15(5) (no pagination), 2025. Article Number: e092068. Date of
Publication: 14 May 2025.
Author
Yu J.; Che L.; Zhu Q.; Xu L.; Fu J.; Zhang Y.; You M.; Zheng X.; Liu C.;
Huang L.; Wang W.; Yao L.; Fan G.; Chen J.; Zhang J.; Huang Y.
Institution
(Yu, Che, Zhu, Xu, Huang) Department of Anesthesiology, Peking Union
Medical College Hospital, Beijing, China
(Fu) Department of Clinical Nutrition, Peking Union Medical College
Hospital, Beijing, China
(Zhang) Medical Research Center, Peking Union Medical College Hospital,
Beijing, China
(You, Zheng) Department of Anesthesiology, Shengli Clinical Medical
College, Fujian Medical University, Fujian Provincial Hospital, Fuzhou,
China
(Liu, Huang) Department of Anesthesiology, The Second Hospital of Hebei
Medical University, Shijiazhuang, China
(Wang, Yao) Department of Anesthesiology, Peking University International
Hospital, Beijing, China
(Fan, Chen) Clinic Center of Anesthesiology and Pain, Ningbo No.2
Hospital, Ningbo, China
(Zhang) Department of Anesthesiology, Shenzhen Qianhai and Shekou Free
Trade Zone Hospital, Shenzhen, China
Publisher
BMJ Publishing Group
Abstract
Introduction Elderly patients are known to be vulnerable to postoperative
pulmonary complications (PPCs), especially pneumonia. Apart from elder
age, preoperative pulmonary diseases, anaemia, malnutrition, dysphagia and
frailty may all be contributing factors to PPCs. Poor oral hygiene is a
risk factor for PPC as well, as oropharyngeal microflora might be
introduced to the lower respiratory tract following endotracheal
intubation for general anaesthesia during surgery. Immune regulation,
nutrition supplementation and improvement of oropharyngeal microflora
might regulate immune and stress response and can be beneficial to elderly
patients exposed to surgical stress. In this study, we will explore the
effects of perioperative oral decontamination and immunonutrition
supplementation on the incidence of postoperative pneumonia in high-risk
elderly surgical patients. Methods and analysis This study is a
multicentre, two-by-two factorial randomised controlled trial evaluating
the efficacy of immunonutrition supplementation and oral chlorhexidine
decontamination. A total of 592 patients aged 65 years and older who are
scheduled for elective non-cardiac surgeries in seven tertiary hospitals
in China will be recruited. Patients will be excluded if they have
contraindications to the intervention. Patients will be randomised into
four groups in a 1:1:1:1 ratio (oral decontamination vs routine oral care,
immunonutrition supplementation vs routine nutrition advice). The primary
outcome is the incidence of PPCs within 7 days after surgery. The
secondary outcomes are the incidence of postoperative pneumonia,
infectious complications, Comprehensive Complication Index, postoperative
functional recovery, length of hospital stay and hospital expenses.
Intention to treat principles will be applied to all outcomes. Descriptive
analysis will be used to compare patients' baseline characteristics.
Logistic regression will be used to compare the incidence of PPCs within 7
days after surgery between different groups. Ethics and dissemination The
study protocol has been approved by the Research Ethics Committee of
Peking Union Medical College Hospital (I-23PJ953). All participants will
provide written informed consent. Study results will be published in
peer-reviewed journals and presented at academic conferences. Trial
registration number NCT05971810. Copyright © Author(s) (or their
employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ Group.

<71>
Accession Number
2038801721
Title
Clinical Response to Resynchronization Therapy: Conduction System Pacing
vs Biventricular Pacing. CONSYST-CRT trial.
Source
JACC: Clinical Electrophysiology. (no pagination), 2025. Date of
Publication: 2025.
Author
Pujol-Lopez M.; Graterol F.R.; Borras R.; Garcia-Ribas C.; Guichard J.B.;
Regany-Closa M.; Jimenez-Arjona R.; Niebla M.; Poza M.; Carro E.; Castel
M.A.; Arbelo E.; Porta-Sanchez A.; Sitges M.; Roca-Luque I.; Doltra A.;
Guasch E.; Tolosana J.M.; Mont L.
Institution
(Pujol-Lopez, Graterol, Borras, Guichard, Regany-Closa, Jimenez-Arjona,
Niebla, Poza, Carro, Castel, Arbelo, Porta-Sanchez, Sitges, Roca-Luque,
Doltra, Guasch, Tolosana, Mont) Institut Clinic Cardiovascular (ICCV),
Hospital Clinic, Universitat de Barcelona, Catalonia, Spain
(Pujol-Lopez, Graterol, Borras, Garcia-Ribas, Guichard, Regany-Closa,
Niebla, Poza, Carro, Castel, Arbelo, Porta-Sanchez, Sitges, Roca-Luque,
Doltra, Guasch, Tolosana, Mont) Institut d'Investigacions Biomediques
August Pi i Sunyer (IDIBAPS), Catalonia, Barcelona, Spain
(Borras) Centro de Investigacion Biomedica en Red;, Salud Mental
(CIBERSAM), Instituto de Salut Carlos III, Madrid, Spain
(Guichard, Castel, Arbelo, Sitges, Roca-Luque, Guasch, Tolosana, Mont)
Centro de Investigacion Biomedica en Red, Enfermedades Cardiovasculares
(CIBERCV), Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Background: Randomized studies comparing conduction system pacing (CSP)
with biventricular pacing (BiVP) are scarce and do not include clinical
outcomes. Objective(s): The CONSYST-CRT (Conduction System Pacing vs
Biventricular Resynchronization Therapy in Systolic Dysfunction and Wide
QRS) trial aimed to test the noninferiority of CSP as compared with BiVP
in patients with an indication for cardiac resynchronization therapy, with
respect to a combined clinical endpoint at 1-year follow-up.
 Method(s): CONSYST-CRT is a randomized, controlled, noninferiority
trial (NCT05187611). One hundred thirty-four patients with cardiac
resynchronization therapy indication were randomized to BiVP or CSP and
followed up for 12 months. Crossover was allowed when the primary
allocation procedure failed. The atrioventricular interval was optimized
to obtain fusion with intrinsic conduction. The primary combined endpoint
was all-cause mortality, cardiac transplant, heart failure
hospitalization, or left ventricular ejection fraction (LVEF) improvement
<5 points at 12 months. Secondary endpoints were LVEF increase, LV
end-systolic volume (LVESV) decrease, echocardiographic response (>=15%
LVESV decrease), QRS shortening, septal flash correction, NYHA functional
class improvement, and a combined endpoint of all-cause mortality, cardiac
transplantation, and heart failure hospitalization. Result(s):
Sixty-seven patients were allocated to each group. Eighteen patients
(26.9%) crossed from CSP to BiVP; 5 (7.5%) crossed over from BiVP to CSP.
Noninferiority (NI) was observed for CSP compared with BiVP for the
primary endpoint (23.9% vs 29.8%, respectively; mean difference -5.9; 95%
CI: -21.1 to 9.2; P = 0.02) and for the combined endpoint of all-cause
mortality, cardiac transplantation, and heart failure hospitalization
(11.9% vs 17.9%; P < 0.01 NI); echocardiographic response (66.6% vs 59.7%;
P = 0.03 NI); NYHA functional class (P < 0.001 NI); and QRS shortening (P
< 0.01). LVEF, LVESV, and septal flash endpoint values were similar, but
noninferiority was not met (14.1 +/- 10% vs 14.4 +/- 10%, -27.9 +/- 27% vs
-27.9 +/- 28%, -2.2 +/- 2.7 mm vs -2.7 +/- 2.4 mm, respectively).
 Conclusion(s): CSP was noninferior to BiVP in achieving clinical and
echocardiographic response, suggesting that CSP could be an alternative to
BiVP. (Conduction System Pacing vs Biventricular Resynchronization Therapy
in Systolic Dysfunction and Wide QRS [CONSYST-CRT];
NCT05187611) Copyright © 2025 The Authors

<72>
Accession Number
647342911
Title
When nudge comes to shove - design and implementation of an ASA Physical
Status decision support tool for pediatric patients.
Source
Anesthesia and Analgesia. Conference: Annual Meeting of the Society for
Technology in Anesthesia, STA 2025. Tempe, AZ United States. 140(4
Supplement) (pp 50), 2025. Date of Publication: 01 Apr 2025.
Author
Johnson G.; Simpao A.F.; Gidaro U.; Sloberman L.; Feng B.; Weintraub A.
Institution
(Johnson, Simpao, Gidaro, Sloberman, Weintraub) Children's Hospital of
Philadelphia (CHOP), Philadelphia, PA, United States
(Johnson, Simpao, Weintraub) Perelman School of Medicine, University of
Pennsylvania, Philadelphia, PA, United States
(Feng) Epic Systems Corporation, Verona, WI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: The American Society of Anesthesiologists Physical Status
(ASA PS) classification was created as a means of communicating a
patient's pre-anesthesia comorbidities. ASA PS is also used as a component
of anesthesia billing. In 2020, the ASA released updated, pediatric
specific guidelines for ASA PS, including that fullterm infants less than
six weeks of age should be considered ASA PS III. We hypothesized that our
department was not only under classifying ASA III PS in patients < 6 weeks
of age, but that we were also grossly underutilizing the emergency, 'E',
designation. We set out to improve our ASA PS and 'E' classification via
our EHR (Epic, Verona, WI). Method(s): Our initial attempt to improve
'E' designation was embedding an alert in our pre-anesthesia evaluation
form to have the user select 'E' if emergency exception to consent was
required. We created a Best Practice Advisory to prompt the user to select
'E' for appendectomies, control of post-tonsillectomy hemorrhage,
testicular torsion, ruptured globe, or ASA PS V. We added a hard stop to
select 'E' for any general case (non-cardiac) marked as an ASA V. We
implemented an additional soft-stop notification if an add on surgical
case was booked as 'now,' 'immediate,' or 'emergent.' Finally, we removed
the ASA I & II PS options from the pre-anesthesia navigator for children <
42 days old. Result(s): The ASA V hard stop to mark 'E' was
implemented in December 2022 and resulted in substantial improvement in
'E' designation for patients in the general operating room (non-cardiac).
The ASA 'E' soft stop notification based on add-on case classification was
then implemented in May of 2023. Unfortunately, after implementation, we
showed almost no improvement in our ASA 'E' designation based on case
classification. Our final intervention, removing the option to mark ASA I
or II for patient < 42 days old resulted in no cases being marked ASA I or
II thereafter. Conclusion(s): An EHR based ASA PS decision support
tool is feasible and effective in improving both 'E' designation in ASA V
patients, and ASA III classification for healthy children < 42 days.
Future plans include continued staff education on appropriate ASA
classification as well as problem list integration into a best practice
advisory for ASA classification.

<73>
Accession Number
2036424115
Title
Impact of obesity on outcomes of transcatheter aortic valve implantation
in patients with aortic stenosis: a systematic review and meta-analysis of
real-world data.
Source
American Journal of Cardiovascular Disease. 15(2) (pp 85-99), 2025. Date
of Publication: 2025.
Author
Yasmin F.; Moeed A.; Zaidi F.; Adil M.; Surani S.; Alraies M.C.
Institution
(Yasmin) Yale University School of Medicine, New Haven, CT, United States
(Moeed, Zaidi, Adil) Dow Medical College, Karachi, Pakistan
(Surani) Texas A&M University, College Station, TX, United States
(Alraies) Detroit Medical Center, Cardiovascular Institute, Detroit, MI,
United States
Publisher
E-Century Publishing Corporation
Abstract
Most recent large-scale global analyses on transcatheter aortic valve
implantation (TAVI) for aortic stenosis (AS) showed favorable survival
outcomes in patients with high body mass index (BMI). We performed a
meta-analysis pooling all clinical studies to assess the validity of
improved post-TAVI prognosis in obese patients. MEDLINE and Scopus were
queried till January 2023 to identify studies comparing AS patients with
BMI>=30 kg/m2, and BMI 18.5 to <25 undergoing TAVI. Data were
analyzed using a random-effects model to derive odds ratios (ORs) for all
outcomes, and hazard ratios (HRs) for long-term overall survival with 95%
confidence intervals. The primary outcomes of interest included 30-day
all-cause mortality and long-term overall survival while secondary
outcomes consisted of myocardial infarction (MI), major bleeding, major
vascular events and acute kidney injury (AKI). A total of 24 studies
comprising 38,743 patients were included in this meta-analysis. All-cause
mortality at 30-days was significantly reduced in patients with BMI>30
kg/m2 (OR 0.71, P<0.0001) vs. normal BMI. Every 1
kg/m2 increase in BMI was associated with better overall
survival (HR 0.96, P<0.0001). Obese patients had greater long-term overall
survival (HR 0.87, P<0.00001) compared with non-obese patients. No
significant differences in MI (OR 0.84, 95% CI 0.52-1.34), major bleeding
(OR 0.94, 95% CI 0.72-1.21), major vascular events (OR 1.18, 95% CI
0.97-1.43) and AKI (OR 1.17, 95% CI 0.87-1.56) were observed between the
two groups. Obese AS patients might have similar procedural complications,
but reduced mortality, and increased overall survival in comparison with
normal weight individuals. Copyright © 2025, E-Century Publishing
Corporation. All rights reserved.

<74>
Accession Number
647343909
Title
REAL LIFE EXPERIENCE OF NEW ANTIPLATELET DRUGS: THE ROAD STUDY.
Source
Giornale Italiano di Cardiologia. Conference: 36. Congresso Nazionale
della Societa Italiana di Cardiologia Invasiva - SICI-GISE. Genova Italy.
16(10 Supplement 2) (pp e58), 2015. Date of Publication: 2015.
Author
Giordana F.; Bianco M.; D'Ascenzo F.; Cerrato E.; Picardi E.; Marchetti
M.; Vilardi I.; Chinaglia A.; Pozzi R.; Controtto F.; Varbella F.; Moretti
C.; Gaita F.
Institution
(Giordana, D'Ascenzo, Marchetti, Vilardi, Controtto, Moretti, Gaita)
Division of Cardiology, Citta della Salute e della Scienza Hospital,
University of Turin, Torino, Italy
(Bianco, Pozzi) Division of Cardiology, San Luigi Hospital, Orbassano,
Italy
(Cerrato, Varbella) Division of Cardiology, Riuniti Hospital, Rivoli,
Italy
(Picardi, Chinaglia) Division of Cardiology, Maria Vittoria Hospital,
Torino, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Background. Prasugrel and ticagrelor have been recently introduced for
patients with Acute Coronary Syndrome (ACS), with most of the evidence
deriving from selected population included randomized controlled trials.
Aim. To evaluate the safety and the efficacy of the new antiplatelet drugs
in a real word setting, at one year follow-up (FU). Methods. This is a
prospective, multicentre study, which has included all consecutive
patients admitted for ACS in the Cardiology Departments of 5 European
centers, for three months, from July to September 2013.The safety
end-point was in-hospital and one-year bleeding (TIMI classification). The
efficacy primary end-point was cardiovascular death at one-year follow-up.
Inhospital MACE (a composite of cardio-vascular death, re-acute myocardial
infarction (AMI), in-stent thrombosis (IST), transitory ischemic attack
(TIA)/stroke) was the secondary end point. Results. 195 pts were enrolled.
70% (137) were male with a mean age of 65+/-11.8 years old. Prevalence of
diabetes mellitus was 20% (39), and previous TIA/stroke and previous AMI
were reported respectively in 7% (14) and 28% (55) of the patients. 37%
(73) of pts were admitted for STEMI (STsegment elevation myocardial
infarction), 30% (58) for NSTEMI (non-STsegment elevation myocardial
infarction) and 33% (64) for unstable angina, with in-hospital GRACE score
risk of death of 133.5+/-33. At discharge, 91.8% (179) of pts assumed
aspirin, 47.2% (92) clopidogrel [group 1], 17.4% (34) prasugrel [group 2],
26.2% (51) ticagrelor [group 3], 8.2% (16) no P2Y12 receptor inhibitor
[group 4] and 1% (2) ticlopidine. Only 1 in-hospital death was recorded
(group 1, p=0.01). 2% (1) of pts in group 3 and 6% (1) in group 4 had
in-hospital non CABG-related bleeding (p=0.11), while 1% (1) of pts in
group 1 and 3% (1) in group 2 had in-hospital MACE (all of them were
confirmed IST, p=0.59). After a FU of 417+/-108 days, both TIMI major and
minor bleeding didn't significantly differ among groups (respectively 1%,
0%, 0%, 6%, p=0.16, and 14%, 12%, 14%, 6%, p=0.84). No significant
differences in all cause of death (2%, 3%, 2%, 6%, respectively, p=0.8)
and in MACE (9%, 9%, 0%, 12%, respectively, p=0.15) were found. Moreover,
during follow-up, 4 (8%) patients have stopped ticagrelor for drug adverse
events and 5 (10%) patients within the group 3 have switched to
clopidogrel. Conclusion. New antiplatelet drugs have a safety profile in
real world, without increasing risk of bleeding in an unselected
population..

<75>
Accession Number
647343917
Title
INCIDENCE AND PROGNOSTIC IMPACT OF UNCOVERED OR MALAPPOSED STRUTS AT
OPTICAL COHERENCE TOMOGRAPHY AFTER CORONARY STENTING: A META-ANALYSIS.
Source
Giornale Italiano di Cardiologia. Conference: 36. Congresso Nazionale
della Societa Italiana di Cardiologia Invasiva - SICI-GISE. Genova Italy.
16(10 Supplement 2) (pp e59), 2015. Date of Publication: 2015.
Author
Iannaccone M.; D'Ascenzo F.; Templin C.; Omede P.; Montefusco A.; Conrotto
F.; Guagliumi G.; Diletti R.; Serruys P.; Di Mario C.; Quadri G.; Zoccai
G.B.; Luscher T.; Moretti C.; Gaita F.
Institution
(Iannaccone, D'Ascenzo, Omede, Montefusco, Conrotto, Quadri, Moretti,
Gaita) Citta della Scienza e della Salute, University of Turin, Torino,
Italy
(Templin, Luscher) University of Zurich, Zurigo, Switzerland
(Guagliumi) Ospedali Riuniti di Bergamo, Bergamo, Italy
(Diletti, Serruys) Department of Interventional Cardiology, Erasmus
University Medical Centre, Thoraxcenter, Rotterdam, Netherlands
(Di Mario) National Institute of Health Research Cardiovascular Biomedical
Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London,
United Kingdom
(Zoccai) Department of Medico-Surgical Sciences and Biotechnologies,
Sapienza University of Rome, Latina, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Introduction. The incidence and impact on prognosis of struts
malapposition (SM), uncovered struts (US) and neointimal thickness (NIT)
visualized by optical coherence tomography (OCT) according to different
stents kind remain to be defined. Methods. All studies including patients
with stent implantation for which OCT was performed were included. The
incidence of SM and US were the coprimary end points, while NIT was the
secondary end-point. The impact of the primary end points on stent
thrombosis (ST), myocardial infarction (MI), target lesion
revascularization (TLR) and a composite of all the previous events (MACE)
at follow-up were tested in a meta-regression analysis. Results. 454
citations were initially appraised at the abstract level and 26 full-text
studies were assessed. The mean incidence of SM, US rate and NIT was 4.8%,
4.9% and 84 mum, respectively. Paclitaxel eluting stents and sirolimus
eluting stents showed higher SM and US (5.6% and 5.3%, 9.1% and 10%,
respectively), while bioresorbable vascular scaffolds the lowest SM rate
(1.6%) and bare metal stents the lowest US rate (1%). A higher rate of SM
was associated with a significantly higher rate of TLR (Beta 45.7;
16.5-74.9, p=0.002) and MACE (Beta 35.2; 17.4-52.9, p=0.0001), but not of
ST or MI. Conclusions. Second generation DESs show a better immediate
struts apposition and better strut coverage compared to first generation
DES and BMS. A limited number of incompletely apposed or uncovered struts
are not associated with more frequent thrombotic events, but predict the
risk of recurrent revascularization..

<76>
Accession Number
647343973
Title
NON-CARDIAC SURGERY AND ASYMPTOMATIC SEVERE AORTIC STENOSIS: A
COMPREHENSIVE META-ANALYSIS OF RECENT STUDIES.
Source
Giornale Italiano di Cardiologia. Conference: 36. Congresso Nazionale
della Societa Italiana di Cardiologia Invasiva - SICI-GISE. Genova Italy.
16(10 Supplement 2) (pp e14), 2015. Date of Publication: 2015.
Author
Fabris T.; Fovino L.N.; Tellaroli P.; Mojoli M.; Masiero G.; D'Amico G.;
Barioli A.; Al Mamary A.; Purita P.A.M.; Figliozzi S.; Zilio F.; Covolo
E.; Fraccaro C.; Napodano M.; Tarantini G.
Institution
(Fabris, Fovino, Tellaroli, Mojoli, Masiero, D'Amico, Barioli, Al Mamary,
Purita, Figliozzi, Zilio, Covolo, Fraccaro, Napodano, Tarantini)
Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari, Universita
di Padova, Padova, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Background. Severe aortic stenosis (SAS) is considered a high-risk
condition for cardiac complications during non-cardiac surgery. However,
this statement is based on outdated reports and does not consider recent
advances in anesthesia and surgical approaches. Moreover, asymptomatic SAS
patients might be at lower risk for non-cardiac surgery when compared to
symptomatic patients. Objectives. With this meta-analysis we aimed to
explore the risk of noncardiac surgery in patients with asymptomatic SAS.
Methods. Studies conducted in the last decade comparing subjects affected
by asymptomatic SAS with age- and gender-matched controls were searched
through an electronic search. All patients underwent a moderate- or
high-risk non-cardiac surgical procedure. The primary study outcomes were
30-day mortality and myocardial infarction, and the composite of mortality
and myocardial infarction. Forest plots with combined odds ratio (OR)
estimates and 95% confidence intervals (CIs) were constructed using fixed
and random effects models. The heterogeneity between studies was
calculated by means of I2-statistics. Results. Out of 9 reports, 6 were
excluded because they lacked information on aortic stenosis severity or
presence of symptoms. Three eligible studies including a total of 352
patients with asymptomatic SAS and 1292 age- and gender-matched controls
were identified. At 30-day follow-up, there was no difference in
myocardial infarction rates (2.5 vs 1.6%; OR 1.68; 95% CI 0.76- 3.70,
p=0.37) and mortality (2.0 vs 1.7%; OR 0.96; 95% CI 0.40-2.30; p=0.93)
between the two groups. Also the composite endpoint did not differ (4.2 vs
3.1%; OR 1.26; 95% CI 0.69-2.31; p=0.46). The I2 statistics for
heterogeneity between studies were 0% (p ranging from 0.37 to 0.95).
Conclusions. Asymptomatic SAS does not confer an increased risk for
perioperative cardiovascular complications during non-cardiac surgery..

<77>
Accession Number
647343933
Title
RADIAL VERSUS FEMORAL APPROACH FOR CORONARY ANGIOGRAPHY AND INTERVENTION
IN PATIENTS WITH CABG: SYSTEMATIC REVIEW AND METAANALYSIS.
Source
Giornale Italiano di Cardiologia. Conference: 36. Congresso Nazionale
della Societa Italiana di Cardiologia Invasiva - SICI-GISE. Genova Italy.
16(10 Supplement 2) (pp e28), 2015. Date of Publication: 2015.
Author
Rigattieri S.; Sciahbasi A.; Brilakis E.; Burzotta F.; Rathore S.;
Pugliese F.R.; Ziakas A.; Zhou Y.J.; Guzman L.
Institution
(Rigattieri, Sciahbasi, Pugliese) Ospedale Sandro Pertini, Roma, Italy
(Brilakis) VA North Texas Healthcare System, Dallas, United States
(Burzotta) Universita Cattolica del S. Cuore, Roma, Italy
(Rathore) Frimley Park Hospital, London, United Kingdom
(Ziakas) AHEPA Hospital, Thessaloniki, Greece
(Zhou) An Zhen Hospital, Beijing, China
(Guzman) University of Florida, Jacksonville, United States
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Background. Cardiac catheterization through the radial approach has been
shown to significantly reduce vascular access complications and bleeding,
as compared with the femoral approach, in multiple clinical settings.
However, in the subset of patients with previous coronary artery bypass
graft (CABG) surgery, optimal vascular access site for coronary
angiography and intervention is still a matter of debate, since
conflicting results were reported. According to several observational
studies, indeed, radial approach was as effective and safer as compared to
femoral approach, but these findings were questioned by the only
randomized trial available. Methods. In order to systematically review
studies comparing radial approach with femoral approach in patients with
previous CABG, we conducted a search on major electronic databases
entering the following key words: "radial", "vascular access", "femoral",
"coronary artery bypass graft", "coronary angiography" and 'percutaneous
coronary intervention'. We included in the analysis studies reporting
outcomes on at least one of the following endpoints: fluoroscopy time,
procedural time, contrast volume, procedural success rate and vascular
complications. Data were extracted by two independent reviewers; weighted
mean differences and 95% confidence interval (C.I.) were calculated for
continuous outcomes, whereas odds ratio (OR) and 95% (C.I.) were
calculated for dichotomous outcomes. Summary statistics were calculated by
random-effects model using Review Manager 5.3 software. Results. We
included in the meta-analysis 1 randomized and 8 nonrandomized studies,
amounting to 2763 patients. Radial and femoral approaches were comparable
for fluoroscopy time (0.62 min [-0.83, 2.07]), procedural time (3.24 min
[-1.76, 8.25]), contrast volume (-2.58 ml [-18.36, 13.20]) and procedural
success rate (OR 1.42 [0.61, 3.31]); differently, radial approach was
associated with lower risk of vascular complications (OR 0.48 [0.28,
0.85]). Forest plot for vascular complications is reported in the figure.
Conclusions. Our meta-analysis, although limited by the inclusion of
mainly nonrandomized studies, suggests that among prior CABG patients use
of the radial versus femoral approach for coronary angiography and
intervention is associated with similar fluoroscopy time, procedural time,
contrast volume and procedural success rate, but lower risk for vascular
complications..

<78>
Accession Number
647343902
Title
DESPITE NO-REFLOW, GLOBAL AND REGIONAL LONGITUDINAL STRAINS ASSESSED BY
TWO-DIMENSIONAL SPECKLE TRACKING ECHOCARDIOGRAPHY ARE PREDICTIVE INDEXES
OF LEFT VENTRICULAR REMODELING IN PATIENTS WITH STEMI TREATED BY PPCI.
Source
Giornale Italiano di Cardiologia. Conference: 36. Congresso Nazionale
della Societa Italiana di Cardiologia Invasiva - SICI-GISE. Genova Italy.
16(10 Supplement 2) (pp e23), 2015. Date of Publication: 2015.
Author
Granata F.; Caracciolo M.M.; Caso P.; Arenga F.; Bianchi R.; Tartaglione
D.; Bigazzi M.C.; Russo M.G.; Calabro P.
Institution
(Granata) Ospedale di Nola, Santa Maria della Pieta, Nola, Italy
(Caracciolo, Bianchi, Tartaglione, Bigazzi, Russo, Calabro) AO dei Colli,
Seconda Universita di Napoli, Napoli, Italy
(Caso, Arenga) Dipartimento di Cardiologia, AO dei Colli, Napoli, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Purpose. Primary percutaneous coronary intervention (PPCI) is the
preferred reperfusion strategy for treating acute ST-elevation myocardial
infarct (STEMI). In a suitable proportion of patients PPCI achieves
epicardial coronary artery recanalization but not myocardial reperfusion,
a condition named "noreflow". No-Reflow after PPCI is associated with a
worse in-hospital and longterm prognosis at follow up. The aim of this
study was to evaluate the GLS performed previous and after PPCI as
predictive factors of angiographic noreflow, major adverse cardiac events
(MACE), and left ventricular remodeling at 3-month follow up. Methods.
From January to April 2015, 30 patients with STEMI undergoing PPCI were
consecutively enrolled. Standard data on bi-dimensional echocardiography
was collected according to American/ European Society of Echocardiography
guidelines. Peak systolic longitudinal strain was determined for each of
the 16 segments, and longitudinal global strain was then calculated. Peak
radial and circumferential systolic strains were determined from papillary
muscle level short axis view. Percutaneous coronary intervention was
performed by the standard manner according to clinical guidelines at the
time of procedure. Results. Overall study population consisted of 30
patients. No significant differences were observed between R and NR group
in terms of cardiac biomarker measurements. No significant differences
were observed pre-PPCI between NR and R group in terms of LV ejection
fraction (LVEF), LV enddiastolic volume index (LVEDV index), and LV
end-systolic volume index (LVESV index). However, the echocardiographic
assessments at 3-month follow-up revealed significant differences between
R and NR group in terms of LVEF (NR group 47.9+/-5.2% vs R group
54.8+/-10.2%; p<0.001) and LVESV index (NR group 27.6 mL/m2 vs R group
22.5 mL/m2; p<0.001). Nevertheless, at 3-month follow-up in the R group
GLS evaluation improves achieving more negative value, but in the NR group
GLS worsens (R group -18.4 +/-4.1% vs NR group -13.5+/-5.2%; p<0.001).
Conclusions. Our findings indicate that there are no significant
differences between R and NR group in terms of LVEF, LVEDV index, and
LVESV index pre and after PPCI. However, there are significant differences
between R and NR group in terms of LVESV index and LVEF at 3-month
follow-up. At last, the GLS evaluation provides an accurate assessment of
global myocardial function with an improvement of this index in the R
group at follow-up, and correlating with LV remodeling at 3 months without
significant differences between R and NR group..

<79>
Accession Number
647343979
Title
PREVENTION OF ACUTE KIDNEY INJURY WITH THE RENALGUARD SYSTEM IN PATIENTS
UNDERGOING TRANSCATHETER AORTIC VALVE IMPLANTATION: THE PROTECT-TAVI
TRIAL.
Source
Giornale Italiano di Cardiologia. Conference: 36. Congresso Nazionale
della Societa Italiana di Cardiologia Invasiva - SICI-GISE. Genova Italy.
16(10 Supplement 2) (pp e35), 2015. Date of Publication: 2015.
Author
Barbanti M.; Gulino S.; Capranzano P.; Imme S.; Sgroi C.; Ohno Y.;
Attizzani G.; Patane M.; Sicuso R.; Pilato G.; Di Landro A.; Todaro D.; Di
Simone E.; Picci A.; Giannetto G.; Costa G.; Deste W.; Giannazzo D.;
Grasso C.; Capodanno D.; Tamburino C.
Institution
(Barbanti, Gulino, Capranzano, Imme, Sgroi, Tamburino, Patane, Sicuso,
Pilato, Di Landro, Todaro, Di Simone, Picci, Giannetto, Costa, Deste,
Giannazzo, Grasso, Capodanno, Tamburino) Division of Cardiology,
Ferrarotto Hospital, University of Catania, Catania, Italy
(Ohno) Department of Cardiology, University of Tokai, School of Medicine,
Isehara, Japan
(Attizzani) Valve and Structural Heart Disease Intervention
Center,Harrington Heart and Vascular Institute, University Hospitals, Case
Medical Center, Cleveland, United States
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Objectives. To investigated the effect of RenalGuard System on prevention
of acute kidney injury (AKI) in patients undergoing transcatheter aortic
valve implantation (TAVI). * *Background. TAVI is associated with varying
degrees of post-procedural AKI. The RenalGuard System (PLC Medical
Systems, Milford, Massachusetts, USA) is a dedicated device designed for
contrast-induced AKI prevention. Whether this device is effective also in
patients with severe aortic stenosis undergoing TAVI is unexplored.
Methods. The present is an investigator-driven, single-center,
prospective, openlabel, registry-based randomized study that used the TAVI
Institutional registry of the Ferrarotto Hospital in Catania, Italy as the
platform for randomization, data collection and follow up assessment. A
total of 112 consecutive patients undergoing TAVI were randomly assigned
to hydration with normal saline solution controlled by the RenalGuard
system and furosemide (RenalGuard group) or normal saline solution
(control group). Primary endpoint was the incidence of VARC-defined AKI in
the first 72 hours after the procedure. Results. The AKI rate was lower in
the RenalGuard group than in the control group [n=3 (5.4%) vs n=14
(25.0%), respectively, p=0.014]. The majority of patients (5.4 vs 23.2%)
developed a mild AKI (stage 1); severe damage (stage 3) occurred only in
one patient in the Control Group (0.0 vs 1.8%). No case of in-hospital
renal failure requiring dialysis was reported. No significant differences
in terms of mortality, cerebrovascular events, bleeding and
hospitalization for heart failure were noticed in both groups at 30 days.
Conclusions. Furosemide-induced diuresis with matched isotonic intravenous
hydration using the RenalGuard system is an effective therapeutic tool to
reduce the occurrence of AKI in patients undergoing TAVI..

<80>
Accession Number
647343976
Title
REMOTE ISCHEMIC PRE-CONDITIONING STUDY TO REDUCE INFLAMMATION IN PATIENTS
UNDERGOING TAVI: A PILOT RANDOMIZED CONTROL TRIAL.
Source
Giornale Italiano di Cardiologia. Conference: 36. Congresso Nazionale
della Societa Italiana di Cardiologia Invasiva - SICI-GISE. Genova Italy.
16(10 Supplement 2) (pp e15), 2015. Date of Publication: 2015.
Author
Giordana F.; Scarano S.; Di Stefano D.; D'Ascenzo F.; Omede P.; Barbanti
M.; Salizzoni S.; D'Amico M.; Rinaldi M.; Tamburino C.; Moretti C.; Gaita
F.
Institution
(Giordana, Scarano, D'Ascenzo, Omede, Salizzoni, D'Amico, Rinaldi,
Moretti, Gaita) Division of Cardiology, Citta della Salute e della Scienza
Hospital, University of Turin, Torino, Italy
(Di Stefano, Barbanti, Tamburino) Department of Cardiology, Ferrarotto
Hospital, University of Catania, Catania, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Background. TAVI has become an option for patients (pts) with severe
aortic stenosis and high open surgery risk. Elevated leucocyte count
during the first 72h after TAVI might be associated with a post-procedural
systemic inflammatory response syndrome which unfavourably impacts the
outcome after TAVI. The remote ischemic pre-conditioning (RIPC) has been
demonstrated to protect the remote organs from a sustained episode of
ischaemia. Aim. The Remote Ischemic Pre-conditioning Study to reduce
Inflammation in pts undergoing TAVI (RIPSI-TAVI Trial) aims to test
whether in a real world setting the use of a remote ischemic
preconditioning protocol vs. the current recommended gold standard therapy
for TAVI would reduce the postintervention increase of white blood cells
and the increase of C-reactive protein (CRP). Methods. This is a
randomized multicenter pilot clinical trial. All the pts undergoing TAVI
between October 2013 and February 2015 were enrolled. 45 minutes before
the procedure, they were randomized 1:1 to the preconditioned group (four
cycles of five minutes of ischemia followed by five minutes of reperfusion
obtained with inflations of a blood pressure cuff to 200 mmHg around the
arm) or to the control one (sham preconditioning with inflation of 10 mmHg
more than baseline). The primary end-point was the variation from baseline
up to 72 hours after TAVI of whole white blood cells (WBC) count; data of
CRP and MACE (according to VARC II classification) were also collected.
Results. 64 pts were enrolled. The mean age was 81+/-5 years. 25 (39%)
were male, 19 (30%) suffer from diabetes mellitus and 54 (84%) from
hypertension. Previous acute myocardial infarction was registered in 8
(13%) of them and previous stroke in 1 (2%). All the pts had a symptomatic
severe aortic stenosis (mean aortic valve are 0.6+/-0.2 cm2), with
preserved left ventricular ejection fraction (median 58%); 5 (8%) pts had
a moderate mitral regurgitation and 20 (31%) had an estimated pulmonary
artery pressure >=40 mmHg. 30 pts were randomly assigned to the
preconditioning group [1] and 34 to the placebo one [2]. At baseline no
between group differences related to WBC [6.56+/-2.06 10 9/L group 1 vs
6.61+/-2.08 10 9/L group 2], neutrophils percentage [65.41+/-11.07% group
1 vs 66.43+/-7.85% group 2], CRP [8.48+/-12.13 mg/L group 1 vs
7.27+/-11.73 mg/L group 2] and clearance creatinine [58.92+/-20.92
ml/kg/min group 1 vs 62.41+/-22.26 ml/kg/min group 2], were found. At 72
hours a significant difference in the reduction of the WBC from the
baseline in favour of group 1 [-2.16+/-4.77 10 9/L vs -2.44+/-5.15 10 9/L]
was recorded and CRP increasing was significantly lower in the group 1
[12.24 vs 6.55 mg/L, p<0.05). No differences in MACE were found between
groups. Conclusions. RIPC is effective in reducing WBC and CRP after TAVI.
No between group differences in MACE were found. Studies with bigger
sample size may help to clarify the role of RIPC in preventing TAVI
complication..

<81>
Accession Number
2038756056
Title
Outcomes of Endovascular Repair Confined to the Ascending Thoracic Aorta:
A Systematic Review and Meta-Analysis.
Source
Journal of Vascular Surgery. Conference: ESVS Annual Meeting 2025.
Istanbul Turkey. 81(6) (pp 1529), 2025. Date of Publication: 01 Jun 2025.
Author
de Kort J.F.; Mandigers T.J.; Bissacco D.; Domanin M.; Piffaretti G.;
Twine C.P.; Wanhainen A.; van Herwaarden J.A.; Trimarchi S.; de Vincentiis
C.
Publisher
Elsevier Inc.
Abstract
Objective: High risk, inoperable patients with ascending aortic disease
are increasingly managed with thoracic endovascular aortic repair (TEVAR).
The aim of this study was to assess the available literature on TEVAR
confined to the ascending aorta (a-TEVAR), describing study and patient
characteristics, procedural and stent graft details, and outcomes. Data
sources: This was a systematic review and meta-analysis. MEDLINE, Web of
Science, and Scopus were systematically searched for eligible studies
reporting on outcomes after a-TEVAR (PROSPERO ID: CRD42023440826).
Eligible studies reported outcomes after a-TEVAR without adjunctive
supra-aortic vessel treatment. Review Methods: The Preferred Reporting
Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was
followed. The ROBINS-I and Joanna Briggs Institute Critical Appraisal
Checklist were used as quality assessment tools. A Grading of
Recommendations Assessment, Development, and Evaluation (GRADE) evidence
certainty analysis was performed for the main outcomes. The main outcome
was death. A proportional meta-analysis was performed with a mean and 95%
confidence interval (CI) for the main outcomes. All articles were included
up to 1 January 2024. Result(s): Ninety four studies were included
(19 cohort studies, 75 case reports or series), reporting on 259 patients
(57.8% male). The mean age was 69.1 (95% CI 65.0 - 73.1) years and mean
follow up 19.6 (95% CI 14.5 - 24.6) months. The most common comorbidity
was prior cardiac or thoracic surgery (n = 191). The most frequent
indications for a-TEVAR (52.1% urgent a-TEVAR) were type A aortic
dissection (43.6%) and pseudoaneurysm (38.6%). The most commonly deployed
stent grafts were Gore (44.5%), Cook (23.5%), and Medtronic (17.0%). The
in hospital mortality rate was 7.3% (95% CI 4.7 - 11.2%), 30 day mortality
rate 7.7% (95% CI 5.1 - 11.6%), and overall mortality rate 17.0% (95% CI
12.9 - 22.0%) during follow up. GRADE showed very low evidence certainty
for all outcomes. Eighty eight complications were reported and there was a
re-operation rate of 13.1% (95% CI 9.5 - 17.8%). In hospital and 30 day
mortality rates for type A dissection were 12.4% (95% CI 7.5 - 19.7%) (n =
14) and 13.3% (95% CI 8.2 - 20.8%) (n = 15), respectively, and for
pseudoaneurysm 4.0% (95% CI 1.6 - 9.8%) (n = 4) and 4.0% (95% CI 1.6 -
9.8) (n = 4), respectively. Conclusion(s): Despite heterogeneous
literature and very low GRADE evidence certainty, a-TEVAR seems
technically feasible in high risk patients. In addition, there is need for
a consensus on when and how to use a-TEVAR and a need for a specific
endograft for use in the ascending aorta.

<82>
Accession Number
2038641840
Title
Incidence of chronic postsurgical pain after cardiac surgery and the
effect of bilateral erector spinae plane block: a randomized controlled
trial.
Source
Regional Anesthesia and Pain Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Dost B.; Ozel E.S.; Kaya C.; Turunc E.; Karakaya D.; Demirag M.K.; Bilgin
S.; De Cassai A.; Elsharkawy H.
Institution
(Dost, Ozel, Kaya, Turunc, Karakaya, Bilgin) Department of Anesthesiology
and Reanimation, Ondokuz Mayis University Faculty of Medicine, Samsun,
Turkey
(Demirag) Department of Cardiovascular Surgery, Ondokuz Mayis University
Faculty of Medicine, Samsun, Turkey
(De Cassai) Department of Medicine (DIMED), University of Padua, Padua,
Italy
(De Cassai) Institute of Anesthesia, Intensive Care Unit, University
Hospital of Padua, Padua, Italy
(Elsharkawy) MetroHealth Medical Center, Cleveland, OH, United States
(Elsharkawy) Case Western Reserve University, Cleveland, OH, United States
(Elsharkawy) Outcomes Research Consortium, Houston, TX, United States
Publisher
BMJ Publishing Group
Abstract
Background The effects of the erector spinae plane (ESP) block on chronic
postsurgical pain (CPSP) after cardiac surgery remain unclear. This study
evaluated the efficacy of bilateral ESP block in reducing the incidence
and severity of CPSP after cardiac surgery. Methods This prospective,
randomized, controlled, single-blind trial included 63 patients aged 18-80
years with American Society of Anesthesiologists physical status II-III,
scheduled for elective cardiac surgery via median sternotomy. Participants
received a bilateral ultrasound-guided ESP block or standard care without
regional anesthesia. The primary outcome was the Brief Pain Inventory
(BPI) score at 3 months postoperatively. Secondary outcomes included
morphine consumption in the first 24 hours; Numerical Rating Scale (NRS)
scores during rest/activity at 0, 3, 6, 12, and 24 hours; BPI scores at 6
months postoperatively; and Douleur Neuropathique 4 (DN4) and Hospital
Anxiety and Depression Scale (HADS) scores at 3 and 6 months
postoperatively. Results The BPI scores of the two groups did not differ
significantly at 3 months postoperatively (median (IQR): 0(26) vs 12 (31),
p=0.166). However, 24 hours postoperative morphine consumption (8 mg vs
10.5 mg, p<0.001) and NRS scores at multiple time points were
significantly lower in the ESP block group. No significant differences
were observed between the groups in terms of the BPI, DN4, or HADS scores
at three or 6 months. Conclusions The ESP block effectively reduced acute
pain and opioid consumption; however, it had no significant effect on the
incidence or severity of CPSP at 3 and 6 months. Copyright ©
American Society of Regional Anesthesia & Pain Medicine 2025. No
commercial re-use. See rights and permissions. Published by BMJ Group.

<83>
Accession Number
2034574383
Title
Quercetin Reduces Vascular Senescence and Inflammation in Symptomatic Male
but Not Female Coronary Artery Disease Patients.
Source
Aging Cell. (no pagination), 2025. Date of Publication: 2025.
Author
Mury P.; Dagher O.; Fortier A.; Diaz A.; Lamarche Y.; Noly P.-E.; Ibrahim
M.; Page P.; Demers P.; Bouchard D.; Bernier P.-L.; Poirier N.; Moss E.;
Durrleman N.; Jeanmart H.; Pellerin M.; Lettre G.; Thorin-Trescases N.;
Carrier M.; Thorin E.
Institution
(Mury, Dagher, Lamarche, Noly, Ibrahim, Page, Demers, Bouchard, Bernier,
Poirier, Moss, Durrleman, Jeanmart, Pellerin, Lettre, Thorin-Trescases,
Carrier, Thorin) Montreal Heart Institute, Research Center, Universite de
Montreal, Montreal, QC, Canada
(Mury, Dagher) Department of Pharmacology & Physiology, Faculty of
Medicine, Universite de Montreal, Montreal, QC, Canada
(Dagher) Department of Cardiac Sciences, Libin Cardiovascular Institute,
Calgary, AB, Canada
(Fortier) Department of Biostatistics, Montreal Health Innovations
Coordinating Centre (MHICC), Montreal, QC, Canada
(Diaz) CIUSSS-MCQ, Universite de Montreal, Campus Mauricie,
Trois-Rivieres, QC, Canada
(Lamarche, Noly, Ibrahim, Page, Demers, Bouchard, Bernier, Poirier, Moss,
Durrleman, Jeanmart, Pellerin, Carrier, Thorin) Faculty of Medicine,
Department of Surgery, Universite de Montreal, Montreal, QC, Canada
(Lettre) Department of Medicine, Faculty of Medicine, Universite de
Montreal, Montreal, QC, Canada
Publisher
John Wiley and Sons Inc
Abstract
Recent studies suggest that vascular senescence and its associated
inflammation fuel the inflammaging to favor atherogenesis; whether these
pathways can be therapeutically targeted in coronary artery disease (CAD)
patients remains unknown. In a randomized, double-blind trial, 97 patients
(78 men) undergoing coronary artery bypass graft surgery were treated with
either quercetin (500 mg twice daily, 47 patients) or placebo (50
patients) for two days pre-surgery through hospital discharge. Primary
outcomes were reduced inflammation and improved endothelial function ex
vivo. Exploratory analyses included plasma proteomics and single-nuclei
RNA sequencing of internal thoracic artery (ITA) samples. Quercetin
treatment showed a trend toward reduced C-reactive protein at discharge (p
= 0.073) and differentially modulated circulating inflammatory protein
expression between men and women, with a pro-inflammatory effect of
quercetin in females. Endothelial acetylcholine-induced relaxation
improved significantly with quercetin (p = 0.049), with effects in men (p
= 0.043) but not in women (p = 0.852). ITA transcriptomics revealed the
overexpression of senescence and inflammaging pathways in male vascular
cells, which quercetin reversed. In female cells, quercetin had minimal
endothelial benefit and increased inflammaging in fibroblasts. In male
cells, a candidate target of quercetin involves interactions between the
receptor PLAUR and its ligands PLAU and SERPINE1. Post-operative atrial
fibrillation incidence was significantly lower with quercetin,
representing 4% of the patients compared to 18% in the placebo group (p =
0.033). In conclusion, short-term quercetin treatment effectively targeted
vascular senescence in male CAD patients, improving inflammatory and
functional outcomes. However, these benefits were not observed in female
patients. Trial Registration: https://clinicaltrials.gov,
NCT04907253. Copyright © 2025 The Author(s). Aging Cell published
by Anatomical Society and John Wiley & Sons Ltd.

<84>
Accession Number
2034564069
Title
Surgical Outcomes After Minimally Invasive Versus Full Sternotomy Aortic
Valve Replacement: Meta-Analysis of 75 Comparative Studies.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2025. Article Number: 15569845251335969. Date
of Publication: 2025.
Author
Servito M.; Ramsay H.; Mann S.; Ramelli L.; Fernandez A.-L.; Diasty M.E.
Institution
(Servito) Division of Cardiac Surgery, University of Manitoba, Winnipeg,
MB, Canada
(Servito) Institute of Health Policy, Management, and Evaluation,
University of Toronto, ON, Canada
(Ramsay, Mann, Ramelli) Faculty of Health Sciences, Queen's University,
Kingston, ON, Canada
(Fernandez) Cardiac Surgery Department, University Hospital, University of
Santiago de Compostela, Spain
(Diasty) Cardiac Surgery Department, Harrington Heart and Vascular
Institute, University Hospitals, Cleveland, OH, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: Whether minimally invasive aortic valve replacement (MIAVR)
offers an advantage over conventional AVR (CAVR) remains a matter of
debate. Although some studies have suggested better postoperative outcomes
with MIAVR, technical challenges and longer operative times remain major
obstacles to the adoption of these techniques. In this meta-analysis, we
compare the reported immediate postoperative outcomes of both approaches.
 Method(s): Cochrane, MEDLINE, and Embase databases were
searched from inception until January 2022 for studies reporting immediate
postoperative outcomes of MIAVR and CAVR. Studies were excluded if they
reported on concomitant procedures or enrolled pediatric patients.
Random-effects meta-analysis was performed using the restricted maximum
likelihood estimator with Hartung-Knapp adjustment. Result(s): The
literature search yielded 3,921 articles, of which 75 were included in
this meta-analysis. The most common techniques were ministernotomy and
minithoracotomy. MIAVR was associated with lower 30-day mortality than
CAVR (odds ratio [OR] = 0.65, 95% confidence interval [CI]: 0.54 to 0.78,
I2 = 0%, P < 0.001). The length of stay (LOS) in the hospital
(standardized mean difference [SMD] = -0.44, 95% CI: -0.61 to -0.26, P <
0.001) and in the intensive care unit (SMD = -0.36, 95% CI: -0.57 to
-0.15, P < 0.001) were shorter for MIAVR. Individual comparisons of
ministernotomy and minithoracotomy to CAVR also yielded similar results.
However, aortic cross-clamping and cardiopulmonary bypass times were
longer for MIAVR. Conclusion(s): Our meta-analysis suggests that
minimally invasive approaches to AVR may provide advantages beyond
cosmesis. Despite longer operative times, MIAVR was associated with
earlier recovery and shorter hospital LOS. These findings were consistent
for both minithoracotomy and ministernotomy. Copyright © The
Author(s) 2025.

<85>
Accession Number
2038755977
Title
Contemporary Outcomes of Lower Extremity Vein Bypass for Chronic
Limb-Threatening Ischemia: A Post Hoc Comparison of BEST-CLI and PREVENT
III Multicenter Prospective Randomized Controlled Trials.
Source
Journal of Vascular Surgery. Conference: ESVS Annual Meeting 2025.
Istanbul Turkey. 81(6) (pp e264-e265), 2025. Date of Publication: 01 Jun
2025.
Author
Hussain M.A.; Menard M.T.; Conte M.S.; Vouyouka A.; Doros G.; Strong M.B.;
Kalish J.; Chew D.; Gasper W.; Tan T.-W.; Darling R.C.; LaMuraglia G.;
Rosenfield K.; Farber A.; Schanzer A.
Institution
(Hussain, Chew, LaMuraglia) Brigham and Women's Hospital, Harvard Medical
School, Boston, MA, United States
(Menard, Strong) Division of Vascular and Endovascular Surgery, Brigham
and Women's Hospital, Harvard Medical School, Boston, MA, United States
(Conte) Division of Vascular and Endovascular Surgery, University of
California, Calif, San Francisco, United States
(Vouyouka) The Icahn School of Medicine at Mount Sinai, New York, NY,
United States
(Doros) School of Public Health, Boston University, Boston, MA, United
States
(Kalish, Farber) Division of Vascular and Endovascular Surgery, Boston
Medical Center, Boston University Chobanian & Avedisian School of
Medicine, Boston, MA, United States
(Gasper) San Francisco VA Health Care System, San Francisco, CA, United
States
(Tan) University of Southern California, Los Angeles, CA, United States
(Darling) Albany Medical Center Hospital, Albany, NY, United States
(Rosenfield) Massachusetts General Hospital, Harvard Medical School,
Boston, MA, United States
(Schanzer) UMass Chan Medical School, Worcester, MA, United States
Publisher
Elsevier Inc.
Abstract
Objective: The BEST-CLI (Best Endovascular vs Best Surgical Therapy in
Patients with Chronic Limb-Threatening Ischemia [CLTI]) trial demonstrated
superiority of vein bypass over endovascular treatment for patients with
CLTI who were candidates for both treatment strategies. However, with the
rise of endovascular techniques and the subsequent decline in the number
of vein bypass procedures being performed, concerns have emerged regarding
the continued ability to perform surgical bypass safely and effectively.
This study aimed to evaluate whether outcomes after lower extremity vein
bypass for CLTI have improved over the past two decades by comparing data
from two major randomized controlled trials: BEST-CLI and PREVENT III
(Project or Ex Vivo vein graft Engineering via Transfection III).
 Method(s): This post hoc comparative analysis included patients with
CLTI who underwent lower extremity vein bypass in the multicenter,
prospective BEST-CLI (2014-2019) and PREVENT III (2001-2003) trials. The
primary outcome was a composite of a major adverse limb event (MALE) or
death at 1 year. Secondary outcomes included perioperative (30-day) rates
of major adverse cardiovascular events (MACE) and MALE. Multivariable Cox
and logistic regression models were used to compare outcomes between the
two cohorts. Result(s): In total, 2114 patients underwent vein bypass
for CLTI (710 BEST-CLI and 1404 PREVENT III). The mean (standard
deviation) age of the patients was 67.9 (11.0) years; 32.8% were female.
Patients in BEST-CLI had higher use of aspirin (66.6% vs 60.7%; P =
.0074), statins (71.5% vs 44.3%; P < .0001), and single segment great
saphenous vein (86.9% vs 80.6%; P = .0003). The primary end point of
1-year MALE or death was lower in BEST-CLI (21.0%) compared with PREVENT
III (37.8%) (adjusted hazard ratio [HR], 0.50; 95% confidence interval
[CI], 0.40-0.62; P < .0001; Fig 1)-this observation was consistent across
predefined subgroups (Fig 2). Major reinterventions (new bypass, surgical
revision, thrombectomy, or endovascular intervention for graft occlusion)
at 1 year were also lower in BEST-CLI (7.2% vs 18.4%; adjusted HR, 0.40;
95% CI, 0.28-0.57; P < .0001), although rates of any reinterventions were
similar (25.8% vs 29.3%; adjusted HR, 0.90; 95% CI, 0.72-1.14; P = .39).
Perioperative major cardiovascular and limb events were significantly
lower in BEST-CLI: MACE (4.1% vs 7.8%; adjusted odds ratio, 0.47; 95%
confidence interval, 0.28-0.79; P = .005) and MALE (2.7% vs 6.3%; odds
ratio, 0.44; 95% confidence interval, 0.24-0.82; P = .009).
 Conclusion(s): Over the past 10 to 15 years, outcomes after lower
extremity vein bypass for CLTI have significantly improved, as evidenced
by the BEST-CLI and PREVENT III trials. These advances reflect broader
progress in cardiovascular risk management, surgical techniques, and
postoperative care for patients with CLTI. [Formula presented] [Formula
presented] Copyright © 2025

<86>
Accession Number
2038757728
Title
Efficacy of Transversus Thoracic Muscle Plane Block for Analgesia After
Pediatric Cardiac Surgery.
Source
Nepalese Heart Journal. 22(1) (pp 11-13), 2025. Date of Publication: 2025.
Author
Parajuli S.S.; Shrestha S.; Shrestha B.M.
Institution
(Parajuli, Shrestha, Shrestha) Department of Cardiac Anaesthesia, Shahid
Gangalal National Heart Centre, Bansbari, Kathmandu, Nepal
Publisher
Cardiac Society of Nepal
Abstract
Background: Perioperative pain management plays a key role in the
management of patients undergoing pediatric cardiac surgery. We studied
the effect of transversus thoracic muscle plane block (TTPB) on acute
postoperative pain and 24-hour opioid consumption in pediatric cardiac
surgical patients. Method(s): Patients in whom transversus thoracic
muscle plane catheter was placed were kept in one group and in the other
group patients who were given conventional medicines for pain management
were kept. The primary study end point was to compare the consumption of
fentanyl and to assess FLACC pain scale in postoperative period in the
first 24 hours post extubation in both groups. Result(s): The 24-hour
fentanyl consumption was 8.00 +/- 5.49 micrograms in the transversus
thoracic muscle plane group and 32.20 +/- 10.53 micrograms in the control
group in the first 24 hours postoperatively, which was statistically
significant (p <0.001). The FLACC score was also significantly lesser in
the TTPB group compared to the control group in the first 24 hours
postoperatively. Conclusion(s): Transversus thoracic plane block is
superior to the conventional opioid injection method for postoperative
pain management in pediatric cardiac surgical patients. Copyright
© 2025 Cardiac Society of Nepal. All rights reserved.

<87>
Accession Number
2034582372
Title
Prophylactic corticosteroids in neonatal cardiac surgeries using
cardiopulmonary bypass: a systematic review and meta-analysis.
Source
Journal of Anesthesia. (no pagination), 2025. Date of Publication: 2025.
Author
Kataoka K.; Cheng S.; Sumie M.; Adam R.-I.; Niimi N.; Cunningham J.; Yang
A.; Ng W.C.K.; Hayes J.; Maynes J.T.; Aoyama K.
Institution
(Kataoka, Sumie, Niimi, Ng, Hayes, Maynes, Aoyama) Department of
Anesthesia and Pain Medicine, The Hospital for Sick Children, 555
University Ave, #2211, Toronto, ON, Canada
(Kataoka, Cheng, Sumie, Niimi, Cunningham, Hayes, Maynes, Aoyama) Temerty
Faculty of Medicine, University of Toronto, Toronto, ON, Canada
(Sumie, Yang, Aoyama) Program in Child Health Evaluative Sciences,
SickKids Research Institute, Toronto, ON, Canada
(Sumie) Department of Anesthesiology, St. Mary's Hospital, Fukuoka, Japan
(Sumie) Department of Anesthesiology and Critical Care Medicine, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan
(Adam) Department of Psychology, Queen's University, Kingston, ON, Canada
(Cunningham) The Hospital for Sick Children, Health Sciences Library, 555
University Avenue, Toronto, ON, Canada
(Ng) Department of Anesthesia and Perioperative Care, University of
California, San Francisco, CA, United States
(Maynes) Program in Molecular Medicine, SickKids Research Institute,
Toronto, ON, Canada
Publisher
Springer
Abstract
Purpose: Neonates undergoing cardiopulmonary bypass (CPB) are at a high
risk of a systemic inflammatory response leading to cardiac, respiratory,
and renal dysfunction due to their small body size and insufficient
adrenal stress response. We hypothesized that corticosteroids reduce
systemic inflammatory response and improve clinical outcomes in neonates
undergoing cardiac surgery with CPB. Method(s): A systematic search
was conducted on six databases including MEDLINE from their inceptions to
August 20, 2024. Inclusion criteria were randomized controlled trials
(RCTs) comparing corticosteroids and placebo in neonates undergoing
cardiac surgery with CPB. The primary outcomes were IL-6 and IL-10 serum
levels. The secondary outcomes were postoperative clinical outcomes such
as length of intensive care unit (ICU) stay, mortality, and incidence of
acute kidney injury. Pooled risk ratios or mean differences (MDs) and 95%
confidence intervals (CIs) were calculated using random-effects
meta-analysis. Certainty of evidence were assessed following GRADE. This
study was registered in PROSPERO (CRD42024548217). Result(s): Seven
RCTs met all inclusion criteria, consisting of 316 patients.
Administration of corticosteroids significantly decreased plasma IL-6 on
POD1 (MD -64.21 pg/mL, 95% CI -118.26 to -10.16) and plasma IL-10 on POD1
(MD - 4.60 pg/mL, 95% CI - 8.07 to - 1.12). We confirmed corticosteroids
administration did not improve clinical outcomes. Conclusion(s):
Corticosteroids significantly reduced inflammatory cytokines on POD1.
Routine prophylactic use of corticosteroids is not recommended even in
neonatal cardiac surgery, however, because of high incidence of adrenal
insufficiency in neonates after cardiac surgery with CPB, neonates with
clinically suspected adrenal insufficiency could benefit from
perioperative corticosteroids administration. Copyright © The
Author(s) under exclusive licence to Japanese Society of Anesthesiologists
2025.

<88>
Accession Number
2034565049
Title
Safety and Efficacy of Outpatient Parenteral Antibiotic Therapy (OPAT) in
Patients With Infective Endocarditis: A Systematic Review and
Meta-Analysis.
Source
Clinical Cardiology. 48(5) (no pagination), 2025. Article Number: e70147.
Date of Publication: 01 May 2025.
Author
Ashraf H.; Nadeem Z.A.; Rehman K.A.; Akhtar S.; Ashfaq H.; Khan M.S.; Butt
M.; Nagmeldin I.; Fatima E.; Waqas M.; Saleh A.; Jain H.; Ahmed R.
Institution
(Ashraf, Nadeem, Ashfaq, Khan, Butt) Department of Medicine, Allama Iqbal
Medical College, Lahore, Pakistan
(Rehman) Department of Medicine, CMH Lahore Medical College, Lahore,
Pakistan
(Akhtar) Department of Medicine, Karachi Medical and Dental College,
Karachi, Pakistan
(Nagmeldin) Department of Medicine, University of Khartoum, Khartoum,
Sudan
(Fatima) Department of Medicine, Services Institute of Medical Sciences,
Lahore, Pakistan
(Waqas) Department of Medicine, Wah Medical College, Wah, Pakistan
(Saleh) Faculty of Medicine, Lebanese University, Beirut, Lebanon
(Jain) Department of Cardiology, All India Institute of Medical Sciences
(AIIMS), Jodhpur, India
(Ahmed) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Infective endocarditis (IE) is a life-threatening infection
requiring prolonged intravenous antimicrobial therapy. Outpatient
parenteral antibiotic therapy (OPAT) has emerged as an alternative to
prolonged hospitalization, but its safety and efficacy in IE remain
debated. Hypothesis: This systematic review and meta-analysis aimed to
evaluate the outcomes of OPAT in IE patients. Method(s): We
systematically searched MEDLINE, Cochrane CENTRAL, Google Scholar, and
Scopus for studies assessing OPAT in IE. Eligible studies included
randomized controlled trials and observational studies reporting at least
one relevant outcome (mortality, relapse, readmission, valve surgery, and
adverse events). Pooled estimates were calculated using a random-effects
model, and heterogeneity was assessed using the I2 statistic. Risk of bias
was evaluated using the ROBINS-I tool. Result(s): A total of 25
studies involving 2654 patients were included in the analysis. Patients
treated with OPAT had a mortality rate of 0% during the treatment period
and 5% during follow-up. The readmission rate was 16% during the treatment
period, 4% of the patients had relapse, while 16% of patients underwent
cardiac surgery. During follow-up, the readmission rate was 19%, with a
relapse rate of 2%, and 14% of patients underwent cardiac surgery.
Sensitivity analyses did not significantly affect the results,
highlighting the robustness of the findings. Conclusion(s): OPAT
appears to be safe and effective for IE patients, with low mortality and
relapse rates. However, increased readmission rates and IV-line
complications warrant careful patient selection and monitoring. Further
prospective trials are needed to refine OPAT protocols. Copyright
© 2025 The Author(s). Clinical Cardiology published by Wiley
Periodicals LLC.

<89>
[Use Link to view the full text]
Accession Number
647315585
Title
Meta-Analysis of Dual Antiplatelet Therapy Versus Low-Dose Direct Oral
Anticoagulation After Left Atrial Appendage Occlusion.
Source
American journal of therapeutics. 32(3) (pp e312-e315), 2025. Date of
Publication: 01 May 2025.
Author
Singh S.; Bliden K.; Tantry U.S.; Gurbel P.A.; Kanjwal M.Y.; Lundgren S.W.
Institution
(Singh) Department of Medicine, Sinai Hospital of Baltimore, Baltimore,
MD, Liberia
(Bliden, Tantry) Sinai Center for Thrombosis Research, Sinai Hospital of
Baltimore, Baltimore, MD, Liberia
(Gurbel, Kanjwal) Division of Cardiology, Sinai Hospital of Baltimore,
Baltimore, MD, Liberia
(Lundgren) Division of Cardiology, University of Nebraska Medical Center,
Omaha, NE, United States

<90>
Accession Number
2034558400
Title
Hypoattenuated Leaflet Thickening Following Transcatheter Aortic Valve
Replacement: Pathophysiology, Diagnosis, and Evolving Management
Strategies.
Source
Current Cardiovascular Imaging Reports. 18(1) (no pagination), 2025.
Article Number: 7. Date of Publication: 01 Dec 2025.
Author
Sawalha K.; Gautam N.; Gupta N.; Kaul R.; Jambhekar K.; Hassanin A.; Dhar
G.; Al'Aref S.J.
Institution
(Sawalha, Gautam, Gupta, Kaul, Al'Aref) Department of Medicine, Division
of Cardiology, University of Arkansas for Medical Sciences, Little Rock,
AR, United States
(Jambhekar) Department of Radiology, University of Arkansas for Medical
Sciences, Little Rock, AR, United States
(Hassanin) Banner North Colorado Medical Center, Greeley, CO, United
States
(Dhar) Department of Cardiology, Rush University Medical Center, Chicago,
IL, United States
(Al'Aref) Department of Medicine, Division of Cardiology, University of
Arkansas for Medical Sciences (UAMS), 4301 W. Markham St, Little Rock, AR,
United States
Publisher
Springer
Abstract
Purpose of Review: Hypoattenuated leaflet thickening (HALT) has emerged as
an important post-procedural finding after transcatheter aortic valve
replacement (TAVR). HALT is characterized by localized thickening of the
leaflets of bioprosthetic valves due to thrombus deposition, potentially
leading to leaflet dysfunction and reduced mobility. Recent Findings:
Although initially thought to be clinically silent, HALT has now been
linked with subclinical valve thrombosis and carries implications for
valve durability, as well as patient outcomes, including stroke and heart
failure. The introduction of advanced and multidimensional imaging
techniques, particularly multi-detector computed tomography (MDCT), has
led to a greater understanding of the pathophysiology of HALT, allowing
for detailed visualization and assessment of leaflet morphology, function,
and mobility. Summary: This review article explores the current
understanding of HALT, its pathophysiology, risk factors, clinical
relevance, and the role of multimodal imaging for establishing an accurate
diagnosis. We also discuss technical considerations in managing HALT,
including anticoagulation strategies, their role in preventing thrombus
formation and improving long-term outcomes. Additionally, we highlight the
ongoing debate regarding optimal follow-up and therapeutic strategies to
balance HALT-related risks with the broader clinical benefits of
TAVR. Copyright © The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2025.

<91>
Accession Number
2038690347
Title
Twice-a-day administration of aspirin in patients with diabetes mellitus
or aspirin resistance after acute coronary syndrome: Rationale and design
of the randomized ANDAMAN trial.
Source
American Heart Journal. 288 (pp 101-110), 2025. Date of Publication: 01
Oct 2025.
Author
Dillinger J.-G.; Pezel T.; Batias L.; Angoulvant D.; Goralski M.; Ferrari
E.; Cayla G.; Silvain J.; Gilard M.; Lemesle G.; Souteyrand G.; Lim P.;
Roubille F.; Georges J.-L.; Bal dit Sollier C.; Petroni T.; Morel O.;
Delarche N.; Elbaz M.; Puymirat E.; Toupin S.; Montalescot G.; Drouet L.;
Vicaut E.; Henry P.
Institution
(Dillinger, Pezel, Toupin, Henry) Department of Cardiology, Universite
Paris Cite, Hopital Lariboisiere, Assistance Publique-Hopitaux de Paris,
Inserm MASCOT - UMRS, Paris, France
(Dillinger, Pezel, Toupin) MIRACL.ai Laboratory, Multimodality Imaging for
Research and Artificial Intelligence Core Laboratory, University Hospital
of Lariboisiere (AP-HP), Paris, France
(Dillinger, Bal dit Sollier, Drouet) Centre de Reference et d'Education
des antithrombotiques d'Ile de France, CREATIF, Hopital Lariboisiere,
Publique-Hopitaux de Paris, Paris, France
(Batias) Centre Hospitalier Metropole Savoie, Service de Cardiologie,
Place Lucien Biset, Chambery, France
(Angoulvant) Cardiology Department, CHU Tours, INSERM Unite 1327 ISCHEMIA,
Universite de Tours, Tours, France
(Goralski) Cardiology Department, CHU Orleans, Orleans, France
(Ferrari) Cardiology Department, Pasteur University Hospital, Nice, France
(Cayla) Cardiology Department, Nimes University Hospital, Montpellier
University, ACTION Group, Nimes, France
(Silvain, Montalescot) Department of Cardiology, Sorbonne Universite,
ACTION Group, INSERM UMRS1166, Hopital Pitie-Salpetriere (AP-HP), Paris,
France
(Gilard) Chest Diseases, CHU_Brest, INSERM U1304, Univ_Brest, Brest,
France
(Lemesle) Heart and Lung Institute, University hospital of Lille, CHU
Lille, Institut Pasteur of Lille, Inserm U1011-EGID, FACT (French Alliance
for Cardiovascular Trials), Paris, France
(Souteyrand) Institut Pascal, Therapies Guidees par l'Image, CNRS SIGMA
UCA UMR 6602 University Hospital Gabriel Montpied, Clermont-Ferrand,
France
(Lim) Service de Cardiologie, Univ Paris Est Creteil, INSERM, IMRB, AP-HP,
Hopital Universitaire Henri-Mondor, Creteil, France
(Roubille) Cardiology Department, PhyMedExp, Universite de Montpellier,
INSERM, CNRS, INI-CRT, CHU de Montpellier, France
(Georges) Centre Hospitalier de Versailles, Service de cardiologie,
cardiologie interventionnelle, Hopital Andre Mignot, Le
Chesnay-Rocquencourt, France
(Petroni) Cardiology Department, Clinique Pont de Chaume, Montauban,
France
(Morel) Division of Cardiovascular Medicine, Nouvel Hopital Civil,
Strasbourg University Hospital, UR 3074 Translational CardioVascular
Medicine CRBS, Strasbourg, France
(Delarche) Cardiology Department, Hopital Francois Mitterrand, Pau, France
(Elbaz) Center for Clinical Investigation (CIC1436)/CARDIOMET, Rangueil
University Hospital, Toulouse, France
(Puymirat) Department of Cardiology, Assistance Publique-Hopitaux de Paris
(AP-HP), Hopital Europeen Georges Pompidou, Universite de Paris Cite,
Paris, France
(Vicaut) Unite de Recherche Clinique, ACTION Group, Hopital Fernand Widal
(AP-HP), Paris, France
Publisher
Elsevier Inc.
Abstract
Background: Patients with diabetes mellitus (DM) or aspirin resistance are
exposed to recurrent atherothrombotic events after acute coronary syndrome
(ACS). Aspirin once-daily can allow the recovery of platelet
cyclooxygenase activity before the next intake in these patients.
Twice-daily administration provides more stable inhibition of platelet
aggregation and may improve prognosis in these patients. Aim(s): To
demonstrate the superiority of twice-daily aspirin compared to once daily
in reducing major adverse cardiovascular events (MACE) in patients with DM
or aspirin resistance after ACS. Method(s): The ANDAMAN trial is a
randomized, multicenter study including patients (aged >=18 years) with DM
or with aspirin resistance defined as: (1) index event occurring under
aspirin; (2) body mass index >=27 kg/m2); (3) increased waist
circumference (>=88 cm for women or >= 102 cm for men). The patients will
be recruited in 39 centers after an ACS (with or without ST elevation)
with at least one significant coronary stenosis and will be randomized
before hospital discharge between twice-daily vs once daily low-dose
aspirin (100 mg bid vs od). The primary composite endpoint will be the
occurrence of MACE including all-cause death, myocardial infarction,
stroke, urgent coronary revascularization or acute arterial thrombotic
event during a follow-up of 18 months. To achieve a 20% reduction in the
relative risk of MACE in the twice-daily aspirin group, a total of 2,574
patients will be included in the trial. The main secondary endpoint will
be major bleeding (type 3-5 following BARC classification).
 Conclusion(s): The trial will evaluate the prognostic impact of
twice-daily aspirin for ACS patients with DM or aspirin resistance and may
change the way aspirin is administered to these patients. Trial
registration: ClinicalTrials.gov Identifier: NCT02520921. Copyright
© 2025 The Author(s)

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

<93>
Accession Number
2038704379
Title
Impact of Baseline Anteroposterior Mitral Annular Dimensions on Clinical
Outcomes after MitraClip for Secondary Mitral Regurgitation.
Source
Structural Heart. (no pagination), 2025. Article Number: 100460. Date of
Publication: 2025.
Author
Rogers J.H.; Smith T.W.; Bax J.J.; Asch F.M.; Lim D.S.; Wong N.; Aiyer J.;
Abraham W.T.; Lindenfeld J.; Mack M.J.; Stone G.W.; Bolling S.F.
Institution
(Rogers, Smith) Division of Cardiovascular Medicine, University of
California, Davis Medical Center Sacramento, CA, United States
(Bax) Department of Cardiology, Leiden University Medical Center, Leiden,
Netherlands
(Asch) Cardiovascular Core Laboratories and Cardiac Imaging Research,
MedStar Health Research Institute, Washington, DC, United States
(Lim) Division of Cardiovascular Medicine, University of Virginia,
Charlottesville, VA, United States
(Wong) Advanced Cardiac Valve Center, University of Virginia,
Charlottesville, VA, United States
(Aiyer) Abbott Structural Heart, Santa Clara, CA, United States
(Abraham) Division of Cardiovascular Medicine, Ohio State University
Medical Center, Columbus, OH, United States
(Lindenfeld) Division of Cardiology, Vanderbilt University Medical Center,
Nashville, TN, United States
(Mack) Division of Cardiothoracic Surgery, Baylor Scott & White Research
Institute, Plano, TX, United States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Bolling) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
Publisher
Cardiovascular Research Foundation
Abstract
Background: In the randomized Cardiovascular Outcomes Assessment of the
MitraClip Percutaneous Therapy for Heart Failure Patients with Functional
Mitral Regurgitation (COAPT; NCT01626079) trial, mitral transcatheter
edge-to-edge repair (M-TEER) improved clinical outcomes in patients with
severe secondary mitral regurgitation (MR). A prior post hoc analysis from
the COAPT trial showed that increasing anteroposterior mitral annular
diameter (APMAD) was the sole independent echocardiographic predictor of
the composite endpoint of death or heart failure hospitalizations (HFH) at
2 years. Given the relationship between the mitral annulus and leaflets,
we examined the association of baseline APMAD with long-term clinical
outcomes. Method(s): COAPT patients (n = 575) were stratified into
tertiles by baseline APMAD as follows: small APMAD, medium APMAD, and
large APMAD. APMAD was measured in the anteroposterior direction from the
parasternal long-axis view at end-diastole and in the intercommissural
direction from the apical two-chamber view. Result(s): Patients with
larger baseline APMAD were more often male and had fewer comorbidities,
larger ventricles, and larger mitral orifice areas. At 2 years, there were
no significant differences in MR severity and the composite endpoint of
death or HFH in patients treated with M-TEER by baseline APMAD. In
patients treated with guideline-directed medical therapy (GDMT) alone,
there were no significant differences in MR severity, but the composite
endpoint of death or HFH was higher in patients with the largest baseline
APMADs. The treatment effect of M-TEER was consistent among APMAD tertiles
(p<inf>interaction</inf> = 0.87). Conclusion(s): APMAD was a
predictor of adverse outcomes in patients treated with GDMT alone. M-TEER
reduced MR severity and the risk of death or HFH regardless of baseline
APMAD compared with GDMT alone. Copyright © 2025 The Authors

<94>
Accession Number
2038739140
Title
Single Perclose Plus Plug Based Device versus Double Perclose for
Percutaneous Large Bore Arterial Access: An Systematic Review and
Meta-analysis.
Source
Annals of Vascular Surgery. 118 (pp 56-67), 2025. Date of Publication: 01
Sep 2025.
Author
Bertolino E.P.; Mastra Fontoura M.M.; Florencio de Mesquita C.; da Silva
Pimentel D.; Fernandez M.G.; Queiroz I.; Diaz Herrera B.A.; Moraes A.O.;
Millner R.; Mulatti G.C.
Institution
(Bertolino) Departamento de Medicina da Universidade Estadual de Maringa,
Parana, Maringa, Brazil
(Mastra Fontoura) Faculdade de Medicina da Universidade Federal do Rio de
Janeiro, Rio de Janeiro, Brazil
(Florencio de Mesquita) Faculdade de Medicina da Universidade Federal de
Pernambuco, Recife, Brazil
(da Silva Pimentel) Faculdade de Medicina da Universidade Federal
Fluminense, Niteroi, Brazil
(Fernandez) Escola Bahiana de Medicina e Saude Publica, Bahia, Brazil
(Queiroz) Universidade Catolica de Pernambuco, Recife, Brazil
(Diaz Herrera) Universidad Autonoma del Estado de Hidalgo and Instituto
Nacional de Cardiologia "Ignacio Chavez", Mexico City, Mexico
(Moraes) IMV, Instituto de Molestias Vasculares, Maringa, Brazil
(Millner) Section of Vascular Surgery and Endovascular Therapy of the
University of Chicago, Chicago, IL, United States
(Mulatti) Departamento de Cirurgia Vascular e Endovascular do Hospital das
Clinicas da Universidade de Sao Paulo, Sao Paulo, Brazil
Publisher
Elsevier Inc.
Abstract
Background: Vascular Closure primarily utilizing suture-based devices
(SBDs) are frequently used for large bore percutaneous arterial access in
patients undergoing Transcatheter Aortic Valve Implantation and
Endovascular Aneurysm Repair. Little is known about the intentional
combination of SBD with plug-based device (PBD). Main objective was to
determine the efficacy of adopting a combined SBD and PBD strategy
compared to double SBD for large bore arterial access. Method(s): We
searched randomized and observational studies comparing both strategies
and that reported the outcomes of major vascular and vascular
complications, major bleeding, all bleeding events, need for surgical or
endovascular interventions, device failure, additional device, and
pseudoaneurysm. A meta-analysis was conducted, with heterogeneity assessed
using the I2 statistic and a random-effects model applied to
all outcomes. In addition, trial sequential analysis was performed.
 Result(s): We included 3 randomized trials and 4 observational
studies with 2,064 access. Sheath size ranged from 13Fr to 24 Fr. Vascular
complications (relative risk [RR] 0.54; P < 0.01), major vascular
complications (RR 0.55; P = 0.04), major bleeding (RR 0.49; P = 0.02),
need for surgical intervention (RR 0.25; P = 0.01), and additional device
(RR 0.12; P < 0.01) were significantly less common in patients treated
with the SBD and PBD technique. Pseudoaneurysm (RR 1.13; P = 0.71), all
bleeding events (RR 0.59; P = 0.1), and endovascular intervention (RR
0.65; P = 0.26) were not significantly different between groups.
 Conclusion(s): These findings suggest that 1 SBD, combined with PBD,
was associated with less femoral access complications when compared to the
exclusive double SBD as a vascular closure strategy in patients with large
bore arterial access. Copyright © 2025 Elsevier Inc.

<95>
Accession Number
2034574020
Title
Dual ProGlide Versus ProGlide and Angio-Seal for Femoral Access
Hemostasias in Transcatheter Aortic Valve Replacement: A Meta-Analysis of
Up-to-Date Evidence.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Naeem F.; Tabassum S.; Burhan M.; Qamar U.; Alraies M.C.; Abramov D.
Institution
(Naeem) Department of Cardiology, Massachusetts General Hospital, Harvard
Medical School, Boston, MA, United States
(Tabassum) Department of Internal Medicine, King Edward Medical
University, Lahore, Pakistan
(Burhan) Department of Internal Medicine, Rawalpindi Medical University,
Lahore, Pakistan
(Qamar) Department of Internal Medicine, Mayo Clinic, Rochester, NY,
United States
(Alraies) Department of Cardiology, Department of Medicine, Detroit
Medical Center, Detroit, MI, United States
(Abramov) Department of Medicine, Division of Cardiology, Loma Linda
University Health, Loma Linda, CA, United States
Publisher
John Wiley and Sons Inc

<96>
Accession Number
2038784866
Title
Combination of colchicine and berberine for reducing atrial fibrillation
recurrence post-ablation and preventing postoperative atrial fibrillation:
A promising approach?.
Source
International Journal of Cardiology. 435 (no pagination), 2025. Article
Number: 133393. Date of Publication: 15 Sep 2025.
Author
Liu Z.-B.; Lu Q.; Liu J.; Ding S.-F.
Institution
(Liu, Ding) The First School of Clinical Medicine, Southern Medical
University, Guangzhou, China
(Liu, Liu) Department of Cardiology, Jinling Hospital, Affiliated Hospital
of Medical School, Nanjing University, Nanjing, China
(Lu, Ding) Department of Cardiology, General Hospital of Central Theater
Command, Wuhan Clinical Medicine College of Southern Medical University,
Wuhan, China
Publisher
Elsevier Ireland Ltd
Abstract
We carefully read with great interest the recent paper by Al-Sadawi et al.
titled "Effect of low dose colchicine on long term recurrence after atrial
fibrillation ablation". The research indicates that low-dose colchicine
could help reduce long-term atrial fibrillation (AF) recurrence after
ablation. Wang et al. found that colchicine could effectively reduce the
recurrence of AF post-ablation and prevent post-operative atrial
fibrillation (POAF). Nevertheless, the frequent occurrence of side
effects, especially gastrointestinal reactions like diarrhea, greatly
affects patient tolerance. Therefore, the most effective strategy for
utilizing colchicine to reduce AF recurrence post-ablation and to prevent
POAF remains ambiguous. Previous studies have suggested that berberine
possesses class III antiarrhythmic properties, making it a potential
candidate for treating AF. Zhang et al. observed that berberine can
effectively lower POAF occurrence following coronary artery bypass
grafting. Potential mechanisms include blocking K+ channels, stimulating
the Na+/Ca2+ exchanger, prolonging action potentials, direct antioxidant
activity, and antiinflammatory effects. Considering the potential benefits
of berberine for AF and its effectiveness and safety in treating
gastroenteritis and diarrhea, it is a reasonable hypothesis that the
combination of colchicine and berberine might work synergistically to
lower AF recurrence post-ablation and POAF occurrence while also
alleviating gastrointestinal side effects caused by colchicine.
Nonetheless, this hypothesis needs further validation by experiment and
clinical studies. Copyright © 2025 Elsevier B.V.

<97>
Accession Number
647332255
Title
Bicuspid aortic valve disease: advancements and challenges of
transcatheter aortic valve implantation.
Source
European heart journal. (no pagination), 2025. Date of Publication: 09
May 2025.
Author
Barbanti M.; Costa G.; Windecker S.; Maisano F.; Laterra G.; Leipsic J.;
Blanke P.; Bapat V.N.; Leon M.B.; Webb J.G.
Institution
(Barbanti, Laterra) Department of Medicine and Surgery, Universita degli
Studi di Enna Kore, Piazza dell'Universita, Enna, Italy
(Barbanti, Laterra) Division of Cardiology, Umberto I Hospital, ASP 4 of
Enna, Enna, Italy
(Costa) Division of Cardiology, Catania, Italy
(Windecker) Department of Cardiology, Bern University Hospital,
Inselspital, University of Bern, Bern, Switzerland
(Maisano) Department of Cardiac Surgery, IRCCS San Raffaele Hospital,
Vita-Salute San Raffaele University, Milan, Italy
(Leipsic, Blanke, Webb) Centre for Heart Valve Innovation, St. Paul's
Hospital, University of British Columbia, Vancouver, BC, Canada
(Bapat) Department of Cardiac Surgery, Minneapolis Heart Institute at
Abbott Northwestern Hospital, 800 E 28th St, MN 55407 Minneapolis, MN,
United States
(Leon) Department of Internal Medicine, Columbia University and
Cardiovascular Research Foundation, New York City, NY, United States
Abstract
Transcatheter aortic valve implantation (TAVI) has revolutionized the
treatment of patients with severe aortic stenosis (AS). Initially
developed for patients with tricuspid aortic valve (TAV) anatomy, the
procedural success and expanding indications of TAVI have spurred interest
in its application to more complex aortic valve anatomies, such as the
bicuspid aortic valve (BAV). The growing interest in this specific sub-set
of patients with AS is driven by the recent extension of TAVI indications
to younger individuals, who exhibit a notably higher incidence of bicuspid
anatomy compared with older populations. Bicuspid aortic valves present
distinct anatomical and pathological complexities that pose significant
challenges to the conventional TAVI approach. These include asymmetric
calcification, aortic root dilation (also known as BAV aortopathy), and
variations in cusp fusion patterns, which can affect valve deployment,
transcatheter heart valve sealing, and long-term durability. Despite these
challenges, advancements in imaging techniques, valve design, and
procedural strategies have led to increased adoption of TAVI in BAV
patients. However, surgical aortic valve replacement still retains a more
prominent role in this group compared with patients with TAVs. This
preference is partly due to the exclusion of BAV patients from almost all
previous randomized controlled trials, which limits the available evidence
supporting the use of TAVI in this unique cohort. This state-of-the-art
review aims to provide a comprehensive overview of the current landscape
of TAVI in BAV patients, including an analysis of anatomical
considerations and procedural pitfalls, as well as outcomes' improvements
with new device iterations. It will also explore clinical data, tackling
the risks, benefits, and the evolving role of TAVI in this unique patient
cohort. Copyright © The Author(s) 2025. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved. For commercial re-use, please contact reprints@oup.com
for reprints and translation rights for reprints. All other permissions
can be obtained through our RightsLink service via the Permissions link on
the article page on our site-for further information please contact

<98>
[Use Link to view the full text]
Accession Number
2038682231
Title
Perioperative Nitric Oxide Conditioning Reduces Acute Kidney Injury in
Cardiac Surgery Patients with Chronic Kidney Disease (the DEFENDER-trial):
a Randomized Controlled Trial.
Source
Anesthesiology. (no pagination), 2025. Article Number: 05494. Date of
Publication: 2025.
Author
Kamenshchikov N.O.; Tyo M.A.; Berra L.; Kravchenko I.V.; Kozlov B.N.;
Gusakova A.M.; Podoksenov Y.K.
Institution
(Kamenshchikov, Tyo, Kravchenko, Kozlov, Gusakova, Podoksenov) Cardiology
Research Institute, Tomsk National Research Medical Center, Russian
Academy of Sciences, 111a Kievskaya St., Tomsk, Russian Federation
(Berra) Department of Anaesthesia,Critical Care and Pain Medicine,
Massachusetts General Hospital, Boston, MA, United States
(Berra) Department of Anaesthesia, Harvard Medical School, Boston, MA,
United States
(Berra) Respiratory Care Service, Patient Care Services, Massachusetts
General Hospital, Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Postoperative Acute kidney injury (AKI) is a significant
concern for cardiac surgery patients with chronic kidney disease (CKD).
Effective pharmacological interventions to mitigate these risks are
urgently needed. This study aimed to evaluate the efficacy and safety of
perioperative nitric oxide (NO) administration in preventing AKI and
limiting CKD progression in patients undergoing cardiac surgery.
 Method(s): A total of 136 patients with CKD undergoing elective
cardiac surgery with cardiopulmonary bypass (CPB) were randomized into two
equal groups: the NO group (n=68), receiving 80 parts per million NO
during the intraoperative period and for 6 hours post-surgery, and the
control group (n=68), receiving a sham treatment. The primary outcome was
AKI incidence within 7 days post-surgery. Result(s): AKI incidence
was significantly lower in the NO group (16/68 patients, 23.5%) compared
to the control group (27/68 patients, 39.7%) with a relative risk (RR) of
0.59 (95% CI 0.35-0.99; p=0.043). Six months post-surgery, the glomerular
filtration rate was higher in the NO group (50 mL/min/1.73 m2
[45; 54]) compared to the control group (45 mL/min/1.73 m2 [41;
51], p=0.038). Postoperative pneumonia was significantly less frequent in
the NO group: 10/68 (14.7%) vs 20/68 (29.4%) RR 0.5; (95% CI 0.25-0.99;
p=0.039). NO administration was safe: methemoglobin and nitrogen dioxide
levels remained within acceptable ranges, oxidative-nitrosyl stress did
not increase, and there were no significant differences between the groups
in blood transfusion requirements, platelet counts, or postoperative blood
loss volumes Conclusion(s): Perioperative NO administration in CKD
patients undergoing cardiac surgery with CPB is safe, reduces the
incidence of AKI, and slows the progression of renal
dysfunction. Copyright © 2025 American Society of
Anesthesiologists. All Rights Reserved.

<99>
Accession Number
2034570283
Title
Use of an insulin titration protocol based on continuous glucose
monitoring in postoperative cardiac surgery patients with type 2 diabetes
and prediabetes: a randomized controlled trial.
Source
Cardiovascular Diabetology. 24(1) (no pagination), 2025. Article Number:
210. Date of Publication: 01 Dec 2025.
Author
Moon S.-J.; Kim M.-S.; Kim Y.T.; Lee H.-E.; Lee Y.-W.; Lee S.-J.; Chung
E.-S.; Park C.-Y.
Institution
(Moon, Lee, Park) Division of Endocrinology and Metabolism, Department of
Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University
School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, South Korea
(Kim, Lee, Lee, Chung) Thoracic and Cardiovascular Surgery, Kangbuk
Samsung Hospital, Sungkyunkwan University School of Medicine, 29
Saemunan-ro, Jongno-gu, Seoul, South Korea
(Kim) Division of Biostatistics, Department of Academic Research, Kangbuk
Samsung Hospital, Seoul, South Korea
Publisher
BioMed Central Ltd
Abstract
Background: Maintaining optimal glucose control is critical for
postoperative care cardiac surgery patients. Continuous glucose monitoring
(CGM) in this setting remains understudied. We evaluated the efficacy of
CGM with a specialized titration protocol in cardiac surgery patients with
type 2 diabetes (T2D) and prediabetes. Method(s): In this
randomized-controlled trial, 54 cardiac surgery patients were randomized
one day post-surgery, with 27 CGM and 25 point-of-care (POC) patients
completing the study. The CGM group used Dexcom G6 with a CGM-specialized
titration protocol, while the POC group used standard monitoring with
blinded CGM. The primary outcome was time-in-range (TIR) 100-180 mg/dL for
7 days post-surgery. Secondary outcomes included various glycemic metrics
and surgical outcomes. Multiple comparison adjustments were performed
using false-discovery-rate (FDR). Result(s): Thirty-one (59.6%) had
diabetes and 21 (40.4%) had prediabetes. While TIR 100-180 mg/dL showed no
difference (74.7% vs. 71.6%, FDR-adjusted p = 0.376), the CGM group
demonstrated improvements in TIR 70-180 mg/dL (83.8% vs. 75.8%,
FDR-adjusted p = 0.026), time-in-tight-range (TITR) 100-140 mg/dL (46.3%
vs. 36.3%, FDR-adjusted p = 0.018), and TITR 70-140 mg/dL (55.3% vs.
40.5%, FDR-adjusted p = 0.003). Both groups maintained very low rates of
time below range (< 70 mg/dL: 0.03% vs. 0.18%, FDR-adjusted p = 0.109).
The CGM group showed lower postoperative atrial fibrillation (AF) (18.8%
vs. 55.6%, FDR-adjusted p = 0.04999). Conclusion(s): While the
primary outcome was not achieved, CGM with a specialized titration
protocol demonstrated safe glycemic control with improvements in TIR
70-180 mg/dL and TITRs in cardiac surgery patients with T2D and
prediabetes. The observed reduction in postoperative AF warrants further
investigation. Trial Registration: ClinicalTrials.gov
NCT06275971 Copyright © The Author(s) 2025.

<100>
Accession Number
2038757618
Title
Mechanical outcomes of coronary stenting guided by intravascular
ultrasound versus optical coherence tomography: A systematic review and
meta-analysis with trial sequential analysis of randomized trials.
Source
International Journal of Cardiology. 435 (no pagination), 2025. Article
Number: 133387. Date of Publication: 15 Sep 2025.
Author
Lingamsetty S.S.P.; Doma M.; Kritya M.; Thyagaturu H.; Ubaid M.; Jitta
S.R.; Prajapati K.; Ramadan A.; Al-shammari A.S.; Martignoni F.V.; Seto
A.; Shlofmitz E.; Basir M.B.; Megaly M.S.; Goldsweig A.M.
Institution
(Lingamsetty) Mamata Medical College, Khammam, India
(Doma) Alexandria Faculty of Medicine, Alexandria, Egypt
(Kritya) Houston Methodist Research Institute, TX, United States
(Thyagaturu) West Virginia University Heart and Vascular Institute, WV,
United States
(Ubaid) Montefiore Health System, NY, United States
(Jitta) Mercy Hospital Saint Louis, MO, United States
(Prajapati) Metropolitan Hospital Center NYC Health + Hospital, NY, United
States
(Ramadan) Massachussets General Hospital, Harvard Medical School, Boston,
MA, United States
(Al-shammari) College of Medicine, University of Baghdad, Baghdad, Iraq
(Martignoni) Texas Tech University Health Sciences Center, TX, United
States
(Seto) Department of Medicine, VA Long Beach Healthcare System, Long
Beach, CA, United States
(Seto) Department of Medicine, Charles R. Drew University of Medicine and
Science, Willowbrook, CA, United States
(Shlofmitz) Department of Cardiology, St Francis Hospital and Heart
Center, Roslyn, NY, United States
(Basir) Henry Ford Hospital, Detroit, MI, United States
(Megaly) Ascension St John Medical Center-Tulsa, OK, United States
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center
and Division of Cardiovascular Medicine, University of
Massachusetts-Baystate, Springfield, MA, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Intravascular imaging with intravascular ultrasound (IVUS) or
optical coherence tomography (OCT) may guide stent sizing and placement
during percutaneous coronary intervention (PCI). We compared IVUS- vs.
OCT-guided PCI in terms of mechanical outcomes. Method(s): PubMed,
Embase and Cochrane databases were systematically searched until December
2024 for randomized controlled trials (RCTs) comparing IVUS- vs.
OCT-guided PCI. Random-effects models were used to estimate mean
differences (MDs) and standard mean differences (SMDs) with 95 %
confidence intervals (CIs). Result(s): Six RCTs with 2696 patients
were included; 1396 (49.6 %) underwent IVUS-guided PCI. The mean age was
65.1 +/- 10.2 years. In the pooled analysis, the post-PCI minimum stent
area (MSA) was significantly higher with IVUS-guided PCI than with
OCT-guided PCI (MD 0.64 mm2; 95 % CI 0.17-1.10; p < 0.01), and
post-PCI mean diameter stenosis was significantly lower with IVUS (MD
-1.05 %; 95 % CI -1.90 to -0.21; p = 0.01). There were no significant
differences between groups in acute lumen gain, stent expansion index,
malapposition, tissue protrusion, or edge dissection. In a subgroup
analysis, IVUS-guided PCI yielded a greater MSA in studies that did not
size vessels by measurement of the external elastic membrane. However,
trial sequential analysis suggested that the RCTs to date have not reached
the required quantity of information to support definitive conclusions
about MSA and mean diameter stenosis. Conclusion(s): This
meta-analysis demonstrated that IVUS-guided PCI was associated with
greater MSA and reduced diameter stenosis compared to OCT-guided PCI, with
no difference in stent expansion index, more trials are required to
confirm this hypothesis. Copyright © 2025 Elsevier B.V.

<101>
Accession Number
2034544669
Title
Cardiac Troponin as a Prognostic Indicator for Major Adverse Cardiac
Events in Non-Cardiac Surgery: A Narrative Review.
Source
Diagnostics. 15(9) (no pagination), 2025. Article Number: 1061. Date of
Publication: 01 May 2025.
Author
Sayed Masri S.N.N.; Basri F.; Yunus S.N.; Cheah S.K.
Institution
(Sayed Masri, Cheah) Department of Anaesthesiology & Intensive Care,
Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti
Kebangsaan Malaysia, Kuala Lumpur, Malaysia
(Basri) Department of Anaesthesiology & Intensive Care, Hospital Kuala
Lumpur, Kuala Lumpur, Malaysia
(Yunus) Department of Anaesthesiology & Intensive Care, Faculty of
Medicine, University of Malaya, Kuala Lumpur, Malaysia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
A major adverse cardiac event (MACE) following non-cardiac surgery
encompasses critical postoperative cardiovascular complications such as
myocardial infarction or injury, cardiac arrest, or stroke that are
associated with increased perioperative morbidity, mortality, and
healthcare resource utilisation. Cardiac troponin (cTn), particularly
high-sensitivity cardiac troponin (hs-cTn), has emerged as a key biomarker
for prediction of MACE. Despite its recognised utility, there is no
consensus on how cTn levels should be used for standardised postoperative
surveillance. Interpretation of the cTn levels may vary depending on
sex-specific reference values and baseline comorbidities such as chronic
kidney disease, sepsis, critical illness, and non-ischaemic conditions.
The balance between cost-effectiveness and clinical benefit in
implementing universal versus targeted postoperative hs-cTn screening
remains to be fully explored. This review examines the prognostic value of
cardiac troponin (cTn) levels in predicting major adverse cardiovascular
events (MACEs) in patients undergoing non-cardiac surgery, with a focus on
perioperative cTn elevations-particularly those associated with myocardial
injury after non-cardiac surgery (MINS)-as potential early indicators of
increased cardiovascular risk. Copyright © 2025 by the authors.

<102>
Accession Number
2038678205
Title
Effects of intraperitoneal instillation of Dexmedetomidine versus Fentanyl
as adjuvants to Ropivacaine for postoperative pain management after
Laparoscopic Cholecystectomy: A Comparative randomized control study.
Source
International Journal of Life Sciences Biotechnology and Pharma Research.
14(5) (pp 375-379), 2025. Date of Publication: 01 May 2025.
Author
Bhadauria R.; Rai S.K.; Maurya R.G.; Shrivastava A.
Institution
(Bhadauria, Rai) Department of Anesthesia, Hind Institute of Medical
Science, Mau Atria, UP, Sitapur, India
(Maurya) Department of Anesthesia, KGMU, India
(Shrivastava) Department of General Surgery, Hind Institute of Medical
Sciences, Mau Atria, UP, Sitapur, India
Publisher
International Journal of Life Sciences Biotechnology and Pharma Research
Abstract
Background:Laparoscopic cholecystectomy has revolutionized the gall
bladder surgery as a day care procedure but for postoperative pain. This
study compared the efficacy of Dexmedetomidine (1 mug/kg) and Fentanyl (1
mug/kg) as intraperitoneal adjuvant to 0.375% ropivacaine (40ml) given
perioperatively for post-operative pain management in patients undergoing
laparoscopic cholecystectomy surgeries under general anaesthesia.
 Material(s) and Method(s):A total of 110 patients fulfilling the
eligibility criteria were enrolled in the study and were randomized either
to receive combination of ropivacaine with fentanyl (Group RF; n=55; mean
age 39.02 years; 94.5% females) or combination of ropivacaine with
Dexmedetomidine (Group RD; n=55; mean age 38.75 years; 90.9% females)
respectively. Post-operative vital parameters (heart rate, systolic blood
pressure, diastolic blood pressure, mean arterial pressure and oxygen
saturation) were noted. Sedation scores were measured using Ramsay
Sedation Score. All the patients were followed up till 24 hours at every 2
hourly interval for pain (measured using Numeric Rating Scale), dose and
amount of rescue analgesia (Diclofenac). Adverse effects, if any were
noted. Result(s):Average NRS scores over 24 hours were significantly
lower in RF as compared to RD group. Amount of rescue analgesia, number of
patients requiring rescue analgesia and number of dosages of rescue
analgesia required were significantly higher in RD as compared to that in
the RF group. Post-operative sedation scores were significantly higher in
RD as compared to that in RF group. No adverse effect was noted in RF
group whereas in RD group, there was 1 (1.8%) patient each experiencing
fever and headache as the adverse effect. Conclusion(s): Findings of
the study showed that though both the combinations were safe to use,
however, combination of fentanyl with ropivacaine provided far better
analgesic effect without causing much sedation as compared to combination
of dexmedetomidine with ropivacaine. Copyright ©2025 Int. J. Life
Sci. Biotechnol. Pharma. Res.

<103>
Accession Number
2034544093
Title
Quality of Life After Minimally Invasive Aortic Valve Replacement Surgery:
A Systematic Review.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2025. Article Number: 15569845251337405. Date
of Publication: 2025.
Author
Hackney M.; Caputo M.; Angelini G.; Vohra H.
Institution
(Hackney) University of Bristol, United Kingdom
(Caputo, Angelini, Vohra) Bristol Heart Institute, University Hospitals
Bristol NHS Foundation Trust, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Objective: Aortic valve replacement surgery (AVR) via median sternotomy
(MS) is the standard surgical intervention used for AVR. However, the
minimally invasive approach is becoming more widely adopted. This review
focuses on quality of life (QoL) after minimally invasive AVR (MIAVR). The
aim of this review is to comprehensively analyze the current body of
evidence for QoL after MIAVR. A second aim is to determine whether a
conclusion can be made based on the literature to indicate whether MIAVR
is more beneficial to the patient compared with MS and should be the
preferred approach. Method(s): A literature search was conducted in
the PubMed database using relevant searches. Papers were either included
or excluded based on their title. Through a cross-reference check from the
papers identified by the search, further articles were identified.
Initially, 375 manuscript titles and abstracts were screened, with 11
being included in this review. Result(s): The 11 studies comparing
postoperative QoL between MIAVR and MS were comprehensively analyzed.
Three studies showed no significant differences between the groups;
however, 8 identified better QoL after surgery in the MIAVR group. Three
studies investigated pulmonary function after MIAVR and MS, concluding
that MIAVR demonstrated superior pulmonary function. Conclusion(s):
Overall, MIAVR can be performed with acceptable postoperative QoL.
However, the current literature is sparse, and it is not possible to say
whether one approach is better than the other. MIAVR is certainly not
inferior to MS in terms of QoL. Well-designed, randomized controlled
trials are needed to draw more definitive conclusions. Copyright
© The Author(s) 2025.

<104>
Accession Number
2038737231
Title
Early Aortic Valve Replacement Versus Conservative Management: A
Meta-Analysis of Randomized Controlled Trials.
Source
Structural Heart. (no pagination), 2025. Article Number: 100461. Date of
Publication: 2025.
Author
Shah T.; Shah Y.; Lansky A.J.; Giri J.; Fanaroff A.; Nathan A.
Institution
(Shah, Giri, Fanaroff, Nathan) Division of Cardiovascular Medicine,
Hospital of the University of Pennsylvania, Philadelphia, PA, United
States
(Shah) Department of Internal Medicine, Strong Memorial Hospital,
Rochester, NY, United States
(Lansky) Division of Cardiology, Yale School of Medicine, New Haven, CT,
United States
(Lansky) Barts Heart Centre, London and Queen Mary University of London,
London, United Kingdom
Publisher
Cardiovascular Research Foundation

<105>
Accession Number
2038681798
Title
Comparison of Outcomes Between Total Arterial Off-Pump Versus On-Pump
Coronary Artery Bypass Surgery: A Meta-Analysis and Meta-Regression.
Source
American Journal of Cardiology. 249 (pp 43-50), 2025. Date of Publication:
15 Aug 2025.
Author
Comanici M.; Bithi N.; Raja S.G.
Institution
(Comanici, Bithi, Raja) Department of Cardiac Surgery, Harefield Hospital,
London, United Kingdom
Publisher
Elsevier Inc.
Abstract
An essential aspect of achieving early optimal outcomes in coronary artery
bypass grafting (CABG) is the careful selection of conduits. Total
arterial grafting (TAG) has been debated, and recent studies suggest its
benefits, especially when combined with off-pump coronary artery bypass
grafting (OPCAB). We conducted a systematic review and meta-analysis of
studies comparing outcomes of TAG in OPCAB versus on-pump CABG (ONCAB),
using data from OVID MEDLINE, EMBASE, SCOPUS, and PUBMED. Seven studies
with a total of 5417 patients were included. Short-term outcomes showed no
significant differences in perioperative complications between TAG-OPCAB
and TAG-ONCAB, but TAG-OPCAB was associated with reduced short-term
mortality (OR 0.48, 95% CI [0.26, 0.89], p = 0.02), lower incidence of
postoperative low cardiac output, atrial fibrillation, and MACCEs, as well
as shorter intubation duration and hospital stay. Meta-regression did not
reveal any associations between pre- or intraoperative variables and
short-term mortality. In conclusion, TAG-OPCAB demonstrates favorable
short-term outcomes and may be considered a safe and effective strategy in
selected patients, while long-term outcomes remain inconclusive due to
limited data. Copyright © 2025 Elsevier Inc.

<106>
Accession Number
2034553271
Title
Glibenclamide Serves as a Potent Vasopressor to Treat Vasoplegia After
Cardiopulmonary Bypass and Reperfusion in a Porcine Model.
Source
International Journal of Molecular Sciences. 26(9) (no pagination), 2025.
Article Number: 4040. Date of Publication: 01 May 2025.
Author
Winter A.; Nepper P.; Hermann M.; Bayer F.; Riess S.; Salem R.; Hlavicka
J.; Prinzing A.; Hecker F.; Holubec T.; Zacharowski K.; Walther T.; Emrich
F.
Institution
(Winter, Nepper, Hermann, Riess, Salem, Hlavicka, Prinzing, Hecker,
Holubec, Walther, Emrich) Department of Cardiovascular Surgery, University
Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
(Bayer) Central Research Unit, Goethe University Frankfurt, Frankfurt am
Main, Germany
(Zacharowski) Department of Anesthesiology, Intensive Care Medicine and
Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt
am Main, Germany
(Emrich) Department of Cardiovascular and Thoracic Surgery, University
Hospital Augsburg, Augsburg, Germany
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
The hemodynamic stabilization of patients after complex cardiac surgery is
a daily challenge. The use of high doses of catecholamines is common but
has potential adverse effects. Glibenclamide, a K<inf>ATP</inf> blocker,
seems to attenuate vasoplegia in different animal models of septic shock.
Therefore, the aim of this study was to investigate the impact of
Glibenclamide on the vasoplegic syndrome after cardiopulmonary bypass in a
porcine model. In this experimental study, 20 landrace pigs were
randomized into two groups and examined: In the control group, standard
medical therapy, including norepinephrine, was used, and in the study
group standard medical therapy plus additional Glibenclamide was
administered. Following general anesthesia, prolonged cardiopulmonary
bypass and aortic cross-clamping was performed. In the study group,
Glibenclamide was administered 45 min after weaning from cardiopulmonary
bypass. The dosage used was 10 mg/kg as a bolus, followed by a continuous
infusion of 10 mg/kg/h. Hemodynamic and laboratory measurements were
performed. Glibenclamide had a relevant effect on circulatory parameters.
With increasing vascular resistance and blood pressure, norepinephrine was
able to be reduced. While the heart rate dropped to physiological levels,
the cardiac index decreased as well. The results lead to the conclusion
that Glibenclamide was able to break through vasoplegic syndrome and could
therefore serve as a potent drug to stabilize patients after cardiac
surgery. Copyright © 2025 by the authors.

<107>
Accession Number
2038682037
Title
Risk factors for infection in patients undergoing hip replacement: a
systematic review and meta-analysis.
Source
Journal of Hospital Infection. 160 (pp 60-73), 2025. Date of Publication:
01 Jun 2025.
Author
Yang B.; Lei Y.; Zeng Y.; Luo M.; Li Z.; Lei K.; Wang Y.; Xiao Q.; Wen J.;
Yan W.; Yan H.
Institution
(Yang) Hengyang Medical School, University of South China, Hunan Province,
Hengyang, China
(Lei, Lei, Wang, Xiao, Wen, Yan) Department of Neurosurgery, Chenzhou
Third People's Hospital and the Second Affiliated Hospital of Xiangnan
University, Hunan Province, Chenzhou, China
(Zeng) Department of Gynecology, The Second Affiliated Hospital, Hengyang
Medical School, University of South China, Hunan Province, Hengyang City,
China
(Luo) Department of Spine Surgery, Lishui Hospital of Wenzhou Medical
University, Lishui People's Hospital, Zhejiang, Lishui, China
(Li, Yan) Department of Joint Surgery, The Second Affiliated Hospital,
Hengyang Medical School, University of South China, Hunan Province,
Hengyang City, China
Publisher
W.B. Saunders Ltd
Abstract
A meta-analysis was conducted to determine the risk of infection following
hip replacement and risk factors were identified for surgical site
infection. PubMed/Medline, Embase and Cochrane Library databases were
systematically searched, as well as the reference lists of previous
systematic reviews and meta-analyses. The pooled odds ratio (OR) was
estimated using a random effects model for each investigated factor. The
evidence of observational studies was classified as high quality (class
I), moderate quality (class II or III) or low quality (class IV) based on
the GRADE system. A total of 25,383 potential articles met the inclusion
criteria in the database search. After reviewing the titles, abstracts,
and full texts, 27 articles were included in the final analysis,
encompassing 699,473 patients who underwent hip arthroplasty. High-quality
evidence shows that BMI (>=30 kg/m2) (OR 2.16; 95% CI
1.72-2.70), male sex (OR 1.39; 95% CI 1.26-1.53), operation time (>=120
min) (OR 1.72; 95% CI 1.39-2.14), American Society of Anesthesiologists
(ASA) class >=3 (OR 2.05; 95% CI 1.49-2.83), diabetes (OR 1.33; 95% CI
1.23-1.43), and heart disease (OR 1.99; 95% CI 1.48-2.68) are associated
with a greater risk of infection. The meta-analysis revealed that age and
renal disease were not associated with infection. In conclusion, this
meta-analysis identified significant risk factors for infection after
hip-replacement surgery, including BMI, male sex, operation time, heart
disease, diabetes, and ASA class. Copyright © 2025

<108>
Accession Number
2038689941
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: 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, Konigs, Oosterlaan) Department of Pediatrics, Emma Children's
Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam,
Netherlands
(Haas, van der Hulst, Adel, Blom, 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, Willem-Alexander's Children's
Hospital, Leiden UMC, Leiden, Netherlands
(Konigs) Emma Neuroscience Group, Department of Pediatrics, Emma
Children's Hospital, Amsterdam UMC location University of Amsterdam,
Amsterdam, Netherlands
(Konigs, Oosterlaan) Amsterdam Reproduction and Development research
institute, Amsterdam, Netherlands
(van den Aardweg) Department of Pulmonology, Amsterdam UMC location
University of Amsterdam, Amsterdam, Netherlands
Publisher
Elsevier Inc.
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 (VO<inf>2peak</inf>) 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 VO<inf>2peak</inf> (standardized mean difference =
1.13, 95 % CI 0.98 to 1.28), with those having univentricular hearts being
most affected (standardized mean difference = 1.61, 95 % CI 1.34 to 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

<109>
Accession Number
2038641122
Title
Preoperative consecutive treatment with isoprenaline and adenosine is safe
and reduces ischaemia-reperfusion injury in a porcine model of cardiac
surgery with recent acute myocardial infarction.
Source
European Journal of Cardio-thoracic Surgery. 67(5) (no pagination), 2025.
Article Number: ezaf120. Date of Publication: 01 May 2025.
Author
Smith S.; Khaliulin I.; Tommaso E.D.; Bruno V.D.; Johnson T.W.; Sammut E.;
Baz-Lopez D.; Deutsch J.; Suleiman M.-S.; Ascione R.
Institution
(Smith, Khaliulin, Tommaso, Bruno, Johnson, Sammut, Baz-Lopez, Suleiman,
Ascione) Medical School, Faculty of Health and Life Science, University of
Bristol, Bristol, United Kingdom
(Deutsch) Veterinary School and Translational Biomedical Research Centre,
Faculty of Health Science, University of Bristol, Bristol, United Kingdom
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The goal of this study was to assess the feasibility, safety
and efficacy of consecutive treatment with isoprenaline/adenosine
(ISO/ADE) in a pig model of myocardial infarction and cardiac surgery.
 METHOD(S): The final ISO/ADE dose was selected from a pilot study (n
= 8). In the subsequent randomized trial, 16 pigs underwent cardiac
magnetic resonance imaging 4 weeks after a myocardial infarction, then
were randomized to either the ISO/ADE (n = 8) or the control (n = 8) group
before undergoing cardiac surgery with 1 h recovery. Feasibility and
safety end points included the method of ISO/ADE delivery, serial blood
pressure, heart rate, pH, HCO- <inf>3</inf> , circulating
lactate levels, troponin levels and arrhythmias. Biomarkers of efficacy
included serial lactate levels and serial pO<inf>2</inf> mean
arterial-to-venous functional ratio along with histologic levels of
glycogen, protein carbonyls, O<inf>2</inf>, CO<inf>2</inf>,
HCO- <inf>3</inf> and fibrosis. Postoperative rates of low
cardiac output and death were also recorded. RESULT(S): Cardiac
magnetic resonance measures of myocardial infarction did not differ
between the groups. The selected method of ISO/ADE delivery was feasible.
At no time were all safety outcomes measured in the ISO/ADE group worse
than those in the control group. ISO/ADE reduced circulating lactate
levels, preserved the serial pO<inf>2</inf> mean arterial-to-venous
functional ratio and reduced tissue-based glycogen and protein
carbonylation. No other differences were observed. Low cardiac output and
death occurred in 3/8 (37.5%) and 2/8 (25%) control animals versus 0% in
the ISO/ADE group. CONCLUSION(S): The therapy was feasible and safe
and improved biomarkers of efficacy. ISO/ADE was not associated with any
postoperative low cardiac output and deaths versus 37.5% and 25%,
respectively, in the control group. A pilot human study is
warranted. Copyright © The Author(s) 2025. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery.

<110>
Accession Number
647301466
Title
Awareness Under Anesthesia: Evidence from Clinical Trials.
Source
Anesthesia and Analgesia. Conference: 1st International Symposium in
Georgia on Cognitive Disorders, ISCD 2024. Tbilisi Georgia. 140(2
Supplement) (pp 22), 2025. Date of Publication: 01 Feb 2025.
Author
Pryor K.O.
Institution
(Pryor) Department of Anesthesiology Weill Cornell Medicine, 525 East 68th
St, Box 124, New York, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
An understanding of the clinical problem of 'awareness under anesthesia'
must begin with recognition that the powerful amnestic properties of
anesthetics can readily create the illusion of a void of consciousness -
but only because experience is forgotten. Thus posed is a difficult
clinical and ethical question of whether we are concerned that patients
have any form of conscious substrate while under anesthesia, or if our
concern is reserved only for those circumstances in which an enduring
memory is formed. Rigorous studies using the isolated forearm test found
that 4.6% of all adults and 11% of those aged 18-40 have some form of
connected consciousness during general anesthesia in a clinical setting,
while highly controlled laboratory studies of propofol and dexmedetomidine
infusions at doses leading to unresponsiveness found that 89.8% of
subjects receiving dexmedetomidine and 73.5% of those receiving propofol
reported some form of conscious experience during unresponsiveness. The
current state of the literature suggests that some form of conscious
substrate can occur in a small but non-zero percentage of patients under
general anesthesia, but this is mostly highly internalized and not
connected to external events or stimuli. The reported incidence of
awareness under anesthesia in clinical settings depends dramatically on
how the information is sought. Studies actively questioning for awareness
using the modified Brice interview consistently report an incidence of 0.1
- 0.2% (1:500 - 1:1,000 cases), while those relying of self-report are
more than an order of magnitude less, at 0.005 - 0.007% (1:15,000 -
1:20,000 cases). This wide discrepancy could be the result of
under-reporting via selfreport and over-reporting via targeted
questioning, but the extent of each contribution is presently unclear.
Prominent anesthetic risk factors include the use of neuromuscular
blockade, rapid sequence induction, and total intravenous anesthesia
(TIVA), while surgical risk factors include obstetric and cardiothoracic
procedures. Of particular concern is the ability for awareness under
anesthesia to lead to psychological morbidity, including the development
of post-traumatic stress disorder (PTSD). The presence of pain and
paralysis during the awareness event are most strongly correlated to
psychological distress, and psychological distress at the time of the
awareness event is most predictive of long-term psychological harm.
Reports from awareness trials have found that 43% of patients experiencing
awareness will screen for PTSD symptoms postoperatively (compared to 16%
of those without awareness), while 14.3% will meet full PTSD diagnostic
criteria (cf. 7.6%). A series of large randomized controlled trials
conducted through the 2000s and 2010s found that the use of processed
electroencephalography (pEEG, usually the bispectral index, BIS) in the
titration of anesthesia was not superior to following end-tidal
concentrations of anesthetic gases in the case of general anesthesia using
volatile gases. However, the use of pEEG is superior to routine care in
the case of general anesthesia administered by TIVA. In cases of definite
awareness, referral to psychological or psychiatric expertise is highly
advised. Several significant questions in this clinical domain remain,
including whether awareness without recall can cause psychological harm,
and whether there is a genetic predisposition to awareness..

<111>
Accession Number
647299736
Title
The 2025 American Association for Thoracic Surgery (AATS) Expert Consensus
Document: Surgical Management of Esophageal and Gastroesophageal Junction
Cancer.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2025. Date of Publication: 13 Apr 2025.
Author
Molena D.; Sewell M.; Maron S.B.; Hofstetter W.; Worrell S.; Chen K.N.;
Enzinger P.; Gerdes H.; Kleinberg L.; Murthy S.; Palta M.; Pouw R.; Reddy
R.M.; Sanford D.; Schumacher L.; Sihag S.; Berry M.F.
Institution
(Molena, Sewell, Sihag) Thoracic Service, Department of Surgery, Memorial
Sloan Kettering Cancer Center, New York, NY
(Maron) Gastrointestinal Oncology Service, Department of Medicine,
Memorial Sloan Kettering Cancer Center, New York, NY
(Hofstetter) Department of Thoracic and Cardiovascular Surgery, University
of Texas MD Anderson Cancer Center, Houston, TX, United States
(Worrell) Section of Thoracic Surgery, Department of Surgery, University
of Arizona, Tucson, AZ, United States
(Chen) Department of Thoracic Surgery, Beijing Cancer Hospital, Peking
University, Beijing, China
(Enzinger) Center for Esophageal and Gastric Cancer, Dana Farber/Brigham
Cancer Center, Boston, MA, United States
(Gerdes) Gastroenterology, Hepatology, and Nutrition Service, Department
of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
(Kleinberg) Department of Radiation Oncology and Molecular Radiation
Sciences, Johns Hopkins University, Baltimore, MD, Liberia
(Murthy) Department of Thoracic and Cardiovascular Surgery, Heart and
Vascular Institute, Cleveland Clinic, Cleveland, OH, United States
(Palta) Department of Radiation Oncology, Duke University Medical Center,
Durham, NC, United States
(Pouw) Dept. of Gastroenterology and Hepatology, University Medical Center
Utrecht, Utrecht, Netherlands
(Reddy) Section of Thoracic Surgery, Department of Surgery, University of
Michigan, Ann Arbor, MI, United States
(Sanford) Section of Hepato-Pancreato-Biliary Surgery, Washington
University School of Medicine, St. Louis, MO, United States
(Schumacher) Division of Thoracic Surgery, Massachusetts General Hospital,
Boston, MA, United States
(Berry) Department of Cardiothoracic Surgery, Stanford University Medical
Center, Palo Alto, CA, United States
Abstract
OBJECTIVE: Esophagectomy has been a cornerstone of the treatment of
nonmetastatic esophageal cancer, but its use has evolved with advances in
endoscopic resection techniques, systemic therapy, and radiation. This
document reviews the existing literature and reports multidisciplinary
consensus and specific recommendations on how best to treat esophageal and
gastroesophageal junction cancer at different stages, including difficult
clinical scenarios. METHOD(S): The American Association for Thoracic
Surgery Clinical Practice Standards Committee assembled an international,
multidisciplinary panel of gastroenterologists, medical oncologists,
radiation oncologists, surgical oncologists, and thoracic surgeons with
established esophageal and gastroesophageal junction cancer management
expertise. A focused literature review was performed with the assistance
of a medical librarian. The panel used a modified Delphi method to develop
expert consensus statements with a class of recommendations and level of
evidence for 3 topics: early-stage adenocarcinoma, locally advanced
adenocarcinoma, and squamous cell carcinoma. RESULT(S): Consensus was
reached on 23 recommendations, reflecting insights based on the latest
literature and current clinical experience that focused on disease stage
and histology. The recommendations provide input on the role of surgery,
endoscopic therapy, and surveillance for early-stage adenocarcinoma, how
to best combine surgery with multimodality therapy for locally advanced
adenocarcinoma, and when surgery should be used for patients with squamous
cell carcinoma. CONCLUSION(S): Despite the complex nature of
esophageal cancer management, consensus on several key recommendations was
achieved by this American Association for Thoracic Surgery expert panel.
These recommendations, based on evidence and developed using the modified
Delphi method and expert opinion, provide guidance for thoracic surgeons
and other medical professionals who care for esophageal cancer
patients. Copyright © 2025. Published by Elsevier Inc.

<112>
Accession Number
2038600185
Title
Effect of Vitamin C Injection on the Use of Inotropes for Cardiac
Vasoplegia after Cardiopulmonary Bypass (CPB): A Randomized Comparative
Study.
Source
European Journal of Cardiovascular Medicine. 15(5) (pp 44-48), 2025. Date
of Publication: 01 May 2025.
Author
Sharma M.; Kumar P.; Hussain M.; Kishore N.; Singh N.
Institution
(Sharma, Kumar) Department of Anaesthesia & Critical Care, Indira Gandhi
Institute of Medical Sciences, Bihar, Patna, India
(Hussain) Department of Anaesthesia & Critical Care, Indira Gandhi
Institute of Medical Sciences, Bihar, Patna, India
(Kishore) Department of Surgery, Netaji Subash Medical College and
Hospital, Amhara, Bihar, Bihta, India
(Singh) Department of Microbiology, Nalanda Medical College and Hospital,
Bihar, Patna, India
Publisher
Healthcare Bulletin
Abstract
Background: Vasoplegic syndrome, a common complication following
cardiopulmonary bypass (CPB), is characterized by refractory hypotension,
low systemic vascular resistance, and high vasopressor requirements,
contributing to increased morbidity. Vitamin C, with its roles in
catecholamine synthesis, endothelial protection, and antioxidant activity,
may mitigate vasoplegia by addressing oxidative stress and inflammation
induced by CPB. Despite promising findings in sepsis, robust evidence for
vitamin C in post-CPB vasoplegia remains limited. This randomized
controlled trial evaluates the efficacy of high-dose intravenous vitamin C
in reducing noradrenaline requirements and improving outcomes in cardiac
surgery patients. Material(s) and Method(s): This prospective,
randomized, double-blind, placebo-controlled trial enrolled 88 patients
undergoing elective mitral or aortic valve replacement under
cardiopulmonary bypass (CPB) at a tertiary care center. Participants were
randomized to receive either intravenous vitamin C (2 g at CPB weaning and
2 g on postoperative day 1) or placebo (normal saline). Inclusion criteria
comprised adults (20-60 years) with postoperative vasoplegia requiring
noradrenaline, while exclusion criteria excluded complex surgeries, severe
cardiac dysfunction (LVEF <30%), or vitamin C supplementation. Statistical
analysis was performed using GraphPad with significance set at p<0.05.
 Result(s): The vitamin C group showed significantly reduced
vasopressor requirements (38.6% vs 68.2%, p=0.004) and faster vasoplegia
resolution (14.4+/-4.6 vs 24.6+/-7.2 hours, p<0.001) compared to placebo.
Vitamin C recipients achieved higher post-CPB mean arterial pressure
(93.2+/-22.8 vs 81.1+/-28.6 mmHg, p=0.035) and shorter ICU stays
(4.1+/-1.8 vs 5.2+/-2.3 days, p=0.017). Mortality did not differ
significantly (1 vs 2 cases, p=0.555). Conclusion(s): Targeted
therapies play a vital role in improving outcomes in post-cardiopulmonary
bypass (CPB) vasoplegia. Among these, vitamin C has emerged as a promising
adjunct, particularly in refractory cases. Its administration has been
associated with enhanced patient outcomes, including reduced reliance on
postoperative inotropic support (such as norepinephrine) to maintain a
mean arterial pressure (MAP) above 65 mmHg, as well as shorter ICU
stays. Copyright © 2025 Healthcare Bulletin. All rights reserved.

<113>
Accession Number
2034544701
Title
Intraoperative Lung Ultrasound in the Detection of Pulmonary Nodules: A
Valuable Tool in Thoracic Surgery.
Source
Diagnostics. 15(9) (no pagination), 2025. Article Number: 1074. Date of
Publication: 01 May 2025.
Author
Yasin D.; Al Khateeb J.; Sbeih D.; Akar F.A.
Institution
(Yasin, Al Khateeb, Sbeih, Akar) Faculty of Medicine, Al-Quds University,
East Jerusalem, Palestine
(Akar) Department of Thoracic Surgery, The Edith Wolfson Medical Center,
Holon, Israel
(Akar) Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
In the last two decades, there has been an increased interest in the
application of lung ultrasound (LUS), especially intraoperatively, owing
to its safety and simple approach to detecting and assessing pulmonary
nodules. This review focuses on recent advancements in intraoperative lung
ultrasound in detecting lung nodules. A systematic search was conducted
using databases such as PubMed and Google Scholar. Keywords included "Lung
ultrasound", "intraoperative lung ultrasound", and "video-assisted
transthoracic surgery (VATS)". Articles published between 1963 and 2024 in
peer-reviewed journals were included, focusing on the ones from the 2000s.
Data on methodology, key findings, and research gaps were reviewed.
Results indicated a significant advantage of intraoperative lung
ultrasound (ILU) in the assessment of pulmonary nodules. ILU offers a
noninvasive, real-time imaging modality that demonstrates up to 100%
accuracy in detecting pulmonary nodules, with shorter time needed compared
to other modalities, as well as less intraoperative periods and
postoperative complications. However, some disadvantages were detected,
such as operator dependency and a lack of specificity and knowledge of
specific signs, as well as assisted localization via percutaneous puncture
and its correct interpretation. The findings suggest that ILU has a
promising future in pulmonary surgeries such as LUS-VATS but needs to be
engaged more in clinical applications and modified with new techniques
such as artificial intelligence (AI). Copyright © 2025 by the
authors.

<114>
Accession Number
2034544976
Title
Robotic-Assisted Thoracoscopic Surgery Versus Video-Assisted Thoracoscopic
Surgery: Which Is the Preferred Approach for Early-Stage NSCLC?.
Source
Journal of Clinical Medicine. 14(9) (no pagination), 2025. Article Number:
3032. Date of Publication: 01 May 2025.
Author
Syrigos N.; Fyta E.; Goumas G.; Trontzas I.P.; Vathiotis I.; Panagiotou
E.; Nikiteas N.I.; Kotteas E.; Dimitroulis D.
Institution
(Syrigos, Fyta, Nikiteas, Dimitroulis) Hellenic Minimally Invasive and
Robotic Surgery (MIRS) Study Group, Medical School, National and
Kapodistrian University of Athens, Athens, Greece
(Syrigos, Fyta, Goumas, Trontzas, Vathiotis, Panagiotou, Kotteas) 3rd
Department of Internal Medicine, Oncology Unit, "SOTIRIA" General Hospital
of Chest Diseases, National and Kapodistrian University of Athens, Athens,
Greece
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Lung cancer is the leading cause of cancer-related mortality among both
men and women worldwide, underscoring the need for an effective treatment
strategy. For early-stage non-small cell lung cancer [NSCLC], surgical
resection is the standard treatment. Robotic-assisted thoracic surgery
[RATS] and video-assisted thoracic surgery [VATS] are better than open
thoracotomy because they are less invasive. Recent lung cancer screening
programs are detecting NSCLC at earlier stages, which is expected to
result in an increase in the number of NSCLC surgeries as early-stage
cases are diagnosed. A limited number of randomized controlled trials have
compared RATS and VATS in operable NSCLC. We conducted a literature review
to summarize the available evidence on these two surgical techniques. The
purpose of this study is to compare the intraoperative and postoperative
outcomes of RATS and VATS in early-stage NSCLC patients. RATS shows lower
conversion rates to thoracotomy (6.3% vs. 13.1% p < 0.01) and more
thorough lymph node dissection than VATS (e.g., 7.5 vs. 5.6 stations, p <
0.001). However, RATS is linked to considerably higher costs (USD 22,582
vs. USD 17,874, p < 0.05) and longer operative times (median 241.7 vs.
214.4 min, p = 0.06). The two techniques exhibited minimal differences in
postoperative complications and pain, while RATS patients experienced
shortened hospital stays (4-5 vs. 5-6 days, p < 0.006). While the accuracy
of staging and treatment planning is improved by the improved lymph node
retrieval in RATS, the long-term survival rate is still
uncertain. Copyright © 2025 by the authors.

<115>
Accession Number
2034548217
Title
New Clinical Advances in Minimally Invasive Coronary Surgery.
Source
Journal of Clinical Medicine. 14(9) (no pagination), 2025. Article Number:
3142. Date of Publication: 01 May 2025.
Author
Raja S.G.
Institution
(Raja) Department of Cardiac Surgery, Harefield Hospital, London, United
Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Minimally invasive coronary surgery (MICS) has emerged as an
alternative approach in the surgical management of coronary artery disease
(CAD), offering potential advantages such as reduced surgical trauma,
shorter hospital stays, and faster recovery. While conventional coronary
artery bypass grafting (CABG) remains the standard treatment for severe
CAD, MICS has seen variable adoption due to concerns over procedural
complexity, the risk of incomplete revascularization, and the increasing
role of percutaneous interventional techniques. Objective(s): This
review examines recent clinical developments in MICS, analyzing its
techniques, technological advancements, and the impact on patient
outcomes, while also addressing its limitations. Method(s): This
narrative review incorporates studies from PubMed, tracing the evolution
of coronary surgery, the refinement of minimally invasive approaches, and
the innovations that have enabled the selective implementation of MICS.
This review evaluates robot-assisted coronary surgery and totally
endoscopic coronary revascularization, discussing their clinical
indications and comparative outcomes. Result(s): Advances in imaging,
surgical instrumentation, and anesthesia have improved procedural safety
and precision, yet MICS remains a selectively utilized technique rather
than a universally preferred alternative. Comparative studies demonstrate
mixed clinical outcomes, highlighting both the recovery benefits and
technical challenges associated with MICS. Discussion(s): Patient
selection, preoperative planning, and individualized surgical strategies
play a crucial role in optimizing the effectiveness of MICS. Challenges
include technical complexity, integration into broader clinical practice,
and the need for procedural refinement. While ongoing research continues
to address these hurdles, the role of MICS in CAD management remains
context-dependent, influenced by case complexity and institutional
expertise. Conclusion(s): MICS presents an evolving surgical approach
with defined benefits and limitations, requiring careful patient selection
and procedural optimization for the best outcomes. This review provides a
comprehensive evaluation of recent advances in MICS while acknowledging
its challenges and selective application in coronary
surgery. Copyright © 2025 by the author.

<116>
Accession Number
647301054
Title
The association of pulmonary artery catheterization utilization and
surgical patients' outcomes: a PRISMA-compliant systematic review and
meta-analysis.
Source
Journal of cardiothoracic surgery. 20(1) (pp 227), 2025. Date of
Publication: 06 May 2025.
Author
Xie C.-M.; He L.-X.; Shen M.-Q.; Yao Y.-T.
Institution
(Xie, He, Shen) Department of Anesthesiology, Fuwai Yunnan Hospital,
Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of
Kunming Medical University, Kunming, China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College and Chinese Academy
of Medical Sciences, Beijing, China
Abstract
BACKGROUND: The utilization of pulmonary artery catheterization (PAC) in
surgical patients remains controversial. This study aims to assess the
impact of PAC utilization on surgical patient outcomes. METHOD(S):
Electronic databases were searched for studies comparing PAC with no-PAC
in surgical patients. The primary outcome was short-term mortality.
Secondary outcomes included the incidence of postoperative complications,
postoperative recovery indicators, and hospitalization costs.
 RESULT(S): Ten randomized controlled trials (n = 2,889) and sixteen
observational studies (n = 2,221,917) were included. Among these studies,
fifteen involved cardiac surgical patients (n = 2,217,736), and eleven
involved non-cardiac surgical patients (n = 7,070). The present study
demonstrated PAC utilization did not affect short-term mortality in
cardiac surgical patients [odds ratio (OR) 1.20, 95% confidence interval
(CI) 0.79-1.82, p 0.40], and was associated with a higher incidence of
postoperative chronic heart failure, acute renal failure, cerebrovascular
events, infectious complications, and longer length of stay (LOS) in
intensive care unit (ICU) or hospital. Moreover, PAC utilization was not
associated with short-term mortality (OR 0.40, 95% CI 0.16-1.02, p 0.06)
and other outcomes for non-cardiac surgical patients. CONCLUSION(S):
This meta-analysis suggested PAC utilization was not associated with
short-term mortality in surgical patients but with a higher incidence of
major complications and longer LOS in the ICU or hospital in cardiac
surgical patients. Copyright © 2025. The Author(s).

<117>
Accession Number
647304864
Title
CardioAlex 2024 Conference.
Source
European Heart Journal, Supplement. Conference: CardioAlex 2024
Conference. Alexandria Egypt. 26(Supplement 5) (no pagination), 2024. Date
of Publication: 01 Sep 2024.
Author
Anonymous
Publisher
Oxford University Press
Abstract
The proceedings contain 7 papers. The topics discussed include: clinical
characteristics and management of patients with heart failure in Egypt:
real-world insights from iCaReMe Global Registry; impact of age at
intervention on three-dimensional RV functions post percutaneous pulmonary
valvuloplasty; incidence of in-hospital MACE in patients presented with
acute STEMI in the presence of CTO in Non-IRA; is LVH a must in an amyloid
heart?; is dabigatran a good alternative to warfarin in patients with
atrial fibrillation accompanied by valvular and nonvalvular heart
diseases? a systematic review and meta-analysis; main predictor of post
CABG mortality and morbidity at national heart institute; and sudden
cardiac death initiative: a national campaign to raise awareness of sudden
cardiac death.

<118>
Accession Number
647303858
Title
Weighing the options: Surgical and medical management of unilateral
aldosterone excess demonstrate distinct profiles of benefits and harms.
Source
Canadian Urological Association Journal. Conference: 79th Annual Meeting
of the Canadian Urological Association, CUA 2024. Victoria, BC Canada.
18(6 Supplement) (pp S76), 2024. Date of Publication: 01 Jun 2024.
Author
Salman M.; Le Roux A.; Hundemer G.; Rowe N.
Institution
(Salman, Hundemer, Rowe) Department of Medicine, University of Ottawa,
Ottawa, Canada
(Salman, Hundemer) Department of Nephrology, Ottawa Hospital, Ottawa,
Canada
(Le Roux, Rowe) Department of Urology, Ottawa Hospital, Ottawa, Canada
Publisher
Canadian Urological Association
Abstract
Introduction: Primary aldosteronism (PA) is characterized by autonomous
aldosterone production that may lead to hypertension and hypokalemia in
affected patients. One-third of such patients have unilateral disease,
which was our study's focus. The main treatment options for unilateral
disease include adrenalectomy or mineralocorticoid receptor antagonists
(MRA), with each treatment carrying its respective risks and benefits. Our
study aimed to clarify the benefits and harms of the main treatment
modalities to inform patients making treatment decisions. Method(s):
We performed a scoping review of the English literature. Medline and
Cochrane databases were used to extract meta-analysis, treatment
guidelines, and systematic reviews. Inclusion criteria were
hyperaldosteronism, drug therapy, prevention and control, surgery,
therapy, peer-reviewed, systematic reviews, metaanalyses, and guidelines;
exclusion criteria were animal studies, case reports, letters, editorials,
and duplicates. Result(s): Our search criteria identified 161
studies. Of these, 101 were excluded based on irrelevance, leaving 60
studies that were informative for surgical and medical treatment outcomes.
We performed a qualitative analysis. Patients receiving either
adrenalectomy or MRA had improved post-treatment blood pressure; however,
patients who underwent adrenalectomy were more often on less
antihypertensive agents compared to patients on a MRA (p< 0.00001),1 and
the odds of cardiac events after surgery, including coronary artery
disease (OR 0.3, p=0.008), major adverse cardiac events (OR 0.55,
p=0.0001), and congestive heart failure (OR 0.52, p=0.004), were reduced.2
Major complications (1.3%) from surgery included blood loss requiring
transfusion, surgical site infections, conversion to open surgery, and
mortality.3 Side effects of MRA therapy include gynecomastia (10%),4
erectile dysfunction (5.8%),5 and hyperkalemia (11.2%).6
 Conclusion(s): Unilateral aldosterone excess can be managed with
either extirpative surgery or a mineralocorticoid antagonist; however,
each treatment modality has a unique profile of benefits and risks. These
data may facilitate treatment discussions and support shared
decision-making..

<119>
Accession Number
647301656
Title
Ultrasound-guided vs. Conventional closure device deployment after
transfemoral endovascular procedures: A systematic review and
meta-analysis.
Source
Vasa - European Journal of Vascular Medicine. Conference: 53. Jahrestagung
der Deutschen Gesellschaft fur Angiologie - Gesellschaft fur
Gefabetamedizin e.V. und 8. DGA-Interventionskongress. Leipzig Germany.
53(Supplement 1) (pp 15), 2024. Date of Publication: 01 Sep 2024.
Author
Meertens M.; Kalaja I.; Macherey-Meyer S.; Smeets R.; Wagner M.; Adam M.;
Baldus S.; Espinola-Klein C.; Mees B.
Institution
(Meertens, Kalaja, Espinola-Klein) Unimedizin Mainz, Mainz, Germany
(Macherey-Meyer, Adam, Baldus) Uniklinik Koln, Cologne, Germany
(Smeets, Mees) Maastricht University Medical Center, Maastricht,
Netherlands
(Wagner) Uniklinik Koln, Vascular Surgery, Cologne, Germany
Publisher
Hogrefe Verlag GmbH and Co. KG
Abstract
Background Endovascular interventions such as peripheral arterial disease
intervention or transcatheter aortic valve implantations are performed
percutaneously via transfemoral access. Access site complications are an
omnipresent concern, and predictive for interventional outcome by
increasing 30-day mortality. The prevalence of access complications (AC)
has only slightly decreased over the last years. Earlier meta-analysis
have shown that the use of ultrasound-guided (USG) puncture reduces the
risk for AC in several types of procedures. Advantages offered by USG
puncture are most accurate guidance of puncture. USG closure can mitigate
the risk of access vessel occlusion by deploying the entire device
intravascularly, placing the closure device extravascularly, and
preventing improper closure caused by anterior or posterior calcification,
summarized by ensuring precise deployment at the intended location.
Patients and methods The aim of this study was to evaluate the effect of
USG vs. conventional closure (CC) after cardiovascular interventions with
artery puncture, and the impact on the incidence of access complications.
A systematic literature search was performed using the Web of science,
Cochrane Database and Medline database. Studies reporting and comparing
the incidence of AC after USG closure for transfemoral cardiovascular
procedures were included. Results Eleven studies were included of which
six were included in the meta-analysis. Three studies included TAVI
patients, four studies included patients who underwent a variety of
endovascular, three studies included PTA patients and one reported on ECMO
patients. Overall, 2738 patients who received USG closure were included.
The overall incidence of AC was 4.7%, in large sheath size procedures it
was 7.4% and in small sheath size procedures it was 3.2%. In the
meta-analysis 2339 patients received USG closure and 1175 conventional
closure. Three studies were conducted on TAVI patients and three evaluated
patients undergoing PTA or pooled small sheath endovascular procedures.
The effect was consistent for patients who received a PTA or an
endovascular procedure (OR 0.47, CI 0.26-0.83, P = .0009) and patients who
underwent a transfemoral TAVI procedures (OR 0.49, CI 0.34-0.72, P =
.0002). USG closure reduced access site complications (OR 0.49, CI
0.36-0.66, P < .001), major AC (OR 0.26, CI 0.12-0.59, P = .001) and
bleeding complications (OR 0.49, CI 0.32-0.76, P = .001) significantly
compared to CC. Conclusions USG closure is an upcoming topic in vascular
closure and is already used in various cardiovascular interventions.
Compared to CC, USG closure reduced access site complications in a pooled
analysis of retrospective studies including large and small sheath size
procedures.

<120>
Accession Number
647304815
Title
Opportunities for mechanistic studies of stroke in collaboration with the
Cardiothoracic Surgical Trials Network.
Source
Neurology: Genetics. Conference: 24th International Stroke Genetics
Consortium, ISGC. Washington, DC United States. 5(1 Supplement 1) (pp 6),
2019. Date of Publication: 01 Apr 2019.
Author
Kirkwood K.A.; Messe S.R.; Taylor D.A.
Institution
(Kirkwood) Icahn School of Medicine at Mount Sinai, New York, United
States
(Messe) University of Pennsylvania, School of Medicine, Philadelphia,
United States
(Taylor) Texas Heart Institute, Houston, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objective To describe the Cardiothoracic Surgical Trials Network (CTSN),
its research, and opportunities for collaboration with the International
Stroke Genetics Consortium (ISGC). Background Cardiovascular disease (CVD)
is a leading cause of morbidity and mortality in the United States and
worldwide. In response to the growing burden of CVD and the need for
rigorous clinical evaluation of new treatments, the National Heart Lung
and Blood Institute, along with the Canadian Institutes for Health
Research and the National Institute of Neurological Disorders and Stroke,
created the CTSN in 2007 to design, conduct, and analyze collaborative
clinical trials that evaluate surgical interventions and management
approaches for the treatment of CVD in adult patients. CTSN includes
clinical sites enrolling patients throughout the US, Canada, and Europe,
and is supported by a data and clinical coordinating center; a
biorepository facility; and neurocognitive, imaging, and biospecimen core
laboratories. Importantly, stroke is a known and feared complication of
cardiac surgery, and CTSN has focused on neurologic outcomes of surgery as
a core mission, in order to improve outcomes for patients. Design/Methods
CTSN has completed 7 randomized controlled trials (RCTs) with nearly 3,500
patients focusing on ischemic mitral regurgitation, atrial fibrillation,
advanced heart failure, and intra-operative embolic protection;
biospecimens were collected and banked in 5 of these trials and are linked
to clinical data. The results of these trials will be used to inform the
design of up to 5 future clinical trials focused on management of the risk
of perioperative and long-term neurologic events and outcomes. Results
CTSN is currently planning trials of anticoagulation for post-operative
atrial fibrillation and bioprosthetic valve surgery, neuroprotection in
valve surgery, and novel left ventricular assist devices. The Network
hopes to collaborate with the ISGC on design and analysis of genetic
analyses related to stroke events in these populations. Conclusions In
conclusion, CTSN has successfully completed multiple CVD RCTs including
studies focused on stroke and neurologic outcomes of surgery. New trials
in populations at high risk of stroke provide an ideal opportunity for
collaboration with the ISGC.

<121>
Accession Number
647304833
Title
24th Workshop of the International Stroke Genetics Consortium.
Source
Neurology: Genetics. Conference: 24th International Stroke Genetics
Consortium, ISGC. Washington, DC United States. 5(1 Supplement 1) (no
pagination), 2019. Date of Publication: 01 Apr 2019.
Author
Anonymous
Publisher
Lippincott Williams and Wilkins
Abstract
The proceedings contain 20 papers. The topics discussed include: the role
of mitochondrial DNA variations on intracranial atherosclerosis in Han
Chinese patients; the promise of standardized biobanking in regenerative
medicine; the second phase GISCOME initiative: a genome-wide association
meta-analysis of functional outcome after ischemic stroke; seven loci
identified in epigenome wide survival analysis of time to recurrent
stroke, composite vascular endpoint, and disabling/fatal stroke,
myocardial infarction or death in participants from the VISP clinical
trial; beyond the brain: a systematic review of phenotypes associated with
mutations in mendelian cerebral small vessel disease genes; Japan
collaborative project on intracranial aneurysm; and opportunities for
mechanistic studies of stroke in collaboration with the cardiothoracic
surgical trials network.

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