EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 114

Results Generated From:
Embase <1980 to 2025 Week 23>
Embase Weekly Updates (updates since 2025-05-30)

<1>
Accession Number
2038843067
Title
ACURATE neo2 valve versus commercially available transcatheter heart
valves in patients with severe aortic stenosis (ACURATE IDE): a
multicentre, randomised, controlled, non-inferiority trial.
Source
The Lancet. (no pagination), 2025. Date of Publication: 2025.
Author
Makkar R.R.; Ramana R.K.; Gnall E.; Ramlawi B.; Cheng W.; Diamantouros P.;
Potluri S.; Kleinman N.; Gupta A.; Chakravarty T.; Samy S.; Rassi A.;
Rajagopal V.; Yakubov S.; Sorajja P.; Patel D.; Garcia S.; Yadav P.;
Thourani V.; Wang J.; Rinaldi M.; Kapadia S.; Waksman R.; Webb J.; Ren
C.B.; Gregson J.; Modolo R.; Sathananthan J.; Reardon M.J.
Institution
(Makkar, Cheng, Gupta, Chakravarty, Patel) Cedars-Sinai Medical Center,
Los Angeles, CA, United States
(Ramana, Ramlawi) Lankenau Hospital, Wynnewood, PA, United States
(Gnall) Advocate Christ Medical Center, Mokena, IL, United States
(Diamantouros) London Health Sciences Centre, London, ON, Canada
(Potluri) Baylor Scott & White The Heart Hospital, Plano, TX, United
States
(Kleinman, Reardon) Houston Methodist Hospital, Houston, TX, United States
(Samy) Albany Medical Center, Albany, NY, United States
(Rassi) Kaiser Permanente, San Francisco, CA, United States
(Rajagopal, Yadav, Thourani) Piedmont Hospital, Atlanta, GA, United States
(Yakubov) OhioHealth Research and Innovation Institute-Riverside Methodist
Hospital, Columbus, OH, United States
(Sorajja) Abbott Northwestern Hospital, Minneapolis, MN, United States
(Garcia) Lindner Center for Research and Education at Christ Hospital,
Cincinnati, OH, United States
(Wang) Union Memorial Hospital, Baltimore, MD, United States
(Rinaldi) Carolinas Medical Center, Charlotte, NC, United States
(Kapadia) Cleveland Clinic Foundation, Cleveland, OH, United States
(Waksman) Washington Hospital Center, Washington, DC, United States
(Webb) Providence Health-St Paul's Hospital, Vancouver, BC, Canada
(Ren) Cardialysis, Rotterdam, Netherlands
(Gregson) London School of Public Hygiene, London, United Kingdom
(Modolo, Sathananthan) Boston Scientific, Minneapolis, MN, United States
Publisher
Elsevier B.V.
Abstract
Background: ACURATE neo2 is an open-cell, supra-annular, self-expanding
transcatheter heart valve that is commercially available in over 50
countries but has not previously been evaluated in a randomised trial.
ACURATE-IDE aimed to prospectively evaluate the safety and efficacy of
transcatheter aortic valve replacement (TAVR) with the ACURATE neo2 valve
compared with commercially available valves for the treatment of severe
symptomatic aortic stenosis. <br/>Method(s): In this multicentre,
randomised, controlled, non-inferiority trial, patients with symptomatic
severe aortic stenosis and any level of surgical risk were recruited from
71 medical centres in the USA and Canada. Eligible patients were randomly
assigned (1:1) to TAVR with ACURATE neo2 or one of the control valves,
SAPIEN 3 (SAPIEN 3 or SAPIEN 3 Ultra) or Evolut, using permuted block
randomisation with a pseudo-random number generator, and stratified by the
clinical investigation site and type of control valve. All devices were
implanted according to the manufacturer's instructions. The primary
endpoint was a composite of all-cause mortality, all stroke, and
rehospitalisation at 1 year, tested for non-inferiority using a Bayesian
approach. The primary analysis was performed in the intention-to-treat
population and sensitivity analyses were done in the implanted population.
The non-inferiority margin was 8.0%. This study is registered with
ClinicalTrials.gov, NCT03735667, and is ongoing. <br/>Finding(s): Between
June 10, 2019, and April 19, 2023, 1500 patients were recruited, of whom
752 were randomly assigned to the ACURATE neo2 group and 748 to the
control group. The median age of participants was 79 years (IQR 74-83).
778 (51.9%) of 1500 patients were female and 721 (48.1%) were male. At 1
year, the posterior median probability of the primary composite endpoint
was higher in the ACURATE neo2 group (16.2% [95% Bayesian credible
interval 13.4-19.1) than in the control group (9.5% [7.5-11.9];
between-group difference 6.6% [3.0-10.2]). The upper bound of treatment
difference exceeded the prespecified non-inferiority margin of 8%, with a
posterior probability of treatment difference of >0.999. At 1 year, the
ACURATE neo2 group, had significantly higher Kaplan-Meier rates of the
composite endpoint of all-cause mortality, all stroke, and
rehospitalisation (14.8% [95% CI 12.5-17.6] vs 9.1% [7.2-11.4]; hazard
ratio [HR] 1.71 [95% CI 1.26-2.33]; p=0.0005). At 1 year, all-cause
mortality occurred in 36 of 752 patients in the ACURATE neo2 group versus
28 of 748 patients in the control group (HR 1.30 [95% CI 0.80-2.14]),
stroke in 41 patients versus 25 patients (1.68 [1.02-2.75]), and
rehospitalisation in 38 patients versus 25 patients (1.57 [0.95-2.61]).
Cardiovascular mortality (3.7% vs 1.8%, p=0.024) and spontaneous
myocardial infarction at 1 year (2.4% vs 0.7%, p=0.0092) were more
frequent in the ACURATE neo2 group than in the control group. Prosthetic
valve aortic regurgitation (central plus paravalvular) at 1 year was
significantly more frequent in the ACURATE neo2 group than in the control
group (mild aortic regurgitation 42.5% vs 24.8%, p<0.0001; moderate 4.4%
vs 1.8%, p=0.0070; severe 0.5% vs 0%; p=0.12). <br/>Interpretation(s): In
patients with symptomatic severe aortic stenosis, TAVR with ACURATE neo2
did not meet non-inferiority and resulted in significantly worse outcomes
with respect to the primary endpoint of composite of all-cause mortality,
all stroke, and rehospitalisation at 1 year when compared with commercial
valves. <br/>Funding(s): Boston Scientific.<br/>Copyright &#xa9; 2025
Elsevier Ltd

<2>
Accession Number
2034589507
Title
Sugammadex or neostigmine for reversal of neuromuscular block on the
quality of postoperative recovery in elderly adults undergoing
video-assisted thoracoscopic lobectomy: a randomised controlled trial.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 250. Date
of Publication: 01 Dec 2025.
Author
Yang Y.; Wang Z.; He X.; Shen X.; Jia W.; Sheng X.; Yao X.; Jiao H.
Institution
(Yang, Wang, He, Shen, Jia, Sheng, Yao, Jiao) School of Anesthesiology,
Xuzhou Medical University, 209 Tongshan Road, Jiangsu, Xuzhou, China
(Jiao) Department of Anesthesiology, The Affiliated Hospital of Xuzhou
Medical University, No.99 Huaihai West Road, Jiangsu, Xuzhou, China
Publisher
BioMed Central Ltd
Abstract
Background: Although neostigmine has been traditionally used for
neuromuscular blockade reversal in thoracic surgery, incomplete reversal
and potential pulmonary complications remain concerns. However, we did not
preclude its clinical use. In contrast, sugammadex offers more predictable
recovery of neuromuscular function with a superior safety profile. This
study aims to compare the efficacy of sugammadex versus neostigmine in
improving postoperative recovery outcomes. <br/>Method(s): This study is a
prospective, randomized, double-blind trial. Patients above 65 years old
undergoing video-assisted thoracoscopic lobectomy were randomly assigned
to receive either sugammadex (2 mg/kg) or neostigmine (0.04 mg/kg) with
atropine for neuromuscular block reversal after T2 appearance on TOF. The
primary outcome was the quality of recovery at postoperative day (POD) 1,
assessed by the QoR-15 questionnaire. Secondary outcomes included
extubation time, PACU stay, incidence of hypoxaemia, PRNB, and
postoperative pulmonary complications (PPCs). <br/>Result(s): Data
analysis included 77 patients (39 in Group S and 38 in Group N). The
QoR-15 scores were significantly higher in the sugammadex group at day 1
(125 vs. 122, P < 0.001). Sugammadex significantly reduced extubation time
(18 vs. 27.5 min, P = 0.001) and PACU stay (52 vs. 62 min, P = 0.001).
Hypoxaemia (28% vs. 53%, P = 0.029) and PRNB (5% vs. 24%, P = 0.020) were
less frequent in the sugammadex group. The sugammadex group had fewer
PPCs, the difference was not statistically significant (26% vs. 45%, P =
0.079). <br/>Conclusion(s): For elderly patients receiving VATS lobectomy,
sugammadex is beneficial for acute recovery except PONV up to POD1
recovery quality mainly in ease of breath, eating, resting but not in
postoperative outcomes over one month. Trial registration: Retrospectively
registered, Chinese Clinical Trial Registry,
ChiCTR2400089863(Date:18/09/2024).<br/>Copyright &#xa9; The Author(s)
2025.

<3>
Accession Number
2038916613
Title
Sex differences on the effect of hemoadsorption during cardiac surgery - A
REMOVE trial post-hoc analysis.
Source
International Journal of Cardiology. 435 (no pagination), 2025. Article
Number: 133371. Date of Publication: 15 Sep 2025.
Author
Caldonazo T.; Doenst T.; Fazzini L.; Kirov H.; Hagel S.; Lehmann T.; Saha
S.; Boburg R.S.; Freiburger S.; Rustenbach C.J.; Marin-Cuartas M.; Diab M.
Institution
(Caldonazo, Doenst, Kirov, Freiburger) Department of Cardiothoracic
Surgery, Friedrich-Schiller-University Jena, Jena, Germany
(Fazzini) Department of Medical Sciences and Public Health, University of
Cagliari, Cagliari, Italy
(Hagel) Institute for Infectious Diseases and Infection Control,
Friedrich-Schiller-University Jena, Germany
(Lehmann) Center for Clinical Studies, UniversityHospital Jena, Jena,
Germany
(Saha) Department of Cardiac Surgery, LMU University Hospital, Munich,
Germany
(Boburg, Rustenbach) Department of Thoracic and Cardiovascular Surgery,
Eberhard Karls University of Tubingen, Tubingen, Germany
(Marin-Cuartas) University Department of Cardiac Surgery, Leipzig Heart
Center, Leipzig, Germany
(Diab) Department of Cardiothoracic Surgery, Helios-University-Wuppertal,
Germany
Publisher
Elsevier Ireland Ltd
Abstract
Objectives: Multi-organ failure is one of the leading causes of mortality
after cardiac surgery for infective endocarditis (IE). Although the
randomized evidence does not support the use of hemoadsorption during
cardiac surgery for IE, observational studies suggest a beneficial effect
in selected patient groups. We aimed to analyze the effect of sex
differences on hemoadsorption in patients with IE. <br/>Method(s): This is
a post-hoc analysis of the REMOVE-trial that randomized patients with IE
who underwent cardiac surgery with hemoadsorption using CytoSorb or
control. The primary endpoint was variation of Sequential Organ Failure
Assessment (DELTASOFA), defined as the difference between the mean total
postoperative and baseline SOFA score within 24 h of surgery. The
secondary endpoints were 30-day mortality and other usual postoperative
outcomes. <br/>Result(s): Among 282 patients, 73 (25.9 %) were females (38
and 35 patients in the hemoadsorption and control group, respectively) and
209 (74.1 %) were males (98 and 111 patients in the hemoadsorption and
control group, respectively). The overall DELTASOFA did not differ
significantly between the intervention groups in both female and male
subgroups (MD: -2.13, 95 % CI -5.20 to 0.93, p = 0.163; MD: 0.31, 95 % CI
-0.91 to 1.53, p = 0.612, respectively) and neither did 30-day mortality
(HR = 0.54, 95 % CI 0.23 to 1.24, p = 0.132; HR 1.17, 95 % CI 0.61 to
2.21, p = 0.634, respectively). No significant differences were observed
concerning the other secondary outcomes. <br/>Conclusion(s): The
intraoperative use of hemoadsorption was not associated with reduction of
postoperative organ dysfunction, 30-day mortality, or other major clinical
endpoints in both sex subgroups.<br/>Copyright &#xa9; 2025 The Author(s)

<4>
Accession Number
2038852765
Title
Late Outcomes After Transcatheter Aortic Valve Implantation with
Balloon-Versus Self-Expandable Valves: Meta-Analysis of Reconstructed
Time-To-Event Data.
Source
Interventional Cardiology Clinics. 14(3) (pp 351-366), 2025. Date of
Publication: 01 Jul 2025.
Author
Jacquemyn X.; Van den Eynde J.; Caldonazo T.; Brown J.A.; Dokollari A.;
Serna-Gallegos D.; Clavel M.-A.; Pibarot P.; Sultan I.; Sa M.P.
Institution
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Caldonazo) Department of Cardiothoracic Surgery, Friedrich Schiller
University, Jena, Germany
(Brown, Serna-Gallegos, Sultan, Sa) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, PA, United States
(Brown, Serna-Gallegos, Sultan, Sa) UPMC Heart and Vascular Institute,
University of Pittsburgh Medical Center, Pittsburgh, PA, United States
(Dokollari) Department of Cardiac Surgery, St. Boniface Hospital,
University of Manitoba, Winnepeg, Canada
(Clavel, Pibarot) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, Quebec, Canada
(Clavel, Pibarot) Department of Medicine, Universite Laval, Quebec City,
Quebec, Canada
Publisher
Elsevier Inc.

<5>
Accession Number
2038903438
Title
S100B in postoperative cognitive impairment: systematic review and
meta-analysis.
Source
Clinica Chimica Acta. 576 (no pagination), 2025. Article Number: 120380.
Date of Publication: 15 Aug 2025.
Author
Lu S.; Zhang J.; He X.; Huang J.
Institution
(Lu) General Practice, The 924th Hospital of Joint Logistics Support Force
of the PLA, No.1, Xinqiaoyuan Road, Xiangshan District, Guangxi Zhuang
Autonomous Region, Guilin, China
(Zhang, He, Huang) Department of Neurosurgery, Quanzhou First Hospital,
NO.1028, Anji South Road, Fengze District, Fujian, Quanzhou, China
Publisher
Elsevier B.V.
Abstract
Background: Postoperative cognitive dysfunction (POCD) is prevalent after
cardiac and non-cardiac surgeries. It has been generally accepted that
POCD is caused by an inflammatory response. This study aimed to determine
whether mini-mental state examination (MMSE) scores and the serum levels
of two prominent inflammatory factors, S-100B protein (S-100B) and
neuron-specific enolase (NSE), can predict POCD among patients undergoing
non-cardiac surgeries. <br/>Method(s): A comprehensive literature search
was conducted using electronic databases such as PubMed, Web of Science,
Scopus, Google Scholar, and Embase up to 14, January 2025 to identify
eligible observational studies evaluating the relationship between the
incidence of POCD and the serum levels of S100B, NSE, and MMSE score
before surgery and 24 h and 7 days after surgery among patients undergoing
non-cardiac surgeries. <br/>Result(s): Our findings demonstrated that
patients who developed POCD had higher S100B levels 24 h after surgery
compared to before surgery. Compared to pre-operative levels, there were
no significant differences in S100B levels at 7 days, NSE levels at 24 h
or 7 days, and MMSE scores at 24 h or 7 days after surgery. Age-based
analysis revealed that patients with POCD aged >=60 had higher S100B
levels at 24 h post-operative. Among different surgery types, S100B and
NSE levels increased significantly 24 h after spinal surgery, while MMSE
scores significantly decreased after spinal surgery. <br/>Conclusion(s):
S100B may help the early detection of POCD, and the prognostic value of
S100B can be evaluated in future studies. Unlike S100B, NSE and MMSE did
not show significant differences between POCD and non-POCD
groups.<br/>Copyright &#xa9; 2025 Elsevier B.V.

<6>
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. <br/>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). <br/>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). <br/>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<br/>Copyright &#xa9; The Author(s) 2025.

<7>
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.<br/>Copyright &#xa9; 2025, E-Century Publishing
Corporation. All rights reserved.

<8>
Accession Number
2038529018
Title
The Impact of Thyroid Hormones on Brain-Dead Organ Donors: A Systematic
Review and Meta-Analysis.
Source
Transplantation Proceedings. 57(5) (pp 698-705), 2025. Date of
Publication: 01 Jun 2025.
Author
Cavalcante L.F.F.; Prata A.A.; Lima C.R.; Stutz G.B.; Melamed T.; Lins
P.R.G.; Brigido A.R.D.
Institution
(Cavalcante) Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo, Sao
Paulo, Brazil
(Prata) Universidade Federal do Espirito Santo, Espirito Santo, Brazil
(Lima, Stutz) Universidade Federal do Rio de Janeiro, Rio de Janeiro,
Brazil
(Melamed) Queen Mary University of London Faculty of Medicine and
Dentistry, London, United Kingdom
(Lins) Universidade Federal de Sao Paulo, Sao Paulo, Brazil
(Brigido) Instituto do Coracao do Hospital das Clinicas da Faculdade de
Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
Publisher
Elsevier Inc.
Abstract
Introduction: The administration of thyroid hormones (TH) in brain-dead
donors has been proposed as a strategy to improve organ viability for
transplantation, addressing the neuroendocrine insufficiency caused by
brain death. While evidence suggests potential benefits, such as
hemodynamic stabilization and enhanced organ function, the impact of TH
replacement on donor utilization rates and transplant outcomes remains
unclear. <br/>Method(s): We performed a systematic review and
meta-analysis of randomized controlled trials (RCT) comparing TH
administration with placebo or standard-of-care. Mean differences (MD) and
risk ratios (RR) with 95% confidence intervals (CI) were pooled using a
random-effects model, and Heterogeneity was assessed using I².
<br/>Result(s): Six studies involving a total of 1,197 brain-dead organ
donors were included. Of these, 601 received TH, while 597 were given
either a placebo or standard-of-care treatment. Overall, the number of
transplanted hearts (RR 0.99; 95% CI 0.84-1.17; P = .92), lungs (RR 1.07;
95% CI 0.65-1.75; p 0.80), and livers (RR 1.00; 95% CI 0.78-1.28; P = .99)
was similar between groups. Cardiac index showed no significant difference
between groups (MD -0.05; 95% CI -0.28 to 0.19; P = .71), and similar
trends were observed for other hemodynamic parameters, including heart
rate (MD 5.11; 95% CI -1.47 to 11.69; P = .13), pulmonary capillary wedge
pressure (MD -0.02; 95% CI -1.54 to 1.50; P = .98), and central venous
pressure (MD 0.76; 95% CI -0.63 to 2.14; P = .28), indicating that TH
administration did not significantly alter these measures compared to
placebo or standard-of-care treatment. <br/>Conclusion(s): Our data
suggest that administering TH to brain-dead potential organ donors does
not effectively increase the number of organ transplants and has no impact
on hemodynamic parameters.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<9>
Accession Number
2034563895
Title
IGFBP5 mediates the therapeutic effect of isoliquiritigenin in myocardial
ischemia-reperfusion injury via AKT/GLUT4 regulated insulin resistance.
Source
Frontiers in Pharmacology. 16 (no pagination), 2025. Article Number:
1544869. Date of Publication: 2025.
Author
Bai J.; Yang S.-Y.; Yu S.-M.; Cao Y.; Ma C.-H.; Hu X.-Y.; Chen X.; Song
Y.-N.; Chen H.-J.
Institution
(Bai, Ma, Song, Chen) Translational Medicine Research Center, Guizhou
Medical University, Guizhou, Guiyang, China
(Bai, Yang, Ma, Hu, Song, Chen) Division of cardiac surgery, Guizhou
Institute of Precision Medicine, Affiliated Hospital of Guizhou Medical
University, Guizhou, Guiyang, China
(Yu) Department of Ultrasound Medicine, The Affiliated Hospital of Guizhou
Medical University, Guizhou, Guiyang, China
(Cao) Department of Anesthesiology, The Affliated JinYang Hospital of
Guizhou Medical University, The Second People's Hospital of Guiyang,
Guizhou, Guiyang, China
(Chen) Department of Endocrinology, the First Affiliated Hospital of
Wenzhou Medical University, Wenzhou, China
(Chen) Department of Pharmacology, School of Basic Medical Sciences,
Guizhou Medical University, Guizhou, Guiyang, China
Publisher
Frontiers Media SA
Abstract
Background: Myocardial ischemia/reperfusion injury (MIRI) is a critical
problem in cardiovascular medicine, often occurring after coronary
revascularization procedures or cardiopulmonary bypass. The characters of
MIRI are both energy metabolism disturbances and severe myocardium insulin
resistance (IR), which exacerbated myocardial damage and cell death.
Isoliquiritigenin (ISL), a flavonoid derived from licorice roots
(Glycyrrhiza spp.), has demonstrated protective effects on MIRI. However,
the potential cardio-protective effects and mechanism of ISL in MIRI
remain unclear. Propose: In this study, we aimed to investigate ISL's
therapeutic effects on MIRI. Moreover, we elucidate the underlying
mechanisms of ISL regulated myocardium insulin resistance in vivo and in
vitro. <br/>Method(s): In vivo, SD rats underwent left anterior descending
coronary artery ligation/reperfusion to induce MIRI. Chest
echocardiography was performed to monitor cardiac function
post-reperfusion, followed by measurement of myocardial injury and IR
markers. In vitro, H9C2 cardiomyocytes subjected to oxygen-glucose
deprivation/reperfusion (OGD/R). Markers associated with myocardial injury
and IR were assessed. Then, we identified potential therapeutic targets
IGFBP5 for MIRI by network pharmacology and molecular docking analysis.
Finally, lentivirus were used to silence or over-express IGFBP5 to
elucidate the role of IGFBP5 in regulating the therapeutic effects of ISL
on IR in MIRI. <br/>Result(s): In the present study, In vivo experiments
demonstrated that ISL attenuated myocardial infarct size, decreased serum
markers of myocardial injury, improved left ventricular systolic function,
and enhanced insulin sensitivity. In vitro data revealed that ISL
ameliorated glucose uptake and cell survival rate. Furthermore, ISL
increased AKT phosphorylation and upregulated membrane-bound GLUT4
(M-GLUT4) protein expression levels. These effects of ISL are mediated by
the induction of IGFBP5, as demonstrated using gene-specific shRNA or
overexpression for IGFBP5. <br/>Conclusion(s): Our results reveal that ISL
protects against myocardial damage caused by MIRI through the regulation
of IR via the IGFBP5/AKT/GLUT4 pathway.<br/>Copyright &#xa9; 2025 Bai,
Yang, Yu, Cao, Ma, Hu, Chen, Song and Chen.

<10>
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. <br/>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. <br/>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. <br/>Conclusion(s): Transversus thoracic plane block is
superior to the conventional opioid injection method for postoperative
pain management in pediatric cardiac surgical patients.<br/>Copyright
&#xa9; 2025 Cardiac Society of Nepal. All rights reserved.

<11>
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.
<br/>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). <br/>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. <br/>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.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<12>
Accession Number
2038690157
Title
Another Engine to Advance the Development of Structural Heart
Interventions: A Special Issue to Grow With the China Valve.
Source
JACC: Case Reports. 30(10) (no pagination), 2025. Article Number: 104017.
Date of Publication: 14 May 2025.
Author
So K.C.-Y.
Publisher
Elsevier Inc.

<13>
Accession Number
2038881775
Title
Noninvasive Ventilation for Cardiac Surgical Patients: Reducing
Postoperative Complications.
Source
Chest. 167(6) (pp 1528-1529), 2025. Date of Publication: 01 Jun 2025.
Author
Tetteh E.S.
Institution
(Tetteh) Department of Anesthesiology and Perioperative Medicine, Loyola
University Medical Center, Maywood, IL, United States
Publisher
Elsevier Inc.

<14>
Accession Number
2038825700
Title
Negative extra-abdominal pressure (NEXAP)-based lung recruitment maneuver
versus standard lung recruitment maneuver in the treatment of
postoperative atelectasis after cardiac surgery: A single-center
randomized controlled trial.
Source
Journal of Critical Care. 89 (no pagination), 2025. Article Number:
155124. Date of Publication: 01 Oct 2025.
Author
Xiong S.; Xiao J.; Hong L.; Shen X.; Tao H.; Jin R.; Xu Q.; Su L.; Zhang
C.
Institution
(Xiong, Xiao, Hong, Shen, Jin, Xu, Zhang) Department of Critical Care
Medicine, Nanjing First Hospital, Nanjing Medical University, No. 68
Changle Road, Nanjing, China
(Tao) Nanjing Drum Tower Hospital, Nanjing Medical University, Nanjing,
China
(Su) McGill University, 845 Sherbrooke St W, Montreal, Quebec, Canada
Publisher
W.B. Saunders
Abstract
Objective: To evaluate the effect of negative extra-abdominal pressure
(NEXAP)-based lung recruitment maneuver (LRM) for atelectasis after
cardiac surgery, and compare it with stepwise positive end-expiratory
pressure (PEEP)-based LRM. <br/>Method(s): In this single-center
randomized controlled clinical trial, patients were assigned to the NEXAP
or PEEP groups. The primary outcome was the lung ultrasound score (LUSS)
on global (LUSStot) and regional (LUSSp, posterior, LUSSa, anterior and
LUSSl, lateral regions). <br/>Result(s): 29 patients in the NEXAP group
and 33 patients in the PEEP group were analyzed. The LUSStot was
significantly decreased after LRM in both the NEXAP group (20.7 +/- 3.2
vs. 15.6 +/- 3.3; p < 0.001) and PEEP group (21.5 +/- 4.2 vs. 17.1 +/-
4.6; p < 0.001), and DELTALUSStot was significantly greater in the NEXAP
group than PEEP group (-5.1 +/- 2.3 vs. -3.8 +/- 2.2, p = 0.020). Regional
LUSS showed that NEXAP reduced LUSSl and LUSSp.
PaO<inf>2</inf>/FiO<inf>2</inf>, PaO<inf>2</inf>, Vt, and Crs were
significantly improved in the two groups. <br/>Conclusion(s): NEXAP is an
effective treatment for atelectasis after cardiac surgery, which
significantly reduced patients' LUSS, improved pulmonary ventilation
(especially in the lateral and posterior regions). NEXAP can further
reduce LUSStot than the traditional PEEP-based LRM. Regional LUSS analyses
reflecting the different mechanisms between the two methods of LRMs may
require further investigation.<br/>Copyright &#xa9; 2025 The Authors

<15>
Accession Number
2034132390
Title
Antithrombotic therapy after left atrial appendage occlusion.
Source
Expert Review of Cardiovascular Therapy. 23(4) (pp 141-152), 2025. Date of
Publication: 2025.
Author
Raffo C.; Greco A.; Capodanno D.
Institution
(Raffo, Greco, Capodanno) Cardiovascular Department, A.O.U. Policlinico
"G. Rodolico-San Marco", University of Catania, Catania, Italy
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Left atrial appendage occlusion (LAAO) represents a strategy
to minimize thromboembolic risk in atrial fibrillation (AF) patients.
However, LAAO carries some risks of periprocedural bleeding, device
embolization, peri-device leaks or device-related thrombosis; the latter
is due to direct blood contact with the device, justifying and represents
the rationale behind antithrombotic therapy following LAAO. Areas covered:
A comprehensive literature search (PubMed, Web of Science, Cochrane) has
been performed up to November 2024. Antithrombotic drugs after LAAO
include vitamin K antagonists (VKA), direct oral anticoagulants (DOAC),
antiplatelet drugs, and their combinations. Initially, high-intensity
regimens were implemented, while current strategies prioritize simplified
approaches to promote device healing without increasing the bleeding risk.
The aims of our review were to define the rationale and implications for
post-LAAO antithrombotic therapy and provide an overview of current
evidence on various antithrombotic regimens. Expert opinion: The optimal
post-LAAO antithrombotic regimen remains controversial, highlighting the
need for randomized trials on this topic. Current data suggest that DOACs
have the lowest probability of thromboembolic events and major bleeding,
while DAPT may be preferred in patients who do not tolerate OAC; finally,
single antiplatelet therapy or no antithrombotic therapy are alternative
options for patients at high bleeding risk.<br/>Copyright &#xa9; 2025
Informa UK Limited, trading as Taylor & Francis Group.

<16>
Accession Number
2037117753
Title
Single vs dual antiplatelet therapy after left atrial appendage closure: A
propensity score matching analysis.
Source
Heart Rhythm. 22(4) (pp 971-978), 2025. Date of Publication: 01 Apr 2025.
Author
Galea R.; Krsnik J.P.; Bini T.; Chalkou K.; Gasys A.; Brugger N.; Madhkour
R.; Seiffge D.J.; Roten L.; Siontis G.C.M.; Raber L.
Institution
(Galea, Krsnik, Bini, Gasys, Brugger, Madhkour, Roten, Siontis, Raber)
Department of Cardiology, Bern University Hospital, University of Bern,
Bern, Switzerland
(Galea) Department of Cardiology, Hospital Centre of Biel, Biel,
Switzerland
(Chalkou) Department of Clinical Research, University of Bern, Bern,
Switzerland
(Seiffge) Department of Neurology, Bern University Hospital, University of
Bern, Bern, Switzerland
Publisher
Elsevier B.V.
Abstract
Background: Dual antiplatelet therapy and oral anticoagulation in
combination with aspirin represent recommended treatment regimens after
left atrial appendage closure (LAAC). As most patients receiving LAAC have
high bleeding risk, less aggressive antithrombotic treatments are needed,
such as single antiplatelet therapy. <br/>Objective(s): We sought to
compare both ischemic and bleeding outcomes in patients receiving single
antiplatelet therapy (SAPT) or dual antiplatelet therapy (DAPT) after
successful LAAC. <br/>Method(s): Data on consecutive patients undergoing
percutaneous LAAC between 2009 and 2023 were prospectively collected
including 1-year follow-up. Propensity score matching was performed for
patients discharged under SAPT and DAPT. The primary end point was the
1-year composite of cardiovascular death, stroke, systemic embolism, or
device-related thrombosis (DRT). The secondary end points included major
bleeding and DRT. <br/>Result(s): Of 1033 patients discharged with
antiplatelet therapy, 154 patients receiving SAPT were compared with 230
matched patients receiving DAPT. The primary end point was similar between
the study groups (SAPT 11.0% vs DAPT 8.3%; rate ratio, 1.14; 95%
confidence interval [CI], 0.83-1.55; P = .420). Consistently, we found no
difference in terms of both major bleeding (SAPT 9.7% vs DAPT 12.6%;
hazard ratio, 0.77; 95% CI, 0.43-1.39; P = .387) and DRT (2.6% vs 1.1%;
rate ratio, 1.47; 95% CI, 0.89-2.43; P = .130) between the SAPT and DAPT
groups. <br/>Conclusion(s): In this propensity score matching analysis of
a single-center LAAC cohort, ischemic and bleeding outcomes did not differ
at 1 year for patients discharged with SAPT or DAPT. These results have to
be confirmed in an adequately powered randomized clinical
trial.<br/>Copyright &#xa9; 2024 Heart Rhythm Society

<17>
Accession Number
2034672009
Title
Effectiveness of amino acid supplementation in preventing acute kidney
injury following cardiac surgery: A systematic review and meta-analysis of
randomized controlled trials.
Source
Acta Anaesthesiologica Scandinavica. 69(6) (no pagination), 2025. Article
Number: e70037. Date of Publication: 01 Jul 2025.
Author
Majeed M.W.; Finnegan E.; Gallo Ruelas M.; Lopes L.M.; Righetto B.B.;
Salha I.; Delgado D.; Quiros M.C.; Tomo A.T.J.; Ahmad R.; Andrabi S.;
Abujaber S.
Institution
(Majeed) Government Medical College Srinagar, VMMC and Safdarjung
Hospital, New Delhi, India
(Finnegan) School of Medicine, Trinity College Dublin, Dublin, Ireland
(Gallo Ruelas) Department of Nutrition, Instituto de Investigacion
Nutricional (IIN), Lima, Peru
(Lopes) Department of Epidemiology, Johns Hopkins Bloomberg School of
Public Health, Baltimore, MD, United States
(Righetto) Department of Medicine, Universidade Positivo, Curitiba, Brazil
(Salha) Department of Global Health, Trinity Centre for Global Health,
Trinity College Dublin, Dublin, Ireland
(Delgado) Universidad Peruana de Ciencias Aplicadas, Lima District, Peru
(Quiros) Facultad de Medicina, Universidad de Costa Rica, San Jose, Costa
Rica
(Tomo) Department of Medicine, Universidade Eduardo Mondlane, Maputo,
Mozambique
(Ahmad) Department of Cardiology, Royal Brompton Hospital, London, United
Kingdom
(Andrabi) Department of Nephrology, Columbia University Vagelos College of
Physicians and Surgeons, NYC Health + Hospitals/Harlem, New York, NY,
United States
(Abujaber) Department of Pulmonary and Critical Care, SUNY Downstate
Medical Center, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Acute kidney injury (AKI) is a frequent complication of
cardiac surgery, contributing to increased morbidity, longer hospital
stays, and higher mortality. Evidence suggests amino acid (AA)
supplementation may enhance renal blood flow and glomerular filtration
rate (GFR), potentially reducing AKI risk; however, findings remain
inconclusive. This study evaluated the efficacy of perioperative AA
supplementation in preventing AKI and related complications post-cardiac
surgery. <br/>Method(s): PubMed, Embase, and Cochrane databases were
searched for randomized controlled trials (RCTs) comparing AA
supplementation versus standard care in preventing cardiac
surgery-associated AKI. Main outcomes included AKI incidence (defined by
the Kidney Disease Improving Global Outcomes (KDIGO) criteria), 30-day
mortality, and renal replacement therapy (RRT) requirement. Pooled risk
ratios (RRs) with 95% confidence intervals (CIs) were calculated using
random-effects models. Statistical significance was set at p < 0.05. The
certainty of the evidence (CoE) was assessed using the GRADE approach.
<br/>Result(s): Six RCTs involving 4501 cardiac surgery patients were
included. AA mixture interventions significantly reduced the risk of AKI
stage 1 (RR: 0.56; 95% CI: 0.77-0.96; p =.009; CoE: Moderate) and Stage 3
(RR: 0.53; 95% CI: 0.34-0.83; p =.005; CoE: Moderate), but not stage 2
(RR: 1.24; 95% CI: 0.60-2.55; p =.568; CoE: Low). Preliminary findings
from glutamic acid and glutamine (single AA interventions) showed
potential benefits in reducing AKI incidence (CoE: Very low) and improving
surrogate biomarkers, respectively. No significant effects were observed
on mortality or RRT incidence for any intervention. <br/>Conclusion(s): AA
mixtures likely reduce AKI incidence following cardiac surgery but show
limited effects on mortality and RRT. Further trials are needed to confirm
the benefits of glutamic acid and glutamine supplementation. Editorial
Comment: Use of amino acid supplementation for the prevention of acute
kidney injury after cardiac surgery may be effective, but more trial data
and confidence in a beneficial effect is needed for this to be implemented
in everyday clinical practice.<br/>Copyright &#xa9; 2025 Acta
Anaesthesiologica Scandinavica Foundation.

<18>
Accession Number
647181546
Title
Enhanced recovery in cardiac surgery patients with frailty through
comprehensive perioperative nursing interventions: A randomized controlled
trial.
Source
Clinical rehabilitation. 39(5) (pp 632-645), 2025. Date of Publication: 01
May 2025.
Author
Jin N.; Gu T.; Song S.; Yao J.; Pang X.
Institution
(Jin, Gu, Song, Yao, Pang) Department of Cardiac Surgery, First Hospital
of China Medical University, Shenyang, China
Abstract
ObjectiveTo evaluate the effects of comprehensive perioperative nursing
interventions on postoperative recovery in cardiac surgery patients with
frailty, with a focus on physical activity, nutritional status, and
cognitive function.DesignA prospective, randomized, single-blind,
parallel-group design with a 1:1 allocation ratio.SettingCardiac surgery
department in a tertiary care hospital.ParticipantsThis study included 300
patients with frailty after cardiac surgery. Using a computer-generated
random number table, patients were randomly assigned to the experimental
group (150 patients) and the control group (150 patients). The
intervention group received preoperative psychological counseling,
targeted nutritional support, skincare, and continuous hemodynamic
monitoring; the control group received routine care, including
postoperative vital sign monitoring, basic nutritional support, wound
care, and standard cardiovascular assessments (e.g., heart rate and blood
pressure).Primary outcomesPostoperative recovery was assessed through
improvements in physical activity (Barthel Index), nutritional status
(Mini Nutritional Assessment), cognitive function (Mini-Mental State
Examination), biostatistical data and cardiopulmonary function
indicators.ResultsThe intervention group showed significant improvements:
Barthel Index increased by 20 points (95% CI: 15-25, p < 0.01), Mini
Nutritional Assessment scores by 3 points (95% CI: 1-5, p < 0.05), and
Mini-Mental State Examination scores by 4 points (95% CI: 2-6, p < 0.05).
Hospital stay was reduced by 5 days (95% CI: 3-7, p < 0.01), and the
6-month survival rate was 10% higher (95% CI: 5-15%, p < 0.05) compared to
the control group.ConclusionsComprehensive perioperative nursing
interventions significantly improve postoperative recovery, self-care
ability, nutritional status, cognitive function, and short-term survival
in cardiac surgery patients with frailty.

<19>
Accession Number
2034133079
Title
Optimizing the management of tricuspid regurgitation: an update on current
treatment strategies and perspectives.
Source
Expert Review of Cardiovascular Therapy. 23(4) (pp 131-139), 2025. Date of
Publication: 2025.
Author
Angellotti D.; Franzone A.; Brugger N.; Reineke D.; Esposito G.; Praz F.
Institution
(Angellotti, Brugger, Reineke, Praz) Department of Cardiology, Bern
University Hospital, Bern, Switzerland
(Angellotti, Franzone, Esposito) Department of Advanced Biomedical
Science, University of Naples Federico II, Naples, Italy
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Tricuspid regurgitation (TR) is a prevalent condition and is
independently associated with high morbidity and mortality rates. Despite
its prognostic impact, TR remains undertreated, with patients often
referred at late stages when medical therapy is ineffective and surgical
intervention high risk. Emerging transcatheter therapies offer a promising
alternative for safer and effective management of this elderly patient
population with numerous comorbidities. Areas covered: This review
highlights recent advances in treatment strategies and future directions
for addressing significant TR. The literature search was conducted across
the PubMed, Embase, Scopus, and Google Scholar databases. A structured
search strategy was developed using 'tricuspid regurgitation' and
'management' or 'treatment' or 'therapy' and 'surgery' or 'tricuspid valve
repair' or 'tricuspid valve replacement' or 'transcatheter tricuspid
intervention' as MeSH terms and keywords. Selected articles from 2017 to
present were critically analyzed for strengths, limitations, and gaps in
evidence. Expert opinion: Enhancing disease awareness, the involvement of
multidisciplinary Heart Team and intervening earlier are critical
priorities for TR therapies to prevent treatment futility. Improved device
designs, more performant imaging techniques, and dedicated research
endpoints will help optimizing the management of TR.<br/>Copyright &#xa9;
2025 Informa UK Limited, trading as Taylor & Francis Group.

<20>
Accession Number
2034676760
Title
Using a Markov Model and Real-World Evidence to Identify the Most
Cost-Effective Cholesterol Treatment Escalation Threshold for the
Secondary Prevention of Cardiovascular Disease.
Source
Applied Health Economics and Health Policy. (no pagination), 2025.
Article Number: e011805. Date of Publication: 2025.
Author
Mariani A.; Mohiuddin S.; Muller P.; Samarasekera E.; Swain S.A.; Mills
J.; Patel R.; Preiss D.; Shantsila E.; Downing B.C.; Lonergan M.; Rowark
S.; Welton N.J.; Williams R.; Wonderling D.
Institution
(Mariani, Mohiuddin, Muller, Rowark, Wonderling) Science, Evidence and
Analytics Directorate, National Institute for Health and Care Excellence,
2 Redman Place (2nd Floor), London, United Kingdom
(Samarasekera, Swain) Centre for Guidelines, National Institute for Health
and Care Excellence, London, United Kingdom
(Mills) Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
(Patel) Barts Health NHS Trust, University College London Hospitals NHS
Foundation Trust, London, United Kingdom
(Preiss) Nuffield Department of Population Health, University of Oxford,
Oxford, United Kingdom
(Shantsila) Institute of Population Health, University of Liverpool,
Liverpool, United Kingdom
(Downing, Welton) Population Health Science, Bristol Medical School,
University of Bristol, Bristol, United Kingdom
(Lonergan, Williams) Clinical Practice Research Datalink (CPRD), Safety
and Surveillance Group, Medicines and Healthcare Products Regulatory
Agency, London, United Kingdom
Publisher
Adis
Abstract
Background: Despite the decreased risk of cardiovascular disease (CVD)
with statins, there remains an unfulfilled clinical need to prevent CVD
events and premature mortality through further cholesterol-modifying
interventions. In people with established CVD taking a statin, lipid
therapy escalation to reduce low-density lipoprotein cholesterol (LDL-C)
or non-high-density lipoprotein cholesterol (non-HDL-C) levels may lower
the risk of CVD hospital admissions and improve survival. However, the
cost-effectiveness of different cholesterol treatment escalation
thresholds is uncertain. <br/>Objective(s): This study aimed to identify
the most cost-effective cholesterol threshold for escalating lipid therapy
in people with established CVD who are taking a statin, to support the
2023 update of the NICE guideline on CVD in England. <br/>Method(s): A
cohort Markov model with a yearly cycle length was developed to compare
the lifetime costs and quality-adjusted life years (QALYs) of various
LDL-C treatment escalation thresholds (0-4.0 mmol/L), using a combination
of treatment effects from an original network meta-analysis of randomised
controlled trials (RCTs), real-world data for estimating baseline
cholesterol levels and CVD event rates from a published meta-analysis of
statin RCTs. The model used the following CVD events: ischaemic stroke;
transient ischaemic attack; peripheral artery disease; myocardial
infarction; unstable angina; coronary revascularisation; and mortality.
The model also used evidence-based estimates of resource use and costs,
and published quality of life data. Baseline LDL-C levels and CVD hospital
admission rates were estimated through a bespoke analysis of the English
primary care data from Clinical Practice Research Datalink (CPRD), linked
to Hospital Episode Statistics Admitted Patient Care (HES) and Office for
National Statistics (ONS) death registrations. <br/>Result(s): Data from
590,917 adult individuals (61.7% men) with CVD on a statin in primary care
between 1 January 2013 and 28 February 2020 were included in the
CPRD-HES-ONS analysis. The most cost-effective threshold for lipid therapy
escalation was an LDL-C of 2.2 mmol/L (or equivalent non-HDL-C of 2.9
mmol/L) at NICE's lower cost per QALY of 20,000. An LDL-C of 2.0 mmol/L
(or equivalent non-HDL-C of 2.6 mmol/L) was the most cost-effective
treatment escalation threshold in a significant proportion (38%) of
probabilistic simulations and produced more health. At this threshold, the
model predicted that 42% of people with CVD would require combination
therapy with ezetimibe while 19% would require an injectable drug such as
inclisiran. At NICE's upper cost per QALY of 30,000, the most
cost-effective LDL-C treatment escalation threshold was 1.7 mmol/L (or
equivalent non-HDL-C of 2.2 mmol/L). <br/>Conclusion(s): The results
demonstrate the importance of establishing evidence of cost-effectiveness
for cholesterol treatment escalation thresholds. The study's findings
support the updated NICE guideline recommending a threshold of 2.0 mmol/L
LDL-C (or equivalent non-HDL-C of 2.6 mmol/L) for secondary prevention of
CVD.<br/>Copyright &#xa9; Crown 2025.

<21>
Accession Number
2032143725
Title
The effect of individualized nutrition training of children with
congenital heart disease (CHD) on their growth and development a
randomized controlled trial.
Source
Current Problems in Cardiology. 49(7) (no pagination), 2024. Article
Number: 102567. Date of Publication: 01 Jul 2024.
Author
Yuruk E.; Cetinkaya S.
Institution
(Yuruk, Cetinkaya) Department of Nursing, Child Health and Diseases
Nursing, Cukurova University, Faculty of Health Sciences, Adana, Turkey
Publisher
Elsevier Inc.
Abstract
Objective: This study investigated the effectiveness of individualized
nutrition training for mothers of children who underwent congenital heart
disease (CHD) surgery on their children's growth and development.
<br/>Method(s): The researchers conducted a randomized controlled trial at
Cukurova University Medical Faculty Balcali Hospital in Adana, Turkey,
between January 20th, 2021, and June 30th, 2021. They recruited 42
children with CHD and their families. Researchers used a personal
information form, growth parameter measurements, and the Ankara
Developmental Screening Inventory to assess the children. Participants
were randomly divided into three groups. Control group, received standard
care. Experimental group 1 (orally fed), received family-centered care and
individualized nutrition training focused on age-appropriate food content,
preparation methods, and meeting children's caloric needs. Experimental
group 2 (orally and nutritionally fed), received the same interventions as
group 1. The training programs for the experimental groups included
information on strengthening breast milk and additional nutritional
nutrition support. The training programs for the experimental groups
likely addressed feeding challenges specific to children with CHD.
<br/>Result(s): The study found a statistically significant difference in
weight gain between the first and third follow-ups within the training
group (children who received individualized nutrition education). This
suggests that the training may have positively impacted weight gain.
Additionally, the children in the training groups who were breastfed for
longer than 12 months had better growth parameters and developmental
scores compared to those with shorter breastfeeding durations.
<br/>Conclusion(s): This study suggests that individualized nutrition
training for mothers of children with CHD surgery may support their
children's growth and development, particularly when combined with
prolonged breastfeeding.<br/>Copyright &#xa9; 2024

<22>
Accession Number
2018177589
Title
Surgical site wound infection, and other postoperative problems after
coronary artery bypass grafting in subjects with chronic obstructive
pulmonary disease: A meta-analysis.
Source
International Wound Journal. 20(2) (pp 302-312), 2023. Date of
Publication: 01 Feb 2023.
Author
Gao J.; Wang H.; Liu X.; Song X.; Zhong X.
Institution
(Gao, Wang, Zhong) Department of Respiratory and Critical Care Medicine,
The First Affiliated Hospital of Guangxi Medical University, Nanning,
China
(Gao, Liu, Song) Department of Rheumatism and Immunology, The Fourth
Affiliated Hospital of Guangxi Medical University, Liuzhou, China
Publisher
John Wiley and Sons Inc
Abstract
We performed a meta-analysis to evaluate the effect of chronic obstructive
pulmonary disease on surgical site wound infection, and other
postoperative problems after coronary artery bypass grafting. A systematic
literature search up to April 2022 was performed and 37 444 subjects with
coronary artery bypass grafting at the baseline of the studies; 4320 of
them were with the chronic obstructive pulmonary disease, and 33 124 were
without chronic obstructive pulmonary disease. Odds ratio (OR), and mean
difference (MD) with 95% confidence intervals (CIs) were calculated to
assess the effect of chronic obstructive pulmonary disease on surgical
site wound infection, and other postoperative problems after coronary
artery bypass grafting using the dichotomous, and contentious methods with
a random or fixed-effect model. The chronic obstructive pulmonary disease
subjects had a significantly higher surgical site wound infection (OR,
1.27; 95% CI, 1.01-1.60, P = 0.04), respiratory failure (OR, 1.84; 95% CI,
1.55-2.18, P < 0.001), mortality (OR, 1.61; 95% CI, 1.37-1.89, P < 0.001),
pneumonia (OR, 2.30; 95% CI, 1.97-2.68, P < 0.001), pleural effusion (OR,
1.78; 95% CI, 1.12-2.83, P = 0.02), stroke (OR, 1.99; 95% CI, 1.17-3.36, P
= 0.01), and length of intensive care unit stay (MD, 0.73; 95% CI,
0.19-1.26, P = 0.008) after coronary artery bypass grafting compared with
subjects without chronic obstructive pulmonary disease. However, chronic
obstructive pulmonary disease subjects did not show any significant
difference in length of hospital stay (MD, 0.83; 95% CI, -0.01 to 1.67, P
= 0.05), and pneumothorax (OR, 1.59; 95% CI, 0.98-2.59, P = 0.06) after
coronary artery bypass grafting compared with subjects without chronic
obstructive pulmonary disease. The chronic obstructive pulmonary disease
subjects had a significantly higher surgical site wound infection,
respiratory failure, mortality, pneumonia, pleural effusion, stroke, and
length of intensive care unit stay, and no significant difference in
length of hospital stay, and pneumothorax after coronary artery bypass
grafting compared with subjects without chronic obstructive pulmonary
disease. The analysis of outcomes should be with caution because of the
low sample size of 1 out of 11 studies in the meta-analysis and a low
number of studies in certain comparisons.<br/>Copyright &#xa9; 2022 The
Authors. International Wound Journal published by Medicalhelplines.com Inc
(3M) and John Wiley & Sons Ltd.

<23>
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. <br/>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. <br/>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. <br/>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.<br/>Copyright
&#xa9; 2025 The Author(s). Clinical Cardiology published by Wiley
Periodicals LLC.

<24>
Accession Number
647424752
Title
Efficacy, Safety, and Cost-Effectiveness of "Internet + Pharmacy Care" Via
the Alfalfa App in Warfarin Therapy Management After Cardiac Valve
Replacement: Randomized Controlled Trial.
Source
JMIR mHealth and uHealth. 13 (pp e53586), 2025. Date of Publication: 20
May 2025.
Author
Qian Y.; Chen W.; Zhou B.; Li J.; Guo Y.; Weng Z.; Zhang J.
Institution
(Qian) Clinical Research and Trial Center, Second Affiliated Hospital of
Kunming Medical University, Inpatient Building, 1st floor ,Building 1#374
Dianmian Road, Kunming, China
(Chen, Zhou) Second Clinical College of Kunming Medical University,
Kunming, China
(Li, Weng) School of Pharmacy, Kunming Medical University, Kunming,
Yunnan, China
(Guo) Department of Vascular Surgery, Fuwai Yunnan Hospital, Chinese
Academy of Medical Sciences, Kunming, Yunnan, China
(Zhang) Department of Pharmacy, Fujian Maternity and Child Health Hospital
College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics,
Fuzhou, China
Abstract
Background: Anticoagulation management is important in preventing
complications in patients undergoing cardiac valve replacement. The
development of mobile apps offers new opportunities for the management of
long-term anticoagulants. However, there is a lack of randomized
controlled trials evaluating the effectiveness, safety,
cost-effectiveness, and user demand for internet-based anticoagulation
management. <br/>Objective(s): This study aimed to evaluate the efficacy,
safety, and cost-effectiveness of a 3-month warfarin dose adjustment
mobile app Alfalfa compared to offline management in patients postcardiac
valve replacement. We also explored the app's feasibility on user
satisfaction and demand. <br/>Method(s): This study was a randomized
controlled trial with assessments conducted at baseline and at a 3-month
follow-up. Participants were eligible if they had been on warfarin therapy
for at least 3 months, received warfarin management either through the
Alfalfa app or through pharmacist-led anticoagulation outpatient clinic
visits, consented to regular follow-ups, and had not experienced serious
bleeding or thrombotic events in the 3 months before warfarin treatment. A
P value of <=.05 was considered statistically significant. <br/>Result(s):
A total of 405 participants were included in the analysis. The time in
therapeutic range was significantly higher in the Alfalfa app group than
in the offline group (66.46% vs 46.65%, P<.001). Participants in the
Alfalfa app group had a higher monitoring frequency (8.14 vs 4.47, P<.001)
and a greater percentage of international normalized ratio values within
the target range (896/1660, 53.98% vs 346/899, 38.49%; P<.001) than those
in the offline group. In addition, the Alfalfa app group exhibited lower
rates of subtherapeutic (235/1660, 14.16% vs 152/899, 16.91%; P<.05) and
extreme subtherapeutic international normalized ratio values (273/1660,
16.45% vs 186/899, 20.69%; P<.05) than the offline group. However, the
incidence of minor bleeding was higher in the Alfalfa app group (12/204,
5.9% vs 3/201, 1.5%; P=.02). In terms of cost-effectiveness, the Alfalfa
app group had a significantly lower average cost per test (42.37 vs 78.3,
P<.001), average time per test (47.42 vs 90.74, P<.001), and
cost-effectiveness ratio (385.9 vs 662.9) than the offline group. A total
of 86 participants completed the satisfaction questionnaire, and the vast
majority of participants expressed high levels of satisfaction with the
Alfalfa App, while also providing further suggestions for improvement.
<br/>Conclusion(s): The integration of "Internet+Pharmacy Care" using the
Alfalfa App can improve the effectiveness of warfarin anticoagulation
management in patients following heart valve surgery. The Alfalfa app
provides a more efficient, secure, and cost-effective solution to warfarin
management than traditional offline methods.<br/>Copyright &#xa9; Yiyi
Qian, Weizhao Chen, Bin Zhou, Jiangya Li, Yuanyuan Guo, Zhiying Weng,
Jinhua Zhang. Originally published in JMIR mHealth and uHealth
(https://mhealth.jmir.org).

<25>
Accession Number
2038828266
Title
Optimizing Tranexamic Acid Use in Adult Cardiac Surgery: From Rationale to
Clinical Practice.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
La Via L.; Cuttone G.; Terranova C.; Sorbello M.; Martucci G.; Pappalardo
F.
Institution
(La Via) Department of Anesthesia and Intensive Care, University Hospital
Policlinico "G. Rodolico-San Marco", Catania, Italy
(Cuttone, Sorbello, Pappalardo) Faculty of Medicine and Surgery, "Kore"
University of Enna, Enna, Italy
(Cuttone, Terranova, Pappalardo) Policlinico Centro Cuore GB Morgagni,
Catania, Italy
(Sorbello) Department of Anesthesia and Intensive Care, Giovanni Paolo II
Hospital, Ragusa, Italy
(Martucci) Department of Anesthesia and Intensive Care, IRCCS-ISMETT,
UPMC, Palermo, Italy
Publisher
W.B. Saunders
Abstract
Tranexamic acid (TXA) has emerged as a cornerstone in blood conservation
strategies for cardiac surgery. This comprehensive review synthesizes
current evidence on TXA's efficacy, safety, and optimal use in various
cardiac surgical procedures. We examine the pharmacological properties of
TXA, its historical development as an antifibrinolytic agent, and its
evolution in cardiac surgical practice. The review critically evaluates
key clinical trials and meta-analyses demonstrating TXA's efficacy in
reducing blood loss and transfusion requirements across a spectrum of
cardiac surgeries, including coronary artery bypass grafting, valve
procedures, and aortic surgery. Special consideration is given to its use
in pediatric cardiac surgery. We address ongoing debates surrounding
optimal dosing strategies, timing of administration, and integration with
other hemostatic interventions. The safety profile of TXA is thoroughly
examined, with particular focus on the risk of seizures and thromboembolic
events. The review also explores practical aspects of TXA implementation
in clinical practice, including its role in comprehensive blood management
protocols and potential cost-effectiveness. Emerging research areas, such
as pharmacokinetic-guided dosing and topical TXA application, are
discussed. Finally, we outline future directions and research priorities,
including the need for long-term outcome studies and refinement of
patient-specific protocols. This review provides a balanced assessment of
TXA's role in modern cardiac surgery, offering clinicians and researchers
a comprehensive resource for optimizing its use to improve patient
outcomes while minimizing potential risks.<br/>Copyright &#xa9; 2025
Elsevier Inc.

<26>
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. <br/>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%.
<br/>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). <br/>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.<br/>Copyright &#xa9; 2025 Cardiac Society
of Nepal. All rights reserved.

<27>
Accession Number
2034647114
Title
Development and validation of a nomogram to pediatric postoperative
pulmonary complications following thoracic surgery.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 255. Date
of Publication: 01 Dec 2025.
Author
Wang L.; Xiao T.; Du Z.; Chen T.; Pei D.; Qu S.
Institution
(Wang, Xiao, Du, Pei, Qu) Department of Anesthesiology, the Affiliated
Children's Hospital Of Xiangya School of Medicine, Central South
University (Hunan children's hospital), Yuhua District, 86 Ziyuan Road,
Hunan, Changsha, China
(Chen) Department of Neurosurgery, Xiangya Hospital, Central South
University, Hunan, Changsha, China
Publisher
BioMed Central Ltd
Abstract
Background: Since the respiratory anatomy and physiology of children
differ from those of adults, they are more susceptible to postoperative
pulmonary complications after thoracic surgery that requires one-lung
ventilation. Hypothesizing that the incidence of postoperative pulmonary
complications could be predicted using easily accessible perioperative
variables, we aimed to develop a nomogram specifically for children
receiving thoracic surgery with one-lung ventilation. <br/>Method(s): A
total of 361 children undergoing thoracic surgery with one-lung
ventilation were randomly assigned to two groups: a training cohort (80%)
and a validation cohort (20%). The training cohort was utilized to develop
a nomogram, whereas the validation cohort was used to assess its
performance. The outcome of this study was the incidence of postoperative
pulmonary complications. Univariate analysis and the least absolute
shrinkage and selection operator regression model were applied to select
the most relevant prognostic predictors. Multivariable logistic regression
was used to develop a nomogram based on the selected prediction factors.
Internal validation was conducted to evaluate its performance. The C-index
and calibration plots were used to assess its discriminative ability and
calibration. <br/>Result(s): Among the included patients, 109 (30.2%)
presented postoperative pulmonary complications. Four predictive factors
were ultimately selected to develop the nomogram. They were preoperative
neutrophil-to-lymphocyte ratio, intraoperative ventilation mode, maximum
peak airway pressure and minimum oxygenation index during one-lung
ventilation. By incorporating these factors, the nomogram demonstrated
strong C-indices of 0.909 (95% confidence interval (CI) [0.809-0.82]) and
0.871 (95% CI [0.795-0.945]) in the training and validation cohorts,
respectively, along with well-matched calibration curves.
<br/>Conclusion(s): The nomogram, based on four objective and easily
assessed factors, demonstrates excellent predictive performance for
pediatric postoperative pulmonary complications after one-lung
ventilation, enabling early risk assessment and targeted interventions to
improve patient outcomes. Trial registration: This study is registered at
the Chinese Clinical Trial Registry (Registration number:
ChiCTR2300072042, Date of Registration: 1/6/2023).<br/>Copyright &#xa9;
The Author(s) 2025.

<28>
Accession Number
2038858354
Title
Epicardial ablation in high-risk Brugada syndrome to prevent ventricular
fibrillation: Results from a randomized clinical trial.
Source
Europace. 27(5) (no pagination), 2025. Article Number: euaf097. Date of
Publication: 01 May 2025.
Author
Pappone C.; Ciconte G.; Vicedomini G.; Micaglio E.; Boccellino A.; Negro
G.; Giannelli L.; Rondine R.; Creo P.; Tarantino A.; Ballarotto M.; Maiolo
V.; Ciaccio C.; Manuello R.; Locati E.T.; Mazza B.C.; Vecchi M.; Calovic
Z.; Anastasia L.
Institution
(Pappone, Ciconte, Vicedomini, Micaglio, Boccellino, Negro, Giannelli,
Rondine, Ballarotto, Maiolo, Ciaccio, Manuello, Locati, Mazza, Vecchi,
Calovic) Arrhythmia and Electrophysiology Department, IRCCS Policlinico
San Donato, Piazza E. Malan 1, San Donato Milanese, Milano, Italy
(Pappone, Ciconte, Boccellino, Anastasia) School of Medicine, University
Vita-Salute San Raffaele, Via Olgettina, 58, Milan, Italy
(Pappone, Ciconte, Vicedomini, Micaglio, Creo, Tarantino, Locati,
Anastasia) Institute of Molecular and Translational Cardiology (IMTC),
Piazza Malan 2, San Donato Milanese, Milan, Italy
Publisher
Oxford University Press
Abstract
Aims: Epicardial ablation for Brugada syndrome (BrS) has shown promise in
reducing ventricular fibrillation (VF), but its role remains controversial
due to the lack of randomized trials. This study evaluates the efficacy of
catheter ablation in high-risk BrS patients. <br/>Methods and Results:
This prospective, single-centre, randomized (2:1) study enrolled BrS
patients with cardiac arrest (CA) or appropriate ICD therapies. All
patients had an ICD and were randomized to undergo epicardial ablation
(ablation group) or no ablation (control group). Enrolment began in
September 2017 and prematurely terminated in February 2024. The primary
endpoint was freedom from VF recurrences. Secondary endpoints included
procedure safety, ICD-related complications, and quality-of-life
assessment. Forty patients (83% male, mean age 43.7 +/- 12.1) were
randomized: 26 in the ablation group and 14 in the control group.
Thirty-six patients received appropriate ICD therapies before enrolment:
24 (92%) in the ablation group and 12 (86%) in the control group. One
patient in the ablation group experienced a post-procedural pericardial
effusion requiring pericardiocentesis. Thirteen patients (33%) had major
ICD-related complications. After a mean follow-up of 4.0 +/- 1.7 years,
freedom from VF recurrence was 96% (25/26) in the ablation group and 50%
(7/14) in the control group (P < 0.001). No unexplained or arrhythmic
deaths occurred during follow-up. <br/>Conclusion(s): Epicardial catheter
ablation was associated with a reduction in VF recurrence compared with
ICD therapy alone. These findings support the use of epicardial ablation
in high-risk BrS patients.<br/>Copyright &#xa9; 2025 The Author(s).

<29>
Accession Number
2034637219
Title
Metrics to assess the quality of anesthesia, perioperative care, and acute
pain management in Canada: a scoping review.
Source
Canadian Journal of Anesthesia. 72(5) (pp 822-854), 2025. Article Number:
e010006. Date of Publication: 01 May 2025.
Author
Ke J.X.C.; Sparrow K.; Smith M.A.; Yoo K.M.; Yee M.-S.; Sun L.Y.; Beattie
W.S.; Lim E.; Gorges M.
Institution
(Ke, Gorges) Department of Anesthesiology, Pharmacology & Therapeutics,
The University of British Columbia, Vancouver, BC, Canada
(Ke) Department of Anesthesia, St. Paul's Hospital, Providence Health
Care, Vancouver, BC, Canada
(Ke) Department of Anesthesia, Pain Management & Perioperative Medicine,
Dalhousie University, Halifax, NS, Canada
(Sparrow) Discipline of Anesthesia, Memorial University of Newfoundland,
St. John's, NL, Canada
(Smith) Department of Family Medicine, Michigan State University, East
Lansing, MI, United States
(Yoo) MD Undergraduate Program, Faculty of Medicine, The University of
British Columbia, Vancouver, BC, Canada
(Yee) Department of Anesthesiology, Southlake Regional Health Centre,
Newmarket, ON, Canada
(Sun) Division of Cardiothoracic Anesthesiology, Department of
Anesthesiology, Perioperative and Pain Medicine, Stanford University
School of Medicine, Stanford, CA, United States
(Beattie) Department of Anesthesiology & Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Lim) Woodward Library, The University of British Columbia, Vancouver, BC,
Canada
(Gorges) BC Children's Hospital Research Institute, Vancouver, BC, Canada
(Ke) Department of Anesthesia, St. Paul's Hospital, Third Floor,
Providence Building, 1081 Burrard Street, Vancouver, BC, Canada
Publisher
Springer
Abstract
Purpose: The aim of this scoping review was to consolidate a list of
metrics that can be used to measure quality in anesthesiology,
perioperative medicine, and acute pain management in Canada.
<br/>Method(s): We included English-language full-text articles involving
metrics (including patient-reported outcome and patient-reported
experience measures, quality and safety indicators, and practice
standards) for adults aged 18 yr and older undergoing inpatient
non-cardiac surgery requiring an anesthesiologist. We searched MEDLINE,
Embase, CINAHL, Web of ScienceTM, the Cochrane Database of Systematic
Reviews, and grey literature to find articles on the topic from January
2015 to March 2022. In addition, we contacted 64 Canadian hospitals for
existing anesthesia quality assurance and improvement metrics; they
responded from June to October 2022. Two independent reviewers performed
screening and data extraction. We grouped and condensed similar candidate
metrics using thematic analysis. <br/>Result(s): We assessed 4,493
publications, of which 63 met the inclusion criteria. We extracted 662
candidate metrics and consolidated them into 94 distinct metrics. Metrics
reflected themes of perioperative management (n = 47), safety and
standards (n = 23), patient-centredness (n = 11), intraoperative
anesthetic care (n = 5), perioperative team leadership (n = 4), and
efficiency (n = 4). Metrics spanned all quality-of-care categories
(process, outcome, and structure) and perioperative phases but were
limited by poor supporting evidence. <br/>Conclusion(s): We consolidated a
list of 94 metrics that can be used to evaluate the quality of anesthesia
care. Further work will require verification of feasibility and validity
prior to adoption, with operationalization of these metrics into practical
indicators that are measurable and comparable.<br/>Copyright &#xa9;
Canadian Anesthesiologists' Society 2025.

<30>
Accession Number
2034672381
Title
Association between venous to arterial carbon dioxide tension gap and
clinical outcome in cardiac surgery patients: A systematic review and
meta-analysis.
Source
Perfusion (United Kingdom). (no pagination), 2025. Article Number:
02676591251344858. Date of Publication: 2025.
Author
Lin D.; Luo H.; Long F.; Liu M.-H.; Zhang Y.; Liu T.; Zhou R.-H.
Institution
(Lin, Long, Liu, Zhang, Liu, Zhou) Department of Anesthesiology, West
China Hospital of Sichuan University, Chengdu, China
(Luo) Operating Room, West China Hospital, Sichuan University, West China
School of Nursing, Sichuan University, China
Publisher
SAGE Publications Ltd
Abstract
Background: Cardiac surgery is associated with increased risk of major
adverse outcomes. Venous to arterial carbon dioxide tension gap
(Pv-aCO<inf>2</inf> gap) showed significant prognostic value of
non-cardiac surgery, while their prognostic value after cardiopulmonary
bypass (CPB) remains controversial. <br/>Method(s): We conducted a
systematic research of PubMed, MEDLINE, EMBASE and Web of science
electronic database and ClinicalTrials.gov to analysis the association
between high Pv-aCO<inf>2</inf> gap and adverse outcomes in adult cardiac
surgery patients. Random effect model was used to pool data.
<br/>Result(s): Eight studies (n = 2136 patients) were enrolled. High
Pv-aCO<inf>2</inf> gap was mainly defined as Pv-aCO<inf>2</inf> >= 6-8
mmHg. In cardiac surgery, high Pv-aCO<inf>2</inf> gap was not associated
with increased hospital mortality (odds ratio, 0.63; 95% CI, 0.17-2.32; p
= 0.49)), but was related with higher ICU mortality (odds ratio, 5.27; 95%
CI, 2.31-12.00; p < 0.001), higher incidence of major complications (p <
0.05), longer ICU length of stay (p = 0.03) and prolonged ventilation time
in the ICU (p < 0.001). Moreover, high Pv-aCO<inf>2</inf> gap was linked
to postoperative lower cardiac index (p < 0.01) and lower ScvO<inf>2</inf>
(p < 0.001). Interesting, high Pv-aCO<inf>2</inf> gap was not associated
with increased postoperative lactate level and longer hospital length of
stay. <br/>Conclusion(s): An elevated Pv-aCO<inf>2</inf> gap seems to be
associated with adverse outcomes in very short time and indicates tissue
hypoperfusion rather than tissue hypoxia. Therefore, interventions aiming
at normalizing Pv-aCO<inf>2</inf> gap may potentially improve clinical
outcomes, while further validation is required.<br/>Copyright &#xa9; The
Author(s) 2025.

<31>
Accession Number
2034647734
Title
Ticagrelor vs. clopidogrel in dual antiplatelet therapy after coronary
artery bypass surgery: a meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1542437. Date of Publication: 2025.
Author
Wang L.; Zhao Y.; Zhang S.; Zhang T.; Song J.; Yun Y.; Wu Y.; Wang Z.; Ma
X.
Institution
(Wang, Zhang, Song, Wang, Ma) Department of Cardiovascular Surgery,
Shandong Provincial Hospital Affiliated to Shandong First Medical
University, Shandong, Jinan, China
(Zhao) Department of Anesthesiology, Shandong Provincial Hospital
Affiliated to Shandong First Medical University, Shandong, Jinan, China
(Zhang) Department of Cardiovascular Surgery, Shandong Provincial
Hospital, Qilu College of Medicine, Shandong University, Shandong, Jinan,
China
(Yun, Wu) Department of Radiology, Qilu Hospital of Shandong University,
Shandong, Jinan, China
Publisher
Frontiers Media SA
Abstract
Background: Following coronary artery bypass grafting (CABG), the standard
treatment regimen typically involves dual antiplatelet therapy (DAPT),
which includes a P2Y12 receptor antagonist in combination with aspirin.
There is currently no clear consensus regarding the optimal DAPT strategy
after CABG. The aim of this meta-analysis was to evaluate and compare the
safety and efficacy of ticagrelor vs. clopidogrel in patients post-CABG.
<br/>Method(s): A meta-analysis of eligible studies of patients undergoing
CABG and receiving either aspirin plus clopidogrel (A + C) or aspirin plus
ticagrelor (A + T) as antiplatelet therapy, was carried out. The outcomes
of interest included all-cause mortality, cardiovascular mortality, major
adverse cardiovascular and cerebrovascular events (MACCEs), major
bleeding, myocardial infarction, stroke, revascularization, saphenous vein
occlusion and total graft occlusion. <br/>Result(s): 4 randomized
controlled trials and 3 observational studies (n = 2,424) were eligible
for final analysis. A + T was associated with a decreased risk of
all-cause mortality (OR = 0.47, 95% CI 0.31-0.70, p < 0.001, p
heterogeneity = 0.80, I² = 0%) and cardiovascular mortality (OR
= 0.50, 95% CI 0.31-0.82, p = 0.006, p heterogeneity = 0.71, I²
= 0%), compared with A + C group. No statistically significant difference
was found in the rates of major bleeding (OR = 1.16; 95% CI 0.69-1.96; p =
0.57; p heterogeneity = 0.26; I² = 23%) between two groups.
Besides, the rates of MACCEs, myocardial infarction, stroke, total graft
occlusion, revascularization and saphenous vein occlusion were comparable
between two groups (p > 0.05). <br/>Conclusion(s): The meta-analysis
presented the evidence supporting the use of A + T post-CAVG in reducing
all-cause mortality and cardiovascular mortality, with no increase in
bleeding events, in comparison with A + C. Additional RCTs are needed to
determine the optimal DAPT after CABG.<br/>Copyright 2025 Wang, Zhao,
Zhang, Zhang, Song, Yun, Wu, Wang and Ma.

<32>
Accession Number
2038684863
Title
Impact of Noninvasive Ventilation Before and After Cardiac Surgery for
Preventing Cardiac and Pulmonary Complications: A Clinical Randomized
Trial.
Source
Chest. 167(6) (pp 1727-1736), 2025. Date of Publication: 01 Jun 2025.
Author
Goret M.; Pluchon K.; Le Mao R.; Badra A.; Oilleau J.-F.; Morvan Y.;
Beaumont M.; Desanglois G.; Guegan M.; Barnier A.; Gut-Gobert C.; Tromeur
C.; Leroyer C.; Choplain J.-N.; Khalifa A.; Bezon E.; Couturaud F.
Institution
(Goret, Le Mao, Beaumont, Barnier, Gut-Gobert, Tromeur, Leroyer,
Couturaud) Institut National de la Sante et de la Recherche Medicale
U1304, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO),
Univ_Brest, Brest, France
(Badra, Bezon) Institut National de la Sante et de la Recherche Medicale
1078, Univ_Brest, Brest, France
(Goret, Le Mao, Beaumont, Desanglois, Guegan, Barnier, Gut-Gobert,
Tromeur, Leroyer, Couturaud) Department of Internal Medicine, Vascular
Medicine and Chest Diseases, CHU_Brest, Brest, France
(Goret, Le Mao, Beaumont, Desanglois, Guegan, Barnier, Gut-Gobert,
Tromeur, Leroyer, Couturaud) Institut National de la Sante et de la
Recherche Medicale CIC1412, CHU_Brest, Brest, France
(Pluchon, Badra, Oilleau, Morvan, Choplain, Khalifa, Bezon) Department of
Cardio-thoracic and Vascular Surgery, CHU_Brest, Brest, France
(Le Mao, Tromeur, Leroyer, Couturaud) F-CRIN INNOVTE, Saint-Etienne,
France
Publisher
Elsevier Inc.
Abstract
Background: The immediate postoperative period after heart surgery poses a
substantial risk of life-threatening complications, notably acute
pulmonary and cardiac failure. Use of noninvasive ventilation (NIV) may
reduce the incidence of pulmonary or heart failure, or both. Research
Question: Is the use of NIV before and after cardiac surgery associated
with a lower rate of acute pulmonary and heart failure in patients at risk
of postoperative complications? Study Design and Methods: We designed a
prospective, randomized, monocentric trial comparing preoperative and
postoperative NIV in cardiac surgery with standard care. Adult patients
classified as being at risk of postoperative cardiac or pulmonary failure
were allocated to receive NIV for 5 days before and 5 days after surgery
in addition to usual care vs usual care alone. The primary outcome was the
composite of predefined and adjudicated cardiorespiratory failure at 1
month after cardiac surgery. <br/>Result(s): Two hundred sixteen patients
were included. During the 1-month follow-up period after surgery, the
composite outcome occurred in 59 of 107 patients (55.1%) in the NIV group
and in 87 of 109 patients (79.8%) in the no NIV group (relative risk,
0.69; 95% CI, 0.57-0.84; P < .001). The benefit persisted at 3 months. No
difference between the 2 groups was found in terms of intubation need and
length of hospital stay in cardiac and pulmonary surgery ICUs and in
cardiac and pulmonary surgery units. <br/>Interpretation(s): Our results
indicate that the use of NIV before and after cardiac surgery reduces the
rate of cardiopulmonary failure after high-risk cardiac surgery. Clinical
Trial Registry: ClinicalTrials.gov; No.: NCT02302300; URL:
www.clinicaltrials.gov<br/>Copyright &#xa9; 2025 American College of Chest
Physicians

<33>
Accession Number
2031648066
Title
A multi-centre randomised control trial of directly observed therapy to
promote medication adherence in paediatric heart transplant recipients.
Source
Cardiology in the Young. 34(6) (pp 1359-1362), 2024. Date of Publication:
01 Jun 2024.
Author
Killian M.O.; Mayewski S.; Gupta D.
Institution
(Killian, Mayewski) College of Social Work, Florida State University,
Tallahassee, FL, United States
(Killian) College of Medicine, Florida State University, Tallahassee, FL,
United States
(Gupta) Pediatrics, Congenital Heart Center, University of Florida,
Gainesville, FL, United States
Publisher
Cambridge University Press
Abstract
Medication non-adherence remains a significant challenge for adolescent
heart transplant recipients. Building on the success of a pilot
intervention study, herein we describe the protocol for a follow-up
randomised control trial using mobile video directly observed therapy,
featuring several innovations, to promote medication adherence in a
multi-centre sample of adolescent heart transplant patients.<br/>Copyright
&#xa9; The Author(s), 2024.

<34>
Accession Number
2034624624
Title
mHealth intervention delivered in general practice to increase physical
activity and reduce sedentary behaviour of patients with prediabetes and
type 2 diabetes (ENERGISED): statistical analysis plan.
Source
Trials. 26(1) (no pagination), 2025. Article Number: 166. Date of
Publication: 01 Dec 2025.
Author
Vetrovsky T.; Kral N.; Pfeiferova M.; Seifert B.; Capek V.; Jurkova K.;
Steffl M.; Cimler R.; Kuhnova J.; Harris T.; Ussher M.; Wahlich C.;
Malisova K.; Pelclova J.; Dygryn J.; Elavsky S.; Maes I.; Van Dyck D.;
Rowlands A.; Yates T.
Institution
(Vetrovsky, Capek, Jurkova, Steffl) Faculty of Physical Education and
Sport, Charles University, Prague, Czechia
(Vetrovsky, Kral, Pfeiferova, Seifert) Institute of General Practice, 1st
Faculty of Medicine, Charles University, Prague, Czechia
(Cimler, Kuhnova) Faculty of Science, University of Hradec Kralove, Hradec
Kralove, Czechia
(Harris, Ussher, Wahlich) School of Health & Medical Sciences, City St
George's University of London, London, United Kingdom
(Ussher) Institute for Social Marketing and Health, University of
Stirling, Stirling, United Kingdom
(Malisova, Pelclova, Dygryn) Faculty of Physical Culture, Palacky
University Olomouc, Olomouc, Czechia
(Elavsky) Department of Human Movement Studies, University of Ostrava,
Ostrava, Czechia
(Maes, Van Dyck) Department of Movement and Sports Sciences, Faculty of
Medicine and Health Sciences, Ghent University, Ghent, Belgium
(Rowlands, Yates) Diabetes Research Centre, University of Leicester,
Leicester, United Kingdom
(Rowlands, Yates) NIHR Leicester Biomedical Research Centre, University
Hospitals of Leicester NHS Trust and the University of Leicester,
Leicester, United Kingdom
(Rowlands) Alliance for Research in Exercise, Nutrition and Activity
(ARENA), UniSA Allied Health and Human Performance, University of South
Australia, Adelaide, Australia
Publisher
BioMed Central Ltd
Abstract
Background: Type 2 diabetes and prediabetes represent significant global
health challenges, with physical activity (PA) being essential for disease
management and prevention. Despite the well-documented benefits, many
individuals with (pre)diabetes remain insufficiently active. General
practitioners (GP) provide an accessible platform for delivering
interventions; however, integrating PA interventions into routine care is
hindered by resource constraints. <br/>Objective(s): The ENERGISED trial
aims to address these barriers through an innovative GP-initiated mHealth
intervention combining wearable technology and just-in-time adaptive
interventions. <br/>Method(s): The ENERGISED trial is a pragmatic,
12-month, multicentre, randomised controlled trial, assessing a
GP-initiated mHealth intervention to increase PA and reduce sedentary
behaviour in patients with type 2 diabetes and prediabetes. The primary
outcome is daily step count, assessed via wrist-worn accelerometry. The
primary analysis follows the intention-to-treat principle, using mixed
models for repeated measures. Missing data will be handled under the
missing-at-random assumption, with sensitivity analyses exploring
robustness through reference-based multiple imputation. The trial
incorporates the estimand framework to provide transparent and structured
treatment effect estimation. <br/>Discussion(s): This statistical analysis
plan outlines a robust approach to addressing participant non-adherence,
protocol violations, and missing data. By adopting the estimand framework
and pre-specified sensitivity analyses, the plan ensures methodological
rigour while enhancing the interpretability and applicability of results.
<br/>Conclusion(s): The ENERGISED trial leverages innovative mHealth
strategies within primary care to promote PA in individuals with
(pre)diabetes. The pre-specified statistical framework provides a
comprehensive guide for analysing trial data and contributes to advancing
best practices in behavioural intervention trials for public health. Trial
registration: ClinicalTrials.gov NCT05351359. Registered on April 28,
2022.<br/>Copyright &#xa9; The Author(s) 2025.

<35>
[Use Link to view the full text]
Accession Number
2038848628
Title
Methylprednisolone for Infant Heart Surgery: Subpopulation Analyses of a
Randomized Controlled Trial.
Source
Critical Care Medicine. (no pagination), 2025. Article Number: 6721. Date
of Publication: 2025.
Author
Sunthankar S.D.; Hill K.D.; Jacobs J.P.; Baldwin H.S.; Jacobs M.L.; Li
J.S.; Graham E.M.; Blasiole B.; Husain S.A.; Bleiweis M.S.; Mettler B.;
Benscoter A.; Wald E.; Karamlou T.; Van Bergen A.H.; Eghtesady P.; Scott
J.P.; Anderson B.R.; Alfieris G.; Vener D.F.; Kannankeril P.J.
Institution
(Sunthankar, Baldwin, Kannankeril) Thomas P. Graham Jr. Division of
Pediatric Cardiology , Center for Pediatric Precision Medicine, Department
of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt ,
Vanderbilt University Medical Center, Nashville, TN, United States
(Hill, Li) Division of Pediatric Cardiology, Duke University Medical
Center, Durham, NC, United States
(Jacobs, Bleiweis) Division of Cardiac Surgery, University of Florida,
Gainesville, FL, United States
(Jacobs, Mettler) Division of Cardiac Surgery, Johns Hopkins School of
Medicine, Baltimore, MD, United States
(Graham) Division of Pediatric Cardiology, Medical University of South
Carolina, Charleston, SC, United States
(Blasiole) Division of Pediatric Cardiac Anesthesiology, UPMC Children's
Hospital of Pittsburgh, Pittsburgh, PA, United States
(Husain) Division of Cardiac Surgery, Primary Children's Hospital, Salt
Lake City, UT, United States
(Benscoter) Division of Pediatric Cardiology, Cincinnati Children's
Hospital, Cincinnati, OH, United States
(Wald) Division of Pediatric Cardiology, Northwestern University Feinberg
, School of Medicine, Chicago, IL, United States
(Karamlou) Division of Cardiac Surgery, Cleveland Clinic, Cleveland, OH,
United States
(Van Bergen) Division of Pediatric Cardiology, Advocate Children's
Hospital, Chicago, IL, United States
(Eghtesady) Division of Cardiac Surgery, Washington University , School of
Medicine, St. Louis, MO, United States
(Scott) Division of Pediatric Cardiology, Medical College of Wisconsin,
Madison, WI, United States
(Anderson) Division of Pediatric Cardiology, Icahn School of Medicine at
Mt Sinai, New York, NY, United States
(Alfieris) Division of Cardiac Surgery, University of Rochester,
Rochester, NY, United States
(Vener) Division of Pediatric Cardiac Anesthesiology, Texas Children's
Hospital, Baylor College of Medicine, Houston, TX, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: Evaluate benefits and harms of prophylactic intraoperative
methylprednisolone in subpopulations undergoing infant heart surgery.
<br/>Design(s): Subpopulation analyses of The Steroids to Reduce Systemic
Inflammation after Infant Heart Surgery (STRESS) trial, a double-blind
randomized placebo-controlled trial. <br/>Setting(s): Twenty-four
congenital heart centers. <br/>Patient(s): Infants (< 1 yr old) undergoing
heart surgery with cardiopulmonary bypass. Patients stratified by Society
of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery
Congenital Heart Surgery (STAT) mortality category, age, gestational age,
and presence of chromosomal or syndromic diagnosis (CSD).
<br/>Intervention(s): Methylprednisolone (30 mg/kg) vs. placebo
administered into cardiopulmonary bypass pump-priming fluid.
<br/>Measurements and Main Results: Six postoperative outcomes: steroid
use, acute kidney injury (AKI), thrombosis, infections, prolonged
mechanical ventilation, peak blood glucose levels, and insulin exposure.
One thousand two hundred patients received methylprednisolone or placebo.
Beneficial effects associated with methylprednisolone included reduced use
of postoperative hydrocortisone in neonates (odds ratio [OR], 0.39
[0.25-0.60]), both STAT category groups (1-3: OR, 0.64 [0.46-0.89]; 4-5:
OR, 0.57 [0.34-0.97]), term infants (OR, 0.63 [0.47-0.83]), and those
without CSD (OR, 0.63 [0.46-0.86]). Methylprednisolone was associated with
lower thrombosis occurrence among neonates (OR, 0.37 [0.16-0.87]) and term
infants (OR, 0.38 [0.19-0.75]). Adverse associations included increased
thrombosis among premature infants (p = 0.005), increased AKI among
neonates (OR, 1.55 [1.02-2.37]) and those following STAT category 1-3
operations (OR, 1.34 [1.02-1.75]), and increased peak blood glucose levels
and insulin exposure (all subgroups; p < 0.001). No increase in overall
infection or reduction in prolonged mechanical ventilation with
methylprednisolone. <br/>Conclusion(s): Both beneficial and adverse
associations were observed with prophylactic methylprednisolone. Reduction
in postoperative hydrocortisone administration and absence of increased
infection rates are arguments favoring prophylactic methylprednisolone
use. Methylprednisolone was associated with increased peak blood glucose
levels and a neutral to harmful association with odds of AKI. These data
suggest certain subpopulations may benefit from prophylactic
intraoperative methylprednisolone without significant harm.<br/>Copyright
&#xa9; 2025 by the Society of Critical Care Medicine and Wolters Kluwer
Health, Inc. All Rights Reserved.

<36>
Accession Number
2034649754
Title
The utility of real-time transthoracic 3-dimensional echocardiography in
congenital heart disease in current clinical practice.
Source
International Journal of Cardiovascular Imaging. (no pagination), 2025.
Date of Publication: 2025.
Author
Saengsin K.; Intamul K.; Sittiwangkul R.
Institution
(Saengsin, Intamul, Sittiwangkul) Division of Cardiology, Department of
Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai,
Thailand
Publisher
Springer Science and Business Media B.V.
Abstract
To evaluate the utility of three-dimensional transthoracic
echocardiography (3D TTE) in the assessment and management of congenital
heart disease (CHD). The use of three-dimensional TTE with both pediatric
and adult patients has helped to clarify the cardiac anatomy and
hemodynamic physiologic lesions in CHD. However, few practical aspects of
3D TTE have undergone systematic review. A retrospective study of CHD
patients from January-December 2022 who underwent 3D TTE was conducted to
determine the utility of 3D TTE with respect to answering the primary
diagnostic question, adding diagnostic information to 2D imaging,
concordance with 2D TTE or cardiac CT, and impact on management. During
the study period, 76 CHD patients underwent 3D TTE at a median age of 104
months (IQR 29-175.5). The common cardiac segment under investigation was
related to the atrioventricular valve. The mean heart rate was 89 +/- 20
BPM. The mean volume rate was 17 +/- 5. The single beat acquisition was
used in all cases. Sedation use was infrequent (22.67%). Three-dimensional
TTE answered the primary diagnostic question and added diagnostic
information to 2D TTE imaging in all cases (100%). Additionally, 3D TTE
impacted the management of the following: provided guided intervention
(3/76, 4%), provided information before cardiac surgery (27/76, 36%), and
increased understanding of the cardiac anatomy (76/76, 100%).
Three-dimensional TTE can be applied in simple to complex CHD cases,
across all age groups, from infants to adults. It provides real-time
performance, requires no radiation, and infrequent use of sedation. This
study showed that 3D TTE was accurate, answered the diagnostic questions
in all cases, and frequently added diagnostic information that impacted
management.<br/>Copyright &#xa9; The Author(s) 2025.

<37>
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.
<br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9;2025 Int. J. Life
Sci. Biotechnol. Pharma. Res.

<38>
Accession Number
2038809707
Title
Comparative effects of transcatheter versus surgical pulmonary valve
replacement: A systematic review and meta-analysis.
Source
PLoS ONE. 20(5 MAY) (no pagination), 2025. Article Number: e0322041. Date
of Publication: 01 May 2025.
Author
Chongmelaxme B.; Kua K.P.; Amornvetchayakul C.; Chawviriyathep N.;
Kerdklinhom T.
Institution
(Chongmelaxme, Amornvetchayakul, Chawviriyathep, Kerdklinhom) Department
of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences,
Chulalongkorn University, Bangkok, Thailand
(Chongmelaxme, Kua) Revolution Health Research Consulting (RHRC) Group,
Bangkok, Thailand
(Kua) Sultan Idris Shah Hospital, Selangor, Serdang, Malaysia
(Kua) A.S. Watson Group, Kuala Lumpur, Malaysia
(Kua) Stanford Alumni Association, Stanford University, Stanford, CA,
United States
(Kua) Harvard T.H. Chan School of Public Health, Harvard University,
Boston, MA, United States
(Kua) MIT Alumni Association, Massachusetts Institute of Technology,
Cambridge, MA, United States
Publisher
Public Library of Science
Abstract
Introduction Transcatheter pulmonary valve replacement (TPVR) is developed
as a non-surgical, minimally invasive procedure to reduce the need for
re-do cardiac surgical interventions. However, its impacts on patient
outcomes are less clear. This study aims to investigate the effects of
TPVR among patients with pulmonary valve or right ventricular outflow
tract dysfunctions. Materials and methods In this systematic review and
meta-analysis, we searched PubMed, Cochrane CENTRAL, EMBASE, CINAHL
Complete, and Web of Science, from database inception to March 1, 2024, to
identify studies that assessed the comparative effectiveness of
transcatheter pulmonary valve replacement (TPVR) and surgical pulmonary
valve replacement (SPVR). The key outcomes of interest included mortality,
pulmonary regurgitation (PR), infective endocarditis (IE),
re-intervention, improvements in cardiac failure based on the New York
Heart Association (NYHA) functional classification, and adverse events.
Meta-analyses using a random-effects model were performed. Results A total
of 28 studies (n = 16,150) were included. The meta-analyses depicted that
when compared with SPVR, TPVR reduced risks of mortality by 36% (odds
ratio [OR] = 0.64 [95% confidence interval, CI: 0.43, 0.95]), but
conferred a three-fold greater odd of IE over the follow-up duration (OR =
3.10 [95% CI: 2.22, 4.33]). No significant differences were observed for
30-day mortality, and the early PR, IE and re-intervention, as well as the
PR and re-intervention during follow-up. Meta-analyzed results across the
outcome measures varied according to geographical region, publication year
cut-off, and income status of country. All patients who had undergone
valve replacement showed improvements in heart function and experienced
relevant post-procedural complications. Conclusions TPVR afforded
significant clinical benefits in patient survival, but nonetheless, it was
associated with an elevated risk for infective endocarditis.<br/>Copyright
&#xa9; 2025 Chongmelaxme et al. This is an open access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided
the original author and source are credited.

<39>
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. <br/>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.
<br/>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). <br/>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.<br/>Copyright &#xa9; 2025 Healthcare Bulletin. All rights reserved.

<40>
Accession Number
2038818242
Title
Anxiety during transcatheter aortic valve replacement under local
anesthesia - the ART-VR trial.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Chatterjee S.; Ooms J.; de Ronde M.; van Gorsel S.; Mattace-Raso A.M.;
Goudzwaard J.; Mattace-Raso F.; Kardys I.; Nuis R.-J.; Daemen J.; Van
Mieghem N.
Institution
(Chatterjee, Ooms, de Ronde, van Gorsel, Mattace-Raso, Kardys, Nuis,
Daemen, Van Mieghem) Department of Interventional Cardiology,
Thoraxcenter, Erasmus MC University Medical Center, Rotterdam, Netherlands
(Goudzwaard, Mattace-Raso) Department of Internal Medicine, Section of
Geriatrics, Erasmus MC University Medical Center, Rotterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: The use of local anesthesia during transcatheter aortic valve
replacement (TAVR) could result in patient discomfort. Application of
immersive virtual reality (VR) during TAVR might distract the patient and
enhance the overall experience. <br/>Objective(s): To evaluate the effect
of an immersive VR environment on periprocedural anxiety and patient
discomfort, compared to standard of care in patients undergoing
transfemoral (TF) TAVR under local anesthesia. <br/>Method(s): In this
single-center, randomized controlled pilot study, patients were randomized
to either VR immersion during TAVR or standard of care. The intervention
was a VR headset to create 3D experiences during percutaneous transfemoral
TAVR. The main outcome was patient-reported procedural anxiety assessed
directly after the procedure on a visual analog scale (VAS). Secondary
outcomes were procedural satisfaction, pain, and change in anxiety.
Personality scores were obtained at baseline to explore associations
between personality types and relevant outcomes. <br/>Result(s): A total
of 75 patients (VR = 37, control = 38) were included between September
2021 and January 2023. The median age was 79 (25th-75th: 75-84) years and
32 patients (43 %) were female. Overall procedural anxiety VAS was 1.0
(0.0-3.0) and satisfaction was 9.0 (8.0-10.0). There was no difference in
procedural anxiety between VR and control (VAS: 1.0 [25th-75th: 0.0-3.0]
versus 1.0 [25th-75th: 0.0-3.0], p = 0.59). Procedural satisfaction, pain
perception and change in anxiety were not affected by VR use.
<br/>Conclusion(s): Patients undergoing TF-TAVR under local anesthesia
experienced mild procedural anxiety and high satisfaction levels.
Procedural VR use did not affect procedural anxiety or pain
perception.<br/>Copyright &#xa9; 2025

<41>
[Use Link to view the full text]
Accession Number
2038831089
Title
Stroke Prevention in Atrial Fibrillation: A systematic Review and
Meta-Analysis of Left Atrial Appendage Occlusion Versus Direct Oral
Anticoagulants.
Source
Cardiology in Review. (no pagination), 2025. Date of Publication: 2025.
Author
Thapa S.; Mandal B.; Shah S.; Mehta R.; Sah S.; Thapa A.; Chand S.;
Medicherla C.; Kitago T.; Frishman W.H.; Aronow W.S.
Institution
(Thapa, Medicherla, Kitago) Department of Neurology, Westchester Medical
Center, New York Medical College, Valhalla, NY, United States
(Mandal, Shah) Department of Public Health, Institute of Medicine,
Tribhuvan University, Kathmandu, Maharajgunj, Nepal
(Mehta) Department of Medicine, National Public Health Laboratory Teku,
Kathmandu, Nepal
(Sah) Department of Medicine, Korea University, Seoul, South Korea
(Sah) Department of Public Health Dentistry, D.Y. Patil Dental College and
Hospital, Maharashtra, India
(Thapa) Department of Medicine, Universal College of Medical Sciences,
Bhairahawa, Nepal
(Chand, Aronow) Departments of Cardiology and Medicine, Westchester
Medical Center, New York Medical College, Valhalla, NY, United States
(Frishman, Aronow) Department of Medicine, New York Medical College,
Valhalla, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Atrial fibrillation significantly increases the risk of ischemic stroke,
with thrombi primarily originating in the left atrial appendage (LAA).
While direct oral anticoagulants (DOACs) are the standard for stroke
prevention, LAA occlusion (LAAO) has emerged as a nonpharmacologic
alternative, particularly for patients at high bleeding risk. A systematic
review and meta-analysis included 15 studies (1 randomized control trial
and 14 observational studies) encompassing 22,420 patients (10,704 LAAO,
11,716 DOAC). LAAO and DOACs demonstrated comparable thromboembolic event
rates. LAAO was associated with significantly lower risks of
stroke/transient ischemic attack (risk ratio: 0.86, P = 0.0004), major
bleeding [hazard ratio (HR): 0.74, P = 0.03], cardiovascular mortality
(HR: 0.57, P < 0.00001), and all-cause mortality (risk ratio 0.66, P =
0.006). The composite outcome significantly favored LAAO (HR: 0.67, P =
0.0008). No significant difference was found in intracranial bleeding
rates.<br/>Copyright &#xa9; 2025 Wolters Kluwer Health, Inc. All rights
reserved.

<42>
Accession Number
2034636587
Title
Impact of Periprocedural Statin Therapy on Mortality and Cardiovascular
Outcomes in Transcatheter Aortic Valve Replacement: A Meta-Analysis and
Meta-Regression.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Goyal A.; Maheshwari S.; Mashkoor Y.; Singh A.; Rafique F.; Sheikh A.B.;
Bansal K.
Institution
(Goyal) Department of Internal Medicine, Cleveland Clinic Foundation,
Cleveland, OH, United States
(Maheshwari) Department of Internal Medicine, University of Alabama at
Montgomery, Montgomery, AL, United States
(Mashkoor, Singh, Rafique) Department of Internal Medicine, Dow University
of Health Sciences, Karachi, Pakistan
(Sheikh) Department of Internal Medicine, University of New Mexico,
Albuquerque, NM, United States
(Bansal) Department of Family and Community Medicine, Baylor College of
Medicine, Houston, TX, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Transcatheter aortic valve replacement (TAVR) stands as a
notable alternative to surgical valve replacement for severe aortic
stenosis (AS). Despite the established benefits of statins in
cardiovascular pathologies, their specific impact in patients with severe
AS undergoing TAVR remains uncertain. <br/>Aim(s): Our meta-analysis aims
to assess whether periprocedural statin therapy improves survival and
outcomes post-TAVR, thus addressing this gap in literature.
<br/>Method(s): A comprehensive literature search using various databases
with relevant keywords terms was conducted to identify studies on the
impact of periprocedural statin therapy on TAVR outcomes. We assessed the
primary outcome of all-cause mortality alongside various secondary
outcomes including stroke/transient ischemic attack (TIA), myocardial
infarction, acute kidney injury (AKI), 30-day mortality, in-hospital
mortality, rehospitalization, cardiovascular complications, and pacemaker
requirement. A random-effects model using Comprehensive Meta Analysis
Software was employed to analyze the data for each outcome. Statistical
significance was set at a p < 0.05. <br/>Result(s): Our analysis of 19
observational studies revealed that periprocedural statin therapy
significantly reduces all-cause mortality following TAVR surgery (OR =
0.71, 95% CI: 0.61-0.83, p < 0.001). However, the influence of statins on
other outcomes remains inconclusive. These outcomes include stroke/TIA (OR
= 0.90, 95% CI: 0.68-1.19, p = 0.455), risk of MI (OR = 1.72, 95% CI:
0.73-4.04, p = 0.214), AKI (OR = 0.99, 95% CI: 0.75-1.31, p = 0.968),
30-day mortality (OR = 0.71, 95% CI: 0.46-1.10, p = 0.126), in-hospital
mortality (OR = 0.42, 95% CI: 0.13-1.38, p = 0.151), rehospitalization (OR
= 0.92, 95% CI: 0.66-1.29, p = 0.645), cardiovascular complications (OR =
1.12, 95% CI: 0.91-1.37, p = 0.297), and pacemaker requirement (OR = 0.83,
95% CI: 0.65-1.06, p = 0.133). <br/>Conclusion(s): Our meta-analysis
indicates a potentially promising role for periprocedural statin therapy
in enhancing patient outcomes post-TAVR surgery. We found a notable
association between statin therapy and a reduction in all-cause mortality.
However, the effects on secondary outcomes did not reach statistical
significance, which warrants further investigation through larger,
well-designed, randomized controlled trials.<br/>Copyright &#xa9; 2025
Wiley Periodicals LLC.

<43>
[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. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9;
2025 The Author(s).

<44>
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. <br/>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. <br/>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).
<br/>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.<br/>Copyright
&#xa9; 2025 The Author(s)

<45>
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.<br/>Copyright &#xa9; The Author(s), under
exclusive licence to Springer Nature B.V. 2025.

<46>
Accession Number
647160298
Title
Empagliflozin in Patients With Type 2 Diabetes Undergoing On-Pump CABG:
The POST-CABGDM Randomized Clinical Trial.
Source
Diabetes care. 48(6) (pp 988-995), 2025. Date of Publication: 01 Jun 2025.
Author
Pitta F.G.; Lima E.G.; Tavares C.A.M.; Martins E.B.; Rached F.H.; Moreira
E.M.; Mioto B.M.; Lottenberg S.A.; Bolta P.M.P.; Justino L.G.; Favarato
D.; Carvalho L.N.S.; Pinesi H.T.; Barbosa C.T.M.; Dallan L.A.O.; Dallan
L.R.P.; Barbosa M.H.M.; Kalil Filho R.; de Lemos J.A.; Serrano C.V.
Institution
(Pitta, Lima, Tavares, Martins, Rached, Moreira, Mioto, Bolta, Justino,
Favarato, Carvalho, Pinesi, Barbosa, Dallan, Dallan, Barbosa, Kalil Filho,
Serrano) Instituto do coracao, Hospital das Clinicas Hospital das Clinicas
da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade
de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
(Pitta, Tavares, Martins, Rached, Mioto, Lottenberg, Pinesi, Barbosa,
Barbosa, Serrano) Hospital Israelita Albert Einstein, Sao Paulo, Brazil
(Lima) Hospital Nove de Julho, Sao Paulo, Brazil
(Lottenberg) Servico de endocrinologia e metabolismo, Hospital das
Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao
Paulo, Brazil
(de Lemos) Division of Cardiology, Department of Internal Medicine,
University of Texas Southwestern Medical Center, Dallas, TX, United States
Abstract
OBJECTIVE: To evaluate the efficacy and safety of empagliflozin in
patients with type 2 diabetes mellitus (T2DM) undergoing elective on-pump
coronary artery bypass grafting (CABG). RESEARCH DESIGN AND METHODS:
Investigator-initiated, pragmatic, single-center, randomized, open-label
trial with blinded outcome adjudication conducted in Brazil. A total of
145 patients with T2DM scheduled for elective on-pump CABG were randomized
to receive empagliflozin 25 mg daily plus standard care (n = 71) for at
least 3 months, which was discontinued 72 h before surgery, or to received
standard care alone (n = 74). The primary outcome was postoperative acute
kidney injury (AKI) within 7 days of surgery, defined by creatinine-based
criteria (namely, Acute Kidney Injury Network; Risk, Injury, Failure, Loss
of Kidney Function, and End-Stage Kidney Disease; or Kidney Disease:
Improving Global Outcomes). Secondary outcomes included 30-day
postoperative atrial fibrillation and type 5 myocardial infarction (MI).
Safety outcomes were ketoacidosis, urinary tract infection,
hospital-acquired pneumonia, and wound infection within 30 days after
CABG. <br/>RESULT(S): AKI occurred in 22.5% of the empagliflozin group vs.
39.1% in the control group (relative risk [RR] 0.57 [95% CI 0.34-0.96]; P
= 0.03). Rates of atrial fibrillation (15.4% vs. 13.5%; RR 1.15 [95% CI
0.52-2.53]; P = 0.73) and type 5 MI (1.4% vs. 4.1%; RR 0.35 [95% CI
0.04-3.26]; P = 0.62) were similar between groups. No statistically
significant differences between groups were observed for safety events.
Three deaths occurred, all in the control group. <br/>CONCLUSION(S):
Empagliflozin use before on-pump CABG in patients with T2DM was associated
with a reduced incidence of postoperative AKI without an increase in
safety events. These findings warrant confirmation in larger clinical
trials.<br/>Copyright &#xa9; 2025 by the American Diabetes Association.

<47>
[Use Link to view the full text]
Accession Number
647004339
Title
Impact of pecto-intercostal fascial block on postoperative fatigue in
elderly patients undergoing off-pump coronary artery bypass grafting: a
randomized clinical trial.
Source
International journal of surgery (London, England). 111(5) (pp 3323-3330),
2025. Date of Publication: 01 May 2025.
Author
Wang X.; Zhou M.; Liu Q.; Shen F.; Zhang Z.; Qi Y.; Sun J.; Wang L.
Institution
(Wang, Wang) Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu
Province Key Laboratory of Anesthesia and Analgesia Application
Technology, NMPA Key Laboratory for Research and Evaluation of Narcotic
and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
(Zhou, Liu, Zhang, Wang, Qi, Sun, Wang) Department of Anesthesiology,
Xuzhou Central Hospital, Xuzhou, China
(Zhou, Liu, Zhang, Wang, Qi, Sun, Wang) Xuzhou Clinical College of Xuzhou
Medical University, Xuzhou, China
(Shen) Department of Anesthesiology & Key Laboratory of Clinical Science
and Research, Zhongda Hospital, Southeast University, Nanjing, China
Abstract
BACKGROUND: Postoperative fatigue syndrome (POFS) is a common yet often
under-recognized consequence of surgical interventions, particularly in
cardiac surgery. POFS is associated with prolonged recovery times,
extended hospital stays, and increased healthcare costs. Current
strategies for preventing POFS have demonstrated limited success. This
study aims to evaluate the impact of pecto-intercostal fascial block
(PIFB) on the incidence of POFS in elderly patients undergoing off-pump
coronary artery bypass graft (CABG) surgery. <br/>METHOD(S): In this
randomized controlled trial, 110 elderly patients scheduled for off-pump
CABG surgery were randomly assigned to either the PIFB group ( n = 55;
0.4% ropivacaine) or the control group ( n = 55; normal saline). The
primary outcome was the incidence of POFS, which was assessed using the
ICFS-10 scale. Secondary outcomes included postoperative pain scores,
opioid consumption, extubation time, duration of ICU and hospital stay,
and Quality of Recovery (QoR-15) scores. <br/>RESULT(S): The incidence of
POFS was significantly lower in the PIFB group compared to the control
group on postoperative days 1 (69.0% vs. 92.7%, P = 0.004), 3 (63.6% vs.
83.6%, P = 0.030), and 5 (52.7% vs. 72.7%, P = 0.048), with no significant
differences observed by day 7 and 8 weeks. Pain scores were also markedly
lower in the PIFB group at three time points: immediately after
extubation, 12 hours post-surgery, and 24 hours post-surgery ( P < 0.001,
P < 0.001, and P = 0.002, respectively). Furthermore, opioid consumption
was reduced by an average of 11.1 mg ( P < 0.001). Patients in the PIFB
group experienced significantly shorter extubation times (5.5 +/- 1.8
hours vs. 8.6 +/- 2.1 hours, P < 0.001), ICU stays (31.8 +/- 7.3 hours vs.
39.4 +/- 7.5 hours, P < 0.001), and hospital stays (8.2 +/- 1.1 days vs.
8.8 +/- 1.2 days, P = 0.007). QoR-15 scores were significantly higher in
the PIFB group on postoperative days 1, 3, and 5 ( P < 0.001, P = 0.003,
and P = 0.037, respectively). Notably, no PIFB-related adverse events were
reported in either group. <br/>CONCLUSION(S): PIFB significantly
alleviated early POFS, enhanced pain management, reduced opioid
consumption, and accelerated recovery, thereby improving the overall
quality of recovery in elderly patients undergoing off-pump
CABG.<br/>Copyright &#xa9; 2025 The Author(s). Published by Wolters Kluwer
Health, Inc.

<48>
Accession Number
2038916279
Title
Aortic Valve Calcium: A Narrative Review of its Role in the Assessment of
Aortic Stenosis and as a Predictor of Post-transcatheter Aortic Valve
Implantation Outcomes.
Source
Interventional Cardiology: Reviews, Research, Resources. 20 (no
pagination), 2025. Article Number: e16. Date of Publication: 2025.
Author
Krzowski J.; Weir-McCall J.; D'Errico L.; Costopoulos C.; Costanzo P.
Institution
(Krzowski, Weir-McCall, D'Errico, Costopoulos, Costanzo) Royal Papworth
Hospital, Royal Papworth Hospital, NHS Foundation Trust, Cambridge, United
Kingdom
Publisher
Radcliffe Medical Media
Abstract
Degenerative aortic valve disease is the third most common cause of heart
disease in the developed world. Calcific deposits accrue in the valve
endothelium causing progressive stenosis of the orifice. Increasingly,
transcatheter aortic valve implantation is being used in place of surgery
as treatment for aortic stenosis, particularly for patients who are
considered high surgical risk. Although echocardiography remains the gold
standard for the diagnosis and grading of aortic valve stenosis, there is
an increasing interest in the role that aortic valve calcification scoring
may play in these areas. In this review, the authors evaluate the current
evidence for aortic valve calcium scoring as an adjunct to
echocardiography in grading, and as a prognostic marker in challenging
cases. They also explore the ability of calcium scoring to predict
outcomes following transcatheter aortic valve implantation.<br/>Copyright
&#xa9; The Author(s) 2025.

<49>
Accession Number
2034765502
Title
Synchronized diaphragmatic stimulation for the treatment of HFrEF-a
review.
Source
Heart Failure Reviews. (no pagination), 2025. Date of Publication: 2025.
Author
Goldberg L.R.; Mirro M.; Becker G.; Shaburishvili T.; Fudim M.
Institution
(Goldberg) University of Pennsylvania Perelman School of Medicine,
Philadelphia, PA, United States
(Mirro) Indiana University School of Medicine and Parkview Mirro Center
for Innovation, Fort Wayne, IN, United States
(Becker) University of George and Tbilisi Heart and Vascular Clinic,
Tbilisi, Georgia
(Fudim) Duke Clinical Research Institute and Duke Cardiology, Durham, NC,
United States
(Shaburishvili) Ilia State University and Tbilisi Heart and Vascular
Clinic, Tbilisi, Georgia
Publisher
Springer
Abstract
The gap between maximally tolerated medical therapy and consideration for
permanent mechanical circulatory support and/or cardiac transplant or
palliative treatment of moderate to severe heart failure represents an
underserved patient population. New therapies are evolving which may not
only improve quality of life for these patients but also improve
hemodynamics and potentially reverse the progression of the disease. This
review is focused on one such therapy, synchronized diaphragmatic
stimulation. Current clinical results suggest that patients experience
improved exercise tolerance, quality of life, and hemodynamic function
over 6-12 months of therapy which can be safely implemented through a
minimally invasive laparoscopic procedure, often as an outpatient. This
technology has been granted breakthrough device designation and is being
evaluated for a double-blinded, randomized controlled trial by the US
FDA.<br/>Copyright &#xa9; The Author(s) 2025.

<50>
Accession Number
2034779321
Title
Efficiency and safety of double-lumen bronchial tube and bronchial blocker
for one-lung ventilation in patients with thoracic surgery: a
meta-analysis.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 281. Date
of Publication: 01 Dec 2025.
Author
Wu Y.; Liu Y.; Ruan H.; Zhang Z.; Yang J.; Li N.; Wang G.; Wang X.
Institution
(Wu, Liu, Zhang, Yang, Li, Wang) First Hospital of Lanzhou University,
Lanzhou, China
(Wu, Ruan, Wang) Research Institution for "Ren" Doctors, China Medical
University, Shenyang, China
(Liu, Zhang, Yang, Li, Wang) The First School of Clinical Medicine,
Lanzhou University, Lanzhou, China
(Wang) CMU Center for Health Development Research, School of Health
Management, China Medical University, Shenyang, China
Publisher
BioMed Central Ltd
Abstract
Objectives: To compare the efficiency and safety of double-lumen bronchial
tube (DLBT) and bronchial blocker (BB) for one-lung ventilation (OLV) in
patients with thoracic surgery. <br/>Method(s): A systematic search was
conducted across Chinese databases and English databases from the
inception of the databases until December 31, 2024. Two researchers
independently screened the literature and extracted data. A meta-analysis
was then performed using Review Manager 5 and Stata 18.0 software. The
quality of the studies was assessed using the Cochrane bias risk
assessment tool, and a summary of findings (SoF) table was generated using
GRADEprofiler Version 3.6.1. <br/>Result(s): A total of 39 RCTs were
included, comprising 1360 patients in the BB group and 1349 patients in
the DLBT group. The excellent rate of lung collapse quality in the BB
group was 0.94 times that in the DLBT group [I² = 32%, P =
0.07, fixed-effects; RR = 0.94; 95% CI (0.90, 0.99); P = 0.01]. There was
no significant difference in intubation time [I² = 97%, P <
0.00001; SMD = -0.51; 95% CI (-1.17, 0.14); P = 0.12], the success rate of
first-attempt intubation [I² = 79%, P < 0.00001; RR = 1.04; 95%
CI (0.93, 1.15); P = 0.51] or in the incidence of
malposition[I² = 50%, P = 0.01; RR = 1.36; 95% CI (0.95, 1.96);
P = 0.10)] between the two groups. However, there was a significant
difference in positioning time, with the BB group showing shorter
positioning times compared to the DLBT group [I² = 98%, P <
0.00001; SMD = -0.85; 95% CI (-1.50, -0.21); P = 0.004]. Compared to the
DLBT group, the BB group was associated with a reduced incidence of
hoarseness, sore throat, tracheal mucosal injury, hypoxemia, and
pneumonia. <br/>Conclusion(s): The DLBT group demonstrated certain
advantages in terms of lung collapse time and quality of lung collapse.
However, BB demonstrate significantly shorter positioning time compared to
DLBT, and it is also associated with lower risks of multiple
complications, including hoarseness, sore throat, tracheal injury,
hypoxemia, and pneumonia, highlighting its safety advantage in
postoperative care.<br/>Copyright &#xa9; The Author(s) 2025.

<51>
Accession Number
2034740018
Title
A distributional reinforcement learning model for optimal glucose control
after cardiac surgery.
Source
npj Digital Medicine. 8(1) (no pagination), 2025. Article Number: 313.
Date of Publication: 01 Dec 2025.
Author
Desman J.M.; Hong Z.-W.; Sabounchi M.; Sawant A.S.; Gill J.; Costa A.C.;
Kumar G.; Sharma R.; Gupta A.; McCarthy P.; Nandwani V.; Powell D.;
Carideo A.; Goodwin D.; Ahmed S.; Gidwani U.; Levin M.A.; Varghese R.;
Filsoufi F.; Freeman R.; Shetreat-Klein A.; Charney A.W.; Hofer I.; Chan
L.; Reich D.; Kovatch P.; Kohli-Seth R.; Kraft M.; Agrawal P.; Kellum
J.A.; Nadkarni G.N.; Sakhuja A.
Institution
(Desman, Sabounchi, Sawant, Freeman, Charney, Hofer, Chan, Nadkarni,
Sakhuja) The Charles Bronfman Institute for Personalized Medicine, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Desman, Sabounchi, Sawant, Hofer, Chan, Nadkarni, Sakhuja) Division of
Data-Driven and Digital Medicine, Department of Medicine, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Hong, Agrawal) Improbable AI Lab, Massachusetts Institute of Technology,
Cambridge, MA, United States
(Sawant) Division of Hospital Medicine, Department of Medicine, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Gill, Carideo, Ahmed, Gidwani, Varghese, Kohli-Seth, Sakhuja) Institute
for Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New
York, NY, United States
(Costa, Varghese, Filsoufi) Department of Cardiothoracic Surgery, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Kumar) Department of Pulmonary and Critical Care Medicine, Northeast
Georgia Medical Center, Gainesville, GA, United States
(Sharma) Division of Endocrinology, Hackensack University Medical Center,
Hackensack, NJ, United States
(Gupta) Division of Endocrinology, Millenium Physician Group,
Jacksonville, FL, United States
(McCarthy, Nandwani, Powell, Goodwin) Section of Cardiovascular Critical
Care, Department of Cardiovascular and Thoracic Surgery, West Virginia
University, Morgantown, WV, United States
(Levin, Hofer, Reich) Department of Anesthesiology, Perioperative, and
Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY,
United States
(Shetreat-Klein) Department of Rehabilitation and Physical Medicine, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Chan, Nadkarni) Division of Nephrology, Department of Medicine, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Kovatch) Scientific Computing, Icahn School of Medicine at Mount Sinai,
New York, NY, United States
(Kraft) Samuel Bronfman Department of Medicine, Icahn School of Medicine
at Mount Sinai, New York, NY, United States
(Kellum) Department of Critical Care Medicine, University of Pittsburgh
School of Medicine, Pittsburgh, PA, United States
Publisher
Nature Research
Abstract
This study introduces Glucose Level Understanding and Control Optimized
for Safety and Efficacy (GLUCOSE), a distributional offline reinforcement
learning algorithm for optimizing insulin dosing after cardiac surgery.
Trained on 5228 patients, tested on 920, and externally validated on 649,
GLUCOSE achieved a mean estimated reward of 0.0 [-0.07, 0.06] in internal
testing and -0.63 [-0.74, -0.52] in external validation, outperforming
clinician returns of -1.29 [-1.37, -1.20] and -1.02 [-1.16, -0.89]. In
multi-phase human validation, GLUCOSE first showed a significantly lower
mean absolute error (MAE) in insulin dosing, with 0.9 units MAE versus
clinicians' 1.97 units (p < 0.001) in internal testing and 1.90 versus
2.24 units (p = 0.003) in external validation. The second and third phases
found GLUCOSE's performance as comparable to or exceeding that of senior
clinicians in MAE, safety, effectiveness, and acceptability. These
findings suggest GLUCOSE as a robust tool for improving postoperative
glucose management.<br/>Copyright &#xa9; The Author(s) 2025.

<52>
Accession Number
2034777572
Title
Mind the (research) gap: a retrospective observational study on the
utilization of new medical technologies and related research activities in
German hospitals.
Source
Health Research Policy and Systems. 23(1) (no pagination), 2025. Article
Number: 72. Date of Publication: 01 Dec 2025.
Author
Rombey T.; Eckhardt H.; Felgner S.; Dreger M.; Campione A.; Ermann H.;
Ehlig D.; Rodiger H.; Panteli D.; Henschke C.
Institution
(Rombey, Eckhardt, Campione, Ermann, Rodiger, Panteli) Department of
Health Care Management, Technische Universitat Berlin, Berlin, Germany
(Felgner, Dreger, Henschke) Department of Health Care Management and
Berlin Centre for Health Economics Research (BerlinHECOR), Technische
Universitat Berlin, Berlin, Germany
(Ehlig) Chair of Health Economics, Policy and Management, School of
Medicine (Med-HSG), Universitat St. Gallen, St. Gallen, Switzerland
(Henschke) Institute of General Practice and Interprofessional Care,
University Hospital Tubingen, Tubingen, Germany
Publisher
BioMed Central Ltd
Abstract
Objectives: Hospitals play a major role in generating clinical evidence on
new medical technologies. Thus far, the extent of German hospitals'
contribution to the evidence base has not been sufficiently investigated.
This study aims to: (1) examine the utilization of new medical
technologies in German hospitals and its relationship to different
hospital characteristics; (2) investigate the participation of German
hospitals in research on these technologies and the association between
hospital characteristics and research involvement; and (3) investigate the
contribution of German hospitals to international research activities,
including the levels of evidence of any studies conducted. <br/>Method(s):
Using a systematically derived sample of 13 new medical technologies and
various data sources, we retrospectively analyzed the utilization of and
research activities by German hospitals between 2005 and 2017 and explored
which hospital characteristics they were associated with. The data were
analyzed descriptively and are expressed as bar plots, box plots,
quartiles, and crude odds ratios (ORs). <br/>Result(s): The proportion of
German hospitals using new technologies while also being involved in
related clinical research was relatively low (ranging from 0.3% to 29.4%,
except for transcatheter aortic valve implantation (TAVI), with 60.7%),
particularly for prospective studies. Research involvement was positively
associated with university hospital status, larger bed capacity, and
public ownership. Overall, the research involving German hospitals
predominantly consisted of single-arm studies and not randomized
controlled trials (RCTs). <br/>Conclusion(s): Our study identified a gap
between hospitals using new medical technologies and their involvement in
evidence generation. This imbalance can contribute to uncertainty
regarding the actual efficacy, effectiveness and safety of new medical
technologies. To ensure evidence-based patient care, it is therefore
essential to strengthen the link between research and practice, in both
directions. A first step to achieve this could entail restricting the use
of new medical technologies to specialized innovation centers (e.g.,
university hospitals, specialized hospitals) during the initial years of
their utilization to ensure an adequate evidence base is generated before
widespread implementation.<br/>Copyright &#xa9; The Author(s) 2025.

<53>
Accession Number
647471777
Title
Cost-Effectiveness Analysis of Surgical Strategies Versus Medical
Management for Rheumatic Heart Disease in Rwanda.
Source
Journal of the American Heart Association. (pp e038365), 2025. Date of
Publication: 26 May 2025.
Author
Mlambo V.; Wang S.; Musoni M.; Rando H.; Ingabire L.; Patton-Bolman C.;
Mukeshimana G.; Ntaganda E.; Bolman R.; Bendavid E.; Lin Y.
Institution
(Mlambo, Wang) School of Medicine Stanford University Stanford CA
(Musoni) Department of Cardiothoracic Surgery King Faisal Hospital Kigali
Rwanda, Rwanda
(Rando) Department of General Surgery University of Vermont Medical Center
Burlington MD
(Ingabire) King Faisal Hospital Kigali Rwanda, Rwanda
(Patton-Bolman) Team Heart Kigali Rwanda
(Mukeshimana) Department of Cardiology King Faisal Hospital Kigali Rwanda,
Rwanda
(Ntaganda) Rwanda Biomedical Center Kigali Rwanda, Rwanda
(Bolman) Division of Cardiothoracic Surgery University of Minnesota
Minneapolis MN
(Bendavid) Department of Primary Care and Population Health Stanford
University Stanford CA
(Lin) Department of Cardiothoracic Surgery Stanford University Stanford CA
Abstract
BACKGROUND: One-third of the global rheumatic heart disease burden lies in
sub-Saharan Africa, where 17% of patients with severe rheumatic heart
disease die within 3 years without valve surgery. Surgery is often
considered uneconomical, although this assumption is not grounded in
cost-effectiveness analyses. <br/>METHOD(S): We evaluated the
cost-effectiveness of mechanical valve replacement, bioprosthetic valve
replacement, and valve repair compared with medical management for
patients with severe rheumatic heart disease in Rwanda. Using a Markov
model, we simulated disease progression, incorporating transition
probabilities from a meta-analysis of regional observational studies.
Costs were calculated using microcosting, and health effects were measured
in disability-adjusted life-years (DALYs). Cost-effectiveness was defined
by a willingness-to-pay threshold of United States dollars (USD) $2307 per
DALY, which is 3 times Rwanda's gross domestic product per capita. A 3%
discount rate for costs and DALYs was applied. <br/>RESULT(S): Surgical
strategies extended life expectancy from 7 to 11 to 13 years. Mechanical
and bioprosthetic valve replacements were cost-effective compared with
medical management. Mechanical valve replacement was most efficient,
averting 5.64 discounted DALYs for a lifetime discounted cost of USD $10
539.34, with an incremental cost-effectiveness ratio of USD $1704 per
DALY. Bioprosthetic valve replacement averted 5.27 discounted DALYs but
incurred higher costs (USD $10 873.06). Valve repair only averted 3.30
DALYs despite being least expensive (USD $8790.19). Repair became the most
efficient surgical strategy if valve degeneration rates dropped <3.7%
annually. <br/>CONCLUSION(S): Mechanical valve replacement is the most
efficient surgical strategy for severe rheumatic heart disease in
sub-Saharan Africa, challenging assumptions that surgery is uneconomical.
Reducing surgery costs and optimizing anticoagulation could further
enhance cost-effectiveness.

<54>
Accession Number
2038972068
Title
Differential cardiovascular impact of omega-3 fatty acid in patients at
high cardiovascular risk in Asians versus non-Asians: Sub-analysis of the
strength randomized clinical trial.
Source
Atherosclerosis. (no pagination), 2025. Article Number: 120228. Date of
Publication: 2025.
Author
Wang T.K.M.; Nicholls S.J.; St John J.; Wolski K.; Nissen S.E.
Institution
(Wang, St John, Wolski, Nissen) C5 Research, Department of Cardiovascular
Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic,
Cleveland, OH, United States
(Nicholls) Monash Cardiovascular Research Centre, Melbourne, VIC,
Australia
Publisher
Elsevier Ireland Ltd
Abstract
Background/Aims: Racial differences in lipid and cardiovascular risk
profiles are well-established, including for Asians. We compared
cardiovascular treatment effects of omega-3 carboxylic acid (CA) between
Asians and non-Asians in this post-hoc analysis of the STRENGTH trial.
<br/>Method(s): The STRENGTH trial was a double-blinded randomized
controlled trial of 13,078 high cardiovascular risk patients enrolled at
675 global centers. Efficacy and interactions of omega-3 CA for Asians (n
= 1355) and non-Asians (n = 11,723) were assessed. The primary endpoint is
a 5-point composite of cardiovascular death, non-fatal myocardial
infarction, non-fatal stroke, coronary revascularization, and unstable
angina hospitalizations. <br/>Result(s): In Asians, omega-3 CA was
associated with significantly reduction in the primary endpoint during 3.6
+/- 0.7 years follow-up with 81/698 (Kaplan-Meier estimate (KME): 14.8 %)
events in the omega-3 CA group, 103/657 (KME: 20.4 %) events in the corn
oil group, hazard ratio (HR) 0.72, 95 %CI 0.54-0.96, p = 0.03. In
non-Asians, there was not a significant difference in primary endpoint
rates, 704/5841 (KME: 15.6 %) events in the omega-3 CA group, 692/5882
(KME: 15.9 %) events in the corn oil group, HR 1.03 95 %CI 0.93-1.14, p =
0.60. There were significant interactions between race (Asian vs
non-Asian) and treatment group for the primary endpoint (p = 0.02) and
non-fatal stroke (p = 0.02). <br/>Conclusion(s): In this exploratory
analysis from the neutral STRENGTH trial, omega-3 CA was associated with
significant reduction in the primary endpoint in Asians but not in
non-Asian patients with high cardiovascular risk. Further, ideally
randomized, research is necessary to assess these hypothesis-generating
findings and elucidate potential mechanisms for beneficial effects of
omega-3 CA in Asians.<br/>Copyright &#xa9; 2025 The Authors

<55>
Accession Number
2034757188
Title
Comparison of non-intubated and intubated video-assisted thoracoscopic
surgery for perioperative complications-a systematic review and
meta-analysis.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 272. Date
of Publication: 01 Dec 2025.
Author
Zhang D.; Wu J.; Yang Y.; Pu R.; Liu Z.; Li Y.; Deng W.; Wang J.; Hou B.;
Ge Z.; Gao J.; Li J.; Cheng L.
Institution
(Zhang, Wu, Yang, Pu, Liu, Li, Ge, Gao, Li) Department of Anesthesiology,
Qujing First People's Hospital: Kunming Medical University Affiliated
Qujing Hospital, Yunnan Province, Qujing, China
(Deng) Dali University, Yunnan Province, Dali, China
(Wang) Department of Orthopedics, Yuanmou County First People's Hospital,
Yunnan Province, Chuxiong, China
(Hou) Department of Thoracic Surgery, Qujing First People's Hospital:
Kunming Medical University Affiliated Qujing Hospital, Yunnan Province,
Qujing, China
(Cheng) Department of Anesthesiology, Kunming Children's Hospital, Yunnan
Province, Kunming, China
Publisher
BioMed Central Ltd
Abstract
Background: Non-intubated video-assisted thoracic surgery (NIVATS) avoids
lung injury and intubation-related complications from mechanical
ventilation, but the intraoperative safety and postoperative recovery
quality of NIVATS remain controversial. Consequently, we systematically
assessed the viability and safety of non-intubated video-assisted thoracic
surgery (NIVATS) in comparison to intubated video-assisted thoracic
surgery (IVATS). These findings provide evidence for optimizing anesthetic
and surgical decision-making. <br/>Method(s): PubMed, Web of Science,
Embase, Cochrane Library, OVID, and Google Scholar were queried from their
establishment until October 2024. We included eligible studies that
compared non-intubated anesthesia with intubated anesthesia for
video-assisted thoracoscopic surgery for thoracic conditions. Following
the evaluation of bias risk in these randomized controlled trials (RCTs),
a meta-analysis was conducted using Review Manager (Manager 5.4).
<br/>Result(s): Nineteen randomized controlled trials were incorporated
into the study. NIVATS demonstrated a reduced length of hospital stay,
feeding time, and chest-tube dwell time compared to intubated methods.
IVATS groups, hypoxemia exhibited a reduced incidence, but perioperative
cough and perioperative arrhythmias revealed no statistically significant
differences between IVATS and NIVATS groups. The NIVATS groups exhibited a
significantly reduced risk compared to the IVATS groups for postoperative
pulmonary complications (PPCs), postoperative nausea and vomiting (PONV),
and sore throat. <br/>Conclusion(s): NIVATS avoid complications associated
with intubation and are able to accelerate patient recovery to a certain
extent. Although NIVATS carries intraoperative safety risks, careful
patient selection can mitigate these risks.<br/>Copyright &#xa9; The
Author(s) 2025.

<56>
Accession Number
2038947127
Title
Heart Failure and Dysphagia: A Scoping Review.
Source
Heart and Lung. Conference: AAHFN 21ST ANNUAL MEETING. Savannah Georgia.
72 (pp 101), 2025. Date of Publication: 01 Jul 2025.
Author
Velasco J.-L.P.
Publisher
Elsevier Inc.
Abstract
Background: Swallowing is a complex physiological process involving the
coordinated movement of food from the mouth to the stomach. Dysphagia, or
difficulty swallowing, can arise from abnormalities in the anatomy or
physiology of the structures involved in this process. In heart failure
(HF) patients, dysphagia may occur due to the anatomical proximity of the
esophagus to the heart. Despite its potential impact, this symptom is not
routinely assessed in patients with HF. <br/>Aim(s): This scoping review
aims to summarize and synthesize the association of dysphagia with heart
failure. <br/>Method(s): This scoping review was conducted using a
comprehensive search strategy across databases including PubMed, CINAHL,
Embase, and Google Scholar. The review adhered to the Joanna Briggs
Scoping Review Methodology and complied with the guidelines outlined in
the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
Extension for Scoping Reviews (PRISMA-ScR). The inclusion criteria focused
on studies involving heart failure patients aged 18 years or older, with
no restrictions on publication date or study duration, acknowledging the
chronic nature of heart failure. To capture the global prevalence of the
condition, no geographical limitations were applied. However, due to
constraints in translation resources, only articles published in English
or those with available English translations were included.
<br/>Result(s): A total of 36 articles were reviewed, comprising case
reports (n=20), literature reviews (n=2), longitudinal studies (n=3),
prospective cohort studies (n=5), retrospective cohort studies (n=5), and
a cross-sectional study (n=1). Major risk factors for dysphagia include
advanced age and poor oral health, with a higher prevalence observed
following cardiac surgery and in patients with comorbidities such as
dementia, chronic obstructive pulmonary disease, cancer, and anemia.
Pathophysiological contributors include esophageal dysmotility and
stricture, esophageal dilation causing cardiac compression, and
cardiomegaly causing esophageal compression. Clinically, dysphagia in HF
is associated with dehydration, malnutrition, aspiration, and suffocation.
Furthermore, it is linked to higher readmission rate, prolonged hospital
stays, non-home discharges, and increased mortality. More importantly,
volume overload is both a contributing factor and an adverse outcome of
dysphagia in HF patients. Management strategies range from dietary
modifications and pharmacological treatments to invasive and non-invasive
therapeutic measures. Continuous surveillance is essential to ensure early
detection and prevention of complications. <br/>Conclusion(s): Dysphagia
is a prevalent and significant concern in heart failure (HF) patients,
compounded by various risk factors and associated with notable clinical
challenges and adverse outcomes. This review highlights the critical need
for increased awareness and systematic management strategies for dysphagia
in the HF population. Future research should prioritize the development
and implementation of effective screening and intervention protocols to
alleviate the impact of dysphagia on HF progression and enhance patient
outcomes.<br/>Copyright &#xa9; 2025

<57>
Accession Number
645186440
Title
NT-PRO-BNP LEVELS ARE NOT SIGNIFICANTLY AFFECTED BY LEFT ATRIAL APPENDAGE
OCCLUSION (LAAO), A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Blood Purification. Conference: 42nd Vicenza Course AKI-CRRT-ECOS and
Critical Care Nephrology 2024. Vicenza Italy. 53(Supplement 1) (pp e11),
2024. Date of Publication: 01 Aug 2024.
Author
Sebastian M.; Deantri F.; Sianipar L.M.; Krisna A.I.
Institution
(Sebastian, Deantri, Sianipar, Krisna) Faculty of Medicine, Udayana
University, Denpasar, Indonesia
Publisher
S. Karger AG
Abstract
Background: Left atrial appendage occlusion (LAAO) is a procedure used to
occlude or close the left atrial appendage (LAA), a part of the left
atrium that is associated with thrombus formation in patients with atrial
fibrillation. However, LAA is involved in the neurohumoral homeostasis
that may be affected by this procedure. <br/>Objective(s): This study aims
to evaluate the changes of NT-pro-BNP to see the neurohormonal effects
caused by LAAO. <br/>Method(s): We searched the online databases PubMed
(Search conducted on December 2023), ScienceDirect (Search conducted on
December 2023), and Cochrane Library (Search conducted on December 2023)
for studies of atrial fibrillation patients that underwent left atrial
appendage occlusion which measures NT-Pro-BNP levels as an outcome. All
samples that were included are patients with a prior diagnosis of atrial
fibrillation indicated for LAAO due to contraindications to standard
anticoagulation regimens. Baseline demographic data, as well as NT-pro-BNP
concentration pre and post-LAAO, are extracted for this study. The primary
outcome of this study is the absolute mean difference across NT-Pro-BNP
levels obtained before the procedure and during the initial follow-up
visit for each of the studies included in this analysis with a 95%
confidence interval. <br/>Result(s): To compare NT-Pro-BNP changes after
LAAO, we analyzed 7 studies comparing the changes of NT-Pro-BNP during
follow-up from established baseline levels. Using a random-effects model,
and Hedges's method, the pooled NT-Pro-BNP changes in this study are
statistically not significant, with an absolute mean difference in
NT-Pro-BNP concentration of -27.486 pg/dl (95%CI -81.723;26.750, p=0.32).
Begg's test for publication bias was conducted and showed this study had a
low risk of publication bias (z=-0.90, p=0.548). <br/>Conclusion(s): This
study is among one of the first to quantitatively pool studies of
NT-Pro-BNP changes after LAAO. In this study, NT-Pro-BNP changes are not
statistically significant. Further high-quality studies are required to
validate this result. .

<58>
Accession Number
647467615
Title
Cognitive Behavioral Therapy Optimizing Post-Operative Outcomes Among
Coronary Artery Bypass Graft Surgery Patients: A Systematic Review.
Source
BJPsych Open. Conference: RCPsych International Congress 2024. Edinburgh
United Kingdom. 10(Supplement 1) (pp S45), 2024. Date of Publication: 01
Jun 2024.
Author
Ibrahim D.; Elkhidir I.H.; Mohammed Z.; Abdalla D.; Mohammed O.A.
Institution
(Ibrahim, Elkhidir, Mohammed, Abdalla, Mohammed) Khartoum University,
Faculty of Medicine, Khartoum, Sudan
(Elkhidir) Internal Medicine, Ribat University Hospital, Khartoum, Sudan
Publisher
Cambridge University Press
Abstract
Aims. This review aims to evaluate the lasting advantages of cognitive
behavioral therapy (CBT) in alleviating anxiety and depression and
improving overall health outcomes post-CABG. Methods. A comprehensive
search across databases including Science Direct, PsycINFO, PubMed, Google
Scholar, VHL, Cochrane, and Scopus was conducted up to October 2023. The
study adhered to the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) statement and Cochrane guidelines. Inclusion
criteria involved randomized controlled trials reporting on CBT or
CBT-based interventions tailored for CABG patients and control groups had
usual care, with anxiety and depression symptoms, as well as quality of
life, as primary outcomes. Outcome variations were analyzed through
standard deviation, while efficacy was measured via confidence intervals.
Evaluation of the intervention process included examining feasibility,
adherence, acceptability, inclusion rates, safety, and tolerability.
Results. Three randomized controlled trials including a pilot study in
America and Denmark, encompassing a total of 286 patients, were reported
in this review. The participants' pooled mean age was 63.19 years
(intervention) and 63.9 years (control), the male-to-female ratio was
approximately 2:1 [males n = 174 (intervention n = 101; control = 73)
while females n = 91 (intervention n = 60; control n = 31)], and cardiac
as well as noncardiac comorbidities including psychiatric diagnosis have
been reported. The array of therapies ranged from education on anxiety and
depression management skills to a combination of CBT and supportive stress
management (SSM), and psychoeducational interventions paired with physical
therapy. Results indicated that both CBT and SSM led to improvements in
anxiety and depression symptoms, accompanied by reduced hospital stays,
decreased hopelessness, lower scores in dysmorphic mood and irritability,
lowered perceived cognitive impairment and stress, and increased
satisfaction with therapy. The cognitive behavioral therapy demonstrated
commendable feasibility, acceptability, safety, and efficacy, with some
concerns raised about potential issues of low adherence. Conclusion. This
systematic review emphasizes the positive impact of CBT on depression,
anxiety, and quality of life in individuals post-CABG surgery. Future
studies should adopt standardized CBT protocols, comprehensively
evaluating CBT's influence on overall patient prognosis, considering
cardiovascular outcomes across diverse ethnic groups, exploring
cost-effectiveness, and specific patient cohorts that could benefit the
most from CBT interventions.

<59>
Accession Number
645363213
Title
COMPARING ROBOTIC ESOPHAGECTOMY TO VIDEO-ASSISTED THORACOSCOPIC
ESOPHAGECTOMY FOR ESOPHAGEAL SQUAMOUS CELL CARCINOMA: RESULTS FROM THE
REVATE RANDOMIZED CLINICAL TRIAL.
Source
Diseases of the Esophagus. Conference: 20th ISDE World Congress for
Esophageal Diseases, ISDE 2024. Edinburgh United Kingdom. 37(Supplement 1)
(pp 100), 2024. Date of Publication: 01 Sep 2024.
Author
Chao Y.-K.; Li Z.-G.; Jiang H.; Chiu C.-H.; Li B.; Shang X.
Institution
(Chao, Chiu) Chang Gung Memorial Hopsital-linkou, Taoyuan, Taiwan
(Republic of China)
(Li, Li) Shanghai Chest Hospital, Shanghai, China
(Jiang, Shang) Tianjin Medical University Cancer, Institute and Hospital,
Tianjin, China
Publisher
Oxford University Press
Abstract
Background: The treatment of esophageal squamous cell carcinoma (ESCC)
includes dissecting lymph nodes along the recurrent laryngeal nerve (RLN),
which is oncologically important but is technical demanding. Vocal cord
palsy as a result from RLN injury, carries significant morbidities. This
randomized clinical trial (RCT) compared the efficacy and safety of
robotic esophagectomy (RE) and video-assisted thoracoscopic esophagectomy
(VATE) for performing RLN lymph node dissection (LND) Methods:We conducted
amulticenter RCT(NCT03713749) from November 2018 to March 2022, enrolling
patients with ESCC who required McKeown esophagectomy. The primary
endpoint was to determine the success rate of left RLN LND. Success was
defined as the removal of lymph nodes confirmed by pathology, without
causing permanent nerve palsy (duration > 6months). Secondary endpoints
encompassed perioperative and oncological outcomes. <br/>Result(s): The
per-protocol analysis included data from 203 patients (RE group: n=103;
VATE group: n=100). The primary endpoint was achieved in 88.3% of the RE
group and 69% of the VATE group (p<0.001). Additionally, the RE group had
a higher mediastinal lymph node harvest (16 [12-22] versus 14 [10-20],
p=0.04), shorter thoracic operating time (110 [89-137] min versus
124[103.5-154] min, p=0.004), and earlier drainage removal (4 [3-7] days
versus 6 [4-9] days, p=0.007) compared to the VATE group. The two study
arms exhibited comparable complication rates with no recorded in-hospital
deaths in either group. <br/>Conclusion(s): This multicenter trial
demonstrates the effectiveness of RE in enhancing the feasibility and
safety of RLN LND in ESCC. Additionally, RE leads to an improved
mediastinal lymphadenectomy, shorter operating times, and earlier removal
of drainage.

<60>
Accession Number
2038950956
Title
Comparative Prognostic Value of Risk Factors for Predicting Pacemaker
Implantation After Transcatheter Aortic Valve Replacement: A Systematic
Review and Network Meta-Analysis.
Source
American Journal of Cardiology. 250 (pp 79-89), 2025. Date of Publication:
01 Sep 2025.
Author
Hosseini Mohammadi N.S.; 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
(Hosseini Mohammadi, Tavakoli, Taebi, Karvane, Jenab, Hosseini) Tehran
Heart Center, Cardiovascular Disease Research Institute, Tehran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Hosseini Mohammadi, Tavakoli, Taebi, Jenab, Hosseini) Cardiac Primary
Prevention Research Center, Cardiovascular Diseases Research Institute,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(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, United States
(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, Los Angeles, CA, United
States
(Lakkirrddy) Kansas City Heart Rhythm Institute and Research Foundation,
Overland Park, KA, 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
Publisher
Elsevier Inc.
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.<br/>Copyright &#xa9; 2025
Elsevier Inc.

<61>
[Use Link to view the full text]
Accession Number
2038848693
Title
Continued Versus Interrupted Oral Anticoagulation During Transcatheter
Aortic Valve Replacement in Patients With Atrial Fibrillation: A
Meta-Analysis.
Source
American Journal of Therapeutics. (no pagination), 2025. Article Number:
10.1097/MJT.0000000000001979. Date of Publication: 2025.
Author
Jain H.; Patel N.; Daoud Tariq M.; Al-Shammari A.S.; Khan R.; Jain J.;
Patel R.; Ahmed F.; Ahmed R.; Alexander T.
Institution
(Jain, Patel, Jain) Department of Cardiology, All India Institute of
Medical Sciences (AIIMS), Jodhpur, India
(Daoud Tariq) Department of Internal Medicine, Foundation University
Medical College, Islamabad, Pakistan
(Al-Shammari) Department of Medicine, College of Medicine, University of
Baghdad, Baghdad, Iraq
(Khan) Department of Internal Medicine, University of Pittsburgh Medical
Center, Harrisburg, PA, United States
(Patel) Department of Internal Medicine, University of North Carolina
Health Blue Ridge, Morganton, NC, United States
(Ahmed) Department of Cardiology, Duke University Hospital, Durham, NC,
United States
(Ahmed) Department of Cardiology, National Heart and Lung Institute,
Imperial College London, London, United Kingdom
(Alexander) Department of Cardiology, Corpus Christi Medical Center,
Corpus Christi, TX, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction:A substantial number of patients undergoing transcatheter
aortic valve replacement (TAVR) require long-term oral anticoagulants
(OAC) owing to comorbidities. This study examined whether continuing oral
anticoagulation periprocedurally during TAVR is as safe and effective as
interrupting it. <br/>Method(s):A systematic search of the major databases
was performed to identify relevant studies. Effect estimates were
calculated using risk ratios (RR) and 95% CIs by pooling the data using
the inverse-variance random effects model. Statistical significance was
set at P < 0.05. <br/>Result(s):Four studies were included, with 2962
patients undergoing TAVR with continued OAC (n = 1318) and interrupted OAC
(n = 1644). The pooled analysis demonstrated that TAVR with continued OAC
had comparable risks for all-cause mortality (RR: 0.91; 95% CI, 0.62-1.34;
P = 0.64), cardiovascular mortality (RR: 0.89; 95% CI, 0.43-1.84; P =
0.76), stroke (RR: 0.67; 95% CI, 0.42-1.08; P = 0.09), closure device
failure (RR: 0.86; 95% CI, 0.47-1.59; P = 0.64), major/life-threatening
bleeding (RR: 0.93; 95% CI, 0.74-1.15; P = 0.49), and major vascular
complications (RR: 0.97; 95% CI, 0.79-1.20; P = 0.80) compared with TAVR
with interrupted OAC. <br/>Conclusion(s):In patients undergoing TAVR,
continued OAC showed comparable safety and efficacy with interrupted OAC.
These findings demonstrate that continuing OAC in the periprocedural
period may be a viable option in patients with atrial fibrillation because
of comorbidities requiring anticoagulants.<br/>Copyright &#xa9; 2025 The
Author(s). Published by Wolters Kluwer Health, Inc.

<62>
Accession Number
2038872365
Title
Hemodynamic Impact of Cipepofol vs Propofol During Anesthesia Induction in
Patients With Severe Aortic Stenosis: A Randomized Clinical Trial.
Source
JAMA Surgery. (no pagination), 2025. Date of Publication: 2025.
Author
Ni T.; Zhou X.; Wu S.; Lv T.; Hu Y.; Gao Q.; Luo G.; Xie C.; Zou J.; Chen
Y.; Zhao L.; Xiao J.; Tao X.; Yi Y.; Xu Z.; Wang T.; Zhou J.; Yao Y.; Yan
M.
Institution
(Ni, Zhou, Wu, Hu, Gao, Luo, Xie, Zou, Chen, Zhao, Xiao, Tao, Yi, Xu,
Wang, Zhou, Yao, Yan) Department of Anesthesiology, The Second Affiliated
Hospital of Zhejiang University School of Medicine, Hangzhou, China
(Lv) Department of Anesthesiology, The Fourth Affiliated Hospital of
Zhejiang University School of Medicine, Yiwu City, China
Publisher
American Medical Association
Abstract
Importance: Postinduction hemodynamic instability is a frequent
complication among patients with severe aortic stenosis (AS). Using
cipepofol as the anesthesia agent may reduce the incidence and severity of
hemodynamic instability. <br/>Objective(s): To assess whether cipepofol
outperforms propofol in maintaining postinduction hemodynamic stability in
patients with AS. <br/>Design, Setting, and Participant(s): This
single-center, randomized clinical trial was conducted from June 29, 2023,
to July 8, 2024, at the Second Affiliated Hospital of Zhejiang University
School of Medicine in China. Patients with AS scheduled for transcatheter
aortic valve replacement (TAVR) were eligible for inclusion.
<br/>Intervention(s): Participants were randomized 1:1 to receive either
cipepofol or propofol as anesthesia induction agents at equipotent doses.
<br/>Main Outcomes and Measures: The primary outcome was the area under
the curve (AUC) of the mean arterial pressure (MAP) difference from
baseline during the initial 15 minutes postinduction. <br/>Result(s): A
total of 124 patients with AS scheduled for TAVR were randomized into
either the cipepofol group (n = 62) or the propofol group (n = 62). Of 124
patients randomized, 1 patient from each group was excluded due to
ineligibility for the TAVR procedure, and data were analyzed for 122
patients (61 patients per group) based on the intention-to-treat
principle. Among 122 total patients, mean (SD) age was 72.2 (5.0) years,
and 53 patients (43.4%) were female. The cipepofol group exhibited a
significantly smaller median (IQR) AUC (-8505.0 mm Hg s [-12402.8 to
-5130.0]) compared with the propofol group (-13189.0 mm Hg s [-17006.7 to
-7593.3]; P <.001). Moreover, compared with the propofol group, the
cipepofol group demonstrated a significantly lower incidence of
postinduction hypotension (70.5% vs 88.5%; P =.01) and required a smaller
median (IQR) dose of norepinephrine during the first 15 minutes
postinduction (6.0 mug [0.0-10.0] vs 10.0 mug [5.0-20.0]; P =.006).
Additionally, the 2 groups' bispectral indices were comparable.
<br/>Conclusions and Relevance: In this randomized clinical trial,
cipepofol provided superior hemodynamic stability as an induction agent
compared to propofol at equipotent doses and similar anesthesia depths for
patients with AS. Therefore, cipepofol could serve as an alternative
induction agent to propofol for patients at high cardiovascular risk.
Trial Registration: ClinicalTrials.gov Identifier:
NCT05881291.<br/>Copyright &#xa9; 2025 American Medical Association. All
rights reserved.

<63>
Accession Number
2038945484
Title
Subclinical and Clinical Valve Thrombosis After Transcatheter Tricuspid
Valve Replacement: A Systematic Review and Meta-Analysis.
Source
JACC: Cardiovascular Interventions. 18(11) (pp 1495-1497), 2025. Date of
Publication: 09 Jun 2025.
Author
Zorman M.J.; Vibhishanan J.; Dangas K.; Newton J.; Dawkins S.; Guerrero
M.; Eleid M.F.; Ordonez-Mena J.; Cahill T.J.
Publisher
Elsevier Inc.

<64>
Accession Number
2038940347
Title
Comparison of left atrial appendage closure and oral anti-coagulation
after catheter ablation for atrial fibrillation: Concomitant and
sequential cohorts of the OPTION randomized controlled trial.
Source
Heart Rhythm. (no pagination), 2025. Date of Publication: 2025.
Author
Saliba W.; Nair D.; Swarup V.; Hall T.; Iyer V.; Perez G.C.; Weiner S.;
Shah M.; Islam N.; Grygier M.; Schuler B.; Ibanez Criado J.L.; Duthoit G.;
Reddy Y.M.; Reddy V.Y.; Mansour M.; Natale A.; Leger K.; Christen T.;
Stein K.; Sutton B.; Wazni O.
Institution
(Saliba, Wazni) Cleveland Clinic, Cleveland, Ohio, United States
(Nair) St. Bernards Medical Center & Arrhythmia Research Group, Jonesboro,
AR, United States
(Swarup) Arizona Arrhythmia Research Center, Phoenix, Arizona, United
States
(Hall) Q Cardiology, East Brisbane, QLD, Australia
(Iyer) MarinHealth Medical Center, Greenbrae, California, United States
(Perez) H. Puerta Del Mar, Cadiz, Spain
(Weiner) Christus Trinity Mother Frances Health System, Tyler, TX, United
States
(Shah) Washington Hospital Center, Washington, DC, United States
(Islam) University of Maryland St. Joseph Medical Group, Towson Maryland
(Grygier) Poznan University of Medical Sciences, Poznan, Poland
(Schuler) York Hospital, York, Pennsylvania, United States
(Ibanez Criado) Arrhythmia Unit, Cardiology Department, Hospital
Universitario Doctor Balmis, Alicante, Spain
(Ibanez Criado) Instituto de Investigacion Sanitaria y Biomedica de
Alicante (ISABIAL), Alicante, Spain
(Duthoit) Hopital Pitie-Salpetriere, APHP, Paris, France
(Reddy) University of Kansas Hospital, Kansas City, Kansas, United States
(Reddy) Cardiac Electrophysiology, Mount Sinai Fuster Heart Hospital
School of Medicine, New York, United States
(Mansour) Massachusetts General Hospital, Boston, Massachusetts, United
States
(Natale) Texas Cardiac Arrhythmia Institute, St. David's Medical Center,
Austin, Texas, United States
(Natale) Department of Biomedicine and Prevention, Division of Cardiology,
University of Tor Vergata, Rome, Italy
(Natale) Metro Health Medical Center, Case Western Reserve University,
Cleveland, Ohio, United States
(Leger, Christen, Stein, Sutton) Boston Scientific Corporation,
Marlborough, Massachusetts, United States
Publisher
Elsevier B.V.
Abstract
Background: Left atrial appendage closure (LAAC) can be performed in
separate procedures with cardiac ablation (sequentially) or concomitantly
in the same operative session. <br/>Objective(s): The OPTION trial aims to
compare the efficacy and safety of LAAC with oral anticoagulation (OAC) in
patients who have undergone catheter ablation for atrial fibrillation
(AF). The objective of this sub-analysis is to evaluate LAAC vs OAC within
concomitant and sequential ablation timings. <br/>Method(s): OPTION is a
multicenter, prospective randomized clinical trial. Patients with AF and
an elevated CHA<inf>2</inf>DS<inf>2</inf>-VASc score undergoing catheter
ablation were randomly assigned (1:1) to catheter-based LAAC (Device) vs
OAC (Control). Randomization was stratified by AF catheter ablation
procedure timing: Sequential (90-180 days prior to randomization) or
Concomitant (within 10 days of randomization, 99% of procedures happened
the same day). The primary safety end point was non-procedural major or
clinically-relevant non-major bleeding. The primary efficacy end point was
the composite of all-cause death, stroke, or systemic embolism at 36
months. <br/>Result(s): In both the Concomitant (n = 654) and Sequential
(n = 946) groups, the Device arm compared with Control had fewer primary
safety end point events and similar rates of primary efficacy events and
secondary safety events. Rates of acute safety events were low and similar
between the Device and Control arms within the Concomitant group; the
addition of LAAC to cardiac ablation sessions did not result in increased
procedural events. <br/>Conclusion(s): For both Concomitant and Sequential
ablation timing strategies, LAAC has similar efficacy compared with OAC
and a lower risk of clinically important post-procedure bleeding in
high-risk patients following AF ablation.<br/>Copyright &#xa9; 2025 Heart
Rhythm Society

<65>
Accession Number
2038945075
Title
Percutaneous coronary intervention versus coronary artery bypass in
treatment of non-ST-segment elevation acute syndromes: a systematic review
and meta-analysis study.
Source
European Journal of Translational Myology. 35(1) (no pagination), 2025.
Article Number: 12930. Date of Publication: 2025.
Author
Khalifehsoltani A.; Oghenemaro E.F.; Zwamel A.H.; Rekha M.M.; Srivastava
M.; Akhavan-Sigari R.
Institution
(Khalifehsoltani) Islamic Azad University, Medical Branch of Tehran,
Tehran, Iran, Islamic Republic of
(Oghenemaro) Department of Pharmaceutical Microbiology, Faculty of
Pharmacy, Delta State University, Abraka, Nigeria
(Zwamel) Medical Laboratory Technique College, Islamic University, Najaf,
Iraq
(Zwamel) Department of Medical Analysis, Medical Laboratory Technique
College, Islamic University of Al Diwaniyah, Al Diwaniyah, Iraq
(Zwamel) Department of Medical Analysis, Medical Laboratory Technique
College, Islamic University of Babylon, Babylon, Iraq
(Rekha) Department of Chemistry and Biochemistry, School of Sciences, JAIN
(Deemed to be University), Karnataka, Bangalore, India
(Srivastava) Department of Endocrinology, National Institute of Medical
Sciences, NIMS University Rajasthan, Jaipur, India
(Akhavan-Sigari) Dreifaltigkeits-Hospital Lippstadt, Teaching Hospital of
the University of Munster, Germany
(Akhavan-Sigari) Department of Health Care Management and Clinical
Research, Collegium Humanum Warsaw Management University, Warsaw, Poland
Publisher
Page Press Publications
Abstract
The objective of this study is to compare the effectiveness and safety of
Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass
Grafting (CABG) in the treatment of Non-ST-Segment Elevation Acute
Coronary Syndromes (NSTE-ACS). A literature search was conducted across
PubMed, Scopus, and Web of Science, covering studies up to June 2024.
Studies comparing PCI and CABG in patients with NSTE-ACS were included,
focusing on clinical outcomes such as mortality, myocardial infarction,
cerebrovascular accidents, and the need for repeat revascularization. Data
extraction and quality assessment were performed. Statistical analysis was
conducted using R software, with the Mantel-Haenszel method and
random-effects model employed to pool effect sizes and assess
heterogeneity. A total of 15 studies met the eligibility criteria,
including 48,891 patients. The pooled risk ratio (RR) for mortality showed
no significant difference between PCI and CABG (RR=1.09, 95% CI:
0.90-1.19, p=0.28). CABG was associated with a significantly lower risk of
subsequent MI (RR=0.56, 95% CI: 0.38-0.61, p <0.01) and the need for
repeat revascularization (RR=2.94, 95% CI: 2.30-3.76, p <0.01).
Conversely, PCI had a lower associated risk of CVA (RR=0.58, 95% CI:
0.42-0.79, p <0.01). High heterogeneity was observed in mortality
outcomes, indicating variability among studies. The findings suggest that
while PCI and CABG have comparable mortality risks in NSTE-ACS patients,
CABG offers superior protection against myocardial infarction and the need
for repeat revascularization, whereas PCI is associated with a lower risk
of cerebrovascular accidents. These results underscore the importance of
individualized patient assessment in choosing the optimal
revascularization strategy, considering patient-specific risk factors and
clinical profiles.<br/>Copyright &#xa9; 2025 Page Press Publications. All
rights reserved.

<66>
Accession Number
2036474720
Title
Characteristics and Outcomes of Older Patients Undergoing Protected
Percutaneous Coronary Intervention With Impella.
Source
Journal of the American Heart Association. 14(9) (no pagination), 2025.
Article Number: e038509. Date of Publication: 06 May 2025.
Author
Jakob P.; Lansky A.J.; Basir M.B.; Schonning M.J.; Falah B.; Zhou Z.;
Batchelor W.B.; Abu-Much A.; Grines C.L.; O'neill W.W.; Stahli B.E.
Institution
(Jakob, Stahli) Department of Cardiology, University Heart Center,
University Hospital Zurich and the Center for Translational and
Experimental Cardiology (CTEC), University of Zurich, Zurich, Switzerland
(Lansky) Department of Cardiology, Yale University School of Medicine, New
Haven, CT, United States
(Basir, O'neill) Center for Structural Heart Disease, Division of
Cardiology, Henry Ford Health System, Detroit, MI, United States
(Schonning, Falah, Zhou, Abu-Much) Clinical Trials Center, Cardiovascular
Research Foundation, New York, NY, United States
(Batchelor) Inova Center of Outcomes Research, Inova Heart and Vascular
Institute, Falls Church, VA, United States
(Grines) Department of Cardiology, Northside Hospital Cardiovascular
Institute, Atlanta, GA, United States
(Lansky) Barts Heart Centre, London and Queen Mary University of London,
London, United Kingdom
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: In patients undergoing high-risk percutaneous coronary
intervention, Impella has become an important adjunc-tive tool to support
revascularization. The impact of age on the outcomes of patients
undergoing high-risk percutaneous coronary intervention is limited. The
aim of this study is to describe the characteristics and outcomes of
patients >=75 years of age undergoing Impella-supported high-risk
percutaneous coronary intervention. METHODS AND RESULTS: Baseline
characteristics and outcomes of patients >=75 years of age versus those of
patients <75 years of age in patients enrolled in the cVAD PROTECT III
(Catheter-Based Ventricular Assist Device Prospective, Multi-Center,
Randomized Controlled Trial of the IMPELLA RECOVER LP 2.5 System Versus
Intra Aortic Balloon Pump in Patients Undergoing Non Emergent High Risk
Percutaneous Coronary Intervention) study (NCT04136392). Major adverse
cardiovascular and cerebral events (composite of all-cause death, nonfatal
myocardial infarction, stroke/transient ischemic attack, and repeat
revascularization) were assessed at 30 and 90 days and all-cause death at
1 year. Out of 1237 patients, 493 (39.9%) patients were >=75 years of age.
Patients >=75 years of age had less diabetes and prior myocardial
infarction, more hypertension and dyslipidemia, worse renal function, more
severe valvular heart disease, but higher left ventricular ejection
fraction (P<0.05 for all comparisons). Baseline Synergy Between
Percutaneous Coronary Intervention With Taxus and Cardiac Surgery scores
were similar between groups. Older patients underwent more left main
percutaneous coronary intervention (58% versus 39%; P<0.0001), atherectomy
(32% versus 22%; P<0.0001), and femoral access (87% versus 79%, P=0.0003)
as compared with younger patients. In-hospital vascular complications did
not differ, but rates of respiratory failure, pericardial tamponade, and
cardiogenic shock were higher in older patients. Rates of all-cause death
and major adverse cardiovascular and cerebral events did not differ
between groups at 30 and 90 days. Rates of all-cause death at 1 year were
higher in patients >=75 years (adjusted hazard ratio, 1.99 [95% CI,
1.24-3.18], P=0.004). <br/>CONCLUSION(S): Impella-supported high-risk
percutaneous coronary intervention in older patients is feasible with an
acceptable safety profile. However, age >=75 years remained a
statistically significant predictor for all-cause death at 1 year.
REGISTRATION: URL: https://clinicaltrials.gov; Unique Identifier:
NCT04136392.<br/>Copyright &#xa9; 2025 The Author(s).

<67>
Accession Number
2038929651
Title
Effects of a home-based multicomponent exercise programme on frailty in
post-cardiac surgery patients: a randomized controlled trial.
Source
European Journal of Cardiovascular Nursing. 24(4) (pp 580-592), 2025. Date
of Publication: 01 May 2025.
Author
Huang W.-T.; Liu C.-Y.; Shih C.-C.; Chen Y.-S.; Chou C.-L.; Lee J.-T.;
Chiou A.-F.
Institution
(Huang) Department of Post-Baccalaureate in Nursing, Da-Yeh University,
Changhua, Taiwan (Republic of China)
(Huang) Department of Nursing, Da-Yeh University, Changhua, Taiwan
(Republic of China)
(Liu) Biostatistical Consultant Laboratory, Department of Health Care
Management, National Taipei University of Nursing and Health Sciences,
Taipei, Taiwan (Republic of China)
(Shih) Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
(Republic of China)
(Shih) Division of Cardiovascular Surgery, Department of Surgery, Wan Fang
Hospital, Taipei Medical University, Taipei, Taiwan (Republic of China)
(Shih) Department of Surgery, School of Medicine, College of Medicine,
Taipei Medical University, Taipei, Taiwan (Republic of China)
(Shih) Cardiovascular Research Center, Taipei Medical University Hospital,
Taipei, Taiwan (Republic of China)
(Shih) Cardiovascular Research Center, Wan Fang Hospital, Taipei Medical
University, Taipei, Taiwan (Republic of China)
(Chen) Department of Surgery, National Taiwan University Hospital, College
of Medicine, National Taiwan University, Taipei, Taiwan (Republic of
China)
(Chou) Department of Physical Medicine and Rehabilitation, Taipei Veterans
General Hospital, School of Medicine, National Yang Ming Chiao Tung
University, Taipei, Taiwan (Republic of China)
(Lee) Department of Physical Medicine and Rehabilitation, Taipei Veterans
General Hospital, Taipei, Taiwan (Republic of China)
(Chiou) College of Nursing, National Yang Ming Chiao Tung University,
Taipei, Taiwan (Republic of China)
Publisher
Oxford University Press
Abstract
Aims A randomized controlled trial was conducted to examine the effects of
a home-based multicomponent exercise programme on frailty in patients who
underwent cardiac surgery. Methods and results A convenience sample of 92
patients who underwent cardiac surgery at two medical centres in Taiwan
were recruited and randomly allocated to the intervention (n = 46) and
control (n = 46) groups. The intervention group underwent a 12-week
home-based multicomponent exercise programme, including individual nursing
consultation, home-based exercise intervention, nutritional assessment and
guidance, and continuous support. The control group did not receive any
interventions. Frailty was assessed with the Fried frailty phenotype at
baseline, 6 weeks, and 12 weeks. The prevalence rates of prefrailty and
frailty at baseline were 67 and 33%, respectively, and no statistically
significant differences in frailty status were noted between the two
groups at baseline. However, patients in the intervention group
demonstrated significantly greater improvements in their frailty scores,
handgrip strength, and physical activity than the control group at 6 and
12 weeks post-intervention, with no adverse events reported. Conclusion A
home-based multicomponent exercise programme is safe and effective in
improving frailty outcomes among post-cardiac surgery patients and is
suitable for application in clinical practice. Future studies with larger
sample sizes and long-term follow-up are needed to verify the long-term
effects of this home-based multicomponent exercise
programme.<br/>Copyright &#xa9; The Author(s) 2025. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved.

<68>
Accession Number
2036500358
Title
Effect of Thoracic Paravertebral Block on Postoperative Pulmonary
Complications After Video-Assisted Thoracoscopic Surgery: A Dual-Center
Randomized Clinical Trial.
Source
Therapeutics and Clinical Risk Management. 21 (pp 691-703), 2025. Date of
Publication: 2025.
Author
Zhu J.; Wei B.; Wu L.; Li H.; Zhang Y.; Lu J.; Su S.; Xi C.; Liu W.; Wang
G.
Institution
(Zhu, Wu, Li, Zhang, Xi, Wang) Department of Anesthesiology, Beijing
Tongren Hospital, Capital Medical University, Beijing, China
(Wei, Liu) Department of Anesthesiology, Beijing Chest Hospital, Capital
Medical University, Beijing, China
(Lu) Department of Anesthesiology, Beijing Renhe Hospital, Beijing, China
(Su) Central Laboratory, Beijing Obstetrics and Gynecology Hospital,
Capital Medical University, Beijing, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: TPVB can provide effective postoperative analgesia in lung cancer
patients undergoing video-assisted thoracoscopic surgery (VATS), which may
enhance respiratory mechanics and postoperative expectoration, as well as
relieve inflammation and stress. These mechanisms may reduce the incidence
of postoperative pulmonary complications (PPCs). This study explored
whether TPVB reduces the risk of PPCs in patients undergoing VATS for lung
cancer. <br/>Patients and Methods: In this dual-center trial, patients who
underwent VATS for lung cancer were randomly divided into the PV group (n
= 151, general anesthesia [GA] and TPVB) and the C group (n = 151, GA
only). The primary outcome was the incidence of a composite of PPCs within
seven days postoperatively. <br/>Result(s): The incidence of PPCs within
seven days postoperatively was lower in the PV group (37.7%, 57/151)
compared to the C group (49.0%, 74/151), with a risk ratio of 1.59 (95%
CI: 1.00 to 2.50, P=0.048). And within 8-30 days postoperatively, compared
with that in the C group (33.1%, 50/151), the incidence of PPCs was lower
in patients in the PV group (22.5%, 34/151), with a risk ratio of 1.70
(95% CI, 1.02 to 2.84, P=0.040). There was a significant difference in the
incidence of pneumonia between the PV group (11/151, 7.3%) and the C group
(35/151, 23.3%; P < 0.001), and the incidence of pneumothorax between the
PV group (27/151, 17.9%) and the C group (45/151, 29.8%; P = 0.015).
<br/>Conclusion(s): Compared to GA alone, TPVB combined with GA reduces
the incidence of PPCs within seven days postoperatively in patients
undergoing VATS for lung cancer, and this beneficial effect can last up to
30 days after surgery. A possible mechanism is that TPVB reduces acute
postoperative pain in patients. Plain Language Summary: Inadequate
analgesia was associated with the incidence of pulmonary complications,
and the thoracic paravertebral block provides good postoperative analgesia
in patients undergoing thoracic surgery. However, the effect of thoracic
paravertebral block on the incidence of postoperative pulmonary
complications is unknown. Dr. Wang's team conducted a randomized
controlled study, and the results showed that in patients undergo VATS for
lung cancer, thoracic paravertebral block can lower the incidence of
postoperative PPCs and encourage quicker recovery.<br/>Copyright &#xa9;
2025 Zhu et al.

<69>
Accession Number
2038902578
Title
A Randomized Controlled Trial on Nebulized Dexmedetomidine vs. Normal
Saline for Attenuating Hemodynamic Response to Intubation.
Source
Journal of Cardiovascular Disease Research. 15(12) (pp 5823-5834), 2024.
Date of Publication: 2024.
Author
Datar M.S.; Zanwar Y.N.; Dash A.B.; Tiwari S.B.
Institution
(Datar) Department of Anaesthesiology, Shri Vasantrao Naik Government
Medical College, Maharashtra, Yavatmal, India
(Zanwar) Department of Anaesthesiology, Government Medical College,
Maharashtra, Nagpur, India
(Dash) Department of Anaesthesiology Government Medical College,
Maharashtra, Nagpur, India
(Tiwari) Apollo Hospital, Maharashtra, Navi Mumbai, India
Publisher
EManuscript Technologies
Abstract
Background Direct laryngoscopy and intubation act as unpleasant stimuli
which are known to cause transient, but unpredictable hemodynamic changes.
Our hypothesis was that nebulized dexmedetomidine, given as premedication
blunts pressor response during laryngoscopy and intubation. Methods This
was an open label, prospective, randomized controlled study which was
carried out in 90 patients, male and female, aged 18 to 60 years, American
Society of Anaesthesiologists (ASA) I and II, undergoing planned
non-cardiac, non-neurosurgical surgery under general anesthesia with
endotracheal intubation. Study was aimed at evaluating the effects of
nebulized dexmedetomidine towards bringing down pressor response during
laryngoscopy and intubation when compared with normal saline. The study
population was split using pre-designed, computer-generated random
allocation plan into two groups. Control group (n = 50), where patients
were given nebulisation in sitting position, with 5 mL of 0.9% normal
saline and study group (n = 50), where patients were administered
nebulisation in the dose of 1 microg/kg dexmedetomidine (With 0.9% normal
saline added to make a full volume of 5 mL) in sitting position, ten
minutes before induction with anesthesia. Results The two groups were
demographically similar. Following laryngoscopy and intubation in the
control group, there were noticeable increase in heart rate (HR), systolic
blood pressure (SBP), diastolic systolic blood pressure (DBP) and mean
arterial pressure (MAP), but a drop in HR (at 1 min-72.11 +/- 5.57; P=
0.001, 3 min - 68.62 +/- 5.67; P< 0.001, 5 min-64.867 +/- 5.34; P< 0.001,
10 min-60.867 +/- 5.20; P< 0.001), SBP (at 1 min-116.53 +/- 8.88; P<
0.001, 3 min-110.778 +/- 9.2; P< 0.001, 5 min-105.289 +/- 8.79; P< 0.001,
10 min-99.133 +/- 7.87; P< 0.001), DBP (at 1 min-72.978 +/- 6.10; P=
0.001, 3 min-68.73 +/- 6.47; P< 0.001, 5 min-64.311 +/- 6.07; P< 0.001, 10
min- 60.422 +/- 5.79; P< 0.001) and MAP (at 1 min-87.5 +/- 6.8; P= 0.001,
3 min-82.76 +/- 6.76; P< 0.001, 5 min- 78.04 +/- 6.26; P< 0.001, 10 min-
73.29 +/- 5.57; P< 0.001) was recorded in the study group. Conclusion
Nebulized dexmedetomidine when given as a premedication effectually blunts
the pressor response during laryngoscopy and intubation.<br/>Copyright
&#xa9; 2024 EManuscript Technologies. All rights reserved.

<70>
Accession Number
2038901195
Title
Different Strategies in Simultaneous Coronary and Carotid Artery
Revascularization - A Single Center Experience.
Source
Archives of Iranian Medicine. 22(3) (pp 132-136), 2019. Date of
Publication: 01 Mar 2019.
Author
Zhang J.; Dong Z.; Liu P.; Fan X.; Chen J.; Zheng X.; Ma B.; Ye Z.
Institution
(Zhang, Liu, Fan, Chen, Zheng, Ma, Ye) Department of Cardiovascular
Surgery, China-Japan Friendship Hospital, Beijing, China
(Dong) Department of Vascular Surgery, Daqing Oilfield General Hospital,
Daqing, China
Publisher
Academy of Medical Sciences of I.R. Iran
Abstract
Background: The optimal management for patients with concomitant severe
coronary artery disease (CAD) and carotid artery stenosis (CAS) remains
controversial. We reported our preliminary experience on a synchronous
hybrid strategy. <br/>Method(s): Seven patients with synchronous
percutaneous coronary intervention (PCI)/carotid endarterectomy
(CEA)/coronary artery bypass grafting (CABG) and 36 patients with
synchronous CEA/CABG were enrolled. Then we analyzed the demographics,
risk factors and 30-day results of the 2 groups, retrospectively.
<br/>Result(s): The 2 groups were comparable in demographics. The
operation time was 312.14 +/- 40.08 minutes for synchronous PCI/ CEA/CABG
and 294.58 +/- 47.62 minutes for synchronous CEA/CABG (P = 0.367). The
intraoperative blood loss was 814.29+/-195.18 mL for synchronous
PCI/CEA/CABG and 769.44 +/- 330.21 mL for synchronous CEA/CABG (P =
0.731). There was no death in the 2 groups within 30 days. The incidence
of primary endpoint [stroke, myocardial infarction (MI) and death] was
14.29% (1/7) in synchronous PCI/CEA/CABG group and 5.56% (2/36) in
synchronous CEA/CABG group. The difference between the 2 groups was not
statistically significant (P = 0.421). <br/>Conclusion(s): Synchronous
PCI, CEA and CABG may be safe and effective in the management of patients
with concomitant CAS and complicated multi-vessel CAD. The current data
suggested that more studies and randomized controlled trials may be
necessary to define whether this strategy is suitable for these
patients.<br/>Copyright &#xa9; 2019 The Author(s).

<71>
Accession Number
2034707239
Title
When Real-World Outcomes Do Not Meet the Results of Clinical Trials:
Transfemoral Transcatheter vs. Surgical Aortic Valve Replacement in an
Intermediate-Age Population (The Outstanding Italy Study).
Source
Journal of Clinical Medicine. 14(10) (no pagination), 2025. Article
Number: 3471. Date of Publication: 01 May 2025.
Author
Ranucci M.; Staszewsky L.; Cartabia M.; Tettamanti M.; Lepore V.; Robusto
F.; Clavenna A.; D'Ettorre A.; Arbustini E.; Baldassarre D.; La Rovere
M.T.; Montorfano M.; Parati G.; Pedretti R.F.E.; Raffa G.M.; Santini F.;
Stefanini G.; Volterrani M.; Fortino I.; Bisceglia L.; Menicanti L.;
Latini R.
Institution
(Ranucci) Department of Cardiovascular Anesthesia and Intensive Care,
IRCCS Policlinico San Donato, Milan, Italy
(Staszewsky, Latini) Laboratory Clinical Research in Brain and
Cardiovascular Injury, Department of Acute Brain and Cardiovascular
Injury, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan,
Italy
(Cartabia, Tettamanti) Laboratory of Geriatric Neuropsychiatry, Department
of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS,
Milan, Italy
(Lepore) Laboratory of Medical Research and Consumer Involvement,
Department of Public Health, Istituto di Ricerche Farmacologiche Mario
Negri IRCCS, Milan, Italy
(Robusto, D'Ettorre) Puglia Health System, Medonline-Statte, ASL-TA,
Taranto, Italy
(Clavenna, Arbustini) Scientific Department, Centre for Inherited
Cardiovascular Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia,
Italy
(Baldassarre) Centro Cardiologico Monzino, IRCCS, Milan, Italy
(Baldassarre) Department of Medical Biotechnology and Translational
Medicine, Universita degli Studi di Milano, Milan, Italy
(La Rovere) Department of Cardiology, Istituti Clinici Scientifici
Maugeri, Montescano Institute-IRCCS, Montescano, Italy
(Montorfano) School of Medicine, Vita-Salute San Raffaele University,
Milan, Italy
(Montorfano) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Parati) Istituto Auxologico Italiano, S. Luca Hospital, University of
Milan-Bicocca, Milan, Italy
(Parati) Department of Medicine and Surgery, University of Milano-Bicocca,
Piazza dell'Ateneo Nuovo, Milan, Italy
(Pedretti) School of Medicine and Surgery, University of Milano Bicocca,
Milano, Italy
(Pedretti) Cardiovascular Department, IRCCS MultiMedica, Sesto San
Giovanni, Italy
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
(Raffa) Cardiac Surgery Unit, Department of Precision Medicine in Medical
Surgical and Critical Area (Me.Pre.C.C.), University of Palermo, Palermo,
Italy
(Santini) Cardiac Surgery, Ospedale Policlinico San Martino, University of
Genoa, Genoa, Italy
(Stefanini) IRCCS Istituto Clinico Humanitas, Rozzano, Italy
(Volterrani) Exercise Medicine and Science, San Raffaele Open University,
Rome, Italy
(Fortino) Puglia Health System, Agenzia Regionale Strategica per la Salute
ed il Sociale, AReSS Puglia, Area Epidemiologia e Care Intelligence, Bari,
Italy
(Bisceglia) Laboratory for Pharmacoepidemiology, Department of Public
Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan,
Italy
(Menicanti) Department of Cardiac Surgery, IRCCS Policlinico San Donato,
Milan, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Objective: Aortic valve stenosis is the most common valvular heart disease
in the elderly, and its treatment may be either surgical (SAVR) or
transcatheter (TAVI). Although age is one of the main determinants of the
therapeutic choice, current guidelines leave a "discrepancy area" between
65 and 75 years, with the American guidelines allowing TAVI for patients
older than 65 years, while the European guidelines consider TAVI for
patients older than 75 years. The present study addresses the outcomes of
SAVR vs. TAVI in a real-world population aged 65 to 80 years, that is, one
largely inclusive of the discrepancy area. <br/>Method(s): This is a
retrospective registry study based on data retrieved from administrative
health databases of two large Italian regions (Lombardy and Puglia).
Patients aged 65 to 80 years receiving either SAVR or a TAVI between 2018
and 2021 were selected. SAVR and TAVI outcomes (death, cardiac and
non-cardiac events) were compared using a propensity-matching analysis,
with a follow-up of 2 to 5 years and mortality as the primary outcome.
<br/>Result(s): After propensity matching, two groups of 786 patients were
compared in Lombardy and two groups of 321 patients were compared in
Puglia. In both regions, at the end of follow-up, mortality was
significantly (p < 0.001) lower in SAVR vs. TAVI (24.6% vs. 47.2% in
Lombardy and 18.1% vs. 44.1% in Puglia). <br/>Conclusion(s): Our results
are in contrast with the randomized controlled trials showing equivalence
or even the superiority of TAVI vs. SAVR, but in agreement with other
registry studies based on real-world data. With respect to the randomized
controlled trials, the main difference is a better outcome in SAVR.
Caution should be applied in addressing patients < 80 years with TAVI
unless SAVR is contraindicated.<br/>Copyright &#xa9; 2025 by the authors.

<72>
Accession Number
647459719
Title
Extent of coronary artery disease and clinical outcomes with ticagrelor
monotherapy versus aspirin after coronary artery bypass grafting: Insights
from the TiCAB trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2025.
Date of Publication: 24 May 2025.
Author
Arnreiter M.; von Scheidt M.; Albes J.M.; Attmann T.; Boening A.; Choi
Y.-H.; Conradi L.; Danner B.C.; Fach A.; Friedrich I.; Grubitzsch H.; Heck
R.; Joost A.; Knosalla C.; Misfeld M.; Oberhoffer M.; Riebandt J.;
Schaefer A.; Siepe M.; Walther T.; Wimmer-Greinecker G.; Zeymer U.;
Schunkert H.; Kastrati A.; Sandner S.
Institution
(Arnreiter, Riebandt, Sandner) Department of Cardiac and Thoracic Aortic
Surgery, Medical University of Vienna, Vienna, Austria
(von Scheidt, Schunkert, Kastrati) German Heart Centre Munich, TUM
University Hospital, School of Medicine and Health, Technical University
of Munich, Munich, Germany
(von Scheidt, Schunkert, Kastrati) German Center for Cardiovascular
Research (DZHK e. V.), Partner Site Munich Heart Alliance, Munich, Germany
(Albes) Department of Cardiovascular Surgery, Heart Center Brandenburg,
University Hospital Brandenburg Medical School, Faculty of Health Sciences
Brandenburg, Bernau, Germany
(Attmann) Department of Cardiac Surgery, University Hospital
Schleswig-Holstein, Campus Kiel, Kiel, Germany
(Boening) Department of Adult and Pediatric Cardiovascular Surgery,
University Hospital of Giessen and Marburg, Giessen, Germany
(Choi) Department of Cardiac Surgery, Kerckhoff Klinik Bad Nauheim, Bad
Nauheim, Germany
(Conradi) Department of Cardiovascular Surgery, University Heart &
Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf,
Hamburg, Germany
(Danner) Department of Thoracic and Cardiovascular Surgery, University
Hospital of Goettingen, Goettingen, Germany
(Fach) Bremen Institute for Heart and Circulation Research (BIHKF),
Bremen, Germany
(Friedrich) Department of Cardiothoracic Surgery, Krankenhaus der
Barmherzigen Bruder Trier, Trier, Germany
(Grubitzsch) Department of Cardiothoracic and Vascular Surgery, Berlin,
Germany
(Grubitzsch, Heck, Knosalla) Charite-Universitatsmedizin Berlin, Berlin,
Germany
(Heck, Knosalla) Deparment of Cardiothoracic and Vascular Surgery, German
Heart Center Berlin, Berlin, Germany
(Joost) University Heart Center Lubeck, Medical Clinic II, Lubeck, Germany
(Misfeld) Department of Cardiothoracic Surgery, Royal Prince Alfred
Hospital, Sydney, NSW, Australia
(Oberhoffer) Department of Cardiovascular Surgery, University Hospital of
Johannes Gutenberg-Universitat Mainz, Mainz, Germany
(Schaefer) Department of Cardiovascular Surgery, University Heart Center
Hamburg, Hamburg, Germany
(Siepe) Department of Cardiac Surgery, Inselspital, Bern University
Hospital, University of Bern, Bern, Switzerland
(Walther) Department of Cardiovascular Surgery, University Hospital
Frankfurt and Goethe University Frankfurt, Frankfurt, Germany
(Wimmer-Greinecker) Department for Cardiothoracic Surgery, Heart and
Vessel Center Bad Bevensen, Bad Bevensen, Germany
(Zeymer) Department of Cardiology, Ludwigshafen, Germany
Abstract
OBJECTIVES: Patients with extensive coronary artery disease (CAD) have a
higher risk of cardiovascular events. This post hoc analysis of the
Ticagrelor in CABG (TiCAB) trial examined the association of ticagrelor
monotherapy versus aspirin with clinical outcomes after CABG in relation
to the extent of CAD. <br/>METHOD(S): The TiCAB trial randomized CABG
patients to ticagrelor (90 mg twice daily) or aspirin (100 mg daily) for
12 months. Patients were stratified by SYNTAX score terciles: low (<=22),
intermediate (23-32), and high (>=33). The primary end-point was major
adverse cardiac and cerebrovascular events (MACCE) at 12 months, including
cardiovascular death, myocardial infarction, stroke, or repeat
revascularization. Secondary end-points included individual MACCE
components and major bleeding events. Cox proportional hazards models were
used to assess treatment effects. <br/>RESULT(S): Among 752 patients,
33.4% had low, 36.0% intermediate, and 30.6% high SYNTAX scores (median
26.5 [20.0-33.0]). MACCE rates were similar across groups (low: 7.8%;
intermediate: 9.2%; high: 8.8%; p = 0.87), though the incidence of repeat
revascularization differed significantly among SYNTAX score groups (p =
0.02). Ticagrelor did not show a significant MACCE benefit over aspirin in
any SYNTAX score group (low: HR 2.27, 95% CI 0.87-5.94; intermediate: HR
1.02, 95% CI 0.46-2.27; high: HR 1.76, 95% CI 0.70-4.46; Pint=0.41).
Secondary outcomes, including bleeding, aligned with overall trial
results. <br/>CONCLUSION(S): This analysis did not find a differential
benefit of ticagrelor versus aspirin across CAD complexity levels as
measured by the SYNTAX score. Further studies are warranted to refine
antiplatelet strategies for patients with complex CAD undergoing
CABG.<br/>Copyright &#xa9; The Author(s) 2025. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery.

<73>
Accession Number
647448397
Title
Prevention Of Infections In Cardiac Surgery (PICS)-Prevena Study-a
pilot/vanguard factorial cluster cross-over RCT.
Source
Open Forum Infectious Diseases. Conference: IDWeek 2024. Los Angeles, CA
United States. 12(Supplement 1) (pp S355-S356), 2025. Date of Publication:
01 Feb 2025.
Author
Scheier T.C.C.; Whitlock R.; Loeb M.; Devereaux P.J.; Lee S.F.; Mertz D.
Institution
(Scheier) Population Health Research Institute, Hamilton, ON, Canada
(Whitlock, Devereaux, Lee) McMaster university, Hamilton, ON, Canada
(Loeb, Mertz) McMaster University, Hamilton, ON, Canada
Publisher
Oxford University Press
Abstract
Background. Sternal surgical site infections (s-SSI) after cardiac surgery
can lead to significant morbidity, mortality, and costs. Among cardiac
surgery patients, the effects of negative pressure wound management is
unknown. Table 1: Baseline Characteristics BMI= Body Mass Index; COPD=
Chronic obstructive pulmonary disease; CABG= Coronary artery bypass graft;
SD= Standard deviation Methods. The PICS-PREVENA Vanguard study, a 2x2
factorial, open label, cluster-randomized crossover trial, was conducted
at 2 hospitals in Ontario, Canada (NCT03402945). We randomized each site
to one of four sequences of the four study arms-each arm combining either
cefazolin mono vs. combination prophylaxis with vancomycin (not analyzed)
with either standard wound dressing vs. the 3M Prevena incision management
system (Prevena). Only diabetic or obese patients (BMI >30kg/m2) were
eligible for the latter comparison. For this population, we report the
feasibility and efficacy endpoints of the Prevena versus standard wound
dressing interventions. Feasability was assessed by adherence to the study
protocol and loss to follow-up. The primary efficacy outcome was a
composite of deep and organ-Space s-SSI within 90-days after surgery. We
used mixed logistic regression, accounting for clusters as a random effect
for analysis. <br/>Funding(s): KCI USA, Inc. Results. Among the 4107
included patients, 2230 were obese or diabetic. Of these patients, 1208
underwent surgery during a standard wound dressing period, and 1022 during
a Prevena allocated period (Figure and Table 1). Of the latter, 696
(68.1%) had Prevena applied. Loss to follow up was 3.6% for obese or
diabetic patients Conclusion. The vanguard study showed challenges with
introducing a novel technology as standard of care with only a 68%
compliance overall, with noncompliance mostly driven by one of the sites.
No conclusions should be drawn regarding the efficacy of Prevena, as this
Vanguard phase was not powered for these outcomes.

<74>
Accession Number
647460078
Title
No benefit of adding mannitol to cardiopulmonary bypass priming solution
assessing cystatin C. A randomized clinical trial.
Source
Perfusion. (pp 2676591251344857), 2025. Date of Publication: 24 May 2025.
Author
Skold A.; Dardashti A.; Lindstedt S.; Hyllen S.
Institution
(Skold, Dardashti, Lindstedt, Hyllen) Department of Cardiothoracic
Surgery, Anesthesia and Intensive Care, Skane University Hospital, Lund,
Sweden
(Skold, Dardashti, Lindstedt, Hyllen) Department of Clinical Sciences,
Cardiothoracic Surgery, Lund University, Lund, Sweden
Abstract
IntroductionThere is no recommendation regarding the optimal prime
solution for the cardiopulmonary bypass circuit in adult cardiac surgery.
Despite the lack of scientific evidence, mannitol has frequently been
added to the prime solution with intention to prevent acute kidney injury.
The aim of this study was to investigate the impact of mannitol in
cardiopulmonary bypass circuit prime in patients with preoperative renal
dysfunction.MethodsThis prospective, randomized, double-blind study
included 70 patients, who underwent coronary artery bypass grafting. One
group received 1200 mL of a prime based on Ringer's acetate (n = 35), and
the other a prime consisting of 1000 mL Ringer's acetate and 200 mL
mannitol (n = 35). Primary endpoint were levels of Cystatin C, a renal
function biomarker. Changes in renal-related parameters, electrolytes,
osmolality and acid-base status were monitored.ResultsThe median cystatin
C on day four in the mannitol group were 1.6 mg/L (IQR 1.4-2.0 mg/L) and
1,8 mg/L (IQR 1.5-2.1 mg/L) in the Ringer's acetate group at the same
time. Using mixed model analysis, no differences in cystatin C (p =
0.442), creatinine (p = 0.203), estimated glomerular filtration rate (p =
0.264) and urea (p = 0.141) could be detected between the groups. The
mannitol group showed a more pronounced reduction in sodium levels after
cardiopulmonary bypass circuit commencement compared to the Ringer's
acetate group p < 0.001.ConclusionsIn patients with preoperative renal
dysfunction, the addition of mannitol in the prime solution did not show
any renoprotective effect measured by cystatin C compared to a
cardiopulmonary bypass circuit prime based on Ringer's acetate. This study
was reported to ClinicalTrials.org, id: NCT03302286. Effects of Extra
Corporeal Circuit Prime on Electrolytes Balance and Clinical Outcome
Following Cardiac Surgery
https://clinicaltrials.gov/study/NCT03302286?id=NCT03302286&rank=1.

<75>
Accession Number
2034706703
Title
Meta-Analytic Review of Coronary Angiography in Peri-Procedural Myocardial
Injury and Infarction After Cardiac Surgery.
Source
Journal of Clinical Medicine. 14(10) (no pagination), 2025. Article
Number: 3407. Date of Publication: 01 May 2025.
Author
Cereda A.F.; Toselli M.; Cimaglia P.; Franchina A.G.; Tua L.; Carla M.;
Tumminello G.; Aseni P.; Sangiorgi G.M.; Biolcati M.; Spangaro A.;
Rocchetti M.; Pezzoli E.; Vanelli P.; Lucreziotti S.
Institution
(Cereda, Franchina, Tua, Carla, Biolcati, Spangaro, Rocchetti, Pezzoli,
Lucreziotti) Cardiology Unit, ASST Santi Paolo e Carlo, Milan, Italy
(Toselli) Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
(Cimaglia) Cardiovascular Institute, Azienda Ospedaliero Universitaria di
Ferrara, Ferrara, Italy
(Tumminello) Department of Cardio-Thoracic-Vascular Diseases, Foundation
IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
(Aseni) Department of Emergency Medicine, ASST Grande Ospedale
Metropolitano Niguarda, Milan, Italy
(Sangiorgi) Cardiac Cath Lab, Department of Biomedicine and Prevention,
University of Rome Tor Vergata, Rome, Italy
(Vanelli) Cardiac Surgery Unit, Fondazione IRCCS Ca' Granda Ospedale
Maggiore Policlinico, Milan, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Introduction: Peri-procedural myocardial infarction (PMI) after cardiac
surgery is a significant yet often under-recognised complication,
sometimes necessitating urgent coronary angiography (PMI-rCA). This
meta-analysis evaluates its prevalence, angiographic findings, management
strategies, and associated mortality. <br/>Method(s): A systematic review
and meta-analysis were conducted according to PRISMA guidelines. Data from
nine studies comprising 104,445 post-cardiac surgery patients were
analysed. Among them, those undergoing PMI-rCA were categorised by
treatment strategy: conservative management, percutaneous coronary
intervention (PCI), or reperform surgery. A network meta-analysis compared
mortality risks across these groups, with findings visualised using forest
plots, network diagrams, and SUCRA rankings. <br/>Result(s): PMI-rCA was
performed in 1205 patients (2%). Of these, 34.3% had no significant
angiographic abnormalities, 53.7% exhibited graft failure, and 10.4% had
native vessel ischemia. Management strategies included conservative
treatment (55.5%), PCI (23.5%), and reperforming surgery (21%). Network
meta-analysis indicated that conservative management was associated with
the lowest mortality risk, followed by PCI, while reperforming surgery had
the highest risk. <br/>Discussion(s): These findings highlight the
complexity of PMI diagnosis and treatment. The high proportion of patients
without significant angiographic abnormalities raises concerns about
potential overuse of invasive procedures. Meanwhile, PCI appears to be a
more favourable interventional strategy than reperforming surgery in terms
of mortality outcomes. <br/>Conclusion(s): PMI requiring coronary
angiography is uncommon but clinically significant, with a 16% mortality
rate. A tailored, risk-based approach is essential to optimise management,
balancing conservative therapy, PCI, and reperforming surgery based on
individual patient profiles.<br/>Copyright &#xa9; 2025 by the authors.

<76>
Accession Number
2034681923
Title
Ticagrelor combined with aspirin may improve patency of vein graft one
year after off-pump coronary artery bypass grafting: a single-center,
randomized double-blinded clinical controlled trial.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1461370. Date of Publication: 2025.
Author
Wang W.; Chi Q.; Gao F.; He X.; Gao Y.; Shi L.; Liu W.; Fan W.; Zhang L.;
Xu C.; Zhuang X.
Institution
(Wang, Gao, He, Gao, Shi, Liu, Fan, Zhang, Xu, Zhuang) Department of
Cardiovascular Surgery, Dalian Municipal Central Hospital, Dalian, China
(Chi) School of Energy and Power, Dalian University of Technology, Dalian,
China
Publisher
Frontiers Media SA
Abstract
Background: Dual anti-platelet therapy (DAPT) after coronary artery bypass
graft surgery (CABG) has drawn a lot of controversy. This study aimed to
explore the effects of ticagrelor combined with aspirin (compared with
aspirin combined with clopidogrel) on the patency of saphenous vein graft
(SVG) after off-pump CABG. <br/>Method(s): This was a prospective,
randomized, double-blinded clinical controlled trial. Participants were
first given aspirin (100 mg/d) within 12 h after off-pump CABG, followed
by P2Y12 receptor antagonist (Orally, 75 mg/time of clopidogrel, once
daily, for Group C and 90 mg/time of ticagrelor, twice daily, for Group T)
within 24 h after off-pump CABG for one year. Computed tomography
angiography (CTA) was conducted for all patients. The incidence of major
adverse cardiac events(MACE), death, stroke, hemorrhage, left ventricular
diameter (LVD), and left ventricular ejection fraction (LVEF) of the
participants was assessed one year after off-pump CABG based on a 12-month
follow-up. <br/>Result(s): A total of 73 participants completed the
follow-up, and 219 bypass grafts, including 146 SVGs, were conducted.
Notably, 11 bypass grafts (SVGs) were exposed to occlusion (9 in Group C
and 2 in Group T). The overall occlusion rates of bypass grafts and SVGs
of Groups C and T were significantly different (9/114 vs. 2/105, P =
0.043, 9/76 vs. 2/70, P = 0.04). Moreover, multivariate binary Logistic
regression demonstrated that ticagrelor + aspirin anti-platelet therapy
could reduce the stenosis risk of bypass grafts (OR = 0.195, 95% CI =
0.039-0.978, P = 0.047). <br/>Conclusion(s): Compared with clopidogrel,
ticagrelor may reduce the occlusion rate of vein grafts after CABG.
Clinical Trial Registration: [https://www.chictr.org/], identifier
[ChiCTR1900022390].<br/>Copyright 2025 Wang, Chi, Gao, He, Gao, Shi, Liu,
Fan, Zhang, Xu and Zhuang.

<77>
Accession Number
2038937438
Title
+ Impact of adjunctive lipid-modifying therapy in the CLEAR Outcomes
Ttial.
Source
Journal of Clinical Lipidology. Conference: Scientific Poster Abstracts
Selected for the National Lipid Association 2025 Scientific Sessions.
Miami United States. 19(3 Supplement) (pp e93-e94), 2025. Date of
Publication: 01 May 2025.
Author
Bloedon L.; Li N.; Powell H.; Lincoff A.M.; Nicholls S.; Nissen S.; Menon
V.
Institution
(Bloedon, Li, Powell, Lincoff, Nicholls, Nissen, Menon) ClevelandOHUnited
States
Publisher
Elsevier Ltd
Abstract
Funding: Esperion Therapeutics, Inc. Background/Synopsis: Randomization of
statin intolerant patients to bempedoic acid resulted in a 13% reduction
in the risk of MACE-4 (CV death, nonfatal myocardial infarction, nonfatal
stroke or coronary revascularization) compared to placebo in the Clear
Outcomes trial (n= 13,970). During the median 40.6 month follow up,
adjunctive lipid modifying therapy was observed in 1,749 (12.5%) patients.
Objective/Purpose: As part of a prespecified sensitivity analysis, we
evaluated the frequency of use and impact of adjunctive lipid modifying
therapy on the MACE-4 primary efficacy endpoint in CLEAR Outcomes.
<br/>Method(s): MACE-4 in the bempedoic acid and placebo groups was
evaluated by censoring patient data at the time of starting the first
adjunctive lipid modifying therapy plus 30 days. The hazard ratio for the
treatment effect was estimated with placebo as the reference group
utilizing Cox regression in the intent to treat population. Concomitant
medications were recorded through the end of study visit. <br/>Result(s):
A first MACE-4 event occurred in 819 (11.7%) and 927 (13.3%) patients
randomized to bempedoic acid and placebo, respectively. Adjunctive lipid
modifying therapy was observed in 660 (9.4%) bempedoic acid and 1,089
(15.6%) placebo patients. The majority of first MACE-4 (92.9% and 90.9% of
events in the bempedoic acid and placebo groups, respectively) occurred
before any adjunctive lipid modifying therapy. Statins were used most
often, with all adjunctive lipid modifying therapy usage higher in
placebo. When adjunctive lipid modifying therapy patient data was
censored, bempedoic acid reduced MACE-4 similar to the full analysis set
(Table 1). <br/>Conclusion(s): A minority of patients in CLEAR Outcomes
(placebo more than bempedoic acid) were treated with adjunctive lipid
modifying therapy during the trial. The timing of adjunctive lipid
modifying therapy initiation in more than 90% of subjects occurred after
the first observed MACE event. Consequently, censored data at adjunctive
lipid modifying therapy initiation shows negligible impact of adjunctive
lipid modifying therapies on the overall primary endpoint.<br/>Copyright
&#xa9; 2025

<78>
Accession Number
2034706751
Title
Peri-Procedural Continuation Versus Interruption of Anticoagulation for
Transcatheter Aortic Valve Implantation: A Systematic Review and
Meta-Analysis.
Source
Journal of Clinical Medicine. 14(10) (no pagination), 2025. Article
Number: 3563. Date of Publication: 01 May 2025.
Author
Khater J.; Frazzetto M.; Gurgoglione F.L.; Hasan J.; Donelli D.; Attizzani
G.; Cortese B.
Institution
(Khater, Frazzetto, Gurgoglione, Hasan, Cortese) DCB Academy, Milan, Italy
(Khater) Faculty of Medical Sciences, Lebanese University, Rafic Hariri
University Campus, Hadath, Lebanon
(Frazzetto, Attizzani, Cortese) Department of Cardiology, University
Hospitals Cleveland Medical Center, Cleveland, OH, United States
(Gurgoglione, Donelli) Division of Cardiology, Parma University Hospital,
University of Parma, Parma, Italy
(Hasan) CHU Amiens-Picardie, Amiens, France
(Hasan) Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac
Centre (MKCC), P.O. Box 101, Awali, Bahrain
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Oral anticoagulation therapy (OAC) is crucial for
reducing the risk of ischemic complications in patients with atrial
fibrillation (AF). However, OAC also increases the risk of major bleeding
events. The optimal management of OAC in patients with AF undergoing
transaortic valve implantation (TAVI) is unclear. This study aimed to
compare the efficacy and safety of OAC interruption vs. continuation in
patients with AF scheduled for TAVI. <br/>Method(s): PubMed, EMBASE, and
Cochrane were searched to include all pertinent randomized and
observational studies. The primary endpoint was the occurrence of net
adverse clinical events (NACE), a composite of all-cause death, major
vascular complications, and major bleeding at 30-day follow-up. Secondary
endpoints included all-cause death, cardiovascular death, major vascular
complications, major bleeding, any bleeding, stroke, non-fatal myocardial
infarction, and the need for red-packed blood transfusion. <br/>Result(s):
A total of three studies and 2773 patients were included in the analysis
(1314 were allocated to continuation of OAC therapy and 1459 to
interruption of OAC therapy during TAVI). The two study groups experienced
a similar rate of NACE (OR = 0.89 [95% CI 0.61 to 1.31], I² =
77%, p = 0.56) compared to the OAC-interruption group. No significant
differences were observed in the rate of all-cause death (p = 0.21),
cardiovascular death (p = 0.35), major vascular complications (p = 0.84),
major bleeding events (p = 0.47), total bleeding events (p = 0.62), or
non-fatal MI (p = 0.55). Interestingly, the OAC-continuation group
experienced a lower occurrence of stroke (OR = 0.62 [95% CI 0.39 to 0.97],
I² = 0%, p = 0.04) and the need for red packed blood cells (OR
= 0.66 [95% CI 0.50 to 0.86], I² = 20%, p < 0.01) compared to
the OAC-interruption group. <br/>Conclusion(s): In patients with AF
undergoing TAVI, there was no significant difference between interruption
and continuation of OAC in terms of NACE, composite of all-cause death,
major vascular complications, or major bleeding at 30-day follow-up. Of
interest, the OAC-continuation group patients experienced lower rates of
stroke and the need for blood transfusion.<br/>Copyright &#xa9; 2025 by
the authors.

<79>
Accession Number
647449423
Title
Factors Associated with Chagas Reactivation After Heart Transplantation:
Retrospective Analysis at a Large Volume Academic Transplant Center.
Source
Open Forum Infectious Diseases. Conference: IDWeek 2024. Los Angeles, CA
United States. 12(Supplement 1) (pp S1340-S1341), 2025. Date of
Publication: 01 Feb 2025.
Author
Beaird O.E.; Multani A.; Gaynor P.; Yanagimoto-Ogawa L.; Fraschilla S.;
King M.; Smith J.G.; Nsair A.; Carlson M.; Kubak B.M.; Schaenman J.M.
Institution
(Beaird, Gaynor, Smith, Nsair, Carlson) UCLA, Los Angeles, CA, United
States
(Multani, Yanagimoto-Ogawa) David Geffen School of Medicine at UCLA, Los
Angeles, CA, United States
(Fraschilla) Ronald Reagan UCLA Medical Crnter, Los Angeles, CA, United
States
(King) UCLA Medical Center, Los Angeles, CA, United States
(Kubak) UCLA Med Cntr, Los Angeles, CA, United States
(Schaenman) University of California Los Angeles, David Geffen School of
Medicine, Los Angeles, CA, United States
Publisher
Oxford University Press
Abstract
Background. Chagas cardiomyopathy (CC), caused by Trypanosoma cruzi, is a
common indication for orthotopic heart transplantation (OHT) for patients
born in Latin America, however post-transplant Chagas reactivation (CR) is
common, occurring in ~60% of cases. Serial T. cruzi PCR monitoring
post-OHT with preemptive therapy is the current standard for managing
post-transplant CR in part due to poor tolerability of benznidazole and
nifurtimox. While this approach is often effective, poor accessibility can
create delays in treatment, leading to adverse outcomes. We examined
patients with CC who underwent OHT to evaluate factors associated with CR.
Methods. We conducted a retrospective review of all patients with CC who
underwent OHT at our center between January 2011 - May 2024, reviewing
demographics, pre-transplant desensitization, induction and maintenance
immunosuppression, rejection history, and presence or absence of azole
prophylaxis. Results. 24 patients with confirmed CC were identified, whose
characteristics are listed in Table 1. CR occurred in 5 (20.8%) patients,
of whom2 developed clinical manifestations. Asymptomatic CR occurred in
1/20 patients (5%) on azole prophylaxis, whereas 4/4 (100%) patients not
on azole prophylaxis had CR (p< 0.001). Age, sex, induction
immunosuppression, and treatment for rejection were not significantly
associated with CR. Comparison of patients with and without CR is shown in
Table 2. Conclusion. The rate of CR in our cohort was lower than expected
based on published data. This may be related to the use of azole
prophylaxis which we frequently use for prevention of coccidioidomycosis.
Azoles have varying in vitro and in vivo antitrypanosomal activity. In
randomized clinical trials (RCTs), posaconazole demonstrated ability to
suppress molecular detection of T. cruzi. Our findings suggest that azole
prophylaxis, including fluconazole, may have a protective effect against
CR. Considering favorable cost and tolerability of fluconazole as compared
to benznidazole and nifurtimox, these findings could have significant
implications for post-transplant management of CC. Given the small number
of patients with CR in our cohort, larger studies including RCTs are
needed to validate this observation. (Table Presented).

<80>
Accession Number
647456508
Title
Conjugated bile acids are elevated in severe calcific aortic valve
stenosis.
Source
Journal of lipid research. (pp 100830), 2025. Date of Publication: 21 May
2025.
Author
Zhang H.; Atefi N.; Surendran A.; Han J.; Goodlett D.R.; Jassal D.S.; Shah
A.; Ravandi A.
Institution
(Zhang, Surendran) Cardiovascular Lipidomics Laboratory, St. Boniface
Hospital, Albrechtsen Research Centre; Department of Physiology and
Pathophysiology, Rady Faculty of Health Sciences, University of
Manitoba(3)Mass Spectrometry & Proteomics Core Facility, Rajiv Gandhi
Centre for Biotechnology, Kerala
(Atefi) Cardiovascular Lipidomics Laboratory, St. Boniface Hospital,
Albrechtsen Research Centre; Genome British Columbia Proteomics Centre,
University of Victoria, Victoria, BC, Canada
(Han) Genome British Columbia Proteomics Centre, University of Victoria,
Victoria, BC, Canada; Division of Medical Sciences, University of
Victoria, Victoria, BC, Canada
(Goodlett) Genome British Columbia Proteomics Centre, University of
Victoria, Victoria, BC, Canada; Department of Biology and Microbiology,
University of Victoria, Victoria, BC, Canada
(Jassal) Department of Physiology and Pathophysiology, Rady Faculty of
Health Sciences, University of Manitoba(3)Mass Spectrometry & Proteomics
Core Facility, Rajiv Gandhi Centre for Biotechnology, Kerala; Section of
Cardiology, Department of Internal Medicine, Rady Faculty of Health
Sciences, University of Manitoba
(Shah) Department of Physiology and Pathophysiology, Rady Faculty of
Health Sciences, University of Manitoba(3)Mass Spectrometry & Proteomics
Core Facility, Rajiv Gandhi Centre for Biotechnology, Kerala; Precision
Cardiovascular Medicine Group, St. Boniface Hospital Research; Section of
Cardiology, Department of Internal Medicine, Rady Faculty of Health
Sciences, University of Manitoba
(Ravandi) Cardiovascular Lipidomics Laboratory, St. Boniface Hospital,
Albrechtsen Research Centre; Department of Physiology and Pathophysiology,
Rady Faculty of Health Sciences, University of Manitoba(3)Mass
Spectrometry & Proteomics Core Facility, Rajiv Gandhi Centre for
Biotechnology, Kerala; Precision Cardiovascular Medicine Group, St.
Boniface Hospital Research; Section of Cardiology, Department of Internal
Medicine, Rady Faculty of Health Sciences, University of Manitoba
Abstract
INTRODUCTION: Calcific aortic valve stenosis (CAVS) is a disease
associated with significant morbidity and mortality in the aging
population. Recently, bile acids have been shown to play a significant
role in many disease processes, and untargeted metabolomic analyses of
CAVS patient valves has shown a disrupted bile acid pathway. AIM: We aimed
to understand the changes in human valvular bile acids in relation to CAVS
severity. <br/>METHOD(S): A total of 100 human aortic valves were
collected from patients undergoing aortic valve replacement surgery. Bile
acids were quantified by ultrahigh performance liquid chromatography
coupled to tandem mass spectrometry. <br/>RESULT(S): Patients with mild
aortic stenosis (AS) showed a distinct valvular bile acid composition
compared to moderate and severe AS groups, with five bile acids being
significantly elevated in patients with moderate and severe AS. These
included norcholic, nordeoxycholic, glycodeoxycholic, glycocholic and
taurodeoxycholic acid. When classified by calcification score, five
species were significantly different between mild and severe AS groups;
four bile acids were similar when stratified based on AS severity. Using k
means clustering we were able to distinguish valve severity by their bile
acid composition. Grouping bile acids by conjugation and by primary versus
secondary revealed that conjugated primary and secondary bile acids were
significantly increased in stenotic valves compared to the mild AS group.
<br/>CONCLUSION(S): Conjugated bile acids are significantly elevated in
the valvular tissue of patients with severe calcific aortic stenosis.
These findings suggest a potential link between liverand gut microbiome
physiologyand bile acid pathways in contributing to the pathophysiology of
valvular stenosis.<br/>Copyright &#xa9; 2025 The Authors. Published by
Elsevier Inc. All rights reserved.

<81>
Accession Number
2034706678
Title
Minimally Invasive Percutaneous Techniques for the Treatment of Cervical
Disc Herniation: A Systematic Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 14(10) (no pagination), 2025. Article
Number: 3280. Date of Publication: 01 May 2025.
Author
Rybaczek M.; Mariak Z.; Grabala P.; Lyson T.
Institution
(Rybaczek, Mariak, Grabala, Lyson) Department of Neurosurgery, Medical
University of Bialystok, M. Sklodowskiej-Curie 24A, Bialystok, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: In recent decades, the adoption of minimally invasive
(non-endoscopic) cervical techniques has grown significantly. Advancements
in surgical instrumentation have broadened the spectrum of available
percutaneous interventions, thus providing viable alternative treatment
options for patients with prolonged, conservative treatment-resistant
ailments due to contained cervical disc herniation. The aim of this study
was to perform a systematic review and meta-analysis in order to evaluate
the effectiveness and safety of minimally invasive percutaneous
(non-endoscopic) cervical techniques. <br/>Method(s): A comprehensive
literature search was conducted using the PubMed, Cochrane Library, and
SCOPUS databases up to July 2024, in accordance with the PRISMA
guidelines. Outcomes measured included Visual Analogue Scale (VAS) scores,
the Neck Disability Index (NDI), and MacNab scores, assessing pain relief
and functional recovery. The risk of bias was evaluated using the Cochrane
risk of bias tool (RoB 2) and the risk of bias in nonrandomized studies of
interventions (ROBINS-I) tool, with statistical analyses conducted in R
software (version 4.3.1). <br/>Result(s): Out of 847 records, 21 studies
(covering 1580 patients) were included in the final analysis. Five
different percutaneous minimally invasive cervical procedures were
incorporated into this review: nucleoplasty (n = 973), discectomy (n =
311), a combination of nucleoplasty and discectomy (n = 98), annuloplasty
(n = 33), and pulsed radiofrequency (n = 17). The mean patient age was
49.5, with a gender distribution of 47.7% male and 52.3% female. A
meta-analysis of six studies on cervical nucleoplasty (400 patients)
demonstrated a significant reduction in pain scores, with a standardized
mean difference (SMD) of -4.68 (95% CI: -8.77; -0.59, p = 0.032). However,
a high heterogeneity (I² = 98.8%, Q = 407.31, p < 0.001) was
observed, indicating significant variability across studies. The
reoperation rate among patients was 3.4%, with discitis and device-related
complications being the most frequently reported adverse events.
<br/>Conclusion(s): Minimally invasive percutaneous cervical interventions
provide effective pain relief and functional improvement for patients with
cervical disc herniation, as evidenced by reductions in VAS scores and
positive MacNab outcomes. The choice of the most appropriate technique
should be based on individual clinical scenarios, surgeon expertise, and
patient preferences, as no single method demonstrates clear superiority
according to clinical outcomes or complication rates.<br/>Copyright &#xa9;
2025 by the authors.

<82>
Accession Number
2034681735
Title
Antithrombotic strategies after transcatheter aortic valve replacement a
network meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1496334. Date of Publication: 2025.
Author
Shi M.; Wu Y.; Zhou Q.
Institution
(Shi, Wu, Zhou) Department of Cardio-Thoracic Surgery, Nanjing Drum Tower
Hospital Clinical College of Nanjing University of Chinese Medicine,
Jiangsu, Nanjing, China
(Zhou) Department of Cardio-thoracic Surgery, Nanjing Drum Tower Hospital,
Nanjing, China
Publisher
Frontiers Media SA
Abstract
The optimal antithrombotic regimen for patients without an indication for
oral anticoagulation (OAC) after transcatheter aortic valve replacement
(TAVR) remains unclear. We conducted a network meta-analysis of randomized
controlled trials to clarify the best postoperative antithrombotic
regimen. We searched literature databases including PubMed/Medline and
Cochrane up to June 2024. Safety endpoints included all-cause death,
cardiovascular death, major/life-threatening bleeding, and minor bleeding
during follow-up. Efficacy endpoints encompassed ischaemic stroke
transient ischemic attack (TIA), systemic embolism, hypoattenuated leaflet
thickening (HALT), and reduced leaflet motion (RELM). Outcomes were
assessed during the follow-up period specified in each trial (range:3-24
months). The results were statistically analyzed using R 4.3.2 and Stata
16 software. The final analysis included seven randomized controlled
trials. Single antiplatelet therapy (SAPT) showed a lower incidence of
major/life-threatening bleeding compared to the direct oral anticoagulants
(DOACs) group (OR: 0.68, 95% CI: 0.47-0.99, P = 0.002) during the 3-24
month post-TAVR period. However, no significant differences were found in
other safety or efficacy endpoints. SAPT is the preferred treatment
strategy for TAVR patients without anticoagulation indications. Systematic
Review Registration: identifier, PROSPERO registration number:
CRD42024584735.<br/>Copyright 2025 Shi, Wu and Zhou.

<83>
Accession Number
2034713824
Title
One-Stop Mitral Valve Transcatheter Edge-to-Edge Repair and Left Atrial
Appendage Occlusion in Patients with Atrial Fibrillation and Mitral
Regurgitation: A Systematic Review and Meta-Analysis.
Source
Journal of Personalized Medicine. 15(5) (no pagination), 2025. Article
Number: 197. Date of Publication: 01 May 2025.
Author
Pamporis K.; Tsiachris D.; Grigoriou K.; Karakasis P.; Doundoulakis I.;
Theofilis P.; Kouvatsos P.; Saplaouras A.; Kordalis A.; Karanikola A.-E.;
Goutis P.A.; Tsioufis K.
Institution
(Pamporis, Tsiachris, Doundoulakis, Theofilis, Kouvatsos, Kordalis,
Karanikola, Tsioufis) First Cardiology Department, "Hippokration" General
Hospital, School of Medicine, National and Kapodistrian University of
Athens, Athens, Greece
(Pamporis, Grigoriou, Goutis) Department of Pharmacology, University of
Athens, 75 Mikras Asias Avenue, Goudi, Greece
(Karakasis) Second Department of Cardiology, General Hospital
"Hippokration", Aristotle University of Thessaloniki, Thessaloniki, Greece
(Doundoulakis) Heart Rhythm Management Centre, Postgraduate Program in
Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel,
Vrije Universiteit Brussel, European Reference Networks Guard-Heart,
Brussels, Belgium
(Saplaouras) Arrhythmia Unit, Onassis Cardiac Surgery Center, Athens,
Greece
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Patients with atrial fibrillation and mitral
regurgitation (MR) undergoing transcatheter edge-to-edge mitral valve
repair (M-TEER) often have concomitant indications for left atrial
appendage occlusion (LAAO), mandating a more personalized treatment
approach. This study aimed to examine the effectiveness and safety of
combining M-TEER/LAAO in one procedure. <br/>Method(s): MEDLINE (PubMed),
Scopus, and Cochrane were searched through 21 March 2025 for studies
examining M-TEER/LAAO with or without control (M-TEER only).
Double-independent study selection, extraction, and quality assessments
were performed. Frequentist random-effects models were used to calculate
mean differences (MDs) and risk ratios (RRs) with 95% confidence intervals
(CIs). <br/>Result(s): Seven studies (223 participants) were included. For
M-TEER/LAAO, the mean procedural time was 101.6 min (95% CI = [85.06,
118.13]), the mean radiation time was 29.97 min (95% CI = [23.85, 36.09]),
the mean length of stay was 5.21 days (95% CI = [3.31, 7.12]), procedural
success was achieved in 89.5% of cases (95% CI = [73.4, 96.3], and
post-procedure MR > 2+ occurred in 14.8% of cases (95% CI = [3.6, 44.5]).
Compared to M-TEER only, patients with M-TEER/LAAO had similar procedural
(RR = 0.91, 95% CI = [0.71, 1.17]) and technical success (RR = 1, 95% CI =
[0.94, 1.06]) with a similar risk of acute kidney injury (RR = 1, 95% CI =
[0.07, 15.12]), bleeding (RR = 0.40, 95% CI = [0.01, 18.06]), and
all-cause death (RR = 0.59, 95% CI = [0.22, 1.54]). M-TEER/LAAO was
non-significantly associated with in-hospital death (RR = 3, 95% CI =
[0.13, 70.23]), stroke (RR = 3, 95% CI = [0.13, 70.23]), and vascular
complications (RR = 1.55, 95% CI = [0.43, 5.59]) compared to M-TEER only.
Most patients (34.2%, 95% CI = [2.8, 90.4]) received dual antiplatelet
therapy at discharge, followed by anticoagulation only (20.2%, 95% CI =
[7.5, 44.3]). <br/>Conclusion(s): M-TEER/LAAO can be combined into a
single procedure with good peri-procedural outcomes. Safety was also
satisfactory; however, some concerns may arise regarding in-hospital
death, stroke, and vascular complications. Further research is needed to
explore the effectiveness and safety of this combined strategy and
elucidate the risk-benefit profile of this personalized treatment
approach.<br/>Copyright &#xa9; 2025 by the authors.

<84>
Accession Number
647449589
Title
Incidence, Clinical Characteristics and Outcomes of Heart Transplant
Patients with Mucormycosis Infection: A Systematic Review and
Meta-Analysis.
Source
Open Forum Infectious Diseases. Conference: IDWeek 2024. Los Angeles, CA
United States. 12(Supplement 1) (pp S1324), 2025. Date of Publication: 01
Feb 2025.
Author
Auyeung A.; Gargaritano K.-L.; Doyle F.; Thomas S.
Institution
(Auyeung) University of Central Florida, College of Medicine, HCA Florida
North Florida Hospital, Gainesville, FL, United States
(Gargaritano) Mount Sinai Morningside-West Hospitals, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Doyle) Royal College of Surgeons in Ireland, Dublin, Ireland
(Thomas) HCA Florida North Florida Hospital, Gainesville, FL, United
States
Publisher
Oxford University Press
Abstract
Background. Mucormycosis confers high morbidity and mortality in the
immunocompromised population due to its rapid angio-invasive nature. Of
note, this group of people includes those who have undergone solid organ
or stem cell transplants, many of whom are placed on chronic
immunosuppressive regimens. Mucormycosis incidence and clinical outcomes
have been studied in bone marrow, lung, liver and kidney transplant
recipients but not in heart transplant patients. Thus, our aim with this
systematic review and meta-analysis is to characterize the incidence as
well as clinical outcomes of Mucor infections in heart transplant
recipients. Methods. This study was registered with PROSPERO. Electronic
databases Google Scholar, PubMed, Embase, Scopus and CINAHL were searched
from inception up to 1 February 2024 for peer-reviewed articles of heart
transplant patients who contracted mucormycosis. The primary and secondary
outcome measures were incidence of mucormycosis infection and times to
onset of infection and mortality, respectively. For statistical analysis,
overall meta-analytic incidence was estimated using the user-written
metaprop-one[FD1] [m2] command in Stata 15.1. Results. Our search
identified 296 studies, 88 of which underwent full-text review and 47 met
inclusion criteria with 3916 total cases (Figure 1). Rhizopus was the most
common pathogen identified causing mucormycosis infection (Figure 2).
Pooled incidence of mucormycosis infection in heart transplant patients is
0.6% (95% CI 0 - 2%) across 12 studies (Figure 3). The majority of
patients were male, 39/41 (95%) (Figure 4). Mucormycosis infection most
commonly occurred during first 30 days post-transplant and decreased with
time. Logistic regression analysis did not show significant association
between time of infection post-transplant and mortality: Odds Ratio = 0.89
(95% CI 0.55-1.42, p = 0.616). Conclusion. Overall incidence of
mucormycosis in heart transplant patients is 0.6%. Patients were more
likely to contract the infection early (within 30 days) in the
post-transplant period but there was no significant difference in
mortality over time. The majority of affected patients were male and
further studies are needed to determine if males are at higher risk of
infection. (Figure Presented).

<85>
Accession Number
2038937445
Title
+ Impact of adjunctive lipid-modifying therapy in the CLEAR Outcomes
Ttial.
Source
Journal of Clinical Lipidology. Conference: Scientific Poster Abstracts
Selected for the National Lipid Association 2025 Scientific Sessions.
Miami United States. 19(3 Supplement) (pp e93), 2025. Date of Publication:
01 May 2025.
Author
Bloedon L.; Li N.; Powell H.; Lincoff A.M.; Nicholls S.; Nissen S.; Menon
V.
Institution
(Bloedon, Li, Powell, Lincoff, Nicholls, Nissen, Menon) ClevelandOHUnited
States
Publisher
Elsevier Ltd
Abstract
Funding: Esperion Therapeutics, Inc. Background/Synopsis: Randomization of
statin intolerant patients to bempedoic acid resulted in a 13% reduction
in the risk of MACE-4 (CV death, nonfatal myocardial infarction, nonfatal
stroke or coronary revascularization) compared to placebo in the Clear
Outcomes trial (n= 13,970). During the median 40.6 month follow up,
adjunctive lipid modifying therapy was observed in 1,749 (12.5%) patients.
Objective/Purpose: As part of a prespecified sensitivity analysis, we
evaluated the frequency of use and impact of adjunctive lipid modifying
therapy on the MACE-4 primary efficacy endpoint in CLEAR Outcomes.
<br/>Method(s): MACE-4 in the bempedoic acid and placebo groups was
evaluated by censoring patient data at the time of starting the first
adjunctive lipid modifying therapy plus 30 days. The hazard ratio for the
treatment effect was estimated with placebo as the reference group
utilizing Cox regression in the intent to treat population. Concomitant
medications were recorded through the end of study visit. <br/>Result(s):
A first MACE-4 event occurred in 819 (11.7%) and 927 (13.3%) patients
randomized to bempedoic acid and placebo, respectively. Adjunctive lipid
modifying therapy was observed in 660 (9.4%) bempedoic acid and 1,089
(15.6%) placebo patients. The majority of first MACE-4 (92.9% and 90.9% of
events in the bempedoic acid and placebo groups, respectively) occurred
before any adjunctive lipid modifying therapy. Statins were used most
often, with all adjunctive lipid modifying therapy usage higher in
placebo. When adjunctive lipid modifying therapy patient data was
censored, bempedoic acid reduced MACE-4 similar to the full analysis set
(Table 1). <br/>Conclusion(s): A minority of patients in CLEAR Outcomes
(placebo more than bempedoic acid) were treated with adjunctive lipid
modifying therapy during the trial. The timing of adjunctive lipid
modifying therapy initiation in more than 90% of subjects occurred after
the first observed MACE event. Consequently, censored data at adjunctive
lipid modifying therapy initiation shows negligible impact of adjunctive
lipid modifying therapies on the overall primary endpoint.<br/>Copyright
&#xa9; 2025

<86>
Accession Number
645641302
Title
Quality of life in children with severe congenital heart disease: its
association with surgical factors. a systematic review.
Source
Cardiology in the Young. Conference: 57th Annual Meeting of the
Association for European Paediatric and Congenital Cardiology (AEPC).
Porto Portugal. 34(Supplement 2) (pp S1730), 2024. Date of Publication: 01
Jul 2024.
Author
Wildschut F.F.; Van Beynum I.M.; Dulfer K.; Van Deutekom A.W.
Institution
(Wildschut, Van Beynum, Van Deutekom) Department of Pediatrics, Division
of Cardiology, Sophia Children's Hospital, Rotterdam, Netherlands
(Dulfer) Department of Neonatal and Pediatric Intensive Care, Division of
Pediatric Intensive Care, Sophia Children's Hospital, Rotterdam,
Netherlands
Publisher
Cambridge University Press
Abstract
Background and Aim: Children with severe congenital heart disease (CHD)
often undergo cardiac surgery involving cardiopulmonary bypass (CPB),
early in life. Such procedures are suspected to affect neurocognitive
development and quality of life (QoL), but the specific factors that
underly this association remain unclear. This systematic review aims to
delineate the specific perioperative factors influencing long-term QoL in
children with severe CHD undergoing early cardiac surgery. <br/>Method(s):
A comprehensive search was conducted in Medline, Embase, and Web of
Science Core Collection databases, spanning from 1975 to June 2023, to
identify studies that explored the association of various perioperative
variables-such as the number of surgeries, CPB duration, cross-clamp time,
and length of hospital/ intensive care unit (ICU) stay-with QoL in
children with severe CHD who underwent early cardiac surgery.
<br/>Result(s): Sixteen studies were included, including eight
cross-sectional and six cohort studies, with sample size ranging from 40
to 572. QoL was assessed in subjects aged 1 to 20 years. Predominant
perioperative variables studied were CPB time (9 studies), hospital/ICU
stay duration (8), and number of surgeries (7). The Pediatric Quality of
Life Inventory (4) and Child Health Questionnaire (4) were primarily used
for QoL assessment. A consistent finding was a significant negative
association between the number of surgeries and QoL scores, particularly
in the physical functioning domain. Similarly, prolonged CPB time and
hospital/ ICU stay also correlated with lower QoL scores. However,
heterogeneity in QoL assessment tools and outcome reporting precluded a
conclusive aggregated effect size estimation. <br/>Conclusion(s): This
systematic review highlights a clear inverse association between the
number of surgeries, CPB duration, and length of hospital/ICU stay with
QoL in children with severe CHD. The observed heterogeneity in outcome
assessment and reporting methodologies underscores the need for
standardization in future research and healthcare pathways. In the context
of shared decision-making, QoL assessment can serve as a crucial tool in
consultations with medical specialists, functioning as an initial
screening for children and parents who might need additional diagnostics
or support for developmental delay. Standardization in research
methodologies is crucial to accurately determine the perioperative factors
affecting QoL.

<87>
Accession Number
645641157
Title
To correct or not to correct? A meta-analysis on mitral qsurgery in
patients undergoing surgery for anomalous left coronary artery.
Source
Cardiology in the Young. Conference: 57th Annual Meeting of the
Association for European Paediatric and Congenital Cardiology (AEPC).
Porto Portugal. 34(Supplement 2) (pp S1639), 2024. Date of Publication: 01
Jul 2024.
Author
Brancaccio G.; Chinali M.; Dionisi S.; Trezzi M.; Esposito C.; Iacobelli
R.; Miraldi F.; Butera G.; Galletti L.
Institution
(Brancaccio, Trezzi, Galletti) Cardiac Surgery Unit, Bambino Gesu
Pediatric Research Hospital - IRCSS, Rome, Italy
(Chinali, Esposito, Iacobelli) Cardiology Unit, Bambino Gesu Pediatric
Research Hospital - IRCSS, Rome, Italy
(Butera) Interventional Cardiology Unit, Bambino Gesu Pediatric Research
Hospital - IRCSS, Rome, Italy
(Dionisi, Miraldi) Cardiac Surgery Unit, Policlinico Umberto I, University
La Sapienza of Rome, Italy
Publisher
Cambridge University Press
Abstract
Background and Aim: The present study is the first meta-analysis comparing
long-term outcomes in patients undergoing correction for anomalous left
coronary artery (ALCAPA), in regards to concomitant mitral valve surgery.
<br/>Method(s): A systematic review of the literature was conducted to
identify all relevant studies with comparative data on mitral valve
surgery performed during surgery for ALCAPA correction. Predefined primary
endpoints included mortality and mitral valve reoperation. <br/>Result(s):
Fifty-three relevant retrospective studies were identified from the
existing literature. The study population included 3,851 patients. Mean
age at time of surgery was 6 months [0-99months]. Mean follow-up after
surgery was 22.7years [6.3- 37.2yrs]. Echocardiographic data were
available in 41 studies, including 2,118 patients (55% of total sample).
Among patients with available echocardiographic data at time of ALCAPA
correction, 283 had no mitral regurgitation (13%), 642 had mild mitral
regurgitation (30%), 756 had moderate mitral regurgitation (36%), and 437
had severe mitral regurgitation (21%). A subgroup of patients who
underwent mitral valve surgery (yMVS; n=753; 19.5% of total population)
was identified. Criteria for concomitant mitral surgery included: age at
diagnosis (4 studies; including 146 patients), severity of mitral valve
regurgitation (23 studies; including 471 patients), or evidence of
structural mitral degeneration regardless ofMRgrade (16 studies; including
127 patients). A total of 228 patients died during follow-up (5.9%). Among
the 1,536 patients with available follow-up echocardiographic data, 519
developed no mitral regurgitation (34%), 663 developed mild mitral
regurgitation (43%), 268 developed moderate mitral regurgitation (17%),
and 86 developed severe mitral regurgitation (6%). Overall, during
follow-up, 91 patients underwent mitral valve surgery (first MVS for 20pts
and re-intervention for 71pts, representing a 10% re-intervention rate).
In regression analysis, we found no association between mean age at first
surgery and need for reoperation (p=0.458). <br/>Conclusion(s): Mitral
valve surgery is performed in about 20% of patients undergoing ALCAPA
correction. Indication for MVS vary among centers, although severity of MV
regurgitation was the most common criteria (more than 50% of the yMVS
group). Of yMVS patients, approximately 10% underwent a second MVS during
follow-up, regardless of age at first surgery. Overall, longterm mortality
in these patients is over 5%.

<88>
Accession Number
645641501
Title
Perioperative antibiotic prophylaxis in paediatric cardiac surgery - is
one day sufficient to prevent surgical site infections?.
Source
Cardiology in the Young. Conference: 57th Annual Meeting of the
Association for European Paediatric and Congenital Cardiology (AEPC).
Porto Portugal. 34(Supplement 2) (pp S1635-S1636), 2024. Date of
Publication: 01 Jul 2024.
Author
Zuern C.; Beckschulte K.; Mueller P.; Beiderbeck M.; Paul L.; Uhl S.;
Hoehn R.; Kroll J.; Grieshaber P.; Loukanov T.; Stiller B.; Gorenflo M.;
Ziesenitz V.
Institution
(Zuern, Beckschulte, Mueller, Beiderbeck, Hoehn, Stiller) Department of
Congenital Heart Defects and Paediatric Cardiology, University Heart
Center Freiburg-Bad Krozingen, University of Freiburg, Germany
(Paul, Uhl, Gorenflo, Ziesenitz) Department of Paediatric and Congenital
Cardiology, Centre for Child and Adolescent Health, University Hospital
Heidelberg, Germany
(Kroll) Department of Cardiovascular Surgery, University Heart Center
Freiburg-Bad Krozingen, Medical Center, University of Freiburg, Germany
(Grieshaber, Loukanov) Division of Congenital Cardiac Surgery, Department
of Cardiac Surgery, University Hospital Heidelberg, Germany
Publisher
Cambridge University Press
Abstract
Background and Aim: Perioperative antibiotic prophylaxis (PAbP) is a
standard practice in paediatric cardiac surgery to prevent surgical site
infections (SSI). Current prophylactic regimens in Germany include
cefuroxime (second-generation cephalosporin). The duration of its
administration is debated, due to the lack of randomised controlled
trials. The target of antibiotic stewardship is to effectively treat
infections, prevent antibiotic resistance and to protect patients from
unnecessary harm. This study aims at comparing the efficacy of PAbP with
cefuroxime during one versus five days perioperatively in children
undergoing congenital heart surgery. <br/>Method(s): This retrospective,
bi-centre study included patients <18 years of age undergoing congenital
cardiac surgery with cardiopulmonary bypass (CBP) and primary chest
closure from 2015 to 2019. Patients with preoperative antibiotic treatment
or signs of infection and cases of prior surgeries with CBP during the
same admission were excluded. PAbP consisted of cefuroxime, which was
administered according to two different regimens based on local
guidelines: one day (centre 1) versus five days (centre 2). Patients were
stratified according to age and procedural risk (STAT score). The
endpoints were the duration of invasive ventilation and the duration of
postoperative hospitalisation. <br/>Result(s): A total number of 305
patients could be included in this analysis so far. Bodyweight (mean 14,0
vs. 16,7 kg, p = 0.074) and STAT score (median 2 vs. 2, p = 0.14) were
similar, but the patients were older in centre 2 (median 1,3 vs. 2,5
years, p = 0.04) and mechanical ventilation was longer in center 1 (mean
1,8 vs. 1,7 days, p < 0,01). Mean duration of cefuroxime administration
was 3,1 days in centre 1, and 6,3 days in centre 2 (p < 0.01). These
results show that the shorter use of cefuroxime is non-inferior and does
not cause a significant difference in the duration of postoperative
hospitalisation (median 10 vs. 10 days, p = 0.1414). or mechanical
ventilation (mean 1,8 vs. 1,7 days, p < 0.01). <br/>Conclusion(s):
According to this retrospective bi-centre study, a oneday PAbP regimen is
sufficient to prevent SSI around congenital cardiac surgical procedures.
Prospective data should be obtained in a multicentre study to confirm
these results.

<89>
Accession Number
2034707049
Title
Current status and challenges of DCD heart transplantation in the
Asia-Pacific region.
Source
Journal of Artificial Organs. (no pagination), 2025. Article Number:
101887. Date of Publication: 2025.
Author
Matsumoto Y.
Institution
(Matsumoto) Department of Cardiovascular Surgery, Keio University School
of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, Japan
Publisher
Springer
Abstract
Heart transplantation remains the definitive treatment for end-stage heart
failure, but donor shortages persist globally. This review aims to
evaluate the current status, enabling technologies, ethical
considerations, and future prospects of donation after circulatory death
(DCD) heart transplantation in the Asia-Pacific region. A comprehensive
narrative review was conducted using published literature and
country-specific reports to assess global and regional trends in DCD heart
transplantation. Particular focus was given to enabling technologies
(e.g., thoracoabdominal normothermic regional perfusion [taNRP] and ex
situ machine perfusion), legal and ethical frameworks, and implementation
barriers across countries in the Asia-Pacific. While countries such as the
UK, US, and Australia have achieved comparable survival outcomes between
DCD and donation after brain death (DBD) heart transplantation, most
Asia-Pacific countries remain in early stages. Australia leads the region
with over 70 successful DCD heart transplants using the Organ Care System.
Japan lacks legal clarity and clinical protocols for withdrawal of
life-sustaining therapy, restricting DCD to kidney transplants. China
employs a hybrid DBCD model but faces logistical and ethical constraints.
In South Korea, India, and others, DCD heart programs are not yet
established. High cost and limited availability of enabling technologies,
alongside ethical controversy surrounding taNRP, are key barriers. Broader
adoption of DCD heart transplantation in Asia-Pacific countries requires
legal reform, ethical consensus, cost-effective perfusion strategies, and
public engagement. Coordinated efforts across technological, societal, and
regulatory domains are essential to expand access to this life-saving
modality.<br/>Copyright &#xa9; The Author(s), under exclusive licence to
the Japanese Society for Artificial Organs 2025.

<90>
Accession Number
2036506392
Title
Rationale and Design of the REPEAT Trial: A Multicenter Randomized Trial
Comparing Redo Surgical Aortic Valve Replacement to Valve-in-Valve
Transcatheter Aortic Valve Replacement.
Source
Journal of the American Heart Association. 14(10) (no pagination), 2025.
Article Number: e040954. Date of Publication: 20 May 2025.
Author
Raschpichler M.; de Waha S.; Blankenberg S.; Diniz M.A.; Bagiella E.;
Gelijns A.C.; Calsavara V.F.; Gupta A.; Schofer N.; Kaneko T.; Abdel-Wahab
M.; Thiele H.; Makkar R.; Borger M.A.
Institution
(Raschpichler, de Waha, Borger) Department of Cardiac Surgery, Heart
Center Leipzig at Leipzig University, Leipzig, Germany
(de Waha) Department of Rhythmology, University Hospital
Schleswig-Holstein, Campus Lubeck, Lubeck, Germany
(Blankenberg, Schofer) Department of Cardiology, University Heart &
Vascular Center Hamburg, Hamburg, Germany
(Diniz, Bagiella, Gelijns) Department of Population Health Science and
Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Calsavara) Department of Computational Biomedicine, Cedars-Sinai Medical
Center, Los Angeles, CA, United States
(Gupta, Makkar) Smidt Heart Institute, Department of Interventional
Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Kaneko) Division of Cardiothoracic Surgery, Washington University in St.
Louis, St. Louis, MO, United States
(Abdel-Wahab, Thiele) Department of Cardiology, Heart Center Leipzig at
Leipzig University, Leipzig, Germany
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Redo surgical aortic valve replacement (rSAVR) has for long
been the therapeutic reference standard for degenerated surgical aortic
bioprostheses. Valve-in-valve transcatheter aortic valve replacement
(ViV-TAVR) has emerged as an alternative for patients at high surgical
risk due to its lower invasiveness. The long-term clinical efficacy of
ViV-TAVR in patients at low to intermediate surgical risk remains unknown.
METHODS AND RESULTS: To compare clinical outcomes of redo surgical aortic
valve replacement versus ViV-TAVR in lowto intermediate-risk patients with
degenerated surgical aortic bioprostheses. REPEAT (Repeat Intervention for
Deteriorated Surgical Bioprosthetic Aortic Valves) is an
investigator-initiated, international, multicenter, randomized, parallel,
open-label trial. A total of 890 patients aged <75 years with a failed
surgical aortic bioprosthesis due to structural valve degeneration and low
to intermediate surgical risk (ie, Society of Thoracic Surgeons predicted
risk of death of <8%) will be randomly assigned in a 1:1 ratio to either
redo surgical aortic valve replacement or ViV-TAVR. The primary end point
of REPEAT is a composite of all-cause death, stroke (including both
disabling and nondisabling), myocardial infarction, and rehospitalization
for heart failure or aortic valve reintervention at 5 years, based on
Valve Academic Research Consortium-3 definitions. Secondary end points
include each of the individual components of the primary composite end
point, Valve Academic Research Consortium-3-based conduction disturbances
and arrhythmia, Valve Academic Research Consortium-3-based wound and
bleeding complications, functional status (ie, 6-minute walk test, Kansas
City Cardiomyopathy questionnaire), and treatment costs.
<br/>CONCLUSION(S): The REPEAT trial has been designed to test the
hypothesis that redo surgical aortic valve replacement is superior to
ViV-TAVR regarding clinical outcomes at 5 years in patients with
degenerated surgical aortic bioprostheses and low to intermediate surgical
risk.<br/>Copyright &#xa9; 2025 The Author(s). Published on behalf of the
American Heart Association, Inc., by Wiley.

<91>
Accession Number
647441654
Title
Valve Under-Expansion and Clinical Outcomes with ACURATE neo2: Findings
from the ACURATE IDE Trial.
Source
Journal of the American College of Cardiology. (no pagination), 2025.
Date of Publication: 07 May 2025.
Author
Makkar R.R.; Chakravarty T.; Gupta A.; Soliman O.; Gnall E.; Ramana R.K.;
Ramlawi B.; Diamantouros P.; Potluri S.; Kleiman N.; Samy S.; Rassi A.;
Yadav P.; Thourani V.; Yakubov S.; Frawley C.; Patel D.; Kapadia S.;
Chalekian A.; Modolo R.; Sathananthan J.; Kim W.-K.; Reardon M.J.
Institution
(Makkar, Chakravarty, Gupta, Patel) Cedars-Sinai Medical Center, Los
Angeles, CA, United States
(Soliman) Department of Cardiology and Cardiovascular Research Institute
(CVRI) Dublin, School of Medicine, RCSI University of Medicine and Health
Sciences, Mater Private Network, Dublin, Ireland
(Gnall, Ramlawi) Lankenau Hospital, Wynnewood, PA, United States
(Ramana) Heart Care Centers of Illinois and Advocate Christ Medical
Center, Palos Park, IL, United States
(Diamantouros) London Health Sciences Centre, London, ON, Canada
(Potluri) Baylor Scott and White The Heart Hospital Baylor Plano, Plano,
TX, United States
(Kleiman, Reardon) Houston Methodist Hospital, Houston, TX, United States
(Samy) Albany Medical Center, Albany, NY, United States
(Rassi) Kaiser Permanente, San Francisco, CA, United States
(Yadav, Thourani) Piedmont Hospital, Atlanta, GA, United States
(Yakubov) OhioHealth Research and Innovation Institute - Riverside
Methodist Hospital, Columbus, OH, United States
(Frawley, Chalekian, Modolo, Sathananthan) Boston Scientific Corporation,
Marlborough, MA, USA
(Kapadia) Cleveland Clinic Foundation, Cleveland, OH, United States
(Kim) Justus-Liebig University of Giessen, Giessen, Germany
Abstract
OBJECTIVE: Assess the impact of ACURATE neo2 valve expansion on clinical
outcomes in the ACURATE IDE trial. BACKGROUND: In the ACURATE IDE
randomized controlled trial, ACURATE neo2 failed to demonstrate
non-inferiority to commercially available balloon-expandable (SAPIEN 3/3
Ultra) and self-expanding (Evolut R/PRO/PRO+/FX) valves for the primary
endpoint of all-cause mortality, stroke, or rehospitalization at 1 year. A
retrospective investigation was undertaken to evaluate potential factors
contributing to these outcomes. <br/>METHOD(S): Post-hoc case review
identified angulated (non-parallel) commissure posts in a few implanted
ACURATE neo2 valves, indicating valve under-expansion. Procedural
angiograms for all ACURATE neo2 valves implanted in the trial's main
randomized cohort (n=752) were inspected by an independent core
laboratory. An exploratory analysis was performed to evaluate the
association between valve expansion and clinical outcomes. <br/>RESULT(S):
Of the 624 patients implanted with ACURATE neo2 and with evaluable
procedural angiograms, 135 (21.6%) had under-expanded valves. Greater
aortic valve leaflet and annulus calcification at baseline was
independently associated with ACURATE neo2 valve under-expansion (OR 1.92,
95% CI 1.27-2.91; p=0.002). Procedural techniques, including frequency of
predilation (100% in both groups) and postdilation (26.7% vs 25.2%,
p=0.72), and balloon sizing did not differ between under-expanded and
expanded valve groups. ACURATE neo2 under-expansion was associated with a
higher 1-year rate of death, stroke, or rehospitalization (under-expanded:
18.7%, expanded: 11.8%; P=0.04), which was confirmed in a multivariable
analysis (HR 1.92, 95% CI 1.27-2.91, p=0.002). <br/>CONCLUSION(S):
Under-expansion of the ACURATE neo2 valve in the ACURATE IDE study was
associated with higher risk of the composite endpoint of death, stroke or
rehospitalization. Given the post-hoc nature of these analysis, the study
findings should be considered hypothesis generating. Whether achieving
optimal valve expansion of the ACURATE neo2 valve with improvement in
device design and procedural iterations will translate into improved
clinical outcomes remains to be studied.<br/>Copyright &#xa9; 2025.
Published by Elsevier Inc.

<92>
Accession Number
2038920924
Title
Effect of Nutritional Prehabilitation on Protein Intake and Diet Quality
Assessments in Malnourished Patients Before Cardiac Surgery.
Source
Current Developments in Nutrition. Conference: NUTRITION 2025. Orlando
United States. 9(Supplement 2) (no pagination), 2025. Article Number:
106179. Date of Publication: 01 May 2025.
Author
Ting Cheung H.H.; Sandra Chiu L.C.; Henry Wong M.K.; Jacky Ho Y.K.; Wong
R.H.-L.; Joynt G.; Lee A.
Institution
(Ting Cheung, Sandra Chiu, Henry Wong, Jacky Ho, Wong, Joynt, Lee) The
Chinese University of Hong Kong, Hong Kong
Publisher
Elsevier B.V.
Abstract
Objectives: To determine the effect of nutritional prehabilitation on
protein intake and diet quality in malnourished cardiac surgical patients.
<br/>Method(s): This study is from an ongoing single-center, two-armed,
parallel, blinded randomized controlled trial recruiting 132 patients
undergoing elective cardiac surgery. Participants are randomized into
control (standard care) or treatment (nutritional prehabilitation and
Beneprotein) groups (ethics committee approval (CRE no.: 2021.703)).
Malnourished patients are defined as those with a MUST score >0 or
bioelectrical impedance analysis showing fat-free mass and skeletal muscle
mass indices below accepted thresholds. A registered dietitian evaluates
dietary intake over the past month using a locally validated Food
Frequency Questionnaire. The mean daily energy and protein intake
(calculated using Food Processor Nutrition Analysis software) and the Diet
Quality Index-International (DQI-I) scores at baseline and admission are
compared between groups using mixed-effects regressions. <br/>Result(s):
Of the current 23 patients (median [IQR] age 69 [64-74] years; 10 men
[43%]) randomized into treatment (n=11) and control (n=12) groups, 17
(treatment: 9, control: 8) completed surgery. Among the treatment group, 8
patients (89%) met the minimum program compliance of 14 days (median [IQR]
37 [21-48] days). The median (IQR) number of Beneprotein sachets taken by
5 patients in the treatment group was 90 (24-155). The mean protein intake
from Beneprotein was higher in the treatment group than the control group
(20%, 95% CI: 6%-35%). Overall, there were no changes in energy intake
from carbohydrates (p=0.93), protein (p=0.41), fat (p=0.69), or in DQI-I
scores (p=0.63) between groups over time. <br/>Conclusion(s): A
dietitian-guided nutritional prehabilitation program increased the
preoperative dietary protein intake in malnourished patients, but did not
change the DQI-I score. Funding Sources: Hong Kong PhD Fellowship Award
(PF20-46990) and General Research Fund (GRF#14104222).<br/>Copyright
&#xa9; 2025

<93>
Accession Number
2038911305
Title
Lipoprotein(a) and aortic stenosis: Practical insights.
Source
Nutrition, Metabolism and Cardiovascular Diseases. (no pagination), 2025.
Article Number: 104124. Date of Publication: 2025.
Author
Dimitriadis K.; Kyriakoulis K.G.; Pyrpyris N.; Beneki E.; Kamperidis V.;
Kollias A.; Cenko E.; Aznaouridis K.; Aggeli K.; Tsioufis K.
Institution
(Dimitriadis, Kyriakoulis, Pyrpyris, Beneki, Aznaouridis, Aggeli,
Tsioufis) First Department of Cardiology, School of Medicine, National and
Kapodistrian University of Athens, Hippokration General Hospital, Athens,
Greece
(Kamperidis) First Cardiology Department, Medical School, Aristotle
University of Thessaloniki, AHEPA University Hospital, Thessaloniki,
Greece
(Kollias) Hypertension Center STRIDE-7, School of Medicine, Third
Department of Medicine, Sotiria Hospital, National and Kapodistrian
University of Athens, Athens, Greece
(Cenko) Laboratory of Epidemiological and Clinical Cardiology, Department
of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Publisher
Elsevier B.V.
Abstract
Aims: The role of Lp(a) in cardiovascular diseases is increasingly
recognized, with high Lp(a) levels shown to be associated with worse
outcomes. In this review, we aim to summarize the literature and the
current research status regarding AS and Lp(a) with a comprehensive
approach, in order to inform basic and clinical scientists with the most
up-to-date data and insights. Data synthesis: Lp(a) is significantly
involved in the pathogenesis of aortic stenosis (AS), with the interplay
between AS and Lp(a) being documented in observational studies and a
causal association being proposed based on genetic studies. Patients with
AS have generally higher levels of Lp(a) and increased Lp(a) levels are
associated with higher risk of AS development. The above observations
offer opportunities for further research, mainly regarding potential
therapeutic implications, particularly considering the Lp(a)-specific
lowering therapies that are awaited to influence the prevention and
treatment strategies for AS. <br/>Conclusion(s): Increased Lp(a) levels
can be predictive of the presence, development and progression of AS, as
well as could offer novel insights in the pathophysiology of bioprosthetic
valve function. Further research, focusing on Lp(a)-lowering agents, is
key in order to identify any benefit in such patient
phenotypes.<br/>Copyright &#xa9; 2025 The Authors

<94>
Accession Number
2034687511
Title
Role of strain imaging by echocardiography in pericardial diseases; a
scoping review.
Source
International Journal of Cardiovascular Imaging. (no pagination), 2025.
Date of Publication: 2025.
Author
Behjati M.; Mansouri P.; Mirshafiee S.; Samiei N.
Institution
(Behjati) Cardiac Rehabilitation Research Center, Cardiovascular Research
Institute, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic
Republic of
(Mansouri) Tehran Heart Center, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Mirshafiee) Department of Cardiology, School of Medicine, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Samiei) Heart Valve Disease Research Center, Rajaie Cardiovascular
Research Center, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
Publisher
Springer Science and Business Media B.V.
Abstract
Normal pericardium plays a fundamental role in the maintenance of left
ventricular (LV) twists. Pericardial diseases are among the important
causes of morbidity and mortality in cases with cardiovascular diseases.
The thorough management of suspected pericardial diseases requires early
diagnosis using optimal imaging modalities for each patient. Strain and
strain rate could be calculated using two-dimensional speckle-tracking
echocardiography (STE) through tracking frame-to-frame movements of
myocardial tissue. This modality could also determine the LV torsion and
rotation. Ultrasonic strain imaging can evaluate LV function without being
influenced by the whole heart motion or even tethering forces. This
imaging modality could also identify the disease at earlier stages. This
report reviews the role of strain imaging by echocardiography in the
assessment of pericardial diseases including acute pericarditis,
perimyocarditis, chronic constrictive pericarditis, effusive constrictive
pericarditis, and transient constriction, pericardial tamponade, post
pericardiectomy, pericardial cysts, masses, diverticula and congenital
absence of the pericardium. Being familiar with obtaining data from strain
imaging using STE could help pericardial specialists working in
established pericardial centers of excellence.<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer Nature B.V. 2025.

<95>
Accession Number
2036506368
Title
Cardiovascular Benefit of Colchicine in Relation to Baseline Risk: A
Secondary Analysis of the LoDoCo2 Trial.
Source
Journal of the American Heart Association. 14(10) (no pagination), 2025.
Article Number: e038687. Date of Publication: 20 May 2025.
Author
Mohammadnia N.; Wesselink B.E.; Bax W.A.; Nidorf S.M.; Mosterd A.; Fiolet
A.T.L.; Cetinyurek-Yavuz A.; Thompson P.L.; Bangdiwala S.I.; Eikelboom
J.W.; Cornel J.H.; El Messaoudi S.
Institution
(Mohammadnia, Wesselink, Cornel, El Messaoudi) Department of Cardiology,
Radboud University Medical Center, Nijmegen, Netherlands
(Bax) Department of Internal Medicine, Northwest Clinics, Alkmaar,
Netherlands
(Nidorf, Thompson) Heart and Vascular Research Institute of Western
Australia, Perth, WA, Australia
(Mosterd, Fiolet, Cornel) Dutch Network for Cardiovascular Research (WCN),
Utrecht, Netherlands
(Mosterd) Department of Cardiology, Meander Medical Center, Amersfoort,
Netherlands
(Fiolet) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Cetinyurek-Yavuz) IQ Health Science, Radboud University Medical Center,
Nijmegen, Netherlands
(Thompson) School of Medicine, University of Western Australia, Perth, WA,
Australia
(Thompson) Sir Charles Gairdner Hospital, Perth, WA, Australia
(Bangdiwala) Department of Health Research Methods, Evidence and Impact,
McMaster University, Hamilton, ON, Canada
(Bangdiwala) Statistics Department, Population Health Research Institute,
McMaster University, Hamilton, ON, Canada
(Eikelboom) Department of Medicine, McMaster University, Hamilton, ON,
Canada
(Cornel) Department of Cardiology, Northwest Clinics, Alkmaar, Netherlands
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The LoDoCo2 (Low-Dose Colchicine 2) trial showed that
colchicine reduced the risk for cardiovascular events in patients with
chronic coronary syndrome. Current guidelines recommend colchicine use in
selected high-risk patients. The aim of this secondary analysis was to
explore the relative and absolute benefits of colchicine according to
baseline risk. <br/>METHOD(S): The LoDoCo2 trial randomized 5522 patients
to colchicine 0.5 mg or placebo. The primary end point was a composite of
cardiovascular death, spontaneous myocardial infarction, ischemic stroke,
or ischemia-driven coronary revascularization. First, a LoDoCo2 risk score
was developed by Cox regression to identify high-risk features for the
primary end point. Second, the Thrombolysis in Myocardial Infarction Risk
Score for Secondary Prevention was applied to explore robustness of
findings. <br/>RESULT(S): In the LoDoCo2 risk score, high-risk features
were age >=75, diabetes, and current smoker. In high-risk (>=1 high-risk
feature), compared with low-risk (0 high-risk features) patients,
colchicine was associated with consistent relative (high risk: hazard
ratio [HR], 0.72 [95% CI, 0.56-0.94] versus low risk: HR, 0.67 [95% CI,
0.52-0.88]; P for interaction=0.73) and absolute benefits (high risk: HR,
-1.33 [95% CI, -2.38 to -0.27] versus low risk: HR, -0.93 [95% CI -1.57 to
-0.30] events per 100 person-years). Using the Thrombolysis in Myocardial
Infarction Risk Score for Secondary Prevention, consistent relative and
absolute benefits were found in high-, intermediate-, and low-risk
patients. <br/>CONCLUSION(S): In patients with chronic coronary syndrome,
the relative and absolute benefits of colchicine were consistent in those
at high, intermediate, and low risk for cardiovascular events. These
findings support the use of colchicine across the spectrum of baseline
risk. REGISTRATION: URL: https://www.anzctr.org.au; Unique identifier:
12614000093684.<br/>Copyright &#xa9; 2025 The Author(s). Published on
behalf of the American Heart Association, Inc., by Wiley.

<96>
Accession Number
2034691804
Title
Effectiveness and Safety of Myval Versus Other Transcatheter Valves in
Patients Undergoing TAVI: A Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Apostolos A.; Ktenopoulos N.; Drakopoulou M.; Ielasi A.; Panoulas V.;
Baumbach A.; Tsioufis K.; Serruys P.; Toutouzas K.
Institution
(Apostolos, Ktenopoulos, Drakopoulou, Tsioufis, Toutouzas) Unit of
Structural Heart Diseases, First Department of Cardiology, Medical School,
National and Kapodistrian University of Athens, Hippocration General
Hospital of Athens, Athens, Greece
(Ielasi) U.O. Cardiologia Ospedaliera, IRCCS Ospedale Galeazzi
Sant'Ambrogio, Milan, Italy
(Panoulas) Royal Brompton and Harefield Hospitals, Guy's and St Thomas'
NHS Foundation Trust, London, United Kingdom
(Panoulas) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Baumbach) Centre for Cardiovascular Medicine and Devices, William Harvey
Research Institute, Queen Mary University of London and Barts Heart
Centre, London, United Kingdom
(Baumbach) Cleveland Clinic, London, United Kingdom
(Serruys) Department of Cardiology, School of Medicine, University of
Galway, Galway, Ireland
Publisher
John Wiley and Sons Inc
Abstract
Transcatheter aortic valve implantation (TAVI) has changed the treatment
of aortic stenosis. The Myval transcatheter heart valve (THV), a novel
balloon-expandable THV, has shown promising outcomes. Our aim is to
compare the comparative safety and effectiveness of Myval THV against
established THVs, such as Sapien and Evolut. A systematic review and
meta-analysis was conducted, comparing the Myval THV with other
contemporary THVs. Primary endpoints were periprocedural, 30-day and
1-year all-cause mortality. Seven studies involving 3106 patients (1027
Myval; 2079 other THVs) were included. No significant differences were
observed in the primary endpoints. Myval demonstrated higher procedural
success (RR: 1.04, 95% CI: 1.01-1.07, I2 = 29%) and lower rates of
permanent pacemaker implantation (PPI) during the index hospitalization
(RR: 0.57, 95% CI: 0.36-0.92, I2 = 23%) and 30-days (RR: 0.60, 95% CI:
0.40-0.89, I2 = 43%), compared to other THV. At 30-day, Myval was
associated with lower rates of moderate or severe transvalvular aortic
regurgitation (RR: 0.33, 95% CI: 0.11-0.98, I2 = 57%) and minor vascular
complications (RR: 0.45, 95% CI: 0.23-0.90, I2 = 0%). When compared to
self-expandable THV, Myval was associated with higher procedural and
device success, higher early safety, lower risk for PPI, minor vascular
complications and at least moderate transvalvular AR. When compared to
Sapien, procedural success and risk for in-hospital PPI was borderline
higher and lower in favor of Myval, respectively. The Myval THV
demonstrates comparable safety and effectiveness to contemporary THVs,
with advantages in procedural success, PPI, and vascular
complications.<br/>Copyright &#xa9; 2025 The Author(s). Catheterization
and Cardiovascular Interventions published by Wiley Periodicals LLC.

<97>
Accession Number
2034705396
Title
Comprehensive analysis of acute kidney injury incidence following
transcatheter versus surgical aortic valve replacement in aortic stenosis:
a systematic review and meta-analysis of 13,777 patients.
Source
Cardiovascular Intervention and Therapeutics. (no pagination), 2025.
Article Number: e03. Date of Publication: 2025.
Author
Alazzam A.; Aldroubi Y.; Alhusban T.; said M.
Institution
(Alazzam) The Hashemite University, Zarqa, Jordan
(Aldroubi) Faculty of Medicine, University of Jordan, Amman, Jordan
(Alhusban) Jordanian Royal Medical Services, Prince Hashim Military
Hospital, Zarqa, Jordan
(said) Yarmouk University Faculty of Medicine - Irbid, Aydoun, Jordan
Publisher
Springer
Abstract
This systematic review and meta-analysis evaluate Acute Kidney Injury
(AKI) differences between surgical aortic valve replacement (SAVR) and
transcatheter aortic valve replacement (TAVR) and how surgical risk
stratification and diagnostic criteria influence outcomes. Following the
PRISMA guidelines, we included both non-randomized studies and randomized
clinical trials that reported AKI criteria and patients' surgical risk in
patients with aortic stenosis by searching PubMed, Scopus, and Web of
Science until late September. We executed a random-effects model in Review
Manager to pool effect estimates of AKI incidence or the need for dialysis
as an odds ratio (OR) and I² heterogeneity, and we utilized R
for meta-regression to address any heterogeneity with subgroup analysis
for surgical risk, AKI criteria, and study design. We used the Newcastle
Ottawa Scale (NOS) and the Cochrane Risk of Bias Tool (RoB-1) for risk of
bias assessment and GRADE for certainty assessment. Involving 17 studies
and a total of 13,777 patients, we found that the AKI incidence was
significantly lower in TAVR compared to SAVR (OR = 0.36; 95% CI: [0.30,
0.44], I² = 55%, P = 0.003), along with the need for dialysis
(OR = 0.35; 95% CI: [0.19, 0.63], I² = 0%, P = 0.92). The study
also found that intermediate and low-risk patients had more favorable
outcomes. However, the retrospective study design and VARC-2 criteria were
associated with unfavorable outcomes. TAVR effectively reduced the risk of
AKI in all surgical risk categories and the need for dialysis compared to
SAVR in patients with AS.<br/>Copyright &#xa9; The Author(s) under
exclusive licence to Japanese Association of Cardiovascular Intervention
and Therapeutics 2025.

<98>
Accession Number
2038910576
Title
Custodiol-N versus Custodiol: Results from a prospective noninferiority
randomized single blind, multicenter phase 3 trial in patients undergoing
heart transplantation.
Source
Journal of Heart and Lung Transplantation. (no pagination), 2025. Date of
Publication: 2025.
Author
Aliabadi-Zuckermann A.; Osorio-Jaramillo E.; Knosalla C.; Gummert J.;
Szabo G.; Wittmann F.; Yeter R.; Schramm R.; Goekler J.; Hennig F.;
Morshuis M.; Zuckermann A.
Institution
(Aliabadi-Zuckermann, Osorio-Jaramillo, Wittmann, Goekler, Zuckermann)
Department of Cardiac Surgery, Medical University of Vienna, Vienna,
Austria
(Knosalla, Yeter, Hennig) Department of Cardiothoracic and Vascular
Surgery, Deutsches Herzzentrum der Charite (DHZC), Berlin, Germany
(Knosalla, Yeter, Hennig) Charite-Universitatsmedizin Berlin, corporate
member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin,
Berlin, Germany
(Knosalla, Hennig) German Center for Cardiovascular Research (DZHK),
Partner Site Berlin, Berlin, Germany
(Gummert, Schramm, Morshuis) Department for Cardiac Surgery, Herz und
Diabeteszentrum NRW, Bad Oeynhausen, Germany
(Szabo) Department of Cardiac Surgery, University of Heidelberg,
Heidelberg, Germany
Publisher
Elsevier Inc.
Abstract
Background: Custodiol is a well-established preservation solution for
organ transplantation and was the basis for the development of Custodiol-N
to improve graft preservation. Previous results in coronary artery bypass
graft surgery have shown effective cardiac protection without safety
concerns. This study aimed to evaluate the safety and ability of
Custodiol-N to preserve cardiac grafts for heart transplantation.
<br/>Method(s): This prospective, randomized, single-blind, multicenter,
noninferiority study was conducted at three centers in Austria and
Germany. The primary end-point was creatine kinase (CK-MB) peak value from
4 to 168 hours after opening of the aortic cross clamp, with a 30%
noninferiority margin. Key secondary efficacy end-points include patient
and graft survival, incidence of primary graft failure, or length of stay
in the intensive care unit. The primary and secondary end-points were
analyzed in both the treated and per protocol populations. <br/>Result(s):
A total of 105 randomized patients received Custodiol (n = 52) or
Custodiol-N (n = 53) preserved hearts. Average donor age and ischemic
times were comparable. Average CK-MB peak values were 176.94 +/- 189.61
U/L for the Custodiol versus 130.51 +/- 69.60 U/liter for the Custodiol-N
group (p-value for noninferiority of Custodiol-N by 30% <0.0001). Patient
survival was comparable 1-year post transplantation (90.4% for Custodiol
versus 88.7% for Custodiol-N). The incidence of primary graft failure and
median length of intensive care unit stay were higher for Custodiol group.
Safety assessment showed evenly distributed adverse events.
<br/>Conclusion(s): This study shows that Custodiol-N is safe,
noninferior, and provides similar cardiac graft protection as the
established Custodiol solution.<br/>Copyright &#xa9; 2025

<99>
Accession Number
647440003
Title
Use of Coronary Artery Bypass Graft Surgery and Percutaneous Coronary
Intervention and Associated Outcomes in the ISCHEMIA Trial.
Source
American heart journal. (no pagination), 2025. Date of Publication: 20
May 2025.
Author
White H.D.; O'Brien S.M.; Boden W.E.; Fremes S.E.; Bangalore S.; Reynolds
H.R.; Stone G.W.; Ali Z.A.; Parakh N.; Lopez-Sendon J.L.; Wang Y.; Chen
Y.Q.; Mark D.B.; Chaitman B.R.; Spertus J.A.; Maron D.J.; Hochman J.S.
Institution
(White) Health New Zealand - Whatu Ora -, Green Lane Cardiovascular
Service, Auckland City Hospital, Auckland, New Zealand
(O'Brien) Duke Clinical Research Institute, Duke University Medical
Center, Durham, NC, United States
(Boden) VA New England Healthcare System, Boston University School of
Medicine, Boston, MA, United States
(Fremes) University of Toronto, Schulich Heart Centre, Sunnybrook Health
Sciences Centre, Toronto, United States
(Bangalore, Reynolds, Hochman) NYU Grossman School of Medicine, NYU
Langone Health, Department of Medicine, New York, NY, USA
(Stone) Icahn School of Medicine at Mount Sinai, New York, NY, USA
(Ali) Cardiovascular Research Foundation, New York, NY, USA; Columbia
University Medical Center/New York-Presbyterian Hospital, New York, NY,
USA; St Francis Hospital, Roslyn, NY, USA
(Parakh) All India Institute of Medical Sciences, New Delhi, India
(Lopez-Sendon) IdiPaz Research Institute and Hospital Universitario La
Paz, Spain
(Wang, Chen) Stanford Prevention Research Center, Stanford, CA, United
States
(Mark) Duke Clinical Research Institute, Duke University Medical Center,
Durham, NC, USA; Duke University, Durham, NC, USA
(Chaitman) Saint Louis University School of Medicine Center for
Comprehensive Cardiovascular Care, St. Louis, MO, United States
(Spertus) University of Missouri - Kansas City's Healthcare Institute for
Innovations in Quality and Saint; Luke's Mid America Heart Institute,
Kansas City, MO, USA
(Maron) Stanford Prevention Research Center, Stanford, CA; Department of
Medicine, Stanford University, Stanford, CA, USA
Abstract
BACKGROUND: In the ISCHEMIA Trial, 5179 patients with stable coronary
disease were randomized to initial invasive or conservative management.
<br/>METHOD(S): PCI was recommended with a SYNTAX score 0-22 (low) and
CABG with a SYNTAX score >=33 (high). Either could be recommended for
intermediate scores. The composite primary outcome was cardiovascular
death, MI, or hospitalization for unstable angina, heart failure, or
resuscitated cardiac arrest. There were two cohorts in this analysis. The
descriptive cohort included patients who underwent CABG or PCI within 180
days of randomization and had no primary outcome before revascularization.
The comparative cohort excluded participants with prior CABG, single
vessel disease, SYNTAX score >= 45, and without core laboratory
assessment. We focused on the intermediate (23-32) SYNTAX comparative
group for which either CABG or PCI could be recommended. <br/>RESULT(S):
For 1935 patients in the descriptive cohort (485 CABG, 1450 PCI), the
SYNTAX score was 27.3 +/- 11.0 in the CABG group and 15.3 +/- 8.6 in the
PCI group, p<0.0001. Most patients with low SYNTAX scores underwent PCI
(87.1%), while most with high SYNTAX scores underwent CABG (72.6%). For
the 1203 patients (385 CABG, 818 PCI) in the entire comparative cohort,
the adjusted 4-year primary event rate was 14.5% for CABG and 13.2% for
PCI (difference 1.3%, 95% CI, -4.9% to 7.7%). For the 346 patients (163
CABG, 183 PCI) in the intermediate SYNTAX group, the adjusted 4-year
primary event rate was 10.6% for CABG and 18.3% for PCI (difference -7.6%,
95% CI, -16.1% to 0.9%). <br/>CONCLUSION(S): Selection of
revascularization method resulted in more PCI in the low SYNTAX group and
more CABG in the high SYNTAX group. There was no statistical evidence of a
difference between PCI and CABG in the intermediate SYNTAX group but the
CIs are broad, reflecting uncertainty. GOV IDENTIFIER: NCT01471522;
https://clinicaltrials.gov/ct2/show/NCT01471522.<br/>Copyright &#xa9;
2025. Published by Elsevier Inc.

<100>
Accession Number
2034706771
Title
Randomised Comparison of Culotte- versus Double Kissing Crush Stenting in
de novo non-left Main Coronary Bifurcation Lesions: Rationale and Design
of the Bifurcation Bad Krozingen trial-3 (BBK-3).
Source
Journal of Cardiovascular Translational Research. (no pagination), 2025.
Article Number: e008730. Date of Publication: 2025.
Author
Rahimi F.; Loffelhardt N.; Minners J.; Breitbart P.; Franke K.;
Hartikainen T.S.; Valina C.; Muhlen C.V.Z.; Nuhrenberg T.; Kastrati A.;
Woitek F.; Elsaesser A.; Abdel-Wahab M.; Sossalla S.; Hochholzer W.;
Westermann D.; Neumann F.-J.; Olivier C.; Ferenc M.
Institution
(Rahimi, Loffelhardt, Minners, Breitbart, Franke, Hartikainen, Valina,
Muhlen, Nuhrenberg, Westermann, Neumann, Olivier, Ferenc) Department of
Cardiology and Angiology, Medical Center, Faculty of Medicine, University
of Freiburg, University of Freiburg, Suedring 15, Bad Krozingen, Germany
(Kastrati) Department of Cardiology, Technische Universitaet Muenchen,
Deutsches Herzzentrum Muenchen, Munich, Germany
(Woitek) Department of Internal Medicine and Cardiology, Heart Center
Dresden, University Hospital, Technische Universitat Dresden, Dresden,
Germany
(Elsaesser) Heart-Circulation Centre, Clinic Oldenburg, Oldenburg, Germany
(Abdel-Wahab) Heart Center Leipzig, University of Leipzig, Leipzig,
Germany
(Sossalla) Department of Cardiology, University Hospital Giessen Kerckhoff
Clinic, Giessen, Germany
(Hochholzer) Department of Cardiology and Intensive Care Medicine,
Klinikum Wuerzburg Mitte, Wurzburg, Germany
Publisher
Springer
Abstract
Whether culotte or double kissing (DK)-crush stenting is the superior
systematic 2-stent technique in non-left main bifurcation lesions is
unclear. The BBK-3 (unique identifier NCT 04192760) is a multicenter,
prospective, randomized controlled trial to test the hypothesis that
culotte stenting reduces maximal percent diameter restenosis at 9-month
follow-up compared to DK-crush stenting in de-novo non-left main coronary
bifurcation lesions using approved, third-generation drug-eluting stents
(DES). A total of 400 patients will be randomized in a 1:1 ratio to
receive a two-stent strategy. The primary study endpoint is the maximal
percent diameter in-stent restenosis within the bifurcation at 9 months,
assessed by quantitative coronary angiography. Secondary endpoints include
target lesion revascularization (TLR), the composite of death and
myocardial infarction, emergent cardiac bypass surgery and TLR (MACE) at
12 months. BBK-3 will assist in the identification of the preferable,
contemporary 2-stent strategy in the treatment of de-novo non-left main
coronary bifurcation lesions.<br/>Copyright &#xa9; The Author(s) 2025.

<101>
Accession Number
2034695985
Title
Influenza Vaccination and Cardiovascular Outcomes in Patients with
Coronary Artery Diseases: A Placebo-Controlled Randomized Study, IVCAD.
Source
Vaccines. 13(5) (no pagination), 2025. Article Number: 472. Date of
Publication: 01 May 2025.
Author
Dehesh M.; Gholamin S.; Razavi S.-M.; Eskandari A.; Vakili H.; Rahnavardi
Azari M.; Wang Y.; Gough E.K.; Keshtkar-Jahromi M.
Institution
(Dehesh, Keshtkar-Jahromi) Division of Infectious Diseases, Department of
Medicine, Johns Hopkins University School of Medicine, Baltimore, MD,
United States
(Dehesh) Ciccarone Center for the Prevention of Cardiovascular Disease,
Johns Hopkins University, Baltimore, MD, United States
(Gholamin) Department of Radiation Oncology, City of Hope National Medical
Center, Duarte, CA, United States
(Razavi) Department of Neurology, University of South Dakota Sanford
School of Medicine, Sioux Falls, SD, United States
(Eskandari) Department of Radiology, University of Iowa, Iowa City, IA,
United States
(Vakili) Cardiovascular Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Rahnavardi Azari) Department of Cardiothoracic Surgery, Liverpool
Hospital, Liverpool, NSW, Australia
(Wang) Epidemiology and Data Management Center, Johns Hopkins School of
Medicine Biostatistics, Baltimore, MD, United States
(Gough) Department of International Health, Human Nutrition Program, Johns
Hopkins, Bloomberg School of Public Health, Baltimore, MD, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Influenza infection is associated with
cardiovascular morbidity and mortality; however, the effect of influenza
vaccination on cardiovascular outcomes is not fully understood. This
clinical trial aimed to investigate the correlation between cardiovascular
outcomes and influenza vaccine (FluVac) in coronary artery disease (CAD)
subjects. <br/>Method(s): This was a randomized single-blinded
placebo-controlled trial. Enrolled CAD subjects received 0.5 mL of
2007-2008 trivalent FluVac (15 microg hemagglutinin of each of Solomon
Islands/3/2006 (H1N1), Wisconsin/67/2005 (H3N2), and Malaysia/2506/2004
(B)). The subjects were followed up at 1 month (hemagglutinin (HA)
antibody titers) and at 12 months post-vaccination for evaluation of
outcomes (influenza-like episodes, acute coronary syndrome (ACS),
myocardial infarction (MI), coronary revascularization, and death).
<br/>Result(s): In total, 278 eligible CAD subjects were randomized to
receive either FluVac (n = 137) or a placebo (n = 141), of which
consequently 131 and 135 subjects completed the study. Cardiovascular
deaths (3/131 [2.29%] vs. 3/135 [2.22%]) and all-cause deaths (4/131
[3.05%] vs. 4/135 [2.96%]) were similar in both groups. Adverse
cardiovascular events, including ACS, MI, and coronary revascularization,
were less frequent in the vaccine group but did not reach statistical
significance. The magnitude of the antibody change and serologic response
(>=4-fold HI titer rise) of all three antibodies were significantly higher
in the vaccine group compared to the placebo but did not correlate with
cardiovascular outcomes in the FluVac group. <br/>Conclusion(s): The
influenza vaccine may improve cardiovascular outcomes, though this
improvement is not correlated with post-vaccination antibody titers.
Despite the controversy, influenza vaccination is recommended in the CAD
population (clinicaltrials.gov; NCT00607178).<br/>Copyright &#xa9; 2025 by
the authors.

<102>
Accession Number
2038910630
Title
TAVR vs. SAVR for severe aortic stenosis in the low and intermediate
surgical risk population: An updated meta-analysis, meta-regression, and
trial sequential analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Krishna M.M.; Joseph M.; Ezenna C.; Pereira V.; Rossi R.; Akman Z.; Rubens
M.; Mahadevan V.S.; Nanna M.G.; Goldsweig A.M.
Institution
(Krishna, Joseph) Department of Medicine, Medical College
Thiruvananthapuram, India
(Ezenna) Department of Medicine, University of Massachusetts - Baystate
Medical Center, Springfield, MA, United States
(Pereira) Faculty of Medicine, Universidad Austral, Pilar, Argentina
(Rossi, Akman) Department of Medicine, Yale School of Medicine, New Haven,
CT, United States
(Rubens) Office of Clinical Research, Miami Cancer Institute, Baptist
Health South Florida, Miami, FL, United States
(Rubens) Department of Translational Medicine, Herbert Wertheim College of
Medicine, Florida International University, Miami, FL, United States
(Rubens) Department of Health and Sciences, Universidad Espiritu Santo,
Samborondon, Ecuador
(Mahadevan) Department of Cardiovascular Medicine, University of
Massachusetts Chan School of Medicine, Worcester, MA, United States
(Nanna) Section of Cardiovascular Medicine, Yale School of Medicine, New
Haven, CT, 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: Guidelines recommend transcatheter aortic valve replacement
(TAVR) or surgical aortic valve replacement (SAVR) for patients of age >
65 years. The relative risks and benefits of TAVR vs. SAVR in low and
intermediate surgical risk remain incompletely described. <br/>Method(s):
A systematic search of PubMed, Scopus, and Cochrane Central databases
identified randomized controlled trials (RCTs) comparing clinical outcomes
of TAVR vs. SAVR in low and intermediate surgical risk. <br/>Result(s):
Ten RCTs (9239 patients, TAVR 50.8 %) were included. TAVR was associated
with lower rates of all-cause death or stroke at 30-day (rate ratio [RR]
0.70; 95%CI 0.55-0.89; p = 0.003; I² = 26 %) and 1-year (RR
0.77; 95%CI 0.60-0.98; p = 0.033; I² = 54 %) follow-up.
Bleeding complications, new-onset atrial fibrillation (AF), acute kidney
injury (AKI), and severe patient-prosthesis mismatch (PPM) were lower with
TAVR at 30 days and 1-year. Permanent pacemaker implantation, aortic valve
reintervention, major vascular complications, and paravalvular leak (PVL)
were significantly higher with TAVR at 30-day and 1-year follow-ups. Rates
of all-cause death, stroke, MI, endocarditis, and rehospitalization were
comparable between the groups at 30-day and 1-year follow-up.
<br/>Conclusion(s): In patients with severe AS and low to intermediate
surgical risk, TAVR is associated with reduced rates of all-cause death or
stroke, bleeding, new-onset AF, AKI, and severe PPM compared to SAVR.
However, despite these short-term benefits, higher rates of permanent
pacemaker implantation, PVL, and reintervention raise significant concerns
about the long-term safety of TAVR, particularly for younger, lower-risk
patients.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<103>
Accession Number
647425725
Title
Does the venous cannulation method affect gaseous embolic load to the
patient during extracorporeal circulation?.
Source
Perfusion. (pp 2676591251344859), 2025. Date of Publication: 20 May 2025.
Author
Torild P.; Corderfeldt Keiller A.; Damen T.
Institution
(Torild, Corderfeldt Keiller) Department of Perfusion, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Corderfeldt Keiller, Damen) Department of Anesthesiology and Intensive
Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy,
University of Gothenburg, Gothenburg, Sweden
(Damen) Department of Cardiothoracic Anaesthesia and Intensive Care,
Sahlgrenska University Hospital, Gothenburg, Sweden
Abstract
IntroductionCardiopulmonary bypass (CPB) is essential for cardiac surgery
but poses risks, including gaseous micro emboli (GME). While the incidence
of stroke-a common clinical consequence of embolism-ranges from 1-5% in
cardiac surgery, prevalence of GME during CPB remain poorly
understood.ObjectivesTo quantitatively compare GME incidence in the
arterial line between cavoatrial and bicaval cannulation during open-heart
surgery. Secondary exploratory objectives include evaluating the impact of
venous reservoir volume on GME, and the correlation between GME in the
venous and arterial lines.MethodsThis single center randomized controlled
trial was conducted at Sahlgrenska University Hospital, Sweden. Patients
>=18 years undergoing planned aortic valve repair/replacement with
cavoatrial cannulation, or mitral valve repair/replacement with bicaval
cannulation, with or without coronary artery revascularization, were
screened for eligibility. Patients were further randomized to either
venous reservoir volume of >=300 mL (control) or 200-300mL (intervention).
GME detection was performed using GAMPT BCC300 with probes positioned at
multiple locations within the CPB circuit.Results39 patients were
included. No significant differences in GME quantity in the arterial line
were observed between the cannulation methods (count p=.444; volume
p=967). Similarly, no significant differences were found based on venous
reservoir volume (count p=.074; volume p=.166). Furthermore, no
significant correlation was observed between GME in venous line entering
the arterial line (count p-value=492; volume p-value=.750). The CPB
circuit effectively removed 99.14% of GME, with no adverse events
reported.ConclusionNo significant differences were found in arterial GME
count or volume between cavoatrial and bicaval cannulation during CPB.
These findings underscore the importance of the bypass circuit's
air-handling capacity, as well as the role of modern oxygenators and
arterial line filters in effectively minimizing the passage of GME. Trial
Registration:ClinicalTrials.gov Identifier: NCT05820828URL:
https://clinicaltrials.gov/ct2/show/NCT05820828.

<104>
[Use Link to view the full text]
Accession Number
2038860808
Title
Electronic Provider Notification to Facilitate the Recognition and
Management of Severe Aortic Stenosis: A Randomized Clinical Trial.
Source
Circulation. 151(21) (pp 1498-1507), 2025. Date of Publication: 27 May
2025.
Author
Tanguturi V.K.; Abou-Karam R.; Cheng F.; Duan R.; Inglessis-Azuaje I.;
Langer N.B.; Yucel E.N.; Passeri J.J.; Hung J.W.; Elmariah S.
Institution
(Tanguturi, Abou-Karam, Cheng, Inglessis-Azuaje, Langer, Yucel, Passeri,
Hung) Division of Cardiology, Massachusetts General Hospital, Boston, MA,
United States
(Duan, Elmariah) Division of Cardiology, University of California, San
Francisco, San Francisco, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Symptomatic severe aortic stenosis (AS) remains undertreated
with high resultant mortality despite increased growth and availability of
aortic valve replacement (AVR) since the advent of transcatheter
therapies. We evaluate the impact of electronic provider notifications
(EPNs) on rates of AVR at 1 year. <br/>METHOD(S): In a pragmatic cluster
randomized clinical trial conducted within a multicenter academic health
system from March 2022 through November 2023, 285 providers who had
ordered a transthoracic echocardiogram (TTE) with findings potentially
indicative of severe AS with an aortic valve area <=1.0 cm²were
enrolled. Providers were randomly assigned to receive EPNs for each of
their patients with severe AS on TTE or to usual care. Notifications
highlighted the detection of severe AS and included patient-specific
clinical guideline recommendations for its management. The primary end
point was the proportion of patients with severe AS receiving AVR within 1
year of the index TTE. <br/>RESULT(S): A total of 144 providers were
randomized to intervention and 141 to control, resulting in 496 and 443
patients assigned to each group, respectively. The patient cohort had mean
age of 77+/-11 years, was 47% female, and had a mean aortic valve area of
0.8+/-0.1 cm². Rates of AVR within 1 year were 48.2% with EPNs
versus 37.2% with usual care (odds ratio [OR], 1.62 [95% CI, 1.13-2.32];
P=0.009]) and 60.7% and 46.5%, respectively, among symptomatic patients
(OR, 1.77 [95% CI, 1.17-2.65]; P=0.006). Notification treatment effect was
highest with EPNs for patients >80 years of age (OR, 2.00 [95% CI,
1.17-3.41]; P=0.01), for women (OR, 2.78, [95% CI, 1.69-4.57]; P<0.001),
and when the index TTE was performed within the inpatient setting (OR,
2.49 [95% CI, 1.44-4.31]; P<0.001). Within 1 year, the restricted mean
survival time was longer with EPNs in all (12 days; P=0.04) and
symptomatic patients (23 days; P=0.01). <br/>CONCLUSION(S): In this first
study of EPNs for valvular heart disease, EPNs increased rates of AVR for
severe AS, lessened sex and age disparities in AVR use, and improved
survival time. EPNs may be a simple, scalable intervention to raise
awareness of critical TTE findings and improve the quality of care for
patients with severe AS. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifier: NCT05230225. 2025
American Heart Association, Inc.<br/>Copyright &#xa9; 2025 Lippincott
Williams and Wilkins. All rights reserved.

<105>
Accession Number
2034699506
Title
Biomaterial-Based and Surgical Approaches to Local Hemostasis in
Contemporary Oral Surgery: A Narrative Review.
Source
Journal of Functional Biomaterials. 16(5) (no pagination), 2025. Article
Number: 190. Date of Publication: 01 May 2025.
Author
Dinkova A.; Petrov P.; Shopova D.; Daskalov H.; Harizanova S.
Institution
(Dinkova, Daskalov) Department of Dental, Oral, and Maxillofacial Surgery,
Faculty of Dental Medicine, Medical University-Plovdiv, Plovdiv, Bulgaria
(Petrov, Harizanova) Department of Hygiene and Ecomedicine, Faculty of
Public Health, Medical University-Plovdiv, Plovdiv, Bulgaria
(Shopova) Department of Prosthetic Dentistry, Faculty of Dental Medicine,
Medical University-Plovdiv, Plovdiv, Bulgaria
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Effective local hemostasis is essential in oral surgery to prevent
complications such as delayed healing, infection, and the need for
re-intervention. Postoperative bleeding occurs in 4-6% of cases,
increasing to 9-12% in patients receiving anticoagulant or antiplatelet
therapy. This review evaluates the efficacy, safety, and clinical utility
of local hemostatic agents based on 51 studies published between 1990 and
2023. Traditional agents, such as oxidized cellulose and gelatin sponges,
control bleeding in over 85% of standard cases but offer limited
regenerative benefits. Autologous platelet concentrates (APCs), including
platelet-rich plasma (PRP) and leukocyte- and platelet-rich fibrin
(L-PRF), reduce bleeding time by 30-50% and enhance soft tissue healing.
Studies show the PRP may reduce postoperative bleeding in dental surgery
by 30-50%, and in orthopedic and cardiac surgery by 10-30%, particularly
in patients on anticoagulants. Tranexamic Acid mouthwash can reduce
postoperative bleeding by up to 50-60%. Fibrin sealants achieve a 70-90%
reduction in bleeding among high-risk patients, while topical tranexamic
acid decreases hemorrhagic events by up to 80% in anticoagulated
individuals without increasing thromboembolic risk. However, comparative
studies remain limited, particularly in medically compromised populations.
Additional gaps persist regarding long-term outcomes, cost-effectiveness,
and the standardized use of emerging agents such as nanomaterials. Future
research should prioritize high-quality trials across diverse patient
groups and develop clinical guidelines that integrate both safety and
regenerative outcomes.<br/>Copyright &#xa9; 2025 by the authors.

<106>
Accession Number
647428257
Title
Postoperative Pulmonary Complications Not Increased with Combined Regional
+ General Anesthesia Compared to General Anesthesia Alone: A Sub-Analysis
of the Perioperative Research Network Study.
Source
Anesthesia and Analgesi. Conference: 2017 Annual Meeting of the
International Anesthesia Research Society and International Science
Symposium. Washington, DC United States. 127(5 Supplement) (pp 997-998),
2017. Date of Publication: 01 May 2017.
Author
Coger K.; Frendl G.; Sprung J.; Kor D.J.; Subramaniam B.; Ruiz R.M.; Lee
J.-W.; Henderson W.G.; Moss A.; Mehdiratta N.; Colwell M.; Bartels K.;
Kolodzie K.; Giquel J.; Melo M.F.V.; Fernandez-Bustamante A.
Institution
(Coger, Bartels, Fernandez-Bustamante) University of Colorado, School of
Medicine, Aurora, CO, United States
(Frendl, Mehdiratta) Brigham and Women's Hospital, Boston, MA, United
States
(Sprung, Kor) Mayo Clinic, Rochester, MN, United States
(Subramaniam) Beth Israel Deaconess Medical Center, Boston, MA, United
States
(Ruiz, Giquel) University of Miami, Palmetto Bay, FL, United States
(Lee, Kolodzie) University of California San Francisco, San Francisco, CA,
United States
(Henderson, Moss) Adult and Children Outcomes Research and Delivery
Systems, United States
(Colwell, Melo) Massachusetts General Hospital, Harvard Medical School,
Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Postoperative pulmonary complications (PPCs) are a leading
cause of poor surgical outcomes. The Perioperative Research Network (PRN)
investigators recently investigated the incidence and impact on mortality
and hospital use of PPCs in 1,202 ASA 3 physical status patients
presenting for non-cardiothoracic surgery and requiring >=2 hours general
anesthesia and mechanical ventilation (the PRN PPC study) (1). In this
multicenter prospective observational study, patients who had combined
regional + general anesthesia (RA+GA), compared to general anesthesia (GA)
alone, were significantly more likely to have >=1 PPC (1,2). This was
surprising considering the benefits in respiratory function presumed with
regional anesthesia (3,4,5). A meta-analysis of 141 trials and 9,559
patients found that neuraxial blockade reduced respiratory depression by
59% and pneumonia by 39% (both P<0.001) (3). Receiving RA+GA is often
considered a marker of surgery and/or patient complexity. For this
subanalysis of the PRN PPC study patients (1), we hypothesized that the
presence of >=1 PPC was not increased in patients receiving RA+GA than in
GA patients after adjusting for confounders. <br/>Method(s): We performed
a secondary analysis of the PRN PPC study patient cohort described above.
The 1,202 patients participating in the original study (May to November
2014) were included. IRB approval was obtained at each participating
institution. Predefined PPCs (pneumonia, bronchospasm, ARDS, atelectasis,
pneumothorax, pleural effusion, prolonged [>1 day after end of surgery]
supplemental oxygen by nasal cannula and/or facemask, postoperative
noninvasive ventilation, and re-intubation with postoperative mechanical
ventilation) occurring within the first 7 postoperative days were
prospectively identified. For this sub-analysis patients were classified
as receiving RA+GA or GA alone. Bivariable and multivariable hierarchical
logistic regression analyses were used to investigate the association of
RA+GA with >=1 PPC. Relevant covariates adjusted for in the model were
identified as those considered clinically relevant, those with p<0.05 in
bivariable analysis, and those with no significant statistical association
with other relevant variables. <br/>Result(s): RA+GA was performed in 266
(22.1%) and GA in 936 (77.9%) patients. RA+GA patients were more likely to
have cancer, abdominal/pelvic non-emergent surgery, greater estimated
blood loss and intravenous fluid administration than GA patients (Table
1). RA+GA patients had a higher incidence of >=1 PPC (42.1%) than GA
patients (30.9%) (site adjusted p=0.007, Table 1). After adjusting for
other significant covariates from the bivariable analysis, RA+GA was not
independently associated with >=1 PPC (adjusted OR 1.37; 95% CI,
0.83-2.25; p=0.165) (Table 2). <br/>Conclusion(s): At least 1 PPC was more
common in patients receiving RA+GA than GA alone. However, RA+GA was not
associated with >=1 PPC after adjusting for confounders in the logistic
regression analysis. These results support that the more often presence of
PPCs in patients receiving RA+GA in the PRN PPC study is likely related to
surgical and/or patient complexity. Interpretation of associated variables
from observational studies should be cautious and requires adjusting to
confounders.

<107>
Accession Number
647428521
Title
A Systematic Review of Perioperative Interventions to Improve Outcomes in
Frail Elderly Patients Having Surgery.
Source
Anesthesia and Analgesi. Conference: 2017 Annual Meeting of the
International Anesthesia Research Society and International Science
Symposium. Washington, DC United States. 127(5 Supplement) (pp 1025-1026),
2017. Date of Publication: 01 May 2017.
Author
McIsaac D.I.; Jen T.T.H.; Mookerji N.; Patel A.; Lalu M.M.
Institution
(McIsaac) Perioperative Health Systems and Outcomes Research, Ottawa, ON,
Canada
(Jen, Mookerji, Patel) University of Ottawa, Ottawa, ON, Canada
(Lalu) University of Ottawa, Ottawa Hospital Research Institute, Ottawa,
ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Older patients undergo surgery at a high rate, and
experience an increased rate of adverse outcomes (1, 2). A growing
literature identifies frailty, an aggregate expression of vulnerability to
adverse outcomes due to age- and disease- related deficits, as a key
predictor of morbidity and mortality in older surgical patients (3-5).
Importantly, frailty may be a modifiable risk factor. However, there are
no synthesis of interventions to improve post-operative outcomes in frail
surgical patients. We conducted a systematic review of studies testing
interventions in frail surgical patients in order to improve outcomes, as
outlined by the Institute for Healthcare Improvement's Triple Aim
framework (health, cost, and experience). <br/>Method(s): The need for
ethical approval was waived. A protocol was registered a priori
(2016:CRD42016039909). We searched the Cochrane, Medline, PubMed, CINAHL,
and EMBASE databases using a search strategy. The grey literature was also
evaluated. Studies testing interventions specifically in frail surgical
patients, or studies in which frailty-specific subgroup analysis was
possible, were included. Studies that defined the frailty criteria were
included, but studies were not limited to specific frailty definitions.
Study screenings, full text reviews, data extraction and risk of bias
assessments were done in duplicate using piloted forms in DistillerSR.
Qualitative synthesis was performed, per our protocol. <br/>Result(s): Our
initial screening identified 2593 titles and abstracts for review, of
which 11 were included for final analysis (6 RCTs, 5 non-RCTs). Surgery
populations included general surgery, cardiac, orthopedic and mixed.
Interventions were applied during the perioperative (1), preoperative (3)
and postoperative (7) periods, and included exercise, multicomponent
geriatric-specific interventions, and blood transfusion triggers. Exercise
therapy was consistently associated with improved outcomes (Figure 1).
Geriatric-specific protocols suffered from difficulties in implementation
and poor adherence. Liberal blood transfusion triggers had no impact on
mortality or other outcomes (Figure 1). Substantial heterogeneity was
noted across studies in terms of frailty instruments used and the types of
outcomes reported. Risk of bias was high to moderate in all studies.
<br/>Conclusion(s): Despite the clear emergence of frailty as an important
perioperative risk factor, few studies evaluating interventions specific
to frail surgical patients were identified. Development and evaluation of
frailty-specific interventions in low risk of bias trials is urgently
needed. Such trials should consider perioperative exercise therapy
interventions, and should follow best practice guidelines for the
development and evaluation of complex interventions.

<108>
Accession Number
647428613
Title
Thoracic Epidural Placement in a Patient with Von Hippel-Lindau Disease
Presenting for Abdominal Surgery.
Source
Anesthesia and Analgesi. Conference: 2017 Annual Meeting of the
International Anesthesia Research Society and International Science
Symposium. Washington, DC United States. 127(5 Supplement) (pp 1033-1035),
2017. Date of Publication: 01 May 2017.
Author
Yap A.; Ranganath Y.
Institution
(Yap, Ranganath) University of Iowa Hospitals and Clinics, Iowa City, IA,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Introduction Von Hippel-Lindau disease (VHLD) is an
autosomal dominant disorder characterized by CNS and retinal
hemangioblastomas, renal tumors, and pheochromocytoma (1). We report a
case of thoracic epidural placement in a VHLD patient. There are case
reports of lumbar epidural placement for obstetric VHLD cases but none
about thoracic epidurals. Case Presentation: A 35 year-old woman presented
for left open heminephrectomy. Her history was pertinent for VLHD,
panhypopituitarism s/p suprasellar hemangioblastoma resection, left open
partial nephrectomy with epidural analgesia, right laparoscopic
nephrectomy, left temporal craniotomies for seizures, and fourth
ventricular hemangioblastoma resection. She had no neurological symptoms
preoperatively. Recent abdominal scans did not show any large spinal
hemangioblastomas. No formal spine MRI was performed. We discussed an
epidural or paravertebral catheter for analgesia but with increased risk
due to the potential presence of spinal hemangioblastomas. She felt
strongly about having epidural analgesia. Epidural placement was performed
by an experienced operator. An epidural catheter was placed at T7-8 in one
attempt, without issues. Postoperatively, bupivacaine was infused
epidurally before discontinuation on POD#3. She had no neurological
deficits up to three weeks postoperatively. <br/>Result(s): Discussion No
guidelines exist for neuraxial techniques in VHLD patients. One report
recommended against neuraxial techniques (2) and another made no comments
(3). Four remaining studies (1,4,5,6) did not rule out neuraxial
techniques. Hallsworth et al (1) proposed neuraxial anesthesia was
contraindicated if the puncture site was close to a hemangioblastoma, and
to seek neurosurgical advice if the hemangioblastoma was distant to a
puncture site. Spinal hemangioblastomas occur in 5-28% of VHLD patients
(6). Most are superficial but intermedullary in location at the posterior
aspect of the spinal cord (7,8). Based on the distribution, the risk of
puncture with uncomplicated epidural placement should be low. The risk of
unintended dural puncture during epidural placement has been reported to
be 0.19-3.6% (9). Studies report epidural analgesia improved pain relief
and outcomes in major thoracic and abdominal surgery (10). We considered
alternatives such as TAP and paravertebral catheters. TAP catheters would
require frequent boluses (11), and would be within the surgical field. A
recent RCT suggests epidurals improved to pain control compared to
paravertebral blocks (12). Hemangioblastomas occur at dorsal nerve roots
in 0.3% of cases and could complicate paravertebral blocks (13).
<br/>Conclusion(s): After considering the risks and benefits, the
alternatives and the patient's desires, we proceeded with placing an
epidural. However, we recommend a spine MRI be obtained prior to neuraxial
technique in VHLD patients. The VHL Alliance also recommends surveillance
with spine MRI after age 16 in VHLD patients.

<109>
Accession Number
647428197
Title
The Efficacy of Vasoactive Drugs for the Acute Management of Pulmonary
Hypertension and Right Heart Failure in Adult Intensive Care Patients. A
Systematic Review of the Literature.
Source
Anesthesia and Analgesi. Conference: 2017 Annual Meeting of the
International Anesthesia Research Society and International Science
Symposium. Washington, DC United States. 127(5 Supplement) (pp 210-212),
2017. Date of Publication: 01 May 2017.
Author
Kenth J.; Finnerty J.
Institution
(Kenth) University of Lancaster, Lancaster, United Kingdom
(Finnerty) Pennine Acute Trust, Manchester, Greater Manchester, United
Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: The management of pulmonary hypertension [PHT] in critically
unwell patients is often conceptualised as complex, multifaceted, and
commonly fraught with difficulty. PHT, right ventricular dysfunction
(RVD), and right heart failure (RHF) are all independent prognostic
indices for poor outcomes1-3. There remains a paucity of consensus amongst
the major (cardiothoracic) intensive care units (ICU) across Europe for
the acute management of PHT and RVD2,3. Previous systematic reviews3 had
advocated further high-quality randomised control trials (RCTs), before
consensus guidelines could be synthesised. We undertook a systematic
review of the literature to ascertain the efficacy of vasoactive drugs,
including vasopressors, inotropes, and specific pulmonary vasodilators.
<br/>Method(s): A medical literature search was performed from
bibliographic databases that included: Pubmed/Medline, EMBASE, CINAHL,
Cochrane Central Register (CENTRAL), and Google Scholar; from 1975 until
July 2016. RCTs in English, with a predefined protocol, and having
reported prior specified outcome measures were included. Non-randomised
trials, cohort studies, case series/reports, and abstracts were excluded.
[figure 1]. The main outcomes measures included continuous variables such
as haemodynamic indices [including pulmonary vascular resistance - PVR],
and dichotomous data, including morbidity, mortality, length of hospital
stay, and adverse events. The type of vasoactive drug and mean doses were
also delineated. The quality of the studies was assessed using both the
GRADE methodology, and the Cochrane Review Criteria for RCTs, and bias was
assessed using The Cochrane Risk of Bias Toolkit [table 1].
<br/>Result(s): 38 out of 1275 studies satisfied the inclusion criteria
(figure 1); with older studies demonstrating a greater uncertainty in the
risk of bias, across several domains (table1). 9 studies assessed the
efficacy of vasopressors. Low-dose norepinephrine (NE) was efficacious in
improving haemodynamic parameters, and higher doses were correlated with
poorer outcomes. Vasopressin was superior to NE, with fewer adverse
events, and inducing minimal changes in PVR. 13 studies investigated
inotropic drugs, inferring strong evidence to supporting their usage
across all patient groups. Phosphodiesterase inhibitors [PDEI] and
Levosimendan were both superior to dobutamine, and high doses of the
latter were associated with increased PVR and RVD. Both dopamine and
epinephrine were both strongly associated with increases in PVR. 16
studies investigated the efficacy of pulmonary vasodilators. Selective
PDEI-5 inhibitors (e.g. sildenafil) were highly effective at reducing PVR
and improving RVD. Inhaled pulmonary vasodilators were equally as
effective as intravenous agents (with fewer aftereffects), and iloprost
was found to be superior to nitric oxide. Efficacy of iloprost was
prominent in patients with pre-existing PHT, and following cardiothoracic,
or hepatic surgery. The benefits in patients with ARDS demonstrated
inconsistent results. <br/>Conclusion(s): Whilst the management of PHT and
RVD in ICU may be challenging, certain approbations can be inferred from
current evidence: A strong recommendation for vasopressors to augment
hypotension in RVD, with a recommendation for the early use of
vasopressin. Levosimendan, PDEI, and selective PDEI-5 are recommended,
with inhaled agents being non-inferior to intravenous ones. (Figure
Presented).

<110>
Accession Number
647428477
Title
Perioperative Dexmedetomidine for Prevention of Atrial Fibrillation in
CABG.
Source
Anesthesia and Analgesi. Conference: 2017 Annual Meeting of the
International Anesthesia Research Society and International Science
Symposium. Washington, DC United States. 127(5 Supplement) (pp 133-134),
2017. Date of Publication: 01 May 2017.
Author
Gruntorad G.A.F.; Mendiola W.; Cuartas P.A.; Quintero O.L.
Institution
(Gruntorad, Cuartas, Quintero) Fundacion Cardioinfantil, Bogota,
Cundinamarca, Colombia
(Mendiola) Hospital San Ignacio, Bogota, Cundinamarca, Colombia
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Atrial Fibrillation (AF) is a common condition after
coronary artery bypass graft (CABG) surgery, with an incidence of 14% -
40% it is well known that it increases morbidity and mortality [1].
Dexmedetomidine (DEX) is an alpha2 agonist that has been included in the
perioperative management of patients undergoing CABG. There is some
clinical evidence that it decreases the incidence of AF in the early
postoperative period of this patient population. Based on the above, it is
proposed that the use of perioperative DEX in patients undergoing CABG may
be a safe pharmacological strategy to reduce the incidence of
postoperative AF in this population. <br/>Method(s): This is a
restrospective cohort study conducted in a single institution at a
tertiary care hospital. After IRB approval, hospital's cardiovascular
surgery and perfusion databases were searched over a 5 year period between
2009 - 2013 for patients who underwent CABG, identifying 1566 patients.
From this population we searched those who had DEX perioperatively. To
avoid bias patients with known risk factors for post operative AF such as
age >76 years, ASA >V, presence of pacemaker, urgent surgery and previous
documented arrhythmias were excluded. Control group was randomly selected
in order to match the cases in a 1:1 ratio. The primary endpoint was to
compare the overall incidence of AF in both groups during the first 72
hours after the surgical procedure, the presence of AF was identified from
the CV database and confirmed from the patient's chart. Demographic data,
and ASA classification are presented in frequencies and X2 test was used
in order to calculate p values, quantitative data such as age Ejection
Fraction, and bypass time were presented as means and p values were
calculated using t-student test. For AF, calculation of the relative risk
was done with a 2x2 table DEX and Non DEX vs presence of AF in the first
72 hours were analyzed, relative risk and confidence intervals were
calculated, these being statistically significant with values lower than 1
and the chi-square test with a p value less than 0.05 was defined to
establish statistically significant differences. <br/>Result(s): 1566
patients were initially identified during the study period, within this
population166 patients had DEX as a perioperative anesthetic agent,
excluded patients are shown in (fig 1). Finally a cohort of 196 patients
(98 in the DEX group and 98 in the control group) was the study
population. Demographic and quantitative data were similar in both groups
(table 1), the incidence of AF was lower in the DEX group [5.1% (5/98) vs.
15.3% (15/98)], calculated relative risk for AF in patients exposed to dex
during the perioperative period was 0.333 (IC 0,126 - 0,881) p value
(0.018). <br/>Conclusion(s): To our knowledge this is the first study
suggesting that perioperative DEX might be effective in preventing the
occurrence of AF after CABG, our hypothesis is that the decrease in
circulating cathecolamines and an enhanced vagal tone might be the reasons
why this happens [2] [3]. Recently Geng reported that DEX might not
decrease the incidence of AF [4] although the fact that AF was not the
primary outcome of this meta analysis might explain this findings. One
limitation is that this is a retrospective study, that was designed in
order to confirm our clinical observation, this association should be
confirmed in further clinical trials. (Figure Presented).

<111>
Accession Number
647428551
Title
Prehabilitation Before Cancer Surgery to Improve Patient Function in Frail
Elderly.
Source
Anesthesia and Analgesi. Conference: 2017 Annual Meeting of the
International Anesthesia Research Society and International Science
Symposium. Washington, DC United States. 127(5 Supplement) (pp 1027-1028),
2017. Date of Publication: 01 May 2017.
Author
McIsaac D.I.; Moloo H.; Lavallee L.T.; Nantel J.; Bryson G.L.; Gagne S.;
McCartney C.
Institution
(McIsaac) Perioperative Health Systems and Outcomes Research, Ottawa, ON,
Canada
(Moloo, Lavallee, Nantel, Gagne, McCartney) University of Ottawa, Ottawa,
ON, Canada
(Bryson) Ottawa Hospital, Ottawa, ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Frailty, an aggregate susceptibility to adverse health
outcomes due to age- and disease-related deficits,1 is a key predictor of
complications, health resource use, and mortality in older patients having
surgery.2 Approximately 40% of surgical patients >65 years of age are
frail. Given the high prevalence of frailty, and the strong association
between frailty and adverse postoperative outcomes, the care of frail
older patients has been identified as a key area of focus to improve the
quality and efficiency of perioperative care. Exercise training in
non-surgical frail patients improves functional outcomes,3 however, no
studies to date have investigated the efficacy of preoperative exercise
training (prehabilitation) in improving outcomes of frail elderly surgical
patients. A secondary analysis of a recent randomized trial of colorectal
surgery patients found that prehabilitation resulted in a significant
improvement in postoperative function, and that the impact of the
intervention was greatest in older patients with more comorbidities (i.e.,
characteristics consistent with frailty).4 Therefore, we aim to test the
efficacy of home-based prehabilitation of frail older people to improve
their postoperative function following elective surgery cancer surgery.
<br/>Method(s): We are conducting a research ethics board approved single
center, single-blinded, parallel arm randomized controlled trial of
home-based prehabilitation vs. standard care in frail older patients
undergoing elective surgery for cancer. All consenting patients >65 years
who are scheduled to undergo elective surgery for intraabdominal/thoracic
cancer >= 4 weeks from recruitment, and who are diagnosed with frailty
based on a Clinical Frailty Scale score of >4/9, will be included.
Patients will be randomized via a web-based application. Intervention
patients will perform a home-based total-body exercise training program
(prehabilitation) based on a protocol with proven efficacy in improving
the function of non-frail surgical patients in less than 4 weeks of
preoperative participation.4 Prehabilitation consists of 3 components: 1)
strength; 2) aerobics; and 3) flexibility. Participants will receive
in-person teaching and video instruction to facilitate the program at
home. Compliance will be assessed by weekly phone calls. Control group
participants will receive standard care. Accounting for up to 15%
attrition, we will recruit 100 participants per arm to achieve 80% power
at a 5% level of significance for our primary outcome (6-minute walk test
at the first clinic follow up after hospital discharge). Secondary
outcomes are listed in Table 1. Clinicians and outcome assessors will be
blinded to treatment allocation. The primary outcome will be analyzed
using a repeated measures linear regression analysis with specified
covariance matrix to account for correlation over time. Secondary outcomes
(SPPB, EQ-5D, WHO-DAS) will be analyzed as described for the primary
outcome. We will also perform a per protocol analysis (with >80%
compliance based on activity logs being considered compliant).
<br/>Result(s): Participant recruitment commenced in January 2017, results
will be presented when available. <br/>Conclusion(s): Prehabilitation may
be an efficacious intervention to improve the outcomes of frail older
people having surgery. The results of this randomized trial will inform
current clinical care, as well as future multi-site randomized trials.

<112>
Accession Number
647428334
Title
Plasma Free Hemoglobin, Oxidative Damage, and Acute Kidney Injury in
Cardiac Surgery.
Source
Anesthesia and Analgesi. Conference: 2017 Annual Meeting of the
International Anesthesia Research Society and International Science
Symposium. Washington, DC United States. 127(5 Supplement) (pp 116-118),
2017. Date of Publication: 01 May 2017.
Author
Lopez M.G.; Pretorius M.; Billings F.T.
Institution
(Lopez, Pretorius, Billings) Vanderbilt University Medical Center,
Nashville, TN, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Acute kidney injury (AKI) occurs in up to 30% of patients
who undergo cardiopulmonary bypass (CPB) during surgery.(1,2) CPB lyses
erythrocytes, and free hemoglobin (Hb), similar to other hemeproteins, is
nephrotoxic.(3,4) In a rat model, hemeprotein-induced AKI was mediated by
oxidative damage, and we have recently demonstrated that increased
oxidative damage is an independent predictor of AKI following cardiac
surgery.(5, 6) We tested the hypothesis that increased plasma free Hb
concentrations in patients undergoing cardiac surgery are associated with
AKI and that this association is mediated by oxidative damage.
<br/>Method(s): We measured plasma free Hb 30-minutes into CPB,
immediately after CPB, and at ICU admission in Statin AKI cardiac surgery
RCT participants. We measured plasma concentrations of isofurans, stable
products of arachidonic acid peroxidation, at ICU admission to quantify
intraoperative oxidative damage. AKI was defined using Acute Kidney Injury
Network criteria. To isolate the association between peak free Hb and AKI
we performed multiple logistic regression adjusted for age, estimated
glomerular filtration rate, statin treatment, and baseline hematocrit
(I²Hb1, model 1, Figure 1). To assess any mediation by
oxidative damage, we added isofurans to the model and examined
I²Hb and the independent association between isofurans and AKI
(I²Hb2 and I²isofuran, model 2), and we measured the
association between peak free Hb and isofurans, adjusted for the same
covariates (I²Hb3, model 3). A decrease in the association
between free Hb and AKI in model 2, an association between isofurans and
AKI, and an association between free Hb and isofurans are required to
demonstrate any evidence of oxidative damage mediating an association
between intraoperative plasma free Hb and postoperative AKI.
<br/>Result(s): Sixty-five of 259 patients (25.1%) developed AKI within 72
hours of cardiac surgery. The median (10th, 90th percentile) free Hb
concentration was 0.0 mg/dl (0.0, 75.0) 30 minutes into CPB, 69.8 mg/dl
(0.0 to 295.0) immediately following CPB, and 60.0 mg/dl (0.0, 234.8) at
ICU admission. Median isofurans concentration at ICU admission was 65.4
pg/ml (33.4, 141.6). The peak median plasma free Hb concentration in AKI
patients was 48.6 mg/dl higher than in non-AKI patients, and in adjusted
analyses, a 50 mg/dl increase in peak free Hb was independently associated
with a 16% increase in the odds of AKI (I²Hb1 OR, 1.16 [95% CI,
1.02 to 1.33]; P=0.02; Figure 2). When isofurans were added to the model,
this association was reduced (I²Hb2 OR, 1.13 [95% CI 0.99 to
1.30) and no longer significant (P=0.06). A 25 pg/ml increase in peak
isofurans was independently associated with an 18% increase in the odds of
AKI (I²isofuran OR, 1.18 [95% CI, 1.03 to 1.33]; P=0.03, Figure
3), and a 50 mg/dl increase in peak plasma free Hb was independently
associated with a 4.8 pg/ml [95% CI, 2.0 to 7.5; P=0.001] increase in
plasma isofurans (Figure 4). <br/>Conclusion(s): Intraoperative plasma
free Hb concentrations were independently associated with AKI following
cardiac surgery, and this association may be partially mediated by
increased oxidative damage. Increased free Hb was associated with
increased oxidative damage, and increased oxidative damage was
independently associated with AKI. Interventions to decrease
intraoperative hemolysis, scavenge plasma free Hb, and decrease oxidative
damage during cardiac surgery should be studied to decrease AKI and
subsequent patient morbidity. (Figure Presented).

<113>
Accession Number
647428420
Title
The Use of Incentive Spirometry to Reveal Pulse Pressure and Systolic
Pressure Variability in Spontaneously Breathing Patients.
Source
Anesthesia and Analgesi. Conference: 2017 Annual Meeting of the
International Anesthesia Research Society and International Science
Symposium. Washington, DC United States. 127(5 Supplement) (pp 227-228),
2017. Date of Publication: 01 May 2017.
Author
Choi C.; Shelley K.; Alian A.
Institution
(Choi, Shelley, Alian) Yale University, School of Medicine, New Haven, CT,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: As a clinician, assessing a patient's intravascular volume
is often a challenging task. It has become clear that traditional measures
such as central venous pressure and pulmonary artery occlusion pressures
poorly predict one's fluid responsiveness (1). Over the past decade,
dynamic hemodynamic variables such as pulse pressure variation, which use
heart-lung interactions, have been found to be predictive for fluid
responsiveness (2). However, one of the limitations of these variables is
that they are accurate only under volume controlled mechanical
ventilation. This brings us to the question: can we assess intravascular
volume status in spontaneously breathing patients? Lung recruitment
maneuvers in ventilated patients have been found to depress central
hemodynamics (3). Moreover, the degree of decrease in stroke volume seen
is related to preexisting fluid responsiveness (4). We hypothesize that
incentive spirometry (IS), a lung recruitment maneuver used widely in
spontaneously breathing patients, can be a tool to assess the
cardiovascular-pulmonary interaction. <br/>Method(s): 16 patients POD#1
from CABG surgery post-extubation were enrolled in this study. These
patients were potentially hypovolemic due to intravenous furosemide 40-80
mg administration in order to optimize extubation conditions. They were
monitored with airway pressure, pulse oximeter and arterial waveforms.
Waveforms were recorded during spontaneous breathing and IS. IS use was
instructed at the bedside by nursing and research personnel. A successful
recruitment maneuver was determined by moving 2 balls up on the IS.
Waveforms were analyzed using LabChart v7.3.7 (ADInstruments). T-tests
were done between spontaneous breathing and IS groups with a p-value <
0.05 considered significant Results: Figure 1 show changes in the arterial
waveform during spontaneous breathing and with the use of IS. PPV
significantly increased during IS compared to spontaneous breathing
(p<.05) by an average of 487% (figure 2). SPV was also significantly
higher during IS (p<.05) by an average of 441% (figure 2).
<br/>Conclusion(s): We have previously observed that incentive spirometry
affects venous preload through rapid changes in intrathoracic pressure
(5). Our data not only reaffirms this but also shows that these changes in
preload throughout the cardiac cycle result in increased dynamic indices.
In our cohort, both PPV and SPV increased by an average of over 400%
during IS. To summarize, our data shows that incentive spirometry is a
promising tool for assessing for hypovolemia in spontaneously breathing
patients. (Figure Presented).

<114>
Accession Number
647429063
Title
Fast-Track Protocols- Has Quality Been Pushed to the Edge?.
Source
Anesthesia and Analgesi. Conference: 2017 Annual Meeting of the
International Anesthesia Research Society and International Science
Symposium. Washington, DC United States. 127(5 Supplement) (pp 174-176),
2017. Date of Publication: 01 May 2017.
Author
Jakobsen C.-J.; Ryhammer P.K.
Institution
(Jakobsen, Ryhammer) Aarhus University Hospital, Aarhus N, Denmark
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: The continued demand for cost control in health care has led
to an ever-ongoing work with relevant decisive factors. The pursuit for
more efficient resource use, earlier mobility and increased patient
turnover, has led to a continuing interest in fast-track protocols.
Leading to earlier ICU discharge (1-3), as ICU are one of the main
limiting factors in operating room utilization. However, length of stay in
the ICU is not an objective report tool, as discharge, besides medical
factors, are guided by logistics and politics. Early extubation is usually
considered one of the main steps in fast-track pathways (4) and different
protocols has been suggested (2-3,5-6). Anyhow, the impact of the optimal
extubation time on LOS after cardiac surgery is still debated (5,7) and
applicability, quality and safety are still open (2-3). Further, most
studies have evaluated the impact of different anaesthetic regimes, while
depth of anaesthesia has seldom been adressed. Thus more objective
intraoperative monitoring may facilitate the conclusions. The focus of
this study was to evaluate the association between intraoperatively
administered opioid doses, ventilation time, eligible discharge from ICU
and possible impact on quality of recovery. <br/>Method(s): Sixty cardiac
surgery patients (study A) randomized to STANDARD bolus dose sufentanil (1
mug/kg & propofol 1.8 mg/kg/h) or LOW dose sufentanil (0.5 mug/kg &
propofol 3.6 mg/kg/h). Depth of anaesthesia was monitored with BIS7,
aiming at BIS below 50 during surgery. The data from the standard group
were further compared with 30 control patients from a randomized study
from 2014 (study B). Both studies evaluated the mentioned aspects of
fast-track protocols. Primary endpoints were ventilation time and eligible
time to discharge from ICU and secondary outcomes were actual LOS in the
ICU and quality of recovery using an ICU discharge score (9).
<br/>Result(s): The dose of sufentanil administered showed great variation
in both groups (figure 1). The standard sufentanil patients received twice
as much as the low dose group (0.92 vs 0.46 ug/kg/min; P<0.0001). There
was no difference between the groups in ventilation time (205 vs 191
minutes) or the eligible discharge time (11.1 vs 10.8 hours) (table 1).
There were no differences in ICU score 30 minutes after extubation between
the sufentanil groups (figure 2). The ventilation time decreased
significantly from 261 (study B) to 205 (study A) minutes (P=0.019). The
eligible time to discharge was not different between studies being 10.8
and 11.1 respectively nor was the actual discharge time (table 1). Overall
there was no difference in ICU discharge score after extubation (Study A:
6.9 +/- 2.6 vs Study B: 6.5 +/- 2.3; P=0.473). However, patients in study
A had marginally higher scores in pain (P=0.018), sedation (P=0.014) and
saturation (P=0.040) (figure 3). The overall ICU scores showed
significantly higher scores in study A compared to B in the first 10
postoperative hours (figure 4). The score for pain continued to be higher,
despite higher morphine administration in study A patients.
<br/>Conclusion(s): The total sufentanil amount had no impact on
ventilation time and LOS in the ICU. Our focus through several studies on
shortening the ventilation time and discharge has actually shortened
ventilation times. The shorter ventilation period has not, however,
resulted in an earlier eligibility to be discharged. Furthermore, we fear
that the eager quest for a fast-track protocol can result in a lower
quality of recovery. (Figure Presented).