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<1>
Accession Number
2036115510
Title
Hypotension after induction of anesthesia with remimazolam or etomidate: a
non-inferiority randomized controlled trial in patients undergoing
coronary artery bypass grafting.
Source
Korean Journal of Anesthesiology. 78(2) (pp 139-147), 2025. Date of
Publication: 01 Apr 2025.
Author
Min J.-J.; Oh E.J.; Hwang H.J.; Jo S.; Cho H.; Kim C.; Lee J.-H.
Institution
(Min, Hwang, Jo, Cho, Kim, Lee) Department of Anesthesiology and Pain
Medicine, Samsung Medical Center, Sungkyunkwan University School of
Medicine, Seoul, South Korea
(Oh) Department of Anesthesiology and Pain Medicine, Chung-Ang University
Gwangmyeong Hospital, Chung-Ang University College of Medicine, Seoul,
South Korea
Publisher
Korean Society of Anesthesiologists
Abstract
Background: Remimazolam is a novel ultra-short-acting benzodiazepine known
for its hemodynamic stability over propofol. However, its hemodynamic
effects compared to those of etomidate are not well established. This
study aimed to determine whether the use of remimazolam is non-inferior to
etomidate with regard to the occurrence of post-induction hypotension in
patients undergoing coronary artery bypass grafting. <br/>Method(s):
Patients were randomly assigned to either the remimazolam group (6
mg/kg/h) or the etomidate group (0.3 mg/kg) for induction of anesthesia.
Anesthetic depth was adjusted based on the bispectral index. Primary
outcome was the incidence of post-induction hypotension, defined as a mean
arterial pressure less than 65 mmHg within 15 min after endotracheal
intubation, with a non-inferiority margin of 12%. <br/>Result(s): A total
of 144 patients were finally analyzed. Incidence of post-induction
hypo-tension was 36/71 (50.7%) in the remimazolam group and 25/73 (34.2%)
in the etomidate group, with a rate difference of 16.5% (95% CI
[3.0-32.6]) between the two groups that was beyond the prespecified
non-inferiority margin of 12.0%. The number of patients who needed
vasopressors was similar in the two groups. <br/>Conclusion(s): In this
non-inferiority trial, remimazolam failed to show non-inferiority to
etomidate in terms of post-induction hypotension when used as an induction
drug for general anesthesia in patients undergoing coronary artery bypass
grafting. However, different doses or infusion techniques of remimazolam
should be compared with etomidate in various patient groups to fully
assess its hemodynamic non-inferiority during induction of
anesthesia.<br/>Copyright &#xa9; The Korean Society of Anesthesiologists,
2025.

<2>
Accession Number
2034754514
Title
Comparison of Short-Term Outcomes of Extubation in the Operating Room and
Extubating in the Intensive Care Unit After Cardiac Surgery: Systematic
Review and Meta-Analysis.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination),
2025. Article Number: 10892532251346646. Date of Publication: 2025.
Author
Naito N.; Takagi H.
Institution
(Naito, Takagi) Department of Cardiovascular Surgery, Shizuoka Medical
Center, Shizuoka, Japan
Publisher
SAGE Publications Inc.
Abstract
Objectives: This study aimed to compare short-term outcomes in patients
extubated in the operating room (ORE) vs those extubated in the intensive
care unit (ICUE) following cardiac surgery. <br/>Method(s): A systematic
search of MEDLINE and EMBASE was conducted from inception through
September 2024. Pooled outcome estimates were calculated, and subgroup
analyses were performed focusing on studies utilizing propensity score
matching, weighting, or randomization. <br/>Result(s): Fourteen studies
published between 2000 and 2024, encompassing 679,749 patients, were
included. Of these, 6 utilized propensity score matching, 1 applied
overlap weighting, and 1 employed randomization. Overall, ORE group had
shorter aortic cross-clamp (P = 0.02) and cardiopulmonary bypass (P <
0.01) times. ORE patients had shorter ICU (P < 0.01) and hospital stays (P
< 0.01). Rates of reintubation (P = 0.78), reoperation for bleeding (P =
0.18), prolonged mechanical ventilation (P = 0.12), and hospital
readmission (P = 0.71) were comparable between the groups. Postoperative
stroke rate (P < 0.01) and short-term mortality (P = 0.04) were lower in
the ORE group. In the subgroup analysis, ICU stay, hospital stay, and
cardiopulmonary bypass time remained shorter in ORE groupfund, while
reoperation for bleeding was significantly higher (P < 0.01). However, the
differences in postoperative stroke (P = 0.52) and short-term mortality (P
= 0.42) were no longer statistically significant. <br/>Conclusion(s): This
meta-analysis demonstrates that ORE after cardiac surgery can be performed
in selected patients, with comparable postoperative outcomes to ICUE. The
ORE strategy may result in shorter ICU and hospital stays.<br/>Copyright
&#xa9; The Author(s) 2025.

<3>
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.

<4>
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Accession Number
2038954992
Title
Effectiveness of Transcatheter Aortic Valve Replacement in Pure Severe
Native Aortic Valve Regurgitation: A Systematic Review and Meta-analysis.
Source
Cardiology in Review. (no pagination), 2025. Article Number:
10.1097/CRD.0000000000000960. Date of Publication: 2025.
Author
Jha M.; Agrawal S.P.; Maheta D.; Mal M.; Jain H.; Ahmed R.; Siddiq S.;
Frishman W.H.; Aronow W.S.
Institution
(Jha) Department of Internal Medicine, Government Medical College, New
Civil Hospital, Gujarat, Surat, India
(Agrawal, Siddiq) Department of Internal Medicine, New York Medical
College, Landmark Medical Center, Woonsocket, RI, United States
(Maheta) Department of Public Health, New York Medical College, Valhalla,
NY, United States
(Mal) Department of Internal Medicine, Liaquat University of Medical and
Health Sciences, Jamshoro, Pakistan
(Jain) Department of Internal Medicine, All India Institute of Medical
Sciences (AIIMS), Jodhpur, India
(Ahmed) National Heart and Lung Institute, Imperial College London, United
Kingdom
(Frishman) Department of Medicine, New York Medical College, Valhalla, NY,
United States
(Aronow) Departments of Cardiology and Medicine, Westchester Medical
Center, New York Medical College, Valhalla, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Transcatheter aortic valve replacement (TAVR) has become a
well-established treatment for aortic stenosis, and its use is expanding
to other valvular pathologies. Surgical aortic valve replacement remains
the standard for patients with severe aortic regurgitation (AR),
especially in those without concurrent aortic stenosis. However, in recent
years, TAVR has emerged as a potential option for patients with severe
native aortic valve regurgitation (NAVR), despite challenges such as the
absence of calcification needed for valve anchoring. We conducted a
systematic review and meta-analysis to evaluate the clinical outcomes of
TAVR in NAVR. Databases including PubMed, Cochrane Library, Scopus, and
ClinicalTrials.gov were searched through June 10, 2024. A total of 23
studies comprising 4397 patients were included. All-cause mortality at 30
days post-TAVR was 12%, while device success was achieved in 86% of cases.
Rates of myocardial infarction, stroke, and major bleeding were low at 3%,
3%, and 8%, respectively. Acute kidney injury >= stage 2 occurred in 8% of
patients, and 6% experienced major vascular complications. Permanent
pacemaker implantation was required in 15% of cases. Moderate-to-severe
paravalvular leak and postprocedural moderate-to-severe AR were reported
in 10% and 9% of patients, respectively, with wide confidence intervals
reflecting variability in outcomes. Overall, these findings suggest that
TAVR is a reasonable alternative for selected patients with NAVR, in
carefully selected high-risk patients with AR, especially those deemed
high risk for surgery or when surgery is contraindicated. However, further
large-scale studies with extended follow-up are needed to better define
patient selection criteria and to validate the long-term efficacy and
safety of TAVR in this population.<br/>Copyright &#xa9; 2025 Wolters
Kluwer Health, Inc. All rights reserved.

<5>
Accession Number
2038809797
Title
Relationships between anxiety, depression and wound healing outcomes in
adults: A systematic review and meta-analysis.
Source
PLOS ONE. 20(5 May) (no pagination), 2025. Article Number: e0309683. Date
of Publication: 01 May 2025.
Author
O'Donovan F.; Capobianco L.; Taylor-Bennett J.; Wells A.
Institution
(O'Donovan, Capobianco, Taylor-Bennett, Wells) Division of Psychological
Sciences, School of Health Sciences, Faculty of Biology, Medicine and
Health, The University of Manchester, Manchester, United Kingdom
(O'Donovan) Psychosocial Service, Manchester University NHS Foundation
Trust, Manchester, United Kingdom
(Capobianco, Wells) Department of Research and Innovation, Greater
Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
(Taylor-Bennett) Manchester Specialist Psychotherapy Service, Greater
Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
(Wells) Greater Manchester Mental Health NHS Foundation Trust, Manchester
Academic Health Science Centre, Manchester, United Kingdom
Publisher
Public Library of Science
Abstract
Objectives To examine whether there is a relationship between anxiety
and/or depression and wound healing. Design Systematic review and
meta-analysis. Data Sources Searches were conducted on PsycINFO, MEDLINE,
EMBASE, CINAHL and Web of Science on the 06-March-2023. Methods Eligible
studies explored the effects of anxiety and/or depression on wound healing
in adults. Healing outcomes included time to heal and complication rates.
Anxiety and depression outcomes were considered separately. Results
Fifty-five studies were included in the narrative synthesis (26,612,809
participants), and 26 studies in the meta-analysis. Studies utilised a
range of observational and experimental designs. Wounds included in the
review were: surgical, ulcer, burn and experimental wounds. The narrative
synthesis gave mixed results, with some studies noting positive
associations between increased anxiety or depression and wound healing,
while others did not find an association. Results from the meta-analysis
found no significant effect of anxiety on wound healing outcomes. However,
depression was associated with significantly higher odds of delayed wound
healing, OR=2.10, [1.02, 4.33]; higher risk of wound complications,
RR=1.30, [1.11, 1.53] and increased risk of wound infection RR=1.25,
[1.09, 1.44]. Conclusion These findings suggest depression negatively
impacts wound healing. There is less evidence for an association with
anxiety, but this may be due to less research in this area. Future studies
should explore the mechanism of associations between depression and wound
healing to inform clinical interventions.<br/>Copyright &#xa9; 2025
O'Donovan 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.

<6>
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Accession Number
2035507879
Title
Efficacy and safety of coronary sinus reducer for refractory angina: A
systematic review and meta-analysis of randomized controlled trials.
Source
Coronary Artery Disease. 36(4) (pp 337-347), 2025. Date of Publication: 01
Jun 2025.
Author
Amin A.M.; Khan U.; Khlidj Y.; Katamesh B.E.; Elbenawi H.; Ewis A.; Hammad
A.
Institution
(Amin, Ewis) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Khan) Division of Cardiology, University of Maryland, School of Medicine,
Baltimore, MD, United States
(Khlidj) Faculty of Medicine, Algiers University 1, Algiers, Algeria
(Katamesh) General Internal Medicine, Mayo Clinic, Rochester, MN, United
States
(Elbenawi) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Hammad) Department of Internal Medicine, Englewood Hospital Medical
Center, Englewood, NJ, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Refractory angina affects patients' quality of life around the world.
Coronary sinus reducer (CSR) is a new therapeutic approach that has been
investigated in recent years. We aimed to investigate the efficacy and
safety of CSR for refractory angina. We conducted a systematic review and
meta-analysis of randomized controlled trials (RCTs) from PubMed, Web of
Science, Scopus, Embase, and CENTRAL searches until May 2024. Dichotomous
data were pooled using risk ratio (RR), and continuous data were pooled
using mean difference (MD), both with a 95% confidence interval (CI),
using (R version 4.3). With the inclusion of three RCTs, our cohort
comprised a total of 180 patients. Compared with the control group, after
6 months, CSR was significantly associated with a decreased mean change of
Canadian Cardiovascular Society (CCS) class [MD: -0.54 with 95% CI (-0.80
to -0.27), P<0.01], a decreased number of patients in the CCS class III/IV
[RR: 0.56 with 95% CI (0.38-0.84), P<0.01], and increased exercise time
[MD: 50.46 with 95% CI (9.47-91.45), P=0.02]. However, there was no
significant difference between CSR and the control group in double
products, all Seattle Angina Questionnaire domains, and safety outcomes.
CSR has been shown to reduce angina severity by lowering CCS class scores
and increasing exercise time. Large-scale RCTs are needed to confirm its
effectiveness in patients with refractory angina.<br/>Copyright &#xa9;
2024 Wolters Kluwer Health, Inc.

<7>
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Accession Number
2037744804
Title
Cost-effectiveness of angiographic quantitative flow ratio-guided coronary
intervention: A multicenter, randomized, sham-controlled trial.
Source
Chinese Medical Journal. 138(10) (pp 1186-1193), 2025. Date of
Publication: 20 May 2025.
Author
Zhao Y.; Guan C.; Wang Y.; Jin Z.; Yu B.; Fu G.; Chen Y.; Guo L.; Qu X.;
Zhang Y.; Dou K.; Wu Y.; Yang W.; Tu S.; Escaned J.; Fearon W.F.; Qiao S.;
Cohen D.J.; Krumholz H.M.; Xu B.; Song L.
Institution
(Zhao, Wang) Medical Research and Biometrics Center, National Center for
Cardiovascular Diseases, Beijing, China
(Guan, Dou, Wu, Yang, Qiao, Xu, Song) Department of Cardiology, National
Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences, Peking Union Medical College, Beijing, China
(Jin) Department of Cardiology, Beijing Tiantan Hospital, Capital Medical
University, Beijing, China
(Yu) Department of Cardiology, The Second Affiliated Hospital of Harbin
Medical University, Heilongjiang, Harbin, China
(Fu) Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang
University School of Medicine, Zhejiang, Hangzhou, China
(Chen) Department of Cardiology, The Sixth Medical Center, Chinese PLA
General Hospital, Beijing, China
(Guo) Department of Cardiology, Peking University Third Hospital, Beijing,
China
(Qu) Department of Cardiology, Huadong Hospital Affiliated to Fudan
University, Shanghai, China
(Zhang) Department of Cardiology, Xuzhou Third People's Hospital, Xuzhou
Medical University, Jiangsu, Xuzhou, China
(Tu) Biomedical Instrument Institute, School of Biomedical Engineering,
Shanghai Jiao Tong University, Shanghai, China
(Escaned) Hospital Clinico San Carlos IDISSC, Complutense University of
Madrid, Madrid, Spain
(Fearon) Division of Cardiovascular Medicine, Stanford Cardiovascular
Institute, Stanford University School of Medicine, VA Palo Alto Health
Care System, Palo Alto, CA, United States
(Cohen) Cardiovascular Research Foundation, New York, NY, United States
(Cohen) St. Francis Hospital and Heart Center, Roslyn, NY, United States
(Krumholz) Section of Cardiovascular Medicine, Yale School of Medicine,
New Haven, CT, United States
(Krumholz) Center for Outcomes Research and Evaluation, Yale New Haven
Hospital, New Haven, CT, United States
(Krumholz) Department of Health Policy and Management, Yale School of
Public Health, New Haven, CT, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The FAVOR (Comparison of Quantitative Flow Ratio Guided and
Angiography Guided Percutaneous Intervention in Patients with Coronary
Artery Disease) III China trial demonstrated that percutaneous coronary
intervention (PCI) lesion selection using quantitative flow ratio (QFR)
measurement, a novel angiography-based approach for estimating fractional
flow reserve, improved two-year clinical outcomes compared with standard
angiography guidance. This study aimed to assess the cost-effectiveness of
QFR-guided PCI from the perspective of the current Chinese healthcare
system. <br/>Method(s): This study is a pre-specified analysis of the
FAVOR III China trial, which included 3825 patients randomized between
December 25, 2018, and January 19, 2020, from 26 centers in China.
Patients with stable or unstable angina pectoris or those >=72 hours
post-myocardial infarction who had at least one lesion with a diameter
stenosis between 50% and 90% in a coronary artery with a >=2.5 mm
reference vessel diameter by visual assessment were randomized to a
QFR-guided strategy or an angiography-guided strategy with 1:1 ratio.
During the two-year follow-up, data were collected on clinical outcomes,
quality-adjusted life-years (QALYs), estimated costs of index procedure
hospitalization, outpatient cardiovascular medication use, and
rehospitalization due to major adverse cardiac and cerebrovascular events
(MACCE). The primary analysis calculated the incremental
cost-effectiveness ratio (ICER) as the cost per MACCE avoided. An ICER of
10,000/MACCE event avoided was considered economically attractive in
China. <br/>Result(s): At two years, the QFR-guided group demonstrated a
reduced rate of MACCE compared to the angiography-guided group (10.8% vs.
14.7%, P <0.01). Total two-year costs were similar between the groups
(50,803 +/- 21,121 vs. 50,685 +/- 23,495, P = 0.87). The ICER for the
QFR-guided strategy was 3055 per MACCE avoided, and the probability of QFR
being economically attractive was 64% at a willingness-to-pay threshold of
10,000/MACCE avoided. Sensitivity analysis showed that QFR-guided PCI
would become cost-saving if the cost of QFR were below 3682 (current cost:
3800). Cost-utility analysis yielded an ICER of 56,163 per QALY gained,
with a 53% probability of being cost-effective at a willingness-to-pay
threshold of 85,000 per QALY gained. <br/>Conclusion(s): In patients
undergoing PCI, a QFR-guided strategy appears economically attractive
compared to angiographic guidance from the perspective of the Chinese
healthcare system.<br/>Copyright &#xa9; 2025 The Chinese Medical
Association, produced by Wolters Kluwer, Inc.

<8>
[Use Link to view the full text]
Accession Number
2038799179
Title
Meta-Analysis of Dual Antiplatelet Therapy Versus Low-Dose Direct Oral
Anticoagulation After Left Atrial Appendage Occlusion.
Source
American Journal of Therapeutics. 32(3) (pp e312-e315), 2025. Date of
Publication: 01 May 2025.
Author
Singh S.; Bliden K.; Tantry U.S.; Gurbel P.A.; Kanjwal M.Y.; Lundgren S.W.
Institution
(Singh) Department of Medicine, Sinai Hospital of Baltimore, Baltimore,
MD, United States
(Bliden, Tantry) Sinai Center for Thrombosis Research, Sinai Hospital of
Baltimore, Baltimore, MD, United States
(Gurbel, Kanjwal) Division of Cardiology, Sinai Hospital of Baltimore,
Baltimore, MD, United States
(Lundgren) Division of Cardiology, University of Nebraska Medical Center,
Omaha, NE, United States
Publisher
Lippincott Williams and Wilkins

<9>
Accession Number
2038782723
Title
Intravenous acetaminophen for postoperative delirium in older patients
recovering from major non-cardiac surgery: A randomised-controlled study
protocol.
Source
BMJ Open. 15(5) (no pagination), 2025. Article Number: e097079. Date of
Publication: 15 May 2025.
Author
Zheng M.; Wang B.; Mao M.; Wu Y.; Wang Z.; Yang L.
Institution
(Zheng, Wang, Mao, Wu, Wang, Yang) Department of Anesthesiology, Shanghai
Jiao Tong University, School of Medicine, Affiliated Renji Hospital,
Shanghai, China
Publisher
BMJ Publishing Group
Abstract
Introduction Delirium is a common complication in elderly patients after
major surgeries and can lead to poor outcomes such as neurocognitive
decline. Acetaminophen is one of the most widely used adjuvants for
perioperative multimodal analgesia. Previous studies showed that it can
effectively alleviate postoperative pain, promote opioid sparing and exert
anti-neuroinflammatory response, showing strong potential for preventing
postoperative delirium. We, thus, propose to test the primary hypothesis
that postoperative intravenous acetaminophen would reduce delirium over 5
postoperative days in older patients following major non-cardiac surgery.
Methods and analysis We propose a multicentre, randomised,
placebo-controlled, parallel-group trial in patients aged>65 years old
scheduled for non-cardiac major surgery with general anaesthesia expected
to last at least 2 hours. A total of 1930 elderly patients will be
enrolled and randomised at 1:1 ratio to acetaminophen or saline placebo
groups, stratified by age, education level and trial site with randomsised
blocking. Acetaminophen or saline will be given when the surgical suture
begins at the end of surgery and, thereafter, a total of seven doses
within 48 hours after surgery. Our primary outcome will be the incidence
of delirium, assessed two times per day, through the fifth postoperative
day. Secondary and exploratory outcomes will include pain scores with
movement, total opioid consumption, severity of delirium, intensive care
unit and hospital lengths of stay. Ethics and dissemination This study has
been approved by the Ethics Committee of Ren Ji Hospital, Shanghai Jiao
Tong University School of Medicine (LY2023-239-C) and approved by each
participating centre. This report follows the Consolidated Standards of
Reporting Trials reporting guideline for randomised studies. The findings
will be shared in academic meetings and peer-reviewed academic journals.
Trial registration number NCT06653465.<br/>Copyright &#xa9; 2025 BMJ
Publishing Group. All rights reserved.

<10>
Accession Number
2038374200
Title
5-Year Echocardiographic Results of Transcatheter Versus Surgical Aortic
Valve Replacement in Low-Risk Patients.
Source
JACC: Cardiovascular Imaging. 18(6) (pp 625-640), 2025. Date of
Publication: 01 Jun 2025.
Author
Hahn R.T.; Ternacle J.; Silva I.; Giuliani C.; Zanuttini A.; Theron A.;
Cristell N.; Bernier M.; Skaf S.; Beaudoin J.; Kodali S.K.; Russo M.;
Kapadia S.R.; Malaisrie C.S.; Cohen D.J.; Leipsic J.; Blanke P.; Williams
M.R.; McCabe J.M.; Brown D.L.; Babaliaros V.; Goldman S.; Szeto W.Y.;
Genereux P.; Pershad A.; Park B.; Gunnarsson M.; Webb J.G.; Smith C.R.;
Makkar R.; Thourani V.H.; Mack M.J.; Leon M.B.; Pibarot P.
Institution
(Hahn, Cristell, Cohen, Leon) Cardiovascular Research Foundation, New
York, NY, United States
(Hahn, Kodali, Smith, Leon) Columbia University Irving Medical Center/New
York-Presbyterian Hospital, New York, NY, United States
(Ternacle) Haut-Leveque Cardiology Hospital, Bordeaux University, Pessac,
France
(Silva) Department of Cardiology, Hospital Universitario Central de
Asturias, Oviedo, Spain
(Silva, Giuliani, Zanuttini, Theron, Bernier, Beaudoin, Pibarot) Institut
Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec, Quebec,
Canada
(Theron) Department of Cardiology, Assistance Publique, Hopitaux de
Marseille, Marseille, France
(Skaf, Makkar) Cedars Sinai Medical Center, Los Angeles, CA, United States
(Russo) Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ,
United States
(Kapadia) Cleveland Clinic, Cleveland, OH, United States
(Malaisrie) Feinberg School of Medicine, Northwestern University, Chicago,
IL, United States
(Cohen) St Francis Hospital, Roslyn, NY, United States
(Leipsic, Blanke, Webb) St Paul's Hospital, Vancouver, BC, Canada
(Williams) NYU Langone Medical Center, New York, NY, United States
(McCabe) University of Washington, Seattle, WA, United States
(Brown, Mack) Baylor Scott and White Healthcare, Plano, TX, United States
(Babaliaros) Emory University School of Medicine, Atlanta, GA, United
States
(Goldman) Lankenau Medical Center, Wynnewood, PA, United States
(Szeto) University of Pennsylvania, Philadelphia, PA, United States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Pershad) Chandler Regional and Mercy Gilbert Medical Center, Chandler,
AZ, United States
(Park, Gunnarsson) Edwards Lifesciences, Irvine, CA, United States
(Thourani) Department of Cardiovascular Surgery, Piedmont Heart Institute,
Atlanta, GA, United States
Publisher
Elsevier Inc.
Abstract
Background: The PARTNER 3 (Safety and Effectiveness of the SAPIEN 3
Transcatheter Heart Valve in Low Risk Patients with Aortic Stenosis) trial
compared SAPIEN 3 transcatheter aortic valve replacement (TAVR) to surgery
in low-risk patients with symptomatic, severe aortic stenosis.
Echocardiographic outcomes at 5 years are unknown. <br/>Objective(s): This
study sought to compare 5-year echocardiographic results of TAVR and
surgery in the PARTNER 3 trial. <br/>Method(s): Echocardiograms for 1,000
randomized patients were obtained at baseline, 30 days, 1 year, and
annually through 5 years and were analyzed by a core lab consortium. The
composite primary endpoint of death, stroke, or rehospitalization was
adjudicated by a clinical events committee. <br/>Result(s): At 5 years, >=
mild aortic regurgitation was higher following TAVR vs surgery (24.5% vs
6.3%; P < 0.001), with low >= moderate aortic regurgitation in both
groups. TAVR patients had higher mean transaortic gradient (12.8 +/- 6.5
vs 11.7 +/- 5.6 mm Hg; P < 0.001), stroke volume index (44.6 +/- 9.7 vs
41.1 +/- 9.2; P < 0.0001), and aortic valve area (1.87 +/- 0.46 vs 1.82
+/- 0.46; P = 0.895). Fewer TAVR patients had low-flow stroke volume index
(P < 0.001) and left ventricular hemodynamic burden (valvulo-arterial
impedance; P < 0.01). Tricuspid annular plane systolic excursion was also
higher with TAVR (P < 0.001), as was right ventricular-to-pulmonary artery
coupling (P < 0.0001). In the combined cohorts, 30-day moderate to severe
prosthesis-patient mismatch, mild to severe aortic regurgitation, or low
stroke volume index were not predictive of clinical outcomes; only low
right ventricular-to-pulmonary artery coupling and high valvulo-arterial
impedance at 30 days were associated with increased risk of the 5-year
composite primary endpoint. <br/>Conclusion(s): In low-risk patients with
severe aortic stenosis, TAVR, compared to surgery, was associated with
similar, stable valve hemodynamics at 5 years with less frequent low-flow
state, lower valvulo-arterial impedance, and better right ventricular
function. (PARTNER 3 Trial: Safety and Effectiveness of the SAPIEN 3
Transcatheter Heart Valve in Low Risk Patients with Aortic Stenosis [P3];
NCT02675114)<br/>Copyright &#xa9; 2025 American College of Cardiology
Foundation

<11>
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)

<12>
[Use Link to view the full text]
Accession Number
2035530157
Title
Anticoagulation for Patients with Atrial Fibrillation Receiving Dialysis:
A Pilot Randomized Controlled Trial.
Source
Journal of the American Society of Nephrology. 36(5) (pp 901-910), 2025.
Date of Publication: 01 May 2025.
Author
Harel Z.; Smyth B.; Badve S.V.; Blum D.; Beaubien-Souligny W.; Silver
S.A.; Clark E.; Suri R.; Mavrakanas T.A.; Sasal J.; Prasad B.; Eikelboom
J.; Tennankore K.; Rigatto C.; Prce I.; Madore F.; Mac-Way F.; Steele A.;
Zeng Y.; Sholzberg M.; Dorian P.; Yan A.T.; Sood M.M.; Gladstone D.J.;
Tseng E.; Kitchlu A.; Walsh M.; Sapir D.; Oliver M.J.; Krishnan M.; Kiaii
M.; Wong N.; Kotwal S.; Battistella M.; Acedillo R.; Lok C.; Weir M.; Wald
R.
Institution
(Harel, Wald) Division of Nephrology, Department of Medicine, St.
Michael's Hospital, Toronto, ON, Canada
(Smyth, Badve) Department of Nephrology, St. George Hospital, Kogarah,
NSW, Australia
(Blum, Suri, Mavrakanas) Division of Nephrology, McGill University,
Montreal, QC, Canada
(Beaubien-Souligny, Madore) Department of Medecine, Universite de
Montreal, Montreal, QC, Canada
(Silver) Division of Nephrology, Queen's University, Kingston, ON, Canada
(Clark, Sood) Division of Nephrology, Department of Medicine, The Ottawa
Hospital, Ottawa Hospital Research Institute, Ottawa, ON, Canada
(Sasal) Division of Nephrology, St. Joseph's Hospital, Toronto, ON, Canada
(Prasad) Division of Nephrology, University of Saskatchewan, Regina, SK,
Canada
(Eikelboom) Division of Hematology, McMaster University, Hamilton, ON,
Canada
(Tennankore) Division of Nephrology, Department of Medicine, Dalhousie
University, Halifax, NS, Canada
(Rigatto) Division of Nephrology, University of Manitoba, Winnipeg, MB,
Canada
(Prce) Division of Nephrology, St. Michael's Hospital, Toronto, ON, Canada
(Mac-Way) Division of Nephrology, Laval University, Laval, QC, Canada
(Steele) Division of Nephrology, Lakeridge Hospital, Oshawa, ON, Canada
(Zeng) Division of Nephrology, University of British Columbia, Surrey, BC,
Canada
(Sholzberg) Division of Hematology/Oncology, Departments of Medicine,
Laboratory Medicine and Pathobiology, St. Michael's Hospital, Li Ka Shing
Knowledge Institute, University of Toronto, Toronto, ON, Canada
(Dorian, Yan) Division of Cardiology, Department of Medicine, St.
Michael's Hospital Health, University of Toronto, Toronto, ON, Canada
(Gladstone) Division of Neurology, Department of Medicine, Sunnybrook
Research Institute, Hurvitz Brain Sciences Program, Sunnybrook Health
Sciences Centre, University of Toronto, Toronto, ON, Canada
(Tseng) Division of Hematology/Oncology, Department of Medicine, St.
Michael's Hospital, University of Toronto, Toronto, ON, Canada
(Kitchlu, Battistella, Lok) Division of Nephrology, Department of
Medicine, University Health Network, University of Toronto, Toronto, ON,
Canada
(Walsh) Division of Nephrology, McMaster University, Hamilton, ON, Canada
(Sapir) Division of Nephrology, Oakville Trafalgar Hospital, Oakville, ON,
Canada
(Oliver) Division of Nephrology, Department of Medicine, University of
Toronto, Toronto, ON, Canada
(Krishnan) Division of Nephrology, Royal Victoria Regional Health Centre,
Barrie, ON, Canada
(Kiaii) Division of Nephrology, University of British Columbia, Vancouver,
BC, Canada
(Wong) Division of Nephrology, Nepean Hospital, Sydney, NSW, Australia
(Kotwal) Department of Nephrology, Prince of Wales Hospital, Australia the
George Institute for Global Health, UNSW, Sydney, NSW, Australia
(Acedillo) Division of Nephrology, Thunder Bay Health Sciences Centre,
Thunder Bay, ON, Canada
(Weir) Division of Nephrology, Western University, London, ON, Canada
Publisher
Wolters Kluwer Health
Abstract
Key PointsIs performing a large definitive trial to establish the optimal
anticoagulation strategy in dialysis recipients with atrial fibrillation
feasible?One hundred fifty-one patients at 28 dialysis centers were
enrolled and randomized to apixaban (n=51), warfarin (n=52), or no oral
anticoagulation (n=48).Despite coronavirus disease-related pauses,
recruitment was completed in 30 months, with 83% of participants
completing follow-up in their assigned treatment arm.BackgroundAtrial
fibrillation is common in individuals receiving dialysis. The role of oral
anticoagulation in this population is uncertain given its exclusion from
previous seminal clinical trials. Our objective was to determine the
feasibility of performing a large definitive trial to establish the
optimal anticoagulation strategy in individuals with atrial fibrillation
receiving dialysis.MethodsThe Strategies for the Management of Atrial
Fibrillation in Patients Receiving Dialysis trial was a parallel-group,
open-label, allocation-concealed, pilot randomized control trial that took
place at 28 centers in Canada and Australia. The trial included adults (18
years or older) undergoing dialysis with a history of nonvalvular atrial
fibrillation who met the CHADS-65 criteria. Participants were randomized
1:1:1 to receive dose-adjusted warfarin, apixaban 5 mg twice daily, or no
oral anticoagulation and followed for 26 weeks. The primary outcomes
evaluated the following measures of feasibility: (1) recruitment of the
target population within 2 years from the start of the trial and (2)
adherence of >80% of randomized patients to the allocated treatment
strategy at the conclusion of follow-up. Secondary outcomes included
stroke and bleeding.ResultsFrom December 2019 to June 2022, 151 patients
were enrolled and randomized to apixaban (n=51), warfarin (n=52), or no
oral anticoagulation (n=48). Allowing for pauses related to the
coronavirus disease pandemic, recruitment was completed in 30 months, and
123 (83%) of participants completed follow-up in their allocated treatment
arm. There was one adjudicated stroke event. Eight participants had a
major bleeding event (four warfarin, two apixaban, two no oral
anticoagulation). Death occurred in 15 participants (nine warfarin, two
apixaban, four no oral anticoagulation). Time in the therapeutic range for
warfarin recipients was 58% (interquartile range, 47%-70%).ConclusionsWe
have demonstrated the feasibility of recruitment and adherence in a trial
that compared different anticoagulation strategies in patients with atrial
fibrillation receiving dialysis.Clinical Trial registry name and
registration number:Strategies for the Management of Atrial Fibrillation
in Patients Receiving Dialysis (SAFE-D), NCT03987711.PodcastThis article
contains a podcast at
https://dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast/JASN
/2025_04_09_ASN0000000000000495.mp3.<br/>Copyright &#xa9; 2024 by the
American Society of Nephrology.

<13>
[Use Link to view the full text]
Accession Number
2038766010
Title
Use of Antibacterial Envelopes in Neuromodulation Surgeries With
Implantable Device Insertion: A Systematic Review and Meta-Analysis.
Source
Neurosurgery. 96(6) (pp 1193-1199), 2025. Date of Publication: 01 Jun
2025.
Author
De Oliveira H.M.; Barbosa L.M.; Zamora F.V.; De Paula B.O.; De Paula G.O.;
Pilitsis J.G.; Da Costa P.R.F.
Institution
(De Oliveira, De Paula, De Paula) Department of Medicine, Federal
University of Mato Grosso, Mato Grosso, Sinop, Brazil
(Barbosa) Department of Medicine, Federal University of Minas Gerais,
Minas Gerais, Belo Horizonte, Brazil
(Zamora) Department of Medicine, State University of Rio de Janeiro, Rio
de Janeiro, Rio de Janeiro, Brazil
(Pilitsis) Professor and Chair of the Department of Neurosurgery,
University of Arizona, Tucson, AZ, United States
(Pilitsis) Physician Executive for Functional Neurosurgery, Banner Health
System, Tucson, AZ, United States
(Da Costa) Department of Functional Neurosurgery, Sinedor Clinic, Mato
Grosso, Sinop, Brazil
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND AND OBJECTIVES:Neuromodulation is an advanced therapeutic
intervention for managing various neurological, psychiatric, and
functional disorders. However, a significant challenge is the risk of
infections at the device implantation site. Previous studies have shown
that antibacterial envelopes used in cardiovascular surgeries
significantly reduce infection risk. It is postulated that similar
benefits could occur in neurosurgeries involving implant insertion, but
the literature lacks studies analyzing this efficacy. This study aimed to
evaluate the effectiveness of antibacterial envelopes in reducing
infection rates associated with neuromodulation implants.
<br/>METHOD(S):We systematically searched PubMed, Embase, and the Cochrane
Central Register of Controlled Trials databases up to August 2024 for
clinical trials comparing the use of antibacterial impregnated envelopes
in patients undergoing neuromodulation-related implant insertion. This
study followed Preferred Reporting Items for Systematic Reviews and
Meta-Analysis guidelines. Statistical analyses were performed using R
version 4.3.2. Risk of bias was assessed using the Risk Of Bias In
Nonrandomized Studies - of Interventions tool, and the quality of evidence
was evaluated using the Grading of Recommendations Assessment, Development
and Evaluation assessment. The study was registered in Prospective
Register of Systematic Reviews. <br/>RESULT(S):Four studies, comprising
1242 patients, were included, of whom 704 (56.7%) received antibacterial
envelopes. The pooled analysis showed that the odds of infection were 77%
lower in patients using the antibacterial envelope compared with the
control group (odds ratios = 0.23; 95% CI = 0.10-0.51; P <.001;
I² = 2%). <br/>CONCLUSION(S):The use of an antibacterial
envelope significantly reduces the odds of infection in patients
undergoing neuromodulation-related implant insertion by 77%. These
findings underscore the potential of antibacterial envelopes to improve
postoperative outcomes.<br/>Copyright &#xa9; Congress of Neurological
Surgeons 2024. Unauthorized reproduction of this article is prohibited.

<14>
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.

<15>
Accession Number
2038854057
Title
Goal-directed therapy with continuous SvcO<inf>2</inf> monitoring in
pediatric cardiac surgery: the PediaSat single-center randomized trial.
Source
Brazilian Journal of Anesthesiology (English Edition). 75(4) (no
pagination), 2025. Article Number: 844614. Date of Publication: 01 Jul
2025.
Author
Ferreira F.M.; Araujo D.D.; Dantas G.M.; Cunha L.C.C.; Zeferino S.P.;
Galas F.B.
Institution
(Ferreira, Araujo, Dantas, Cunha, Zeferino, Galas) Faculdade de Medicina
da Universidade de Sao Paulo, SP, Sao Paulo, Brazil
Publisher
Elsevier Editora Ltda
Abstract
Introduction: Low Cardiac Output Syndrome (LCOS) remains a significant
perioperative challenge in pediatric cardiac surgery. This study evaluated
whether a hemodynamic protocol aimed at optimizing continuous central
venous Oxygen Saturation (SvcO<inf>2</inf>) using the PediaSat catheter
could reduce postoperative complications in pediatric patients undergoing
congenital heart surgery. <br/>Method(s): Conducted at the Instituto do
Coracao in Sao Paulo, this randomized clinical trial compared a group
receiving SvcO<inf>2</inf>-based goal-directed therapy via PediaSat
(intervention) against conventional care (control). The main objective was
assessing 24-hour lactate clearance post-surgery, with secondary outcomes
including Vasoactive-Inotropic Score (VIS), Mechanical Ventilation (MV)
duration, vasopressor use, and ICU/hospital stay lengths. <br/>Result(s):
From July 13, 2014, to March 17, 2016, 391 patients were evaluated for
eligibility. After applying inclusion and exclusion criteria, 65 patients
were included and randomized - 33 to the control group and 32 to the
PediaSat group. There were no losses to follow-up in either group. Lactate
clearance did not significantly differ between the intervention and
control groups. However, the PediaSat group showed significantly shorter
mechanical ventilation times, reduced vasopressor use, and shorter ICU
stays. No significant differences were observed in hospital stay length or
incidence of postoperative complications between the group.
<br/>Conclusion(s): While optimizing SvcO<inf>2</inf> did not affect
overall lactate clearance, it was associated with shorter MV duration,
decreased vasopressor need, and shorter ICU stays in pediatric cardiac
surgery patients. These findings highlight the potential benefits of
continuous SvcO<inf>2</inf> monitoring in postoperative
care.<br/>Copyright &#xa9; 2025 Sociedade Brasileira de Anestesiologia

<16>
[Use Link to view the full text]
Accession Number
2035023298
Title
Preoperative Smoking-Cessation Interventions to Prevent Postoperative
Complications: A Quality Assessment and Overview of Systematic Review
Evidence.
Source
Anesthesia and Analgesia. 140(6) (pp 1377-1387), 2025. Date of
Publication: 01 Jun 2025.
Author
Fiddes R.A.; McCaffrey N.
Institution
(Fiddes) Deakin Health Economics, Deakin University, Geelong, Australia
(Fiddes) Institute for Health Transformation, School of Health and Social
Development, Victoria, Australia
(McCaffrey) Cancer Council Victoria, Melbourne, VIC, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Multiple systematic reviews have investigated the effectiveness of
preoperative interventions for smoking-cessation, although relatively few
have focused on the prevention of surgical complications. This overview of
systematic reviews aimed to describe the types of smoking interventions
studied to prevent postoperative complications, summarize the results, and
evaluate the quality of the reviews and strength of evidence to inform
clinicians, health practitioners, policy developers, and government
bodies. Comprehensive searches of Cochrane Library, MEDLINE, EMBASE,
CINAHL, and Johanna Briggs Institute databases were conducted to identify
systematic reviews of preoperative smoking-cessation interventions to
prevent surgical complications (inception-May 14, 2024). Search results
were independently screened by 2 reviewers for articles meeting the
eligibility criteria. Data on key review characteristics and included
studies were extracted: aim, search strategy, included studies, risk of
bias, population, sample size, intervention, comparator, main findings,
and conclusions. Quality appraisal of the reviews was undertaken using the
AMSTAR 2 tool and evidence certainty was evaluated using Grading of
Recommendations Assessment, Development and Evaluation (GRADE).
Sixty-seven full-text articles from 838 citations were screened, resulting
in 6 included systematic reviews with 12 primary studies reporting
postoperative complications. Four reviews which included all primary
studies, provided moderate to high strength of evidence. There was
high-certainty evidence suggesting interventions started >=4 weeks before
surgery incorporating multiple behavioral support sessions and
pharmacotherapy are needed to prevent postoperative complications,
particularly the incidence of surgical site infections. High-certainty
evidence also indicates the duration of smoking-cessation is important,
with benefits amplified for longer periods. However, medium- to
high-certainty evidence suggests interventions initiated <4 weeks before
surgery even with multiple behavioral support sessions (with or without
pharmacotherapy), and interventions commenced >4 weeks before surgery but
with only 1 interventional component, increase quit rates but do not
reduce complications. This overview provides the most up-to-date summary
and quality assessment of systematic review evidence on the effectiveness
of preoperative smoking-cessation interventions to prevent surgical
complications. The evidence supports providing smoking-cessation
interventions which include multiple behavioral support sessions and
pharmacotherapy implemented at least 4 weeks before surgery to reduce
postoperative complications. Consequently, anesthesiologists need to work
with primary care physicians, consultants, and surgeons to optimize
smoking-cessation interventions way in advance of surgery.<br/>Copyright
&#xa9; 2025 International Anesthesia Research Society.

<17>
Accession Number
2038149474
Title
Evaluating the mechanism of action behind controlled hypothermic
preservation of donor hearts: A randomized pilot study.
Source
Journal of Heart and Lung Transplantation. 44(7) (pp 1137-1145), 2025.
Date of Publication: 01 Jul 2025.
Author
Razavi A.A.; Kobashigawa J.; Stotland A.; Chen Q.; Patel J.; Emerson D.;
Mirocha J.; Bowdish M.E.; Catarino P.; Megna D.; Gunn T.; Rafiei M.; Rai
D.; Song Y.; Babalola O.; Daniels A.; Kittleson M.; Kransdorf E.; Nikolova
A.; Czer L.; Chikwe J.; Gottlieb R.A.; Esmailian F.
Institution
(Razavi, Chen, Emerson, Bowdish, Catarino, Megna, Gunn, Chikwe, Esmailian)
Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical
Center, Los Angeles, California, United States
(Kobashigawa, Patel, Rafiei, Babalola, Daniels, Kittleson, Kransdorf,
Nikolova, Czer, Gottlieb) Department of Cardiology, Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, California, United States
(Stotland, Mirocha, Rai, Song) Advanced Clinical Biosystems Research
Institute, Smidt Heart Institute, Cedars-Sinai Medical Center, Los
Angeles, California, United States
Publisher
Elsevier Inc.
Abstract
Background: Controlled hypothermic preservation of donor hearts is
associated with decreased post-transplant primary graft dysfunction
compared to conventional cold storage. However, mechanisms underlying this
benefit in human subjects are unclear. <br/>Method(s): We randomized 20
heart transplant recipients at a single institution to receive donor
hearts preserved with either controlled hypothermic preservation or
standard cold storage. Right ventricular biopsies were obtained at donor
heart recovery, immediately before implantation, and 7 days after
transplantation. Protein expression profiles at each time point were
evaluated using mass spectrometry, Protein Interaction Network Extractor
analysis, and Ingenuity Pathway Analysis. <br/>Result(s): Immediately
before implantation, controlled hypothermic preservation was associated
with increased protein expression related to fatty acid metabolism,
mitochondrial intermembrane space, and contractile fiber machinery.
Pathway analysis indicated increased cell viability, autophagy, and
upregulation of AMP-activated protein kinase pathway with controlled
hypothermic preservation. By post-transplant day 7, the protein expression
profiles of the 2 groups were similar. However, controlled hypothermic
preservation was associated with increased expression in the peroxisome
proliferator-activated receptor signaling pathway and fatty acid
oxidation. <br/>Conclusion(s): Controlled hypothermic preservation of
donor hearts shows beneficial time-dependent variability in protein
expression that may confer improved organ quality at the time of
transplantation.<br/>Copyright &#xa9; 2025

<18>
Accession Number
2038162929
Title
Fractional Flow Reserve Versus Angiography-Guided Revascularisation in
Patients With Severe Aortic Stenosis: A Systematic Review.
Source
Heart Lung and Circulation. 34(6) (pp 556-565), 2025. Date of Publication:
01 Jun 2025.
Author
Mridha N.; Zaka A.; Raffel C.; Murdoch D.; Walters D.
Institution
(Mridha, Raffel, Murdoch, Walters) The Prince Charles Hospital, Brisbane,
QLD, Australia
(Mridha, Raffel, Murdoch, Walters) The University of Queensland, School of
Medicine, Brisbane, QLD, Australia
(Mridha, Zaka) Griffith University, School of Medicine, Gold Coast, QLD,
Australia
(Zaka) Bond University, School of Medicine, Gold Coast, QLD, Australia
(Raffel) Queensland University of Technology, Brisbane, QLD, Australia
Publisher
Elsevier Ltd
Abstract
Background: Aortic stenosis (AS) and coronary artery disease usually
coexist in older adults. Although fractional flow reserve (FFR) is the
gold standard for demonstrating functionally significant coronary artery
stenoses, its efficacy in patients with severe AS awaiting transcatheter
aortic valve implantation is unclear. This systematic review assesses the
clinical outcomes between FFR- and angiography-guided coronary
revascularisation in patients with severe AS. <br/>Method(s): This review
conformed to the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) guidelines. PubMed, Ovid MEDLINE, Web of Science,
and Cochrane databases were searched until 12 March 2024. Eligible studies
included randomised controlled trials or observational studies including
patients with severe AS with concurrent coronary disease comparing FFR-
with angiography-guided percutaneous coronary intervention. Primary
outcomes were all-cause mortality and myocardial infarction. Secondary
outcomes were composite major adverse cardiovascular events.
<br/>Result(s): Five retrospective cohort studies were identified,
including 1,927 patients. The average follow-up was 34.7 months.
FFR-guided cohorts exhibited higher incidence rates for all-cause
mortality (17.4% vs 15.6%), myocardial infarction (4.4% vs 3.3%), and
major adverse cardiovascular events (21.8% vs 18.5%) than the
angiography-guided cohorts. A total of 32.8% the angiography-guided cohort
and 33.1% from the FFR-guided cohort underwent percutaneous coronary
intervention. Due to insufficient power and inconsistency of the available
data (including heterogenous patient selection criteria, differences in
procedural protocols, anatomical distribution of stented lesions,
non-uniform reporting of measured outcomes), a meta-analysis for the
primary and secondary outcomes was not conducted. The methodological
quality of the included studies was found to be of fair quality according
to the Newcastle-Ottawa checklist. <br/>Conclusion(s): Despite the
recognised usefulness of FFR in the assessment of coronary artery disease,
its clinical efficacy in patients with severe AS undergoing transcatheter
aortic valve implantation remains uncertain amidst inconclusive
observational data. Large-scale randomised controlled trials are
required.<br/>Copyright &#xa9; 2024 Australian and New Zealand Society of
Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

<19>
Accession Number
2034614193
Title
Lactate as a Predictor of Citrate Accumulation in Patients Undergoing
Continuous Renal Replacement Therapy? A Systematic Review.
Source
Acta Anaesthesiologica Scandinavica. 69(6) (no pagination), 2025. Article
Number: e70060. Date of Publication: 01 Jul 2025.
Author
Ulrichsen J.U.; Plovsing R.R.; Foss N.B.; Berg R.M.G.; Iepsen U.W.
Institution
(Ulrichsen, Plovsing, Foss, Iepsen) Department of Anesthesiology and
Intensive Care, Copenhagen University Hospital - Hvidovre, Hvidovre,
Denmark
(Ulrichsen, Berg, Iepsen) Centre for Physical Activity Research (CFAS),
Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
(Plovsing, Foss, Berg, Iepsen) Department of Clinical Medicine, University
of Copenhagen, Copenhagen, Denmark
(Berg) Department of Clinical Physiology and Nuclear Medicine, Copenhagen
University Hospital - Rigshospitalet, Copenhagen, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Regional citrate anticoagulation (RCA) is the preferred strategy for
continuous renal replacement therapy (CRRT). However, impaired citrate
metabolism, observed in patients with liver failure, mitochondrial
dysfunction, and/or shock, can result in potentially lethal citrate
accumulation (CA). We aimed to evaluate the ability of elevated lactate
levels to predict CA in critically ill patients undergoing RCA-CRRT. We
performed a comprehensive search in PubMed and Embase databases for
studies involving adult critically ill patients who underwent RCA-CRRT,
where both CA and lactate levels were assessed. The primary outcome was
lactate levels in relation to patients with and without CA. The certainty
of the effect estimates for each outcome and the quality of the included
studies were assessed. We included seven observational studies comprising
1573 critically ill patients undergoing RCA-CRRT. Five studies were deemed
good quality evidence and two poor to answer the research question. We
found a significant mean difference (MD) in baseline lactate levels (MD:
0.87, 95% CI [0.04; 1.70] p = 0.04, six studies, 1474 patients) between
the CA and the non-CA group with low confidence in the estimate. This
difference was persistent between the two groups when using peak lactate
levels (MD: 6.05, 95% CI [0.06; 12.03], p = 0.05, three studies, 271
patients), and the CA group had an overall higher mortality risk (OR:
5.24, 95% CI [1.05; 26.25], p = 0.04, five studies, 1427 patients). The
evidence is very uncertain, but elevated lactate may be associated with an
increased risk of CA in critically ill patients undergoing
RCA-CRRT.<br/>Copyright &#xa9; 2025 Acta Anaesthesiologica Scandinavica
Foundation.

<20>
Accession Number
2034658055
Title
Porphyromonas gingivalis aggravates atherosclerotic plaque instability by
promoting lipid-laden macrophage necroptosis.
Source
Signal Transduction and Targeted Therapy. 10(1) (no pagination), 2025.
Article Number: 171. Date of Publication: 01 Dec 2025.
Author
Huang X.; Xie M.; Wang Y.; Lu X.; Mei F.; Zhang K.; Yang X.; Chen G.; Yin
Y.; Feng G.; Song W.; Dong N.; Deng X.; Wang S.; Chen L.
Institution
(Huang, Xie, Lu, Mei, Zhang, Yang, Chen, Yin, Feng, Song, Chen) Department
of Stomatology, Union Hospital, Tongji Medical College, Huazhong
University of Science and Technology, Wuhan, China
(Huang, Xie, Lu, Mei, Zhang, Yang, Chen, Yin, Feng, Song, Chen) School of
Stomatology, Tongji Medical College, Huazhong University of Science and
Technology, Wuhan, China
(Huang, Xie, Lu, Mei, Zhang, Chen, Yin, Feng, Song, Chen) Hubei Province
Key Laboratory of Oral and Maxillofacial Development and Regeneration,
Wuhan, China
(Wang, Dong) Department of Cardiovascular Surgery, Union Hospital, Tongji
Medical College, Huazhong University of Science and Technology, Wuhan,
China
(Wang, Dong) Key Laboratory of Organ Transplantation, Ministry of
Education, NHC Key Laboratory of Organ Transplantation, Key Laboratory of
Organ Transplantation, Chinese Academy of Medical Sciences, Wuhan, China
(Deng) Department of Geriatric Dentistry, NMPA Key Laboratory for Dental
Materials, National Engineering Laboratory for Digital and Material,
Technology of Stomatology, Beijing Laboratory of Biomedical Materials,
Peking University School and Hospital of Stomatology, Beijing, China
(Wang) Laboratory of Homeostatic Medicine, School of Medicine, Southern
University of Science and Technology, Shenzhen, China
(Wang) Beijing Laboratory of Oral Health, Capital Medical University,
Beijing, China
Publisher
Springer Nature
Abstract
At advanced phases of atherosclerosis, the rupture and thrombogenesis of
vulnerable plaques emerge as primary triggers for acute cardiovascular
events and fatalities. Pathogenic infection such as
periodontitis-associated Porphyromonas gingivalis (Pg) has been suspected
of increasing the risks of atherosclerotic cardiovascular disease, but its
relationship with atherosclerotic plaque destabilization remains elusive.
Here we demonstrated that the level of Pg-positive clusters positively
correlated with the ratio of necrotic core area to total atherosclerotic
plaque area in human clinical samples, which indicates plaque instability.
In rabbits and Apoe^-/- mice, Pg promoted atherosclerotic plaque
necrosis and aggravated plaque instability by triggering oxidative stress,
which led to macrophage necroptosis. This process was accompanied by the
decreased protein level of forkhead box O3 (FOXO3) in macrophages. The
mechanistic dissection showed that Pg lipopolysaccharide (LPS) evoked
macrophage oxidative stress via the TLR4 signaling pathway, which
subsequently activated MAPK/ERK-mediated FOXO3 phosphorylation and
following degradation. While the gingipains, a class of proteases produced
by Pg, could effectively hydrolyze FOXO3 in the cytoplasm of macrophages.
Both of them decreased the nuclear level of FOXO3, followed by the release
of histone deacetylase 2 (HDAC2) from the macrophage scavenger receptor 1
(Msr1) promoter, thus promoting Msr1 transcription. This enhanced
MSR1-mediated lipid uptake further amplified oxidative stress-induced
necroptosis in lipid-laden macrophages. In summary, Pg exacerbates
macrophage oxidative stress-dependent necroptosis, thus enlarges the
atherosclerotic plaque necrotic core and ultimately promotes plaque
destabilization.<br/>Copyright &#xa9; The Author(s) 2025.

<21>
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. 405(10494) (pp 2061-2074), 2025. Date of Publication: 07 Jun
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

<22>
Accession Number
2031359887
Title
Correlations between intraoperative and postoperative echocardiographic
measurements in patients undergoing aortic bioprosthetic valve
replacement: a prospective observational study.
Source
General Thoracic and Cardiovascular Surgery. 73(6) (pp 405-410), 2025.
Date of Publication: 01 Jun 2025.
Author
Minami K.; Kazawa M.
Institution
(Minami, Kazawa) Department of Critical Care Medicine, National Cerebral
and Cardiovascular Center, 6-1 Kishibeshinmachi, Osaka, Suita, Japan
Publisher
Springer
Abstract
Background: Patient-prosthesis mismatch (PPM) should be avoided during
surgical aortic valve replacement because PPM would worsen the mortality
and morbidity. Diagnosis of PPM could be made using various parameters
measured by intraoperative transesophageal echocardiography. However, few
studies have examined which parameters correlate most accurately between
intraoperative and postoperative values. <br/>Method(s): This
single-center prospective observational study analyzed 46 patients who
underwent surgical aortic valve replacement (SAVR). Echocardiography was
performed at the following 3-time points: preoperatively,
intraoperatively, and 1 month postoperatively. The correlation between
intraoperative and postoperative measurement values, including peak
velocity (PV), mean pressure gradient (MPG), effective orifice area (EOA),
and effective orifice area index (EOAI), were assessed using Pearson's
correlation coefficient. Moreover, to evaluate whether a multivariable
linear regression model with intraoperative and postoperative stroke
volume added as an explanatory variable improves the correlation, the
multiple correlation coefficients were calculated. <br/>Result(s): PV,
MPG, EOA, and EOAI measured intraoperatively and 1 month postoperatively
were significantly correlated. The r values of each measurement were 0.35,
0.344, 0.411 and 0.323, respectively. The multivariable linear regression
model showed that the multiple correlation coefficients for MG and EOA
were 0.491 and 0.663, respectively. <br/>Conclusion(s): Intraoperative and
postoperative PV, MPG, EOA, and EOAI were significantly correlated in
patients undergoing SAVR with a bioprosthetic valve. The r value for EOA
was 0.441, the largest among the measured values. Adjustment for stroke
volume improved the strength of the correlation. Intraoperative evaluation
of prosthetic valve function was considered most appropriate using EOA.
Clinical trial number: University Hospital Medical Information Network
Clinical Trials Registry, registration number UMIN000046164,
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000052
695.<br/>Copyright &#xa9; The Author(s), under exclusive licence to The
Japanese Association for Thoracic Surgery 2024.

<23>
Accession Number
2034624306
Title
Clevidipine for the management of hypertension in the perioperative
cardiac and noncardiac surgical settings: a systematic review.
Source
Frontiers in Medicine. 12 (no pagination), 2025. Article Number: 1562681.
Date of Publication: 2025.
Author
Bottussi A.; D'Andria Ursoleo J.; Agosta V.T.; Piazza E.; Mongardini E.;
Monaco F.
Institution
(Bottussi, D'Andria Ursoleo, Agosta, Piazza, Mongardini, Monaco)
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific
Institute, Milan, Italy
Publisher
Frontiers Media SA
Abstract
Introduction: Perioperative hypertension is a common occurrence in
anesthetic practice, potentially leading to cardiac complications
resulting in unfavorable patient outcomes. Clevidipine emerges in the
current drug scenario as an antihypertensive agent with advantageous
properties like ultra-short half-life, titratable effect, and ease of use.
<br/>Method(s): A systematic search of PubMed/MEDLINE, EMBASE, Cochrane
Central Register of Controlled Trials and Google Scholar databases was
performed aided by a specific search string, to provide a synthesis of the
available body of literature regarding clevidipine administration for the
management of hypertension in the perioperative cardiac and noncardiac
surgical settings. <br/>Result(s): Eighteen documents (summarizing data
from 2,066 patients) published between 1997 and 2023 were included in the
present review. Clevidipine was extensively compared to both placebo and
other commonly used antihypertensive medications. <br/>Discussion(s):
Clevidipine demonstrated favorable efficacy and promising safety profiles.
Moreover, it may represent a promising aid for the intraoperative
management of hypertension, and a valuable addition to traditional
antihypertensive drugs. However, significant gaps in research still
persist, and further studies are warranted to better dissect its effects
in frail populations and patients of different ethnicities. Systematic
review protocol: PROSPERO (CRD42024568584).<br/>Copyright &#xa9; 2025
Bottussi, D'Andria Ursoleo, Agosta, Piazza, Mongardini and Monaco.

<24>
[Use Link to view the full text]
Accession Number
2033675642
Title
The Effectiveness of Virtual and Augmented Reality in Surgical Pain
Management: A Systematic Review of Randomized Controlled Trials.
Source
Anesthesia and Analgesia. 140(6) (pp 1388-1400), 2025. Date of
Publication: 01 Jun 2025.
Author
Levit T.; Grzela P.; Lavoie D.C.T.; Wang L.; Agarwal A.; Couban R.J.;
Shanthanna H.
Institution
(Levit, Grzela, Lavoie) Michael G. DeGroote School of Medicine, McMaster
University, Hamilton, ON, Canada
(Wang, Shanthanna) Department of Anesthesia, McMaster University,
Hamilton, ON, Canada
(Wang, Couban, Shanthanna) Michael G. DeGroote Institute for Pain Research
and Care, McMaster University, Hamilton, ON, Canada
(Agarwal) Faculty of Health Sciences, McMaster University, Hamilton, ON,
Canada
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Satisfactory management of postoperative pain remains
challenging. Nonpharmacological modalities such as virtual and augmented
reality (VR/AR) offer potential benefits and are becoming increasingly
popular. This systematic review evaluates the effectiveness and safety of
VR/AR interventions on postoperative pain and recovery. <br/>METHOD(S):
MEDLINE, Embase, CINAHL, Web of Science, and CENTRAL databases were
searched from inception to July 27, 2023, for randomized controlled trials
(RCTs), published in English, evaluating the use of VR/AR interventions
for surgical pain relief. Study selection and data extraction were
performed by pairs of reviewers independently and in duplicate, and
potential risk of bias was determined using the Risk of Bias-version 2
(RoB 2) tool. Our outcomes included pain relief, reduction of anxiety,
satisfaction, and adverse effects. Due to substantial heterogeneity, a
narrative synthesis without meta-analysis was performed. <br/>RESULT(S):
We included 35 trials among 2257 citations, categorized as surgery (n =
12), minor procedures (n = 15), and postoperative physiotherapy (n = 8).
Surgical group included various surgeries, with 11 using immersive VR
predominantly in the postoperative period, and most reporting no
differences in pain, but potential for reduced anxiety and sedation
requirements. In the minor procedures group, most studies reported
decreased pain and anxiety during the procedural performance. Two studies
reported increased heart rate, while 2 others reported better hemodynamic
stability. Home-based AR physiotherapy achieved (n = 6) similar pain and
functional outcomes after knee replacement, with 1 large study (n = 306)
reporting reduction of mean costs by $2745 for provision of 12 weeks
physiotherapy. There were some concerns around potential bias for most
studies, as the nature of interventions make it challenging to blind
assessors and participants. No important adverse effects were noted using
VR/AR technology. <br/>CONCLUSION(S): Evidence from RCTs indicates that
the use of immersive VR during minor procedures may reduce procedural
pain, decrease anxiety, and improve satisfaction. However, small studies,
inconsistent effect, and variation in the application of interventions are
important limitations. Evidence to support the application of AR/VR for
major surgeries is limited and needs to be further investigated. Use of
home-based physiotherapy with AR likely has economic advantages, and
facilitates virtual care for appropriate patients who can access and use
the technology safely.<br/>Copyright &#xa9; 2025 International Anesthesia
Research Society.

<25>
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.

<26>
Accession Number
2038782589
Title
Study protocol of the multicentre, randomised, triple-blind,
placebo-controlled MERCURI-2 trial: promoting effective renoprotection in
cardiac surgery patients by inhibition of sodium glucose cotransporter
(SGLT)-2.
Source
BMJ Open. 15(5) (no pagination), 2025. Article Number: e095504. Date of
Publication: 16 May 2025.
Author
Oosterom-Eijmael M.; Monteiro De Oliveira N.P.; Niesten E.D.; Tolsma M.;
Snellen F.T.F.; Gerritse B.M.; Scohy T.V.; Rettig T.; Godfried M.B.; Voogd
M.F.; Wink J.; Van Der Werff L.M.M.; Eberl S.; Preckel B.; Hermanides J.;
Van Raalte D.H.; Hulst A.H.
Institution
(Oosterom-Eijmael, Eberl, Preckel, Hermanides, Hulst) Department of
Anesthesiology, Amsterdam University Medical Center, Amsterdam,
Netherlands
(Oosterom-Eijmael, Van Raalte) Department of Endocrinology, Amsterdam
University Medical Center, Amsterdam, Netherlands
(Oosterom-Eijmael, Van Raalte) Amsterdam Cardiovascular Sciences Research
Institute, Amsterdam, Netherlands
(Monteiro De Oliveira, Niesten) Department of Anesthesiology, Medisch
Spectrum Twente, Enschede, Netherlands
(Tolsma, Snellen) Department of Anesthesiology and Intensive Care, Isala
Clinics, Zwolle, Netherlands
(Gerritse, Scohy) Anaesthesiology, Amphia Ziekenhuis, North Brabant,
Breda, Netherlands
(Rettig) Anesthesiology, Intensive Care and Pain Medicine, Amphia Hospital
Site Molengracht, Noord-Brabant, Breda, Netherlands
(Godfried) Department of Anesthesiology, Onze Lieve Vrouwe Gasthuis,
Noord-Holland, Amsterdam, Netherlands
(Voogd) Department of Anesthesiology, Medisch Centrum Leeuwarden,
Leeuwarden, Netherlands
(Wink, Van Der Werff) Department of Anesthesiology, Leiden University
Medical Center, Leiden, Netherlands
Publisher
BMJ Publishing Group
Abstract
Introduction Acute kidney injury (AKI) is a major complication after
cardiac surgery and is associated with postoperative morbidity and
mortality. Currently, no effective therapy exists to reduce the incidence
of postoperative AKI. Sodium-glucose cotransporter-2 (SGLT2) inhibitors
are effective in reducing AKI in outpatient settings for patients with
chronic kidney disease. We hypothesised that perioperative SGLT2
inhibition will also reduce AKI incidence after cardiac surgery according
to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Methods and
analysis We designed a multicentre, randomised, placebo-controlled,
triple-blinded, superiority trial. A total of 784 patients, aged above 18
years, undergoing cardiac surgery will be included with stratification for
sex and type 2 diabetes in a 1:1 ratio. Patients will receive either
dapagliflozin 10 mg or placebo from the day before until 2 days after
surgery. Serum creatinine will be measured preoperatively and daily for
the first 7 days after the operation, and urine output will be measured
until the urinary catheter is removed. The primary outcome is the
incidence of postoperative AKI according to the KDIGO criteria. Ethics and
dissemination The medical ethics committee of the Amsterdam University
Medical Centre (UMC) and the Dutch competent authority approved the study
protocol (currently, version 9, 19 January 2024). This is an
investigator-initiated study. The Amsterdam UMC, as sponsor, retains
ownership of all data and publication rights. After completion of the
trial, results will be disseminated to participants, patient societies and
physicians via a network meeting and digital newsletter. Results will be
submitted for publication in a peer-reviewed international medical journal
and presented on (inter)national congresses. Trial registration number
Clinicaltrials.gov identifier: NCT05590143.<br/>Copyright &#xa9; 2025 BMJ
Publishing Group. All rights reserved.

<27>
Accession Number
2038464129
Title
Efficacy of the Glucagon-Like Peptide-1 Agonist Exenatide in Patients
Undergoing CABG or Aortic Valve Replacement: A Randomized Double-Blind
Clinical Trial.
Source
Circulation: Cardiovascular Interventions. 18(5) (no pagination), 2025.
Article Number: e014961. Date of Publication: 01 May 2025.
Author
Kjaergaard J.; Moller C.H.; Wiberg S.; Mikkelsen A.D.; Moller-Sorensen H.;
Ravn H.B.; Ravn J.; Olsen P.S.; Hofsten D.E.; Boesgaard So.; Kober L.;
Nilsson J.C.; Hassager C.
Institution
(Kjaergaard, Mikkelsen, Hofsten, Boesgaard, Kober, Hassager) Department of
Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
(Kjaergaard, Wiberg, Kober, Hassager) Department of Clinical Medicine,
Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
(Moller, Ravn, Olsen) Department of Cardiothoracic Surgery, Copenhagen
University Hospital Rigshospitalet, Rigshospitalet, Denmark
(Wiberg, Moller-Sorensen, Nilsson) Department of Cardiothoracic
Anesthesiology, Copenhagen University Hospital Rigshospitalet,
Rigshospitalet, Denmark
(Ravn) Department of Anesthesiology and Intensive Care, Odense University
Hospital, Copenhagen, Denmark
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: GLP-1 (glucagon-like peptide-1) agonists have been proven
beneficial in reducing the risk of and injury associated with several
cardiovascular diseases. The efficacy in cardiopulmonary bypass-assisted
cardiac surgery is unknown. This trial aimed to investigate the efficacy
of an infusion of the GLP-1 agonist exenatide during and after open-heart
surgery in reducing the risk of death and major organ failure.
<br/>METHOD(S): Randomized, double-blinded, 2-by-2 factorial design,
single-center clinical trial, also including liberal (FiO<inf>2</inf> of
100%) or restrictive (FiO<inf>2</inf> of 50%) oxygenation during and after
bypass. The present article presents the results of the exenatide
intervention. We included adult patients undergoing elective
cardiopulmonary bypass-assisted coronary artery bypass grafting or aortic
valve replacement. Patients were predominantly low risk. The intervention
was an infusion of 17.4 mug of exenatide or placebo during cardiopulmonary
bypass and the first hour after weaning thereof. The main outcome was time
to a composite end point consisting of death, stroke, renal failure
requiring dialysis, or new/worsening heart failure during follow-up.
Secondary end points included occurrence of prespecified adverse events.
<br/>RESULT(S): A total of 1389 patients were included in the analyses.
Within a follow-up period of a median of 5.9 years (min-max; 2.5-8.3
years), 170 (24%) patients in the exenatide group and 165 (24%) patients
experienced a primary end point. We found no difference in time to the
first event between patients randomized to FiO<inf>2</inf> 50% versus
FiO<inf>2</inf> 100% (hazard ratio, 1.0 [95% CI, 0.83-1.3]; P=0.80). We
found no significant difference in rates of adverse events between the 2
groups. <br/>CONCLUSION(S): Exenatide during cardiopulmonary bypass and
weaning thereof did not significantly reduce the incidence of death,
stroke, renal failure, or new/worsening heart failure in patients
undergoing coronary artery bypass grafting and aortic valve replacement.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier:
NCT02673931.<br/>Copyright &#xa9; 2025 Lippincott Williams and Wilkins.
All rights reserved.

<28>
Accession Number
2033160760
Title
Efficacy of respiratory physiotherapy preceding to heart surgery with
extracorporeal circulation.
Source
Cirugia Cardiovascular. 32(3) (pp 125-131), 2025. Date of Publication: 01
May 2025.
Author
Rueda-Gomariz E.; Castillo-Sarmiento C.A.; Munoz-Rodriguez J.R.;
Ballesteros-Yanez I.
Institution
(Rueda-Gomariz) Department of Cardiac Surgery, University Hospital Puerta
del Mar, Cadiz, Spain
(Castillo-Sarmiento) Department of Nursing, Physiotherapy and Occupational
Therapy, School of Physiotherapy and Nursing, University of Castilla-La
Mancha, Toledo, Spain
(Munoz-Rodriguez) Translational Research Unit, University General Hospital
of Ciudad Real, Ciudad Real, Spain
(Ballesteros-Yanez) Department of Inorganic and Organic Chemistry and
Biochemistry, Faculty of Medicine, University of Castilla-La Mancha,
Ciudad Real, Spain
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)
Abstract
Introduction and objectives: Heart surgery is one of the most important
tools for the treatment of cardiovascular diseases. Postoperative
pulmonary complications in patients undergoing heart surgery represent a
meaningful clinical problem. Respiratory physiotherapy is essential in the
management of patients during postoperative period, contributing to a
better prognosis. Our objective is to evaluate the efficacy of respiratory
physiotherapy prior to cardiac surgery in reducing postoperative
complications and hospital stay. <br/>Method(s): Randomized, controlled
and observational study. A group of 92 patients who underwent heart
surgery with extracorporeal circulation were analyzed in the Hospital
Puerta del Mar (Spain), divided into 2 groups (control group and
experimental group with previous respiratory physiotherapy). We study
different postoperative complications and hospital stay. <br/>Result(s):
Atelectasis, pleural effusion, and sternal dehiscence were altered between
both groups. An improvement in the intubation time and the reintubation
rate was reported in the experimental group, in addition, lower oxygen
consumption, an improvement in the fulfillment of respiratory
physiotherapy following surgery and a shorter overall hospital stay and in
the post-operative care unit was also observed. <br/>Conclusion(s):
Fulfillment of respiratory physiotherapy preceding to heart surgery
decreases pulmonary complications and hospital stay, as well as
accelerates the recovery of the breathing capacity.<br/>Copyright &#xa9;
2024 Sociedad Espanola de Cirugia Cardiovascular y Endovascular

<29>
Accession Number
2038782424
Title
Early sedation with dexmedetomidine in patients with acute myocardial
infarction requiring mechanical ventilation.
Source
European Heart Journal: Acute Cardiovascular Care. 14(5) (pp 270-278),
2025. Date of Publication: 01 May 2025.
Author
Banna S.; Schenck C.; Singh A.; Safiriyu I.; Jimenez J.V.; Franko A.;
Thomas A.; Heck C.; Ludmir J.; Gage A.; Ali T.; Katz J.N.; Dudzinski D.M.;
Ross J.S.; Miller P.E.
Institution
(Banna, Jimenez) Department of Internal Medicine, Yale School of Medicine,
New Haven, CT, United States
(Schenck) Department of Medicine, Massachusetts General Hospital, Boston,
MA, United States
(Singh) Division of Cardiovascular Medicine, Department of Medicine,
Brigham and Women's Hospital, Boston, MA, United States
(Safiriyu, Thomas, Ali, Miller) Department of Internal Medicine, Section
of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, United
States
(Franko, Heck) Yale New Haven Hospital, New Haven, CT, United States
(Ludmir, Dudzinski) Department of Medicine, Corrigan Minehan Heart Center,
Massachusetts General Hospital, Boston, MA, United States
(Gage) Centennial Medical Center, Nashville, TN, United States
(Katz) Division of Cardiology, New York University Grossman School of
Medicine, Bellevue Hospital Center, New York, NY, United States
(Ross) Department of Internal Medicine, Section of General Internal
Medicine, Yale School of Medicine, New Haven, CT, United States
(Ross) Department of Health Policy and Management, Yale School of Public
Health, New Haven, CT, United States
Publisher
Oxford University Press
Abstract
Aims Patients with acute myocardial infarction (AMI) who require invasive
mechanical ventilation (IMV) represent a critically ill population with
limited data on optimal sedative and analgesic use. Clinical trials
assessing dexmedetomidine use exclude poorly represent patients with AMI.
This study aimed to compare the use of early sedation with dexmedetomidine
with usual care sedation in patients with AMI requiring IMV. Methods and
results We utilized the Vizient Clinical Data Base to identify patients
aged >=18 years admitted between 2015 and 2019 with a primary diagnosis of
AMI who required IMV. Patients receiving dexmedetomidine on the first day
of IMV were included in the early dexmedetomidine group, while the
remaining patients were assigned to the usual care group. Inverse
probability of treatment weighting (IPTW) was used to estimate adjusted
risk differences between groups. We identified 15 928 patients, of which
1620 (10.2%) received early dexmedetomidine. Patients who received early
dexmedetomidine were more likely to present with cardiogenic shock (52.0
vs. 47.7%, P = 0.001). In unadjusted analyses, patients receiving early
dexmedetomidine had lower in-hospital mortality (33.0 vs. 42.1%) and more
ventilator-free days (13.6 vs. 12.1) compared with usual care (both, P <
0.05). After IPTW, patients receiving early dexmedetomidine had an 11.0%
[95% confidence interval (CI): 8.6-13.5%] lower mortality and more
ventilator-free days (mean difference: +2.2 days, 95% CI: 1.6-2.8 days).
Conclusion Early sedation with dexmedetomidine was associated with lower
mortality compared with usual care in patients with AMI requiring IMV. A
randomized controlled trial of sedative agents in this population is
warranted.<br/>Copyright &#xa9; The Author(s) 2025. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved.

<30>
Accession Number
2032700925
Title
Efficacy of liposomal as compared to standard bupivacaine for intercostal
nerve blocks in patients undergoing minimally invasive thoracic surgery: a
systematic review and meta-analysis.
Source
Minimally Invasive Therapy and Allied Technologies. 34(3) (pp 219-229),
2025. Date of Publication: 2025.
Author
Chen R.; Wang Z.
Institution
(Chen, Wang) Department of Anesthesia, Shengzhou People's Hospital
(Shengzhou Branch of the First Affiliated Hospital of Zhejiang University
School of Medicine, the Shengzhou Hospital of Shaoxing University),
Shaoxing, China
Publisher
Taylor and Francis Ltd.
Abstract
Background: This review aimed to provide evidence on the efficacy of
liposomal bupivacaine as compared to standard bupivacaine for intercostal
nerve blocks (ICB) in patients undergoing minimally invasive thoracic
surgery. <br/>Method(s): Randomized controlled trials (RCTs) and
comparative observational studies published on the databases of PubMed,
CENTRAL, Web of Science, and Embase up to June 20, 2024, were included.
Total opioid consumption in morphine equivalents, pain scores, and length
of hospital stay (LOS) were compared. <br/>Result(s): Two RCTs and eight
observational studies were included. Eight hundred and four patients
received liposomal bupivacaine while 631 patients received standard
bupivacaine in the included studies. The meta-analysis showed that the use
of liposomal bupivacaine for ICB did not reduce opioid consumption as
compared to standard bupivacaine at 24 h, 48 h, and for the total duration
of hospitalization. Pain scores were also not significantly different
between the two groups at 24 h and 48 h. Meta-analysis showed that there
was no difference in the LOS between intervention and control groups.
Subgroup analysis based on study design also generated similar results.
<br/>Conclusion(s): Mostly low-quality evidence shows that liposomal
bupivacaine does not offer additional benefits over standard bupivacaine
when used for ICB in patients undergoing minimally invasive thoracic
surgery.<br/>Copyright &#xa9; 2024 Society of Medical Innovation and
Technology.

<31>
Accession Number
2038983222
Title
Review of minimally invasive coronary artery bypass grafting.
Source
European Journal of Cardio-thoracic Surgery. 67(5) (no pagination), 2025.
Article Number: ezaf160. Date of Publication: 01 May 2025.
Author
Walton A.J.; Pineda A.M.; Rogers L.; Davierwala P.M.; Zwischenberger B.A.
Institution
(Walton, Zwischenberger) Division of Cardiothoracic Surgery, Department of
Surgery, Duke University Medical Center, Durham, NC, United States
(Pineda) Division of Cardiology, Department of Medicine, Duke University
Medical Center, Durham, NC, United States
(Rogers, Davierwala) Division of Cardiovascular Surgery, Peter Munk
Cardiac Centre, Toronto General Hospital, University Health Network,
Toronto, ON, Canada
(Rogers, Davierwala) Department of Surgery, University of Toronto,
Toronto, ON, Canada
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Minimally invasive coronary artery bypass grafting (CABG),
defined broadly as surgical revascularization via any sternotomy-sparing
approach. Here, we provide an overview of minimally invasive CABG targeted
to cardiologists, cardiac surgeons and other clinicians involved in the
care of patients with coronary artery disease (CAD). <br/>METHOD(S): A
narrative review of the literature on minimally invasive CABG was
performed. <br/>RESULT(S): Minimally invasive CABG was first described
over 20 years ago, yet uptake has been slow and available data are
limited. The most common iteration of minimally invasive CABG is a
single-vessel CABG (left internal mammary artery to the left anterior
descending artery) performed without the cardiopulmonary bypass machine
via mini-thoracotomy. However, in patients with multivessel CAD, other
options include minimally invasive multivessel CABG and hybrid
revascularization (minimally invasive CABG with percutaneous coronary
intervention). Patient selection and preoperative planning are paramount.
Observational studies and small randomized controlled trials demonstrate
that minimally invasive CABG is associated with reduced rates of blood
transfusion, surgical site infections, lengths of intensive care unit and
hospital stays, and time to return to full activity with promising late
outcomes. Finally, we describe future areas for growth, including ongoing
clinical trials, gaps in evidence and pragmatic considerations for
surgeons interested in starting a minimally invasive CABG programme.
<br/>CONCLUSION(S): Minimally invasive CABG can expand the armamentarium
of revascularization techniques available for the ageing and increasingly
complex population of patients with CAD.<br/>Copyright &#xa9; 2025 The
Author(s). Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<32>
Accession Number
2034316412
Title
Redo aortic root-complexity vs simplicity with choice of device selected.
Source
Expert Review of Medical Devices. 22(6) (pp 555-568), 2025. Date of
Publication: 2025.
Author
He C.; Norton E.L.; Chen E.P.
Institution
(He, Norton) Division of Cardiothoracic Surgery, Department of Surgery,
Emory University School of Medicine, Atlanta, GA, United States
(Chen) Division of Cardiovascular and Thoracic Surgery, Department of
Surgery, Duke University Medical Center, Durham, NC, United States
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: The field of cardiac surgery continues to evolve
significantly and one such example of advancement is aortic root
replacement. In the setting of prior cardiac surgery, operative complexity
increases due to adhesions, surgically-altered anatomy, and previously
implanted prosthetic graft material. Device choice plays a significant
role in balancing operative complexity with achieving simplicity and
optimal clinical outcomes. Areas covered: This review explores the
critical considerations necessary in performing redo aortic root surgery
and the impact that device selection can have on the procedural complexity
and clinical outcomes. This review was formulated by a systematic
identification of published and unpublished laboratory and clinical
studies evaluating these technologies. Expert opinion: Redo aortic root
surgery represents one of the most challenging procedures in cardiac
surgery, and the choice of both surgical technique and prosthetic device
used are critical factors which influence the clinical success of the
operation and the long-term outcomes for patients. By understanding the
unique challenges of root replacement in a reoperative setting and the
characteristics of different prosthetic devices, a tailored approach must
be employed toward the best possible outcomes.<br/>Copyright &#xa9; 2025
Informa UK Limited, trading as Taylor & Francis Group.

<33>
[Use Link to view the full text]
Accession Number
2038765308
Title
Comprehensive Surgical Management of Thoracic Schwannomas: A Retrospective
Multicenter Study on 98 Lesions.
Source
Neurosurgery. 96(6) (pp 1249-1260), 2025. Date of Publication: 01 Jun
2025.
Author
Corazzelli G.; Corvino S.; Marvulli M.; Cioffi V.; D'Elia A.; Meglio V.;
Tafuto R.; Mastantuoni C.; Scala M.R.; Ricciardi F.; Di Colandrea S.;
Leonetti S.; De Marinis P.; Paolini S.; Esposito V.; Fiorelli A.;
Innocenzi G.; De Divitiis O.; De Falco R.; Bocchetti A.
Institution
(Corazzelli, Cioffi, Tafuto, Mastantuoni, Scala, De Falco, Bocchetti)
Neurosurgery Department, Santa Maria Delle Grazie Hospital, ASL Napoli 2
Nord, Naples, Italy
(Corazzelli, Corvino, Meglio, De Divitiis) Division of Neurosurgery,
Department of Neurosciences, Reproductive and Odontostomatological
Sciences, Federico II University, Naples, Italy
(Marvulli, Fiorelli) Department of Translational Medicine, Thoracic
Surgery Unit, Universita Degli Studi della Campania Luigi Vanvitelli,
Naples, Italy
(D'Elia, Ricciardi, Leonetti, Paolini, Esposito, Innocenzi) Department of
Neurosurgery, IRCCS Neuromed, IS, Pozzilli, Italy
(Meglio, Tafuto, De Marinis) Department of Neurosurgery, AORN Sant'Anna e
San Sebastiano, Caserta, Italy
(Di Colandrea) Department of Anaesthesiology and Intensive Care Medicine,
Santa Maria Delle Grazie Hospital, ASL Napoli 2 Nord, Naples, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND AND OBJECTIVES:The optimal surgical management of thoracic
schwannomas (TSs) remains contentious, with various approaches proposed.
Video-assisted thoracoscopic surgery (VATS) and combined VATS with
neurosurgical procedures have shown promise, particularly for Eden type IV
and III lesions. However, unanimous consent on the most effective surgical
intervention and understanding of prognostic factors for tumor recurrence
needs to be improved. The aim of this study was to elucidate the optimal
surgical approach according to the Eden type and investigate predictive
factors for TS recurrence. <br/>METHOD(S):This retrospective,
multicentric, observational study analyzed 98 surgically treated patients
with TS from 2011 to 2023, assessing preoperative and 6-month follow-up
clinical (recurrences, pain, and myelopathy recovery) and surgical
parameters (operative time, intraoperative blood loss, extent of
resection). Surgical procedures included thoracic laminectomy or
hemilaminectomy for type I, laminectomy or thoracic transpedicular (TPD)
approach for type II, laminectomy alone or combined laminectomy with VATS
for type III, and VATS or thoracotomy (open thoracotomy [OT]) for type IV.
Descriptive and deductive analyses were conducted between and within the 4
cohorts, with multivariate analysis assessing the contribution of
predictor variables. <br/>RESULT(S):No significant differences were found
between hemilaminectomy and laminectomy for all analyzed parameters for
type I. Type II lesions treated with TPD exhibited similar outcomes to
laminectomy, albeit with longer procedure times. Type III lesions
benefited from combined approaches compared with neurosurgical-only
approaches. Video-assisted thoracoscopic surgery emerged as more favorable
than OT for type IV lesions. Multivariate analysis revealed that patient
sex, tumor location, extent of resection, and pathology significantly
influenced recurrence rates. <br/>CONCLUSION(S):For Eden type III TSs,
neurosurgical and VATS combined surgery achieved better outcomes than
neurosurgery alone; for Eden type IV TSs, VATS achieved better results
than OT. For Eden types I and II, hemilaminectomy and bilateral
laminectomy and laminectomy and TPD achieved similar outcomes,
respectively.<br/>Copyright &#xa9; Congress of Neurological Surgeons 2024.
All rights reserved.

<34>
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.

<35>
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.

<36>
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

<37>
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.

<38>
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.

<39>
Accession Number
370203527
Title
Transcatheter pulmonary valve implantation: Systematic literature review.
Source
Revista Brasileira de Cardiologia Invasiva. 21(2) (pp 176-187), 2013. Date
of Publication: 2013.
Author
Botrel T.E.A.; Clark O.A.C.; Queiroga M.C.; Filho R.I.R.; Pilla C.B.;
Arrieta R.S.; Cristovao S.; Silva C.C.; Esteves C.A.; Oliveira E.C.;
Simoes L.C.; Chamie F.; Neves J.; Max R.; Pedra C.A.C.
Institution
(Botrel) Pesquisador da Evidencias - Credibilidade Cientifica, Campinas,
SP, Brazil
(Clark) Credibilidade Cientifica, Campinas, SP, Brazil
(Queiroga) Hospital da Unimed Joao Pessoa, Joao Pessoa, PB, Brazil
(Filho) Instituto de Cardiologia, Fundacao Universitaria de Cardiologia,
Porto Alegre, RS, Brazil
(Pilla) Servico de Cardiologia Pediatrica e Cardiologia Intervencionista,
Complexo Hospitalar Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil
(Arrieta) Servico de Hemodinamica e Cardiologia Intervencionista,
Instituto do Coracao do Hospital das Clinica, Universidade de Sao Paulo,
Sao Paulo, SP, Brazil
(Cristovao) Hospital Beneficencia Portuguesa de Sao Paulo, Sao Paulo, SP,
Brazil
(Silva) Escola Paulista de Medicina, Universidade Federal de Sao Paulo,
Sao Paulo, SP, Brazil
(Esteves) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, SP, Brazil
(Oliveira) Departamento de Cardiopatias Congenitas, Hospital de Clinicas,
Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
(Simoes) Instituto Nacional de Cardiologia, Hospital Laranjeiras, Rio de
Janeiro, RJ, Brazil
(Chamie) Hospital Federal dos Servidores do Estado, RJ, Brazil
(Neves) Instituto de Medicina Integral Prof. Fernando Figueira, Recife,
PE, Brazil
(Max) Departamento de Cardiologia Pediatrica Intervencionista, Hospital
Biocor, Belo Horizonte, MG, Brazil
(Pedra) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, SP, Brazil
Publisher
Sociedade Brasileira de Cardiologia
Abstract
Surgical repair of some complex congenital heart diseases involves
reconstruction of the right ventricular outflow tract using homografts,
bioprostheses, bovine jugular grafts or other valved conduits between the
right ventricle and the main pulmonary artery. Although these surgical
procedures may be performed with low mortality rates, the life span of
these implanted valves or conduits is usually short (< 10 years) due to
either degeneration and/or calcification. Variable degrees of pulmonary
stenosis, often associated with pulmonary insufficiency, are consequences
of conduit degeneration. In 2000, Bonhoeffer et al. were the first to
report the transcatheter pulmonary valve implantation (TPVI) of a
bioprosthetic pulmonary valve later named Melody valve (Medtronic,
Minneapolis, USA). The technique was initially developed to limit the need
for multiple surgical procedures, and, ultimately, to work as a surrogate
of a new surgical valve replacement. Subsequent clinical studies in Europe
and the United States confirmed the safety and efficacy of this technique
in a larger number of patients. Since the National Sanitary Surveillance
Agency (Agencia Nacional de Vigilancia Sanitaria - Anvisa) granted
approval for clinical use of the Melody transcatheter pulmonary biological
valve in February 2103, we deemed that a judicious assessment of this new
technology was timely and necessary before the widespread use in our
country. The objective of this study was to perform a systematic
literature review on the use of TPVI in patients with dysfunctional
homografts, valved conduits and bioprostheses implanted surgically in the
right ventricular outflow tract.

<40>
Accession Number
645537608
Title
The effect of an open-heart surgery patient care protocol on
post-sternotomy pain, anxiety and quality of care: A randomized controlled
trial.
Source
Nursing in critical care. 30(3) (pp e13193), 2025. Date of Publication: 01
May 2025.
Author
Dagcan Sahin N.; Gurol Arslan G.
Institution
(Dagcan Sahin) Faculty of Health Sciences, Kutahya Health Sciences
University, Kutahya, Turkey
(Gurol Arslan) Fundamentals of Nursing Department, Nursing Faculty, Dokuz
Eylul University, Izmir, Turkey
Abstract
BACKGROUND: Open-heart surgery patients face many problems because of
post-sternotomy pain. Care protocols can eliminate pain and pain-related
problems by providing holistic care. AIM: The aim of this study was to
examine the effect of an open-heart surgery patient care protocol
developed in the study on post-sternotomy pain, anxiety and quality of
care. STUDY DESIGN: The study was carried out as a double-blind randomized
controlled trial. The sample size was calculated. Considering some
attrition, the sample size was increased by 10% for each group, and a
total of 68 participants, including 34 in each group, were included in the
sample. Data were collected using a 'Patient Information Form', a
'Post-Sternotomy Pain Follow-up Form', the 'Numeric Rating Scale', the
'State Anxiety Inventory' and the 'Strategic and Clinical Quality
Indicators in Postoperative Pain Management Questionnaire'. The patients
in the experimental group were given care in accordance with the protocol,
which was developed in the study, on postoperative days 0, 1 and 2.
<br/>RESULT(S): The statistical evaluation showed a significant difference
between the mean scores of the experimental (F = 7.28; p < .001) and
control groups (F = 2.42; p < .05) on the pain assessment scale. It was
determined that the number of analgesics used in the experimental group
was statistically significantly lower than in the control group.
Intra-group comparisons showed that there was a difference between the
mean pre-test and post-test state anxiety scale scores of the groups (p <
.001). The experimental group had higher mean scores on the Strategic and
Clinical Quality Indicators in Postoperative Pain Management Questionnaire
than that of the control group (p < .001). <br/>CONCLUSION(S): The
protocol developed in the study was found to be effective in reducing
pain, the use of NSAIDs and opioids, and anxiety levels and increasing the
level of quality of care. RELEVANCE TO CLINICAL PRACTICE: The protocol was
original and feasible in that it included independent nursing
interventions to improve the quality of care by reducing pain and anxiety.
Particularly, the use of protocols in intensive care units was nurses'
strongest resource in patient care management. Thus, the protocol, which
was prepared for intensive care patients who most frequently experience
pain and anxiety, was promising for nurses in improving the quality of
care by reducing pain and anxiety. However, it is necessary to conduct
further studies involving longitudinal follow-up in samples and
institutions with similar conditions.<br/>Copyright &#xa9; 2024 The
Author(s). Nursing in Critical Care published by John Wiley & Sons Ltd on
behalf of British Association of Critical Care Nurses.

<41>
Accession Number
2038765168
Title
The effect of passive leg raising on the cross-sectional area of the right
internal jugular vein in obese patients undergoing surgery: A prospective
observational study.
Source
BMJ Open. 15(5) (no pagination), 2025. Article Number: e098031. Date of
Publication: 14 May 2025.
Author
Wang S.; Cao X.; Zhu P.; Sun C.; Cao L.; Pei D.
Institution
(Wang, Cao, Zhu, Sun, Pei) Department of Anesthesiology, Tongren Hospital,
Shanghai Jiaotong University, School of Medicine, Shanghai, China
(Cao) Guilin Hospital of the Second Xiangya Hospital, Central South
University, Guilin, China
Publisher
BMJ Publishing Group
Abstract
Objectives To observe the association between passive leg raising (PLR)
and the cross-sectional area (CSA) of the right internal jugular vein
(IJV) in obese patients undergoing elective surgery. Design Prospective
observational study with randomised position sequence. Setting
Single-centre, tertiary care hospital in Shanghai, China. Participants
Forty obese patients (body mass index (BMI) >30 kg/m2) scheduled for
elective surgery were enrolled. Inclusion criteria were American Society
of Anesthesiologists Physical Status Classification (ASA) physical status
II-III and age >=18 years. Exclusion criteria included history of neck
surgery, severe cardiovascular disease, end-stage renal disease, severe
infection or sepsis and significant coagulopathy. Observations Patients
underwent ultrasound measurements of the right IJV in two positions:
supine (S0) and passive leg raise at 40degree (PLR40). Each position was
maintained for at least 1 min prior to measurement. Primary outcome The
primary outcome was to observe whether the CSA of the right IJV differed
between the S0 position and passive leg elevation. In post hoc analyses,
we examined factors affecting the relative CSA change (CSAgamma),
including neck circumference, BMI, age, sex, ASA physical status and heart
rate as predictors. Results The CSA of the right IJV was significantly
larger in the PLR40 position (2.05 cm2) compared to the S0 position (1.67
cm2, p=0.003). Linear regression analysis showed a slight positive
correlation between neck circumference and the percentage change in CSA
(correlation coefficient: 0.066, p<0.05). Conclusion The CSA of the right
IJV was significantly larger in the PLR40 position in obese patients
undergoing surgery.<br/>Copyright &#xa9; Author(s) (or their employer(s))
2025.

<42>
Accession Number
2034562486
Title
Qu-shi-hua-tan decoction's efficacy and safety for patients with angina
following coronary revascularization: a randomized, double-blind,
placebo-controlled trial study protocol.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1512385. Date of Publication: 2025.
Author
Xu W.; Wen J.; Li X.; Zhang Y.; Lu W.
Institution
(Xu, Wen, Li, Li, Zhang, Lu) The Second Clinical Medical College of
Guangzhou University of Chinese Medicine, Guangzhou, China
(Lu) State Key Laboratory of Traditional Chinese Medicine Syndrome,
Guangdong Provincial Hospital of Chinese Medicine, China
(Lu) Guangzhou University of Chinese Medicine, Guangzhou, China
(Lu) Chinese Medicine Guangdong Laboratory, Guangdong, Guangzhou, China
Publisher
Frontiers Media SA
Abstract
Introduction: The Qu-shi-hua-tan decoction (QSHTD), formulated by
academician Chen Keji, is an empirical decoction for coronary heart
disease (CHD). We conducted a randomized controlled trial to assess the
effectiveness and safety of QSHTD in managing angina after coronary
revascularization (AACR) in CHD patients. Methods and design: This
double-blind randomized controlled trial will be conducted at Guangdong
Provincial Hospital of Traditional Chinese Medicine. We will allocate 98
qualified participants to either the experimental or control group in a
1:1 ratio through random selection. The experimental group will be given
standard care along with QSHTD, whereas the control group will receive
standard care and a placebo. The study will span 26 weeks, consisting of a
2-week initial phase, a 12-week intervention phase, and a 12-week
monitoring phase. The main outcome measure will be myocardial blood flow
(MBF) assessed using adenosine stress real-time myocardial perfusion
echocardiography (RTMPE). The secondary outcomes will be Canadian
Cardiovascular Sociation Classification, Seattle Angina Questionnaire,
Traditional Chinese Medicine (TCM) symptom evaluation; and major adverse
cardiac events (MACE). <br/>Discussion(s): This study seeks to deliver
compelling proof of the superior methodological and reporting standards of
QSHTD's effectiveness and safety within AACR treatment. Clinical Trial
Registration: Chinese Clinical Trial Registration Center
[www.chictr.org.cn]. The trial was registered on November 26, 2020
[ChiCTR2000040270].<br/>Copyright 2025 Xu, Wen, Li, Li, Zhang and Lu.

<43>
Accession Number
2038767145
Title
Perioperative Oral decontamination and ImmunoNuTrition (POINT) to prevent
postoperative pulmonary complications in elderly patients scheduled for
elective non-cardiac surgeries: Protocol for a multicentre, randomised
controlled trial.
Source
BMJ Open. 15(5) (no pagination), 2025. Article Number: e092068. Date of
Publication: 14 May 2025.
Author
Yu J.; Che L.; Zhu Q.; Xu L.; Fu J.; Zhang Y.; You M.; Zheng X.; Liu C.;
Huang L.; Wang W.; Yao L.; Fan G.; Chen J.; Zhang J.; Huang Y.
Institution
(Yu, Che, Zhu, Xu, Huang) Department of Anesthesiology, Peking Union
Medical College Hospital, Beijing, China
(Fu) Department of Clinical Nutrition, Peking Union Medical College
Hospital, Beijing, China
(Zhang) Medical Research Center, Peking Union Medical College Hospital,
Beijing, China
(You, Zheng) Department of Anesthesiology, Shengli Clinical Medical
College, Fujian Medical University, Fujian Provincial Hospital, Fuzhou,
China
(Liu, Huang) Department of Anesthesiology, The Second Hospital of Hebei
Medical University, Shijiazhuang, China
(Wang, Yao) Department of Anesthesiology, Peking University International
Hospital, Beijing, China
(Fan, Chen) Clinic Center of Anesthesiology and Pain, Ningbo No.2
Hospital, Ningbo, China
(Zhang) Department of Anesthesiology, Shenzhen Qianhai and Shekou Free
Trade Zone Hospital, Shenzhen, China
Publisher
BMJ Publishing Group
Abstract
Introduction Elderly patients are known to be vulnerable to postoperative
pulmonary complications (PPCs), especially pneumonia. Apart from elder
age, preoperative pulmonary diseases, anaemia, malnutrition, dysphagia and
frailty may all be contributing factors to PPCs. Poor oral hygiene is a
risk factor for PPC as well, as oropharyngeal microflora might be
introduced to the lower respiratory tract following endotracheal
intubation for general anaesthesia during surgery. Immune regulation,
nutrition supplementation and improvement of oropharyngeal microflora
might regulate immune and stress response and can be beneficial to elderly
patients exposed to surgical stress. In this study, we will explore the
effects of perioperative oral decontamination and immunonutrition
supplementation on the incidence of postoperative pneumonia in high-risk
elderly surgical patients. Methods and analysis This study is a
multicentre, two-by-two factorial randomised controlled trial evaluating
the efficacy of immunonutrition supplementation and oral chlorhexidine
decontamination. A total of 592 patients aged 65 years and older who are
scheduled for elective non-cardiac surgeries in seven tertiary hospitals
in China will be recruited. Patients will be excluded if they have
contraindications to the intervention. Patients will be randomised into
four groups in a 1:1:1:1 ratio (oral decontamination vs routine oral care,
immunonutrition supplementation vs routine nutrition advice). The primary
outcome is the incidence of PPCs within 7 days after surgery. The
secondary outcomes are the incidence of postoperative pneumonia,
infectious complications, Comprehensive Complication Index, postoperative
functional recovery, length of hospital stay and hospital expenses.
Intention to treat principles will be applied to all outcomes. Descriptive
analysis will be used to compare patients' baseline characteristics.
Logistic regression will be used to compare the incidence of PPCs within 7
days after surgery between different groups. Ethics and dissemination The
study protocol has been approved by the Research Ethics Committee of
Peking Union Medical College Hospital (I-23PJ953). All participants will
provide written informed consent. Study results will be published in
peer-reviewed journals and presented at academic conferences. Trial
registration number NCT05971810.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ Group.

<44>
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.

<45>
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.

<46>
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.

<47>
Accession Number
2034619008
Title
Clinical outcomes of transcatheter edge-to-edge repair in patients with
acute mitral regurgitation complicated by cardiogenic shock: a systematic
review and meta-analysis.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
380. Date of Publication: 01 Dec 2025.
Author
Ahmed A.; Contreras R.; Gurram A.; Saberian P.; Kaddoura R.; Boyea K.;
Issaka Y.; Hashemi S.M.; Ameen D.; Nobakht S.; Amini-Salehi E.; Nayak S.S.
Institution
(Ahmed, Contreras, Boyea, Issaka, Ameen, Nayak) Department of Internal
Medicine, Yale New Haven Health Bridgeport Hospital, Bridgeport, United
States
(Gurram) Department of Hospital Medicine, Cleveland Clinic, 33300
Cleveland Clinic Blvd, Avon, OH, United States
(Saberian, Hashemi) Cardiovascular Research Center, Hormozgan University
of Medical Sciences, Bandar Abbas, Iran, Islamic Republic of
(Kaddoura) Pharmacy Department, Heart Hospital, Hamad Medical Corporation,
Doha, Qatar
(Nobakht, Amini-Salehi) School of Medicine, Guilan University of Medical
Sciences, Rasht, Iran, Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
Background: Acute mitral regurgitation (AMR) complicated by cardiogenic
shock (CS) is a critical cardiovascular emergency associated with high
morbidity and mortality. Surgical intervention is often not feasible due
to the unstable clinical status of these patients. Transcatheter
edge-to-edge repair (TEER) has emerged as a minimally invasive
alternative, yet its safety and efficacy in this specific population
remain uncertain. This study aimed to systematically evaluate and
synthesize the evidence on the clinical outcomes of TEER in patients with
AMR complicated by CS. <br/>Method(s): Databases including PubMed, Embase,
and Web of Science were searched through March 4, 2025. Eligible studies
included adult patients with AMR and CS undergoing TEER and reporting
clinical outcomes. Data were synthesized using a random-effects model.
<br/>Result(s): The pooled in-hospital mortality rate following TEER was
17.8% (95% CI: 11.2-25.2%). One-month mortality was 7.9% (95% CI:
1.1-16.8%), six-month mortality was 21.0% (95% CI: 11.2-32.7%), and
one-year mortality was 36.5% (95% CI: 34.9-38.2%). Among patients with
degenerative MR, the one-year mortality was 7.9% (95% CI: 0.8-19.0%),
while for functional MR it was 9.4% (95% CI: 1.3-21.5%). Postprocedural MR
reduction to <= grade 2 was achieved in 86.2% of patients (95% CI:
70.7-97.3%). The intra-aortic balloon pump (IABP) application rate was
57.9% (95% CI: 24.2%-88.5%). Compared to usual care, TEER significantly
reduced in-hospital mortality (OR = 0.64; 95% CI: 0.51-0.81; P < 0.01).
However, no significant reduction was found in rehospitalization risk (OR
= 0.65; 95% CI: 0.14-3.03; P = 0.59). <br/>Conclusion(s): TEER appears to
be a promising therapeutic option for patients with AMR complicated by CS.
Compared to usual care, it is associated with significantly lower
in-hospital mortality. However, high heterogeneity and low certainty of
evidence highlight the need for further high-quality prospective studies
to validate long-term outcomes and optimize patient selection. Clinical
trial number: Not applicable.<br/>Copyright &#xa9; The Author(s) 2025.

<48>
[Use Link to view the full text]
Accession Number
2038741234
Title
Dr. Shao-Wei Chen's contribution to analysis of outcomes of patients
undergoing cardiac surgery and aortic disease: Big data analytics.
Source
Formosan Journal of Surgery. 58(3) (pp 93-102), 2025. Date of Publication:
01 May 2025.
Author
Chen S.-W.
Institution
(Chen) Division of Thoracic and Cardiovascular Surgery, Department of
Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung
University, Taoyuan City, Taiwan (Republic of China)
(Chen) Center for Big Data Analytics and Statistics, Chang Gung Memorial
Hospital, Linkou Medical Center, Taoyuan City, Taiwan (Republic of China)
Publisher
Wolters Kluwer Medknow Publications
Abstract
This retrospective review underscores Dr. Shao-Wei Chen's significant
contributions to aortic disease research, utilizing big data analytics to
advance understanding and optimize treatment outcomes. With a focus on
aortic dissection and aneurysm management, Dr. Chen 's studies cover a
range of critical topics, including genetic predisposition, pharmacologic
impacts, and procedural approaches. His research highlights the strong
correlation between family history and early-onset aortic disease,
underscoring the importance of screening and personalized interventions
for genetically at-risk populations. Notably, his work has demonstrated
the adverse effects of fluoroquinolones on aortic outcomes, revealing
increased mortality and complication rates, which has implications for
clinical guidelines on medication management in aortic patients. Dr.
Chen's comparative analyses of endovascular versus open repair for aortic
conditions, such as traumatic thoracic aortic injuries, suggest superior
outcomes with endovascular approaches for certain high-risk patients,
offering insights that support tailored procedural choices. Additionally,
his translational research into the role of lumican in aortic pathology
adds a valuable dimension to understanding connective tissue integrity and
potential biomarker applications, bridging the gap between basic science
discoveries and clinical care. Dr. Chen's work advances the field of
aortic disease through interdisciplinary collaboration, large-scale data
analysis, and translational research. Future studies should continue
refining surgical techniques, investigating innovative therapeutic
strategies, and integrating advanced analytics to further enhance
patient-specific care and improve long-term outcomes in aortic disease
management.<br/>Copyright &#xa9; 2025 Taiwan Surgical Association.

<49>
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.

<50>
Accession Number
2034196582
Title
Impact of cardiopulmonary bypass flow on the lower limit of cerebral
autoregulation during cardiac surgery: a randomized cross-over pilot
study.
Source
Journal of Clinical Monitoring and Computing. 39(3) (pp 571-580), 2025.
Date of Publication: 01 Jun 2025.
Author
Desebbe O.; Berna A.; Joosten A.; Raphael D.; Malapert G.; Rolo D.;
Taccone F.S.; Gergele L.
Institution
(Desebbe, Berna, Rolo) Department of Anesthesiology and perioperative
care, Ramsay Sante, Sauvegarde Clinic, Lyon, France
(Joosten) Department of Anesthesiology & Perioperative Care, University of
California Los Angeles, Los Angeles, CA, United States
(Raphael) Department of Anesthesiology & Perioperative Care, University of
California Irvine, Irvine, CA, United States
(Malapert) Department of Cardiac Surgery, Ramsay Sante, Sauvegarde Clinic,
Lyon, France
(Taccone) Department of Intensive Care, Hopital Universitaire de Bruxelles
(HUB), Universite Libre de Bruxelles, Brussels, Belgium
(Gergele) Department of Anesthesiology and Perioperative Care, Ramsay
Sante, Hopital Prive de la Loire, Saint-Etienne, France
(Desebbe) Department of Anesthesiology & Perioperative Medicine, Clinique
de la Sauvegarde, 480 avenue Ben Gourion, Lyon, France
Publisher
Springer Science and Business Media B.V.
Abstract
Assessment of cerebral autoregulation is challenging under different
hemodynamic conditions during cardiac surgery and must be rapidly
calculated in order to optimize mean arterial pressure (MAP). Whether
systemic flow during cardiopulmonary bypass impacts the lower limit of
cerebral autoregulation (LLA) remains unclear. Forty patients requiring
cardiac surgery were included in this randomized crossover study. Patients
assigned to the conventional/high blood flow arm received 20 min of
conventional cardiopulmonary bypass (CPB) blood flow (2.2
L/min.m^-2) followed by 20 min of high blood flow (2.8
L/min.m^-2), both during aortic cross clamping. Patients
assigned to the high/conventional arm received the same flows but in
reverse order. During each 20-minute period, MAP was gradually increased
from 40 to 90 mmHg, while PaCO<inf>2</inf>, hematocrit, depth of
anesthesia, central temperature and arterial oxygen tension were kept
constant. Continuous cerebral blood flow velocities of the middle cerebral
artery (Fv) were monitored using transcranial doppler. Cerebral
autoregulation was calculated using a Pearson's correlation coefficient
(Mean flow index, Mxa) between the MAP and Fv. Mxa values were then
plotted across MAP ranges. The LLA was defined as the corresponding MAP
value when Mxa initially decreased and crossed the threshold value of 0.4.
A mixed model, including the LLA as the dependent variable, the CPB flow
and period as fixed effects and patients as a random effect was used to
compare conventional and high CPB flows. Thirty-seven patients were
analyzed. The LLA mean difference between groups, adjusted on the period,
was - 2.8 (SE 2.4) mmHg with 95% CI [-7.8, + 2.1 mmHg], p = 0.2538). 24%
of patients presented an LLA < 65 mmHg during the conventional CPB flow
phase versus 35% during the high CPB flow phase. Increasing the
cardiopulmonary pump flow did not decrease the LLA during cardiac
surgery.<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer Nature B.V. 2025.

<51>
Accession Number
628825341
Title
Review of available evidence supporting different transfusion thresholds
in different patient groups with anemia.
Source
Annals of the New York Academy of Sciences. 1450(1) (pp 221-238), 2019.
Date of Publication: 01 Aug 2019.
Author
Chai K.L.; Cole-Sinclair M.
Institution
(Chai, Cole-Sinclair) Department of Haematology, St Vincent's Hospital,
Melbourne, VIC, Australia
Publisher
John Wiley and Sons Inc
Abstract
In patients with anemia, transfusion of red blood cells (RBCs) can save
lives and improve quality of life. The choice to transfuse should be
cautiously made owing to risks of transfusion, economic costs, and
limitations on the blood supply. Until the 1980s, the decision for RBC
transfusion was guided by Hb threshold, with the aim of maintaining the
patient's blood Hb level over 100 grams per liter. Since then, multiple
randomized controlled trials and key systematic reviews have provided
evidence-based guidelines as to appropriate transfusion thresholds in a
number of clinical settings. Here, we aimed to address the outcome of
defining different anemia criteria in specific clinical populations
exclusively on the basis of the need for RBC transfusion based on Hb
concentration. We focused on the patient populations, where there were the
most available data on differing transfusion thresholds, which looked at
transfusing to a higher or liberal transfusion threshold in comparison
with a lower or restrictive transfusion threshold. These included patients
in intensive care with or without septic shock, hip fracture surgery,
cardiovascular surgery, and upper gastrointestinal bleeding, the pediatric
population, and also those with malaria, by reviewing key randomized
controlled trials and systematic reviews. Twenty-four randomized
controlled studies and 12 systematic reviews have been included, and these
are discussed below.<br/>Copyright &#xa9; 2019 New York Academy of
Sciences.

<52>
Accession Number
2039066539
Title
Long-term secondary prevention with colchicine in patients with CAD: an
updated systematic review and meta-analysis.
Source
European Journal of Internal Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Boracchi P.; Marano G.; Luconi E.; Cimminiello C.
Institution
(Boracchi, Marano) Medical Statistics Unit, Department of Biomedical and
Clinical Sciences, University of Studies of Milan, Milan, Italy
(Luconi) Department of Clinical and Community Sciences University of
Studies of Milan, Milan, Italy
(Cimminiello) Arianna Foundation on Anticoagulation, Via P. Fabbri 1/3,
Bologna, Italy
Publisher
Elsevier B.V.
Abstract
The CLEAR SYNERGY trial failed to demonstrate any benefit of colchicine in
patients with acute myocardial infarction (MI). In this meta-analysis of
the randomized clinical trials (RCTs) of colchicine in coronary artery
disease (CAD), we updated the estimates of effect on cardiovascular events
in patients with CAD. We searched for the largest RCTs of colchicine in
CAD patients. The effect was assessed in a pooled analysis of individual
events such as MI, urgent coronary revascularization (UR), stroke,
cardiovascular mortality, and total mortality, for each of these endpoints
using hazard ratios (HR) and their 95 % confidence intervals (CI),
estimated by the Cox model. Fixed-effects or random-effects models were
used. A similar approach was used for the composite of MI, UR, and
cardiovascular mortality (MACE 1) and stroke, MI, total mortality (MACE
2). Safety was also assessed. Five studies were selected with a total of
18,656 patients. Colchicine reduced the risk of MI by 21 %, HR 0.79 (95 %
CI: 0.68 - 0.92).Its effect was neutral on total and cardiovascular
mortality. The composite endpoints MACE 1 and MACE 2 were reduced by
colchicine, HR 0.81 (95 % CI: 0.68 - 0.98), and HR 0.88 (95 % CI: 0.79 -
0.98), respectively. There were no differences in non-cardiovascular
mortality, cancer, and serious gastrointestinal and infectious events. The
benefit of colchicine appears attenuated compared to past analyses, but is
still valuable in reducing the risk of MI and the composite of MI, UR, and
cardiovascular death. The safety appears reassuring in relation to all
serious adverse reactions.<br/>Copyright &#xa9; 2025 European Federation
of Internal Medicine

<53>
Accession Number
2039038133
Title
Maori Responsiveness in Cardiothoracic Surgical Research: A Systematic
Review.
Source
Heart Lung and Circulation. Conference: The Cardiac Society of Australia
and New Zealand 4th Indigenous Cardiovascular Health Conference 2025.
Sydney Australia. 34(Supplement 3) (pp S73), 2025. Date of Publication: 01
Jun 2025.
Author
Ada S.; Kahi M.; Appleby N.; Tuivaiti E.; Wade N.; Rahiri J.
Institution
(Ada) University of Otago, Dunedin, New Zealand
(Kahi, Appleby, Tuivaiti, Wade) The University of Auckland, Auckland, New
Zealand
(Rahiri) Te Piringa Kotuku, Auckland, New Zealand
Publisher
Elsevier Ltd
Abstract
Aim: Significant health inequities persist for Maori, including access to
and outcomes following surgical interventions. Understanding these
disparities is key to improving Maori health equity. However, the scope,
quality, and focus of surgical research from a Maori perspective have not
yet been evaluated. This review analyses research on cardiothoracic
surgery for Maori, focusing on incidence, access, and perioperative
outcomes. Its goal is to guide future research and policy to enhance
surgical care and promote Maori health equity in line with Te Tiriti
obligations. <br/>Method(s): A systematic review of cardiothoracic
surgical studies focused on Maori was performed in accordance with the
Preferred Reporting Items for Systematic reviews and Meta-Analyses
(PRISMA) guidelines. Eligible studies were assessed using Kaupapa Maori
Research methodologies for cultural alignment and responsiveness to Maori,
utilising the MAORI and adapted CONSIDER frameworks. <br/>Result(s):
Twenty-one studies were included, focusing on surgical access (43%),
outcomes (43%), and epidemiology (14%). Only six studies (29%)
demonstrated responsiveness to Maori under the MAORI framework, and none
fully met the CONSIDER framework criteria. No studies incorporated
Indigenous data sovereignty, highlighting systemic gaps in culturally
responsive research. <br/>Conclusion(s): This review highlights persistent
inequities in cardiothoracic care and the lack of Maori-led, culturally
informed cardiothoracic research. The limited application of KMR
methodologies and alignment with Maori health priorities (re)identify the
need for systemic change. Strengthening Maori research leadership and
culturally grounded frameworks is essential for achieving equitable
cardiothoracic care for Maori.<br/>Copyright &#xa9; 2025

<54>
Accession Number
2039067152
Title
The cardiorespiratory fitness gap.
Source
Trends in Cardiovascular Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Cifra B.; Hamilton R.M.
Institution
(Cifra, Hamilton) Division of Cardiology, Labatt Family Heart Center The
Hospital for Sick Children and Department of Pediatrics, University of
Toronto, 555 University Ave Rm 1725D Atrium, Toronto, ON, Canada
Publisher
Elsevier Inc.

<55>
Accession Number
2039003203
Title
The relationship of baseline high-sensitivity C-reactive protein with
incident cardiovascular events and all-cause mortality over 20 years.
Source
eBioMedicine. 117 (no pagination), 2025. Article Number: 105786. Date of
Publication: 01 Jul 2025.
Author
Hartley A.; Rostamian S.; Kaura A.; Chrysostomou P.; Welsh P.; Ariti C.;
Sattar N.; Sever P.; Khamis R.
Institution
(Hartley, Rostamian, Kaura, Chrysostomou, Ariti, Sever, Khamis) National
Heart and Lung Institute, Imperial College London, United Kingdom
(Welsh, Sattar) Institute of Cardiovascular and Medical Sciences,
University of Glasgow, Glasgow, United Kingdom
Publisher
Elsevier B.V.
Abstract
Background: The prediction of future cardiovascular events in those with
risk factors is important for the appropriate optimisation of preventative
therapies for those at greatest risk. The value of high sensitivity
C-reactive Protein (hsCRP) has been questioned in this regard. The
objectives of this post-hoc analysis of a randomised controlled trial were
to investigate the usefulness of baseline serum hsCRP for predicting very
long-term cardiovascular events in patients with hypertension in the
Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) Legacy Study.
<br/>Method(s): The ASCOT Legacy Study reports events up to 20 years of
follow-up of the UK participants in the Lipid Lowering Arm of the original
ASCOT trial. We examined outcomes related to serum hsCRP levels measured
using a commercial ELISA, in tertiles or continuously, adjusting for
classical cardiovascular risk factors as well as treatment allocation
within ASCOT. The primary outcome was non-fatal myocardial infarction (MI)
and fatal coronary heart disease (CHD); whilst secondary outcomes were
all-cause mortality, total coronary events and procedures, total
cardiovascular events and stroke. <br/>Finding(s): After excluding 3286
participants without hsCRP data, 5294 participants were included in the
final cohort. The highest tertile of hsCRP was associated with the
following outcomes compared to the lowest tertile: non-fatal myocardial
infarction (MI) and fatal CHD (HR 1.32 [1.05-1.67]); total coronary events
and procedures (HR 1.27 [1.09-1.47]); total cardiovascular events (HR 1.22
[1.08-1.37]); and all-cause mortality (HR 1.25 [1.10-1.42]). However,
there was insufficient evidence regarding the association between hsCRP
levels and stroke events. Addition of hsCRP in tertiles resulted in an
improved net reclassification index for the prediction of non-fatal MI and
fatal CHD at 20 years (9.68%, p < 0.0001). <br/>Interpretation(s): Higher
baseline serum hsCRP levels can independently predict cardiovascular
events and all-cause mortality at long-term follow-up in stable patients
with hypertension. <br/>Funding(s): British Heart Foundation Clinical
Research Fellowship (FS/17/16/32560), Wellcome Trust Clinical Research
Fellowship (220572/Z/20/Z), and Sansour Fund at Imperial Healthcare
Charity. The substudy of ASCOT Biomarker Programme was supported by
Pfizer, New York, NY, USA. Infrastructure support was provided by the NIHR
Imperial Biomedical Research Centre as well as the Imperial British Heart
Foundation Research Excellence Award (4) (RE/24/130023).<br/>Copyright
&#xa9; 2025 The Author(s)

<56>
Accession Number
2034812698
Title
Robotic-assisted mediastinal lymphadenectomy in lung cancer: a narrative
review.
Source
Journal of Robotic Surgery. 19(1) (no pagination), 2025. Article Number:
263. Date of Publication: 01 Dec 2025.
Author
Adamica D.; Tulinsky L.; Kepicova M.; Dzurnakova P.; Ihnat P.; Mittak M.;
Varga A.; Neoral C.; Martinek L.
Institution
(Adamica, Tulinsky, Kepicova, Ihnat, Mittak, Varga, Martinek) Department
of Surgery, University Hospital Ostrava, 17. Listopadu 1790, Ostrava,
Czechia
(Adamica, Tulinsky, Kepicova, Ihnat, Mittak, Varga, Neoral, Martinek)
Department of Surgical Studies, Faculty of Medicine, University of
Ostrava, Syllabova 19, Ostrava, Czechia
(Dzurnakova) Department of Anesthesiology and Intensive Care Medicine,
University Hospital Ostrava, 17. Listopadu 1790, Ostrava, Czechia
Publisher
Springer Nature
Abstract
The objective of this study is to undertake a narrative review of the
oncological adequacy of mediastinal lymphadenectomy performed via
robot-assisted thoracic surgery (RATS) in comparison with video-assisted
thoracic surgery (VATS) and thoracotomy for non-small cell lung cancer
(NSCLC). The focus of the review is on lymph node yield, nodal station
dissection, and nodal upstaging rates. A narrative review of literature
published in the last decade was conducted using PubMed, Cochrane, and Web
of Science databases. Studies examining mediastinal lymphadenectomy
outcomes for RATS, VATS, or thoracotomy were included in the discussion.
The analysis of 19 studies from diverse geographical regions showed that
in six out of nine comparative studies, RATS demonstrated superior lymph
node retrieval compared to VATS, with statistically significant
differences. RATS achieved comparable or superior nodal station dissection
rates and showed particular advantages in upstaging from clinical N0 to
pathological N2 status. Additionally, RATS demonstrated favourable
perioperative outcomes with reduced morbidity and mortality rates compared
to conventional approaches. RATS represents a reliable and oncologically
sound approach to mediastinal lymphadenectomy, with potential advantages
over conventional techniques. Its enhanced visualization and precision
make it an increasingly utilised option for NSCLC treatment in centres
with robotic capabilities.<br/>Copyright &#xa9; The Author(s), under
exclusive licence to Springer-Verlag London Ltd., part of Springer Nature
2025.

<57>
Accession Number
2034812960
Title
Optimal Thromboembolism Prevention for Patients With Atrial Fibrillation
on Long-Term Dialysis.
Source
PACE - Pacing and Clinical Electrophysiology. (no pagination), 2025. Date
of Publication: 2025.
Author
Hashimoto K.; Fujisaki T.; Aikawa T.; Iwagami M.; Miyamoto Y.; Slipczuk
L.; Biase L.D.; Briasoulis A.; Yasuhara J.; Takagi H.; Kuno T.
Institution
(Hashimoto) Westmead Applied Research Centre, University of Sydney,
Sydney, NSW, Australia
(Fujisaki) Department of Cardiovascular Medicine, National Cerebral and
Cardiovascular Center, Osaka, Japan
(Fujisaki) Department of Cardiovascular Medicine, Graduate School of
Medical Sciences, Kumamoto University, Kumamoto, Japan
(Aikawa) Department of Cardiovascular Biology and Medicine, Juntendo
University Graduate School of Medicine, Tokyo, Japan
(Iwagami) Department of Digital Health, Social Medicine Group, Institute
of Medicine, University of Tsukuba, Tsukuba, Japan
(Iwagami) Department of Non-Communicable Disease Epidemiology, London
School of Hygiene and Tropical Medicine, London, United Kingdom
(Miyamoto) Department of Real-world Evidence, The University of Tokyo,
Tokyo, Japan
(Slipczuk, Biase, Kuno) Division of Cardiology, Montefiore Health
System/Albert Einstein College of Medicine, New York, NY, United States
(Briasoulis) Division of Cardiovascular Medicine, University of Iowa, Iowa
City, IA, United States
(Yasuhara) Department of Pediatric Cardiology, Monash Heart and Monash
Children's Hospital, Monash Health, Melbourne, Australia
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno) Division of Cardiology, Jacobi Medical Center, Albert Einstein
College of Medicine, New York, NY, United States
(Kuno) Division of Cardiology, Massachusetts General Hospital, Harvard
Medical School, Boston, MA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Optimal strategies for thromboembolism prevention, including
vitamin K antagonists (VKA), direct oral anticoagulants (DOAC), and left
atrial appendage occlusion (LAAO), for patients with atrial fibrillation
(AF) and on dialysis have not been fully investigated. We aimed to
investigate the efficacy and safety of thromboembolism prevention
strategies in AF patients on dialysis through a network meta-analysis.
<br/>Method(s): Multiple databases were searched through January 2024. The
primary efficacy endpoint was thrombotic events, defined as ischemic
stroke or systemic thromboembolism, whereas the primary safety endpoint
was major bleeding. These strategies were ranked using P-scores.
<br/>Result(s): Our study identified 28 eligible studies (including 3
randomized controlled trials) that enrolled 144,630 AF patients on
dialysis. The risks of thrombotic events in any DOAC and VKA were
comparable to no-anticoagulant, whereas LAAO was associated with a lower
risk of thrombotic events (HR [95% CI]: 0.19 [0.06-0.60]). Compared to
no-anticoagulant, VKA, regular-dose rivaroxaban, and dabigatran were
associated with a higher risk of major bleeding, but rivaroxaban 10 mg
daily, and apixaban 2.5 or 5 mg twice daily were not. LAAO, rivaroxaban 10
mg daily and apixaban 2.5 or 5 mg twice daily were highly ranked in
efficacy and safety outcomes. <br/>Conclusion(s): LAAO may possibly be the
reasonable therapeutic option for AF patients on dialysis, but rivaroxaban
10 mg daily and apixaban 2.5 or 5 mg twice daily can also be considered.
Further studies are warranted to confirm these findings.<br/>Copyright
&#xa9; 2025 Wiley Periodicals LLC.

<58>
Accession Number
2034815839
Title
Prophylactic cardiac denervation to prevent post-operative atrial
fibrillation after coronary artery bypass grafting: a systematic review
and meta-analysis.
Source
Journal of Interventional Cardiac Electrophysiology. (no pagination),
2025. Date of Publication: 2025.
Author
Ali J.; Khan M.H.; Majeed Z.; Elsnhory A.B.; Argueta A.E.S.; Afiridi L.;
Nawaz A.; Abuelazm M.; Khan U.; Aamir M.; Dani S.
Institution
(Ali, Argueta, Afiridi) Department of Medicine, Saint Peter's University
Hospital, New Brunswick, NJ, United States
(Khan) Department of Medicine, Saidu Medical College, Swat, Pakistan
(Majeed) Department of Medicine, King Edward Medical University, Lahore,
Pakistan
(Elsnhory) Emergency Medicine Department, Al-Azhar University, Cairo,
Egypt
(Nawaz) Department of Radiology, Pakistan Atomic Energy Commission
Hospital, Islamabad, Pakistan
(Abuelazm) Faculty of Medicine, Tanta University, Tanta, Egypt
(Khan) Division of Cardiology, University of Maryland School of Medicine,
Baltimore, MD, United States
(Aamir) Department of Cardiology, Lehigh Valley Health Network, Allentown,
PA, United States
(Dani) Department of Cardiology, Lahey Hospital & Medical Center,
Burlington, MA, United States
Publisher
Springer
Abstract
Background: Despite revolutionary advances in the field of percutaneous
coronary intervention (PCI), a significant number of patients with
coronary artery disease (CAD) require coronary artery bypass grafting
(CABG), which is associated with postoperative atrial fibrillation (POAF)
risk. This meta-analysis evaluates the efficacy and safety of prophylactic
cardiac denervation (PCD) during CABG to prevent POAF. <br/>Method(s): A
systematic search was conducted across PubMed, CENTRAL, Web of Science,
Scopus, and Embase until December 2024. Pooled data were reported using
risk ratio (RR) for dichotomous outcomes and mean difference (MD) for
continuous outcomes, with a 95% confidence interval (CI). This systematic
review and meta-analysis is registered with PROSPERO ID: CRD42025631310.
<br/>Result(s): Five studies with 1266 patients were included in the final
analysis. Compared to CABG alone, CABG plus PCD did not show any
significant difference in the incidence of POAF (RR 0.77, [95% CI 0.38,
1.56], p = 0.47, I² = 83%) and all-cause mortality (RR 0.70,
[95% CI 0.19, 2.51], p = 0.58, I² = 0). Additionally, there was
no significant difference between both groups in cross-clamp time (MD:
0.68, [95% CI - 1.22, 2.57], p = 0.48, I² = 26%),
cardiopulmonary bypass time (MD - 0.04 [95% CI - 5.29, 5.21], p = 0.99,
I² = 82%), length of hospital stay (MD - 0.13 [95% CI - 0.55,
0.29], p = 0.54, I² = 59%), blood loss (MD 2.22, [95% CI -
23.60, 28.03], p = 0.87, I² = 0%), and number of grafts (MD
0.21, [95% CI - 0.07, 0.49], p = 0.13, I² = 91%).
<br/>Conclusion(s): CABG with adjuvant PCD did not show significant
efficacy in preventing the incidence of POAF compared to CABG alone. This
calls for further research focusing on investigating combined preventive
strategies, rather than relying solely on PCD, and developing risk
stratification tools to identify patients most likely to benefit from
autonomic modulation.<br/>Copyright &#xa9; The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature
2025.

<59>
Accession Number
2036551839
Title
Population Pharmacokinetics of Tranexamic Acid in Chinese Population
Undergoing Cardiac Surgery with Cardiopulmonary Bypass.
Source
Drug Design, Development and Therapy. 19 (pp 4343-4353), 2025. Date of
Publication: 2025.
Author
Liu Y.; Zhou C.; Lv H.; Tian L.; Jiang J.; Shi J.
Institution
(Liu, Lv, Shi) Department of Anesthesiology, State Key Laboratory of
Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
(Zhou) Center for Anesthesiology, Beijing Anzhen Hospital, Capital Medical
University, Beijing, China
(Tian, Jiang) NHC Key Laboratory of Clinical Research for Cardiovascular
Medications, National Clinical Research Center of Cardiovascular Diseases,
Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union
Medical College, Beijing, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Population pharmacokinetics (PK) models could provide specific
references for the formulation of personal drug delivery protocols,
however, there is no population PK study of tranexamic acid (TXA) have
been conducted in the Chinese population. The aim of this study was to
establish a population PK model based on the data of perioperative plasma
concentrations in Chinese participants, and to provide a reference for
individualized administration of TXA. <br/>Method(s): Participants
undergoing cardiac surgery were randomly assigned to high-dose of TXA
group (a 30-mg/kg bolus, a 16-mg/ kg/h maintenance dose, and a 2-mg/kg
prime, n = 7) and low-dose group of TXA (a 10-mg/kg bolus, a 2-mg/kg/h
maintenance dose, and a 1-mg/kg prime, n = 9). Blood samples were
collected at 14 time points and the concentration of TXA was determined by
liquid chromatography-tandem mass spectrometry. Modelling was performed
using Phoenix NLME 8.3 software. <br/>Result(s): The primary covariate
identified was body weight, while no significant influence of
cardiopulmonary bypass (CPB) on the PK was detected. The population
estimates for clearance (CL<inf>1</inf>), volume of the central
compartment (V<inf>1</inf>), diffusional clearance (CL<inf>2</inf>), and
volume of peripheral compartment (V<inf>2</inf>) were 4.7 L/h, 4.9 L, 17.0
L/h, and 11.1 L, respectively, assuming a bodyweight of 70 kg.
<br/>Conclusion(s): This study provides the first population PK model of
TXA in the Chinese population undergoing cardiac surgery with CPB. The
model could serve as a reference for the future development of
individualized TXA administration strategies, with target-controlled
infusion (TCI) emerging as a viable option.<br/>Copyright &#xa9; 2025 Liu
et al.

<60>
Accession Number
647495492
Title
Optimal medical care and coronary flow capacity-guided myocardial
revascularization vs usual care for chronic coronary artery disease: the
CENTURY trial.
Source
European heart journal. (no pagination), 2025. Date of Publication: 29
May 2025.
Author
Gould K.L.; Johnson N.P.; Roby A.E.; Kirkeeide R.; Haynie M.; Nguyen T.;
Bui L.; Patel M.B.; Kitkungvan D.; Mendoza P.; Lai D.; Li R.; Sdringola
S.; McPherson D.; Narula J.
Institution
(Gould, Johnson, Roby, Kirkeeide, Haynie, Nguyen, Bui, Patel, Kitkungvan,
Mendoza, Sdringola, McPherson, Narula) Weatherhead PET Center for
Preventing and Reversing Atherosclerosis, Division of Cardiology,
Department of Medicine, University of Texas McGovern Medical School, Room
MSB 4.256, Memorial Hermann Hospital, 6431 Fannin St., Houston, United
States
(Lai, Li) Department of Biostatistics and Data Science, University of
Texas School of Public Health, Houston, TX, United States
Abstract
BACKGROUND AND AIMS: The randomized CENTURY trial tested the hypothesis
that a comprehensive strategy integrating intense lifestyle modification
and aggressive medical management to goals with revascularization reserved
for severely reduced coronary flow capacity (CFC) by positron emission
tomography (PET) would reduce risk factors, subsequent revascularization,
death and myocardial infarction (MI) compared with standard of care in
chronic stable coronary artery disease (CAD). <br/>METHOD(S): Participants
were randomly assigned to standard or comprehensive care groups.
Rest-stress PET quantified CFC for physiological CAD severity at baseline,
2, 5, and up to 11 years. The comprehensive care group reviewed PET
results with frequent clinic visits and open 24/7 phone/email support.
Standard care lacked supportive contact with blinded PET results that were
unblinded only for severely reduced CFC with high mortality risk for
potential revascularization. <br/>RESULT(S): Between 2009-2017, 515
patients were assigned to comprehensive care and 513 to standard care and
followed for 5 or more years. Comprehensive vs standard care decreased
risk factors and summed 5-year risk score (DELTA-1.1 vs + 0.33; 95%
confidence interval -1.84 to -0.97; P < .0001), decreased cumulative
11-year all-cause death (4.7% vs 8.2%; P = .023), death or MI (7.0% vs
11.1%; P = .024) late revascularization (9.5% vs 14.8%; P = .021) and
major adverse cardiac events (29.5% vs 29.9%; P = .0006). Only 56 of 1028
(5.4%) CENTURY patients with chronic CAD had revascularization within 90
days predominantly guided by CFC severity. <br/>CONCLUSION(S): The
randomized CENTURY trial demonstrates that comprehensive integrated
lifestyle modification and medical management towards goals with
revascularization reserved for severely reduced CFC, significantly reduced
risk factor scores, death, death or MI, and revascularization.
CLINICALTRIALS.GOV: NCT00756379.<br/>Copyright &#xa9; The Author(s) 2025.
Published by Oxford University Press on behalf of the European Society of
Cardiology.

<61>
Accession Number
2039028891
Title
Efficacy and Safety of Desmopressin in Terms of Bleeding and Transfusion
in Cardiac Surgery With Cardiopulmonary Bypass: A Systematic Review and
Meta-Analysis.
Source
Heart Lung and Circulation. (no pagination), 2025. Date of Publication:
2025.
Author
Picchio M.; Marcucci C.; Jaques C.; Mauron S.; Zuercher M.
Institution
(Picchio, Marcucci, Mauron, Zuercher) Department of Anesthesiology,
University Hospital of Lausanne (CHUV), Lausanne, Switzerland
(Marcucci) Faculty of Biology and Medicine, University of Lausanne (UNIL),
Lausanne, Switzerland
(Jaques) Medical Library, University Hospital of Lausanne (CHUV) and
University of Lausanne (UNIL), Lausanne, Switzerland
Publisher
Elsevier Ltd
Abstract
Bleeding and transfusion during cardiac surgery are major sources of
complications. Surgery and cardiopulmonary bypass can induce coagulopathy,
including platelet dysfunction. Desmopressin has been shown to reduce
bleeding and transfusion requirements, although with conflicting results.
This study aimed to systematically evaluate the available evidence
regarding the efficacy and safety of desmopressin in cardiac surgery with
cardiopulmonary bypass. The Embase, MEDLINE, Cochrane Central, Web of
Science, and ClinicalTrials.gov databases were searched for prospective
studies comparing desmopressin with placebo in cardiac surgery with
cardiopulmonary bypass. A meta-analysis with bleeding at 24 hours as the
primary outcome and the amount and incidence of blood product transfusions
as secondary outcomes was performed. Safety outcomes included
re-exploration rate, thromboembolic events, and mortality. Thirty-four
(34) studies comprising 2,523 patients were included. Bleeding at 24 hours
was reduced in the desmopressin group (weighted mean difference, 96.20 mL;
95% confidence interval [CI] -148.44 to -43.96; p=0.0003 with
heterogeneity [I²]=76%). The amount of blood products
transfused (red blood cells) was reduced in the desmopressin group
(standardised mean difference [SMD], -0.32; 95% CI -0.58 to -0.05). No
significant difference was found for transfusion of platelets (SMD, -0.16;
95% CI -0.58 to 0.26) or fresh frozen plasma (SMD, -0.30; 95% CI -0.67 to
-0.06). No significant differences were observed between the two groups
with respect to safety outcomes. Results of the present meta-analysis
demonstrated that desmopressin reduced blood loss and the amount of red
blood cell transfusions after cardiac surgery. However, this result should
be interpreted with caution, given the considerable heterogeneity among
the studies.<br/>Copyright &#xa9; 2025 The Author(s)

<62>
Accession Number
2039049276
Title
Incidence, reasons, and mortality risk of ICU readmission in surgical
patients: A systematic review and meta-analysis.
Source
American Journal of Surgery. 247 (no pagination), 2025. Article Number:
116460. Date of Publication: 01 Sep 2025.
Author
Lu R.; kacha S.; phothikun N.; supphapipat A.; Chanchalotorn S.;
Siripakkaphant C.; Siriniran N.; Chienprasert M.; Chittawatanarat K.
Institution
(Lu, kacha, phothikun, supphapipat, Chittawatanarat) Department of
Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
(Lu) Department of Emergency Medicine, The Affiliated Hospital, Southwest
Medical University, Sichuan, Luzhou, China
(supphapipat, Chittawatanarat) Clinical Surgical Research Center,
Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang
Mai, Thailand
(kacha, phothikun) Department of Anesthesiology, Faculty of Medicine,
Chiang Mai University, Chiang Mai, Thailand
(Chanchalotorn, Siripakkaphant, Siriniran, Chienprasert) Faculty of
Medicine, Chiang Mai University, Chiang Mai, Thailand
Publisher
Elsevier Inc.
Abstract
Background: This study investigates the incidence, reasons, and mortality
risk of ICU readmission in surgical patients. <br/>Method(s): Systematic
searches of PubMed, Embase, Cochrane, and Scopus were conducted for
studies from January 2000 to August 2024. Included studies reported ICU
readmission or in-hospital mortality in adult surgical ICU patients.
Mortality risks were compared between readmitted and non-readmitted
patients. Pooled incidence and causes of ICU readmission across diseases
were analyzed. <br/>Result(s): Among 23 studies, ICU readmission
significantly increased mortality risk (OR: 8.44, 95 % CI: 6.35-11.21).
The overall readmission incidence was 6 % (95 % CI: 0.05-0.06), with
higher rates in gastrointestinal (9 %) and thoracic (8 %) surgeries.
Respiratory issues were the most frequent cause (40 %).
<br/>Conclusion(s): ICU readmission in surgical patients is associated
with higher mortality and longer stays. Gastrointestinal and thoracic
surgeries pose higher risks, with respiratory and cardiovascular factors
being key contributors.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<63>
Accession Number
2034828621
Title
A randomized controlled trial on the impact of anesthetic agents on renal
function in cardiac surgery with cardiopulmonary bypass.
Source
Molecular and Cellular Biochemistry. (no pagination), 2025. Date of
Publication: 2025.
Author
Fan T.; Zhao Z.; Liu J.; Ma W.; Tian J.; Ma G.
Institution
(Fan, Zhao, Liu, Ma, Tian, Ma) The First Affiliated Hospital of Xinxiang
Medical University, Henan, China
Publisher
Springer
Abstract
Acute kidney injury (AKI) is a frequent and severe problem following heart
surgery, particularly in procedures involving cardiopulmonary bypass
(CPB). This research investigates the Randomized Controlled Trial (RCT) on
the impact of agents of anesthetic on renal function in patients receiving
elective cardiac surgery and CPB, comparing propofol-based and volatile
anesthetic-based regimens. A sum of 61 patients was randomly assigned into
two regions: one receiving a propofol-based regimen and the other, a
volatile anesthetic regimen, both combined with opioid analgesia. Renal
function was assessed preoperatively and postoperatively at 24 and 48 h
using serum creatinine and cystatin C levels. Perioperative inflammatory
markers were deliberate to evaluate inflammation-mediated renal impairment
multivariate logistic regression identified risk factors for AKI, and
independent t-tests compared renal function parameters between regimens.
Patients receiving propofol exhibited significantly lower rates of AKI
(p<0.05) and reduced inflammatory marker levels associated to the volatile
anesthetic regimen. These results present that propofol anesthesia
provides a protecting influence on renal function, likely due to its
anti-inflammatory properties. The research emphasizes the necessity of
choosing the right anesthetic for postoperative kidney outcomes by
tailoring anesthetic regimens to mitigate AKI risk in high-risk
populations. Propofol's protective role against AKI offers potential
clinical value, particularly in cardiac surgeries requiring CPB. Further
investigation with bigger cohorts and continued follow-up are necessary
for verifying these findings and exploring their broader applicability in
cardiac anesthesia.<br/>Copyright &#xa9; The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature
2025.

<64>
Accession Number
2034824185
Title
The Effect of Prophylactic Use of Antifibrinolytics During Pediatric
Non-Cardiac Surgeries on Bleeding and Transfusions: A Systematic Review
and Meta-Analysis.
Source
Paediatric Anaesthesia. (no pagination), 2025. Date of Publication: 2025.
Author
Hickey K.S.; Smith M.; Karam O.; Demetres M.; Faraoni D.; Duron V.; Wu
Y.S.; Nellis M.E.
Institution
(Hickey) Department of Pediatric Critical Care, Mount Sinai Kravis
Children's Hospital, New York, NY, United States
(Smith, Nellis) Division of Pediatric Critical Care, Department of
Pediatrics, New York-Presbyterian/Weill Cornell Medicine, New York, NY,
United States
(Karam) Pediatric Critical Care Medicine, Yale School of Medicine, New
Haven, CT, United States
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, United States
(Faraoni) Division of Cardiac Anesthesia. Department of Anesthesiology,
Critical Care and Pain Medicine, Boston Children's Hospital, Harvard
Medical School, Boston, MA, United States
(Duron, Wu) Department of Surgery, Columbia University Irving Medical
Center/NewYork-Presbyterian Morgan Stanley Children's Hospital, New York,
NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Objectives: The objective of this meta-analysis is to determine the effect
of intraoperative tranexamic acid, aminocaproic acid, and aprotinin on
bleeding in pediatric surgery. <br/>Study Design: A literature search was
performed for the meta-analysis and systematic review in the following
databases from inception until April 2023: Ovid MEDLINE, Ovid EMBASE, and
The Cochrane Library. Studies included patients under 18 years of age,
non-cardiac surgery, and administration of antifibrinolytics. Forest plots
were used for statistical analysis. Primary outcomes were intraoperative
blood loss and intraoperative blood transfusions. <br/>Result(s): One
hundred thirty articles met inclusion. Tranexamic acid compared to control
resulted in an estimated blood loss of -410.0 mL p-value = < 0.001 for
scoliosis surgery, -14.0 mL/kg p-value = < 0.001 for craniofacial surgery,
and -21.0 mL p-value < 0.001 for tonsillectomy/adenoidectomy surgery.
Aminocaproic acid compared to control resulted in an estimated blood loss
of -464.0 mL p-value < 0.001 for scoliosis surgery. Tranexamic acid
compared to aminocaproic acid resulted in an estimated blood loss of
-391.0 mL p-value < 0.001 for scoliosis surgery. For blood transfusion
during craniosynostosis surgery, tranexamic acid compared to control
resulted in a mean decrease of -7 mL/kg p-value = 0.010 and aprotinin
compared to control resulted in a mean decrease of -20.0 mL/kg p-value <
0.001. The analysis for VRO/VDRO and hip reconstruction did not reach
statistical significance. <br/>Conclusion(s): In craniofacial, scoliosis,
and tonsillectomy/adenoidectomy surgery, prophylactic administration of
tranexamic acid results in lower estimated blood loss. Tranexamic acid and
aprotinin are effective for reducing transfusion in craniofacial surgery.
For scoliosis surgery, tranexamic acid is more efficacious than
aminocaproic acid. More literature is needed to assess the efficacy of
tranexamic acid in VRDO/VRO and hip reconstruction surgery and the
efficacy of different dosing regimens.<br/>Copyright &#xa9; 2025 John
Wiley & Sons Ltd.

<65>
Accession Number
2034823998
Title
Coronary Artery Bypass Grafting With or Without Concomitant Surgical
Ventricular Reconstruction in Ischemic Cardiomyopathy Patients.
Source
Cardiovascular Drugs and Therapy. (no pagination), 2025. Date of
Publication: 2025.
Author
Liao J.; Zhou Z.; Zhang Y.; Miao Z.; Li G.; Xiao H.; Ren Q.; Jian B.; Wu
Z.; Liang M.
Institution
(Liao, Zhou, Zhang, Miao, Li, Xiao, Ren, Jian, Wu, Liang) Department of
Cardiac Surgery, First Affiliated Hospital of Sun Yat-Sen University, 58
Zhongshan II Road, Guangzhou, China
(Zhou) Department of Anesthesiology, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
Publisher
Springer
Abstract
Purpose: The present study aims to compare the long-term outcomes of
surgical ventricular reconstruction (SVR) combined with coronary artery
bypass grafting (CABG) versus CABG alone in patients with ischemic
cardiomyopathy (ICM). <br/>Method(s): A systematic literature search was
conducted in PubMed, Embase, Scopus, Cochrane Library, and Web of Science
until November 2024. Studies comparing SVR + CABG and CABG in patients
with ischemic cardiomyopathy (left ventricular ejection fraction less than
40%) were included. The primary outcome included long-term mortality, and
the secondary outcomes included hospital mortality, rehospitalization for
cardiac causes, and other cardiac function indicators. <br/>Result(s):
Twelve studies with a total of 3188 patients were included, with 1629
undergoing SVR + CABG and 1559 undergoing CABG. Patients who underwent SVR
+ CABG had a higher survival rate (HR 0.82; 95% CI, 0.69-0.96;
I² = 4%; P = 0.01) and a more significant postoperative left
ventricular end-systolic volume index (ESVI) reduction (MD 15.53; 95% CI,
6.41-24.65; I² = 93%; P = 0.01). In the subgroup analysis, the
Dor (endoventricular circular patch plasty) surgery provided additional
survival benefits compared with CABG (HR 0.83; 95% CI, 0.70-0.97;
I² = 9%; P = 0.02). The reconstructed Kaplan-Meier curves show
that the survival rates in the SVR + CABG, Dor, Non-Dor, Mannequin-free,
Mannequin, and CABG groups were 81.13%, 82.02%, 76.38%, 83.23%, 69.40%,
and 71.42% at 60 months, respectively. <br/>Conclusion(s): Compared with
CABG, SVR + CABG is associated with higher survival, a more significant
reduction in ESVI, fewer rehospitalizations for cardiac causes, and more
patients gaining postoperative New York Heart Association class
improvement.<br/>Copyright &#xa9; The Author(s), under exclusive licence
to Springer Science+Business Media, LLC, part of Springer Nature 2025.

<66>
Accession Number
2038999603
Title
The Comparison of Dexmedetomidine, Esmolol, and Combination of
Dexmedetomidine with Esmolol for Attenuation of Sympathomimetic Response
to Laryngoscopy and Intubation in Patients Undergoing Coronary Artery
Bypass Grafting.
Source
Annals of Cardiac Anaesthesia. 22(4) (pp 353-357), 2019. Date of
Publication: 01 Oct 2019.
Author
Singh D.; Jagannath S.; Priye S.; Syed Mudassar A.
Institution
(Singh, Jagannath, Priye, Syed Mudassar) Department of Anaesthesiology,
Vydehi Institute of Medical Sciences, Karnataka, Bengaluru, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: The aim of this study was to compare the effects of
dexmedetomidine, esmolol, and combination of both on control of
sympathetic response to laryngoscopy and tracheal intubation in coronary
artery disease patients. <br/>Material(s) and Method(s): A prospective,
randomized, double-blinded clinical study included 90 patients scheduled
for elective coronary artery bypass surgery. Patients were randomly
allocated into three groups of 30 each: dexmedetomidine group (Group D) 1
microg/kg, esmolol group (Group E) 2 mg/kg, and group dexmedetomidine with
esmolol (Group DE) 0.5 microg/ kg of dexmedetomidine with 1 mg/kg of
esmolol. Each drug was diluted with 0.9% normal saline to 20 ml volume and
infused in 10 min before induction of anesthesia. Hemodynamic changes
(heart rate [HR], arterial blood pressure, and pulmonary artery pressure)
were compared at various time intervals as follows-baseline, after study
drug, after induction, and 1, 3, and 5 min after intubation. Statistical
analysis included analysis of variance, Chi-square, and Fisher's exact
test. <br/>Result(s): In Group DE, there was no significant increase in HR
at all-time intervals, and the HR was stable compared to Group D and Group
E. Blood pressure values were comparable in all groups except in Group E
at 5 min. The pulmonary arterial pressures were statistically less in DE
group except at 3 and 5 min. <br/>Conclusion(s): The combination of
dexmedetomidine and esmolol group has beneficial effect on HR and
pulmonary arterial pressures but has no additional advantage with respect
to arterial blood pressure when compared with dexmedetomidine and esmolol
groups in patients undergoing elective coronary artery bypass
grafting.<br/>Copyright &#xa9; 2019 Annals of Cardiac Anaesthesia.

<67>
Accession Number
2038999761
Title
Comparative Evaluation of Hemodynamic Responses and Ease of Intubation
with Airtraq Video Laryngoscope versus Macintosh Laryngoscope in Patients
with Ischemic Heart Disease.
Source
Annals of Cardiac Anaesthesia. 22(4) (pp 365-371), 2019. Date of
Publication: 01 Oct 2019.
Author
Varsha A.V.; George G.; Pillai R.; Sahajanandan R.
Institution
(Varsha) Department of Cardiothoracic Surgery, Christian Medical College
and Hospital, Tamil Nadu, Vellore, India
(George, Pillai, Sahajanandan) Department of Anaesthesia, Christian
Medical College and Hospital, Tamil Nadu, Vellore, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Introduction: Hemodynamic responses during laryngoscopy can potentially
precipitate ischemia in patients with coronary artery disease. There are
conflicting reports regarding the hemodynamic stress responses between the
conventional Macintosh and video laryngoscopes. There is a paucity of
studies regarding the same in cardiac surgical patients. <br/>Material(s)
and Method(s): A prospective, randomized control study to compare the
hemodynamic responses and ease of intubation using Airtraq video
laryngoscope and Macintosh laryngoscope in patients with ischemic heart
disease. <br/>Result(s): Seventy patients were randomized into two groups.
Baseline variables including age, weight, Mallampati score, and
comorbidities were comparable between the two groups. There was
statistically significant elevation in mean heart rate in the Macintosh
group at 2^nd-min (P = 0.02) and 3^rd-min (P = 0.05)
postintubation. Similarly, there was a significant increase in mean
arterial pressure at 2^nd (P = 0.06), 3^rd (P = 0.03),
and 4^th (P = 0.03) in the Macintosh group. The time for
laryngoscopy and Intubation Difficulty Scale was significantly better in
the Airtraq group (P = 0.001 and 0.001). However, the median time to
intubation was longer in the Airtraq group (13 s vs. 11 s, P = 0.05).
Laryngoscopy view was better with Airtraq even in patients with Mallampati
score 3 (ten patients). The incidence of trauma was same in both the
groups. <br/>Conclusion(s): Airtraq provides the better hemodynamic
stability and ease of intubation and may be considered superior to
conventional Macintosh laryngoscope for intubation in patients with
ischemic heart disease.<br/>Copyright &#xa9; 2019 Annals of Cardiac
Anaesthesia.

<68>
[Use Link to view the full text]
Accession Number
2038985082
Title
Cardiac Biomarkers in Patients With Asymptomatic Severe Aortic Stenosis:
Analysis From the EARLY TAVR Trial.
Source
Circulation. 151(22) (pp 1550-1564), 2025. Date of Publication: 03 Jun
2025.
Author
Lindman B.R.; Pibarot P.; Schwartz A.; Oldemeyer J.B.; Su Y.R.; Goel K.;
Cohen D.J.; Fearon W.F.; Babaliaros V.; Daniels D.; Chhatriwalla A.;
Suradi H.S.; Shah P.; Szerlip M.; Mack M.J.; Dahle T.; O'neill W.W.;
Davidson C.J.; Makkar R.; Sheth T.; Depta J.; Devries J.T.; Southard J.;
Pop A.; Sorajja P.; Hahn R.T.; Zhao Y.; Leon M.B.; Genereux P.
Institution
(Lindman) Structural Heart and Valve Center, Vanderbilt University Medical
Center, Nashville, TN, United States
(Lindman, Su, Goel) Division of Cardiovascular Medicine, Vanderbilt
University Medical Center, Nashville, TN, United States
(Su) Cardiology Core Laboratory for Translational and Clinical Research,
Vanderbilt University Medical Center, Nashville, TN, United States
(Pibarot) Department of Cardiology, Quebec Heart and Lung Institute, Laval
University, Canada
(Schwartz, Cohen, Hahn, Leon) Columbia University Medical Center,
NewYork-Presbyterian Hospital, New York, United States
(Oldemeyer) University of Colorado Health, Loveland, United States
(Cohen, Leon) Cardiovascular Research Foundation, New York, NY, United
States
(Cohen) St Francis Hospital and Heart Center, Roslyn, NY, United States
(Fearon) Interventional Cardiology Section, Division of Cardiovascular
Medicine, Department of Medicine, Stanford University School of Medicine,
CA, United States
(Fearon) VA Palo Alto Health Care System, CA, United States
(Babaliaros) Emory School of Medicine, Atlanta, GA, United States
(Daniels) Division of Cardiology, California Pacific Medical Center, San
Francisco, United States
(Chhatriwalla) St Luke's Mid America Heart Institute, Kansas City, MO,
United States
(Suradi) Division of Cardiology, Rush University Medical Center, Chicago,
IL, United States
(Shah) Division of Cardiovascular Medicine, Brigham and Women's Hospital,
Boston, MA, United States
(Szerlip, Mack) Baylor Scott & White Heart Hospital, Plano, Richardson,
TX, United States
(Dahle) CentraCare Heart & Vascular Center, Saint Cloud, MN, United States
(O'neill) Center for Structural Heart Disease, Henry Ford Health System,
Detroit, MI, United States
(Davidson) Northwestern University Feinberg School of Medicine, Chicago,
IL, United States
(Makkar) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
(Sheth) Population Health Research Institute, McMaster University and
Hamilton Health Sciences, Hamilton, ON, Canada
(Depta) Sands-Constellation Heart Institute, Rochester Regional Health,
NY, United States
(Devries) Heart and Vascular Center, Section of Cardiovascular Medicine,
Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
(Southard) Division of Cardiovascular Medicine, UC Davis Health System,
University of California-Davis, Sacramento, United States
(Pop) Department of Cardiology, AMITA Alexian Brothers Medical Center, Elk
Grove Village, IL, United States
(Sorajja) Minneapolis Heart Institute Foundation, Abbott Northwestern
Hospital, MN, United States
(Zhao) Edwards Lifesciences, Irvine, CA, United States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center, NJ,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The EARLY TAVR trial (Evaluation of TAVR Compared to
Surveillance for Patients With Asymptomatic Severe Aortic Stenosis)
demonstrated that early transcatheter aortic valve replacement (TAVR)
intervention was superior to clinical surveillance with delayed TAVR in
patients with asymptomatic severe aortic stenosis. Cardiac biomarkers are
associated with maladaptive remodeling, symptom onset, and worse outcomes
after TAVR. Whether elevated biomarkers identify asymptomatic patients
more likely to benefit from early intervention is unknown. <br/>METHOD(S):
A core laboratory measured NT-proBNP (N-terminal pro-B-type natriuretic
peptide) and high-sensitivity cardiac troponin T (hs-cTnT) levels.
Associations between biomarker levels and risk of the trial primary end
point (death, stroke, or unplanned cardiovascular hospitalization) and
other secondary end points were examined with Kaplan-Meier curves and Cox
proportional hazard models. Interaction tests were performed to assess
whether the treatment effect of early TAVR, compared with clinical
surveillance, differed according to biomarker levels. <br/>RESULT(S):
Among 901 patients randomized in EARLY TAVR, 798 (89%) had biospecimens
measured (median NT-proBNP level, 287 [145, 601]; median hs-cTnT level,
14.6 [10.5, 21.0]). Higher levels of NT-proBNP and hs-cTnT were broadly
associated with higher event rates for multiple end points. In general,
there was no significant interaction between baseline biomarkers and
treatment group with respect to any composite or individual end point
examined, although trends broadly demonstrated a greater relative benefit
of early TAVR at lower biomarker levels. There was a significant
interaction between hs-cTnT level and treatment group with respect to
death or heart failure hospitalization (P <inf>interaction</inf>=0.04) and
heart failure hospitalization alone (P <inf>interaction</inf>=0.03) such
that the relative benefit of early TAVR was greater for patients with
normal, rather than elevated, levels of hs-cTnT at baseline. For some end
points, higher baseline NT-proBNP level was associated with numerically
greater absolute risk reduction with early TAVR than were lower NT-proBNP
levels. <br/>CONCLUSION(S): In patients with asymptomatic severe
high-gradient aortic stenosis, higher NT-proBNP and hs-cTnT levels were
broadly associated with higher event rates, as expected. However, the
relative benefit of an early TAVR strategy was consistent regardless of
baseline biomarker levels and, contrary to our hypothesis, tended to be
more pronounced in patients with the lowest biomarker levels. These
findings suggest limited value for single measurements of these biomarkers
to guide the timing of TAVR in asymptomatic patients. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT03042104.<br/>Copyright &#xa9; 2025 The Authors.

<69>
Accession Number
2038978056
Title
Role of Perioperative Oral Thyroid Hormone Supplementation in Infants
Undergoing Surgery for Congenital Heart Disease.
Source
European Journal of Cardiovascular Medicine. 15(5) (pp 800-804), 2025.
Date of Publication: 01 May 2025.
Author
Panchal J.; Sirandas A.; Parmar D.
Institution
(Panchal, Parmar) Department of Cardiac Anaesthesia, U N Mehta Institute
of Cardiology and Research Centre, Gujarat, Ahmedabad, India
(Sirandas) Department of Cardiac Anaesthesia, U N Mehta Institute of
Cardiology and Research Centre, Gujarat, Ahmedabad, India
Publisher
Healthcare Bulletin
Abstract
Background: Congenital heart disease (CHD) frequently requires early
surgical correction under cardiopulmonary bypass (CPB), which is known to
disrupt thyroid hormone balance, leading to non-thyroidal illness syndrome
(NTIS). Thyroid hormones are vital for cardiac performance, metabolism,
and hemodynamic stability, especially in infants. This study evaluates the
role of perioperative oral thyroid hormone supplementation in improving
thyroid profiles and clinical outcomes in infants undergoing open-heart
surgery for CHD. <br/>Material(s) and Method(s): A prospective,
randomized, double-blinded controlled trial was conducted from June 2022
to June 2024 at U.N. Mehta Institute of Cardiology, Ahmedabad. A total of
100 infants (<=1 year) undergoing CHD surgery under CPB were randomized
into two groups: Group T (n=50) received oral thyronorm (10 mcg/kg
preoperatively and 5 mcg/kg daily postoperatively for 4 days), and Group P
(n=50) received placebo. Serum levels of T3, T4, and TSH were measured
preoperatively and at 6, 24, 48, and 72 hours postoperatively. Secondary
outcomes included vasoactive inotropic score (VIS), cardiac function, time
to extubation, and ICU stay. <br/>Result(s): Thyronorm supplementation
significantly elevated serum T3 and T4 levels postoperatively at 24, 48,
and 72 hours (p < 0.001) compared to the placebo group. However, there was
no statistically significant difference between groups in TSH levels, VIS,
cardiac function, duration of mechanical ventilation, or ICU length of
stay (p > 0.05 for all comparisons). <br/>Conclusion(s): Perioperative
oral thyronorm effectively restored thyroid hormone levels in infants
undergoing cardiac surgery under CPB. However, it did not significantly
improve clinical outcomes such as inotropic requirement, extubation time,
or ICU stay. Routine use may be unnecessary in low-risk infants but could
be explored further in complex or high-risk surgical
categories.<br/>Copyright &#xa9; 2025 Healthcare Bulletin. All rights
reserved.

<70>
Accession Number
2038982844
Title
Effect of virtual reality (VR) therapy on pain sensation in patients
undergoing hand surgery under ultrasound-guided regional anesthesia: a
randomized controlled trial.
Source
Regional Anesthesia and Pain Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Nijs K.; Treunen T.; Jalil H.; Lensen M.; Wintmolders H.; Keunen B.;
Vanloon M.; Callebaut I.; Geebelen L.; Van de Velde M.; Stessel B.
Institution
(Nijs) Department of Anesthesiology and Pain Medicine, Jessa Hospital
Campus Virga Jesse, Flanders, Hasselt, Belgium
(Nijs, Van de Velde) Department of Cardiovascular Sciences, KU Leuven,
Leuven, Flanders, Belgium
(Treunen, Lensen) Department of Anesthesiology and Pain Medicine, Jessa
Ziekenhuis vwz, Hasselt, Flanders, Belgium
(Treunen, Lensen) Department of Anesthesiology and Pain Medicine, UZ
Leuven, Leuven, Flanders, Belgium
(Jalil, Keunen, Vanloon, Callebaut, Geebelen, Stessel) Anaesthesiology and
Pain Medicine, Jessa Ziekenhuis vwz, Hasselt, Belgium
(Wintmolders) Department of Anaesthesiology and Pain Medicine, Jessa
Ziekenhuis Campus Virga Jesse, Flanders, Hasselt, Belgium
(Callebaut, Stessel) Faculty of Medicine and Life Sciences, UHasselt,
Diepenbeek, Belgium
(Van de Velde) Anesthesiology and Pain Medicine, KU Leuven, Leuven,
Belgium
Publisher
BMJ Publishing Group
Abstract
Background and objectives During ultrasound-guided regional anesthesia and
surgery, patients receive sensory input, which combined with stress and
anxiety, can exacerbate or cause pain. Virtual reality therapy could
provide digital sedation. Our aim is to assess the effect of virtual
reality therapy on pain levels during the placement of regional anesthesia
and surgery. Methods This prospective randomized controlled superiority
trial enrolled 120 patients undergoing elective hand surgery to
investigate the effect of perioperative virtual reality therapy,
consisting of a visual and audible three-dimensional, passive program.
Patients were randomized to virtual reality therapy (n=60) or no virtual
reality therapy (n=60) during regional anesthesia block placement and
surgical procedure. Mean pain score (11-point numerical rating scale)
during ultrasound-guided regional anesthesia placement was the primary
outcome. Secondary outcomes were the mean pain score during surgery, heart
rate variation during ultrasound-guided regional anesthesia placement and
surgery, perioperative opioid use, anxiety (11-point numerical rating
scale where 0=no anxiety at all and 10=extremely anxious), virtual reality
immersion and presence (Igroup Presence Questionnaire), adverse events and
patient satisfaction (11-point numerical rating scale where 0=not
satisfied at all and 10=extremely satisfied). Results Mean pain scores
during ultrasound-guided regional anesthesia placement were 3.9+/-2.4 in
the control group and 3.6+/-2.4 in the virtual reality group, with a mean
difference of -0.3 (95% CI -1.2 to 0.5; p=0.22). Heart rate variation
during ultrasound-guided regional anesthesia placement and surgery was
non-significantly different. Anxiety during ultrasound-guided regional
anesthesia placement showed no significant difference; however, it was
significantly different during surgery (control: 1.5 (0.0, 4.0) vs virtual
reality: 0.0 (0.0, 2.0), p<0.01). Virtual reality immersion showed a total
mean score of 4.2+/-0.9. Seven patients (11.9%) suffered from adverse
virtual reality effects. Patient satisfaction during surgery and
perioperative opioid use showed no significant difference. Satisfaction
with virtual reality was high: 9.0 (8.0, 10.0).<br/>Copyright &#xa9;
American Society of Regional Anesthesia & Pain Medicine 2025.

<71>
Accession Number
2038988750
Title
Intravenous methadone for perioperative acute and chronic pain management
in Chinese adult cardiac surgical patients: A protocol for pilot
randomized controlled trial.
Source
PLOS ONE. 20(6 June) (no pagination), 2025. Article Number: e0323820. Date
of Publication: 01 Jun 2025.
Author
Wong H.M.K.; Wong W.T.; Liu X.; Au S.S.W.; Wong R.H.L.
Institution
(Wong, Wong, Liu, Au) Department of Anesthesia and Intensive Care, The
Chinese University of Hong Kong, Hong Kong
(Wong) Division of Cardiothoracic Surgery, Department of Surgery, Prince
of Wales Hospital, Hong Kong
Publisher
Public Library of Science
Abstract
Background Postoperative pain is significant in cardiac surgical patients.
Perioperative analgesia with intermittent administration of opioids can
result in significant fluctuations in serum opioid concentrations.
Methadone should provide a rapid onset and long-term pain relief upon a
single intravenous dose at induction of anesthesia, and may reduce chronic
postsurgical pain (CPSP) in cardiac surgical patients. The feasibility of
using intravenous methadone in Chinese cardiac surgical patients, and its
effect on acute and chronic pain management after cardiac surgery will be
evaluated. Methods A single-center, prospective, randomized-controlled
pilot trial. Adult cardiac surgical patients will be randomized to receive
0.2 mg/kg methadone or morphine at induction of anesthesia.
Patient-controlled analgesia morphine protocol, oral paracetamol and
dihydrocodeine will be given for postoperative analgesia. Venous blood
sampling for plasma methadone concentration will be obtained at regular
intervals from study drug infusion to 96 hours after administration. The
primary outcome will be a description of study feasibility, encompassing
recruitment and retention, protocol adherence and stakeholder
acceptability. Secondary outcomes include the time of ventilator weaning
to spontaneous breathing, time of extubation, morphine requirements within
24 hours and 72 hours after surgery, time to first morphine rescue,
postoperative pain scores, patient satisfaction, and length of stay in ICU
and hospital. Opioid-related side effects including sedation, nausea and
vomiting, and time to first bowel opening will be recorded. CPSP will be
assessed with Neuropathic Pain Scale and Pain Catastrophizing Scale at 3
and 6 months after surgery. Discussion Randomized controlled trials on
intravenous methadone in cardiac surgical patients are scarce, with none
in Chinese populations. This study, supported by plasma methadone
concentration analysis, will establish a basis for future large-scale
research aimed at improving recovery through optimized pain
management.<br/>Copyright &#xa9; 2025 Wong et al.

<72>
Accession Number
2038977439
Title
Percutaneous or surgical revascularization in patients with severe left
main coronary artery disease in Latin America: A GRADE clinical practice
guideline.
Source
International Journal of Cardiology. 436 (no pagination), 2025. Article
Number: 133401. Date of Publication: 01 Oct 2025.
Author
Lamelas P.; Pompeu Sa M.; Izcovich A.; Bottaro F.; Tisi Bana M.; Sosa
Liprandi M.I.; Lanas F.; Vilca Mejia O.A.; Zuniga Luna M.; Aubanel P.;
Munera A.; Contreras Reyes J.; Bagur R.; Whitlock R.; Garcia Garcia H.;
Mamas M.; Cohen M.G.; Ricalde A.; Abizaid A.; Mendiz O.; Araya M.; Costa
R.; Santaera O.; Hidalgo P.; Caldonazo T.; Baranchuk A.; Ragusa M.A.
Institution
(Lamelas, Mendiz) Fundacion Favaloro, Buenos Aires, Argentina
(Lamelas, Whitlock) Health Research Methods, Evidence, and Impact,
McMaster University, Canada
(Pompeu Sa) Department of Cardiovascular Surgery, Pronto Socorro
Cardiologico de Pernambuco (PROCAPE), University of Pernambuco (UPE),
Brazil
(Izcovich) Hospital Aleman, Buenos Aires, Argentina
(Bottaro) Department of Internal Medicine, Hospital Britanico, Buenos
Aires, Argentina
(Tisi Bana) Department of Medicine, Hospital Universitario Austral, Pilar,
Buenos Aires, Argentina
(Sosa Liprandi) Sanatorio Guemes, Buenos Aires, Argentina
(Lanas) Universidad de la Frontera, Temuco, Chile
(Vilca Mejia) Department of Cardiovascular Surgery, Instuto de Coracao,
Universidade de Sao Paulo, Brazil
(Zuniga Luna) Department of Interventional Cardiology, Angiografia de
Occidente, Cali, Colombia
(Aubanel) Hospital del Prado, Tijuana, Mexico
(Munera) Clinica Rosario Tesoro, Cardioestudio, Medellin, Colombia
(Contreras Reyes) Department of Cardiac Surgery, Universidad de la
Frontera, Temuco, Chile
(Bagur) Western University, London, ON, Canada
(Whitlock) Department of Surgery, McMaster University, Hamilton, ON,
Canada
(Garcia Garcia) Washington Hospital Center, Washington, United States
(Mamas) Keele Cardiovascular Research Group, Keele University,
Staffordshire, United Kingdom
(Cohen) Cleveland Clinic Florida, Weston, Florida, United States
(Ricalde) Hospital ABC, Ciudad de Mexico, Mexico
(Abizaid) Instituto do Coracao, Sao Paulo, Brazil
(Araya) Clinica Alemana, Universidad del Desarrollo, Santiago de Chile,
Chile
(Costa) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
(Santaera) Clinica privada provincial de Merlo, Buenos Aires, Argentina
(Hidalgo) Policlinica Amado, Maracaibo, Bolivia
(Caldonazo) Department of Cardiothoracic Surgery, Jena University
Hospital, Jena, Germany
(Caldonazo) Department of Cardiothoracic Surgery, Weil Cornell Medicine,
New York, United States
(Baranchuk) Queens University, Kingston, ON, Canada
(Ragusa) Division Clinica Medica, Hospital Fernandez, Buenos Aires,
Argentina
Publisher
Elsevier Ireland Ltd
Abstract
Background: Severe left main coronary artery disease (LMD) poses a major
treatment challenge in Latin America, where both percutaneous coronary
intervention (PCI) and coronary artery bypass grafting (CABG) are used.
<br/>Method(s): This guideline was developed de novo using the GRADE
approach. A multidisciplinary panel reviewed evidence from a systematic
review of randomized trials comparing PCI and CABG, incorporating a
comprehensive literature search of patient values and preferences and
outcome utilities. Thresholds were assigned for each clinical outcome,
from small to large effect. <br/>Result(s): Five randomized trials
enrolling 4612 patients were included. At 30 days, PCI resulted in a large
reduction in major bleeding and a small reduction in strokes. At 5 years,
PCI was associated with a small to moderate increase of spontaneous
myocardial infarction and a moderate to large increase in repeat
revascularization. No important differences in short- or long-term
mortality were observed between PCI and CABG. The overall certainty of
evidence was rated low. There was a notable variability in patient values
and a close call on the balance of effects. <br/>Conclusion(s): For
patients in Latin America with severe left main coronary artery disease,
the guideline panel suggests either PCI or CABG. This is a conditional
recommendation, based on low certainty in the evidence (). It applies when
both procedures are clinically and anatomically appropriate and can be
performed at centers meeting acceptable standards. The decision should be
made through a shared decision-making process involving the patient and
the multidisciplinary care team.<br/>Copyright &#xa9; 2025 The Authors

<73>
Accession Number
2034789279
Title
Single-centre, single-blind, randomized, active-controlled phase-3
non-inferiority study to investigate the safety and efficacy of the
cardioplegic solution CardioplexolTM.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1587713. Date of Publication: 2025.
Author
Tevaearai Stahel H.T.; Weiss G.; Landowski P.; Folkmann S.; Harrer M.;
Voet B.; Grabenwoger M.
Institution
(Tevaearai Stahel) Cardiovascular Department, Inselspital, Bern University
Hospital, University of Bern, Bern, Switzerland
(Weiss, Landowski, Folkmann, Harrer, Grabenwoger) Department of
Cardiovascular Surgery, Clinic Floridsdorf, Vienna, Austria
(Weiss, Landowski, Folkmann, Harrer, Grabenwoger) Karl Landsteiner
Institute of Cardiovascular Research, Vienna, Austria
(Voet) Voet Consulting, Berlin, Germany
(Grabenwoger) Medical Faculty, Sigmund Freud Private University, Vienna,
Austria
Publisher
Frontiers Media SA
Abstract
Objectives: Effective and reliable cardioplegic cardiac arrest is crucial
for maximizing myocardial protection and preserving postoperative
contractile function. Aim of this study was to demonstrate, in line with
an ongoing European registration procedure, the efficacy and safety of the
new CardioplexolTM solution. <br/>Method(s): Single-centre, single-blind,
randomized, active-controlled phase-3 non-inferiority trial comparing
CardioplexolTM and Buckberg solutions during cardiac surgery. Patients
planed for elective CABG, valve surgery and/or aortic root surgery, were
considered eligible after meeting all inclusion and exclusion criteria.
Peak troponin-T (TnT) during the first 24 h post-reperfusion was defined
as primary endpoint. Intraoperative and ICU-related secondary endpoints
were also evaluated, as were safety endpoints. <br/>Result(s): Out of 248
operated patients, 226 (100 CardioplexolTM, 126 Buckberg) were considered
for per-protocol analysis. Peak-TnT was similar in both groups (0.77 vs.
0.78 ng/ml) and non-inferiority of CardioplexolTM was confirmed. Delay
before complete cardiac arrest (11 vs. 71 s, p < 0.001) and cross-clamp
time (51.2 vs. 60.7 min, p < 0.001) were shorter after CardioplexolTM. The
defibrillation rate was also significantly reduced (10% vs. 52%, p <
0.001). Although not statistically significant, cumulative dose of
catecholamines within 24 h postreperfusion (6,202 vs. 7,170 microg/kg, p =
0.07), and ICU stay (38.1 vs. 44.0 h, p = 0.110) also appeared reduced
after CardioplexolTM. Mortality was lower after CardioplexolTM (1 pt. vs.
5 pts.). Safety parameters were comparable in both groups.
<br/>Conclusion(s): Efficacy and safety of CardioplexolTM were
demonstrated. Clinical Trial Registration:
https://www.clinicaltrialsregister.eu/ctr-search/trial/2011-004198-10/resu
lts, Eudra CT-No: 2011-004198-10.<br/>Copyright 2025 Tevaearai Stahel,
Weiss, Landowski, Folkmann, Harrer, Voet and Grabenwoger.

<74>
Accession Number
2032054149
Title
Benefits of prophylactic carotid revascularization in patients with
asymptomatic carotid artery stenosis undergoing coronary artery bypass
surgery: A narrative review.
Source
Vascular Medicine (United Kingdom). 30(1) (pp 93-102), 2025. Date of
Publication: 01 Feb 2025.
Author
Jezovnik M.K.; Poredos P.
Institution
(Jezovnik) Department of Advanced Cardiopulmonary Therapies and
Transplantation, The University of Texas Health Science Center at Houston,
Houston, TX, United States
(Poredos) Department of Vascular Disease, University Medical Centre
Ljubljana, Ljubljana, Slovenia
(Poredos, Poredos) Faculty of Medicine, University of Ljubljana,
Ljubljana, Slovenia
(Poredos) Department of Anaesthesiology and Surgical Intensive Care,
University Medical Centre Ljubljana, Ljubljana, Slovenia
Publisher
SAGE Publications Ltd
Abstract
Patients undergoing coronary artery bypass grafting (CABG) are at
increased risk of perioperative stroke. Carotid atherosclerosis has been
identified as an independent risk factor for stroke during and in the
early postoperative period of cardiac surgery. However, the pathogenesis
of peri-CABG stroke is multifactorial and frequently involves other
noncarotid causes, such as cardiac emboli and aortic atheroma. Therefore,
routine population-wide screening of carotid stenosis is not recommended,
but target screening of patients at high risk of carotid-related
perioperative stroke can have benefits. Carotid duplex sonography is
recommended as an initial screening tool. Elimination of carotid stenosis
before cardiac surgery is indicated in patients in whom carotid
atherosclerosis is suspected to be the primary contributor to
perioperative stroke. In patients with advanced carotid atherosclerosis,
an individualized revascularization approach, including simultaneous or
staged procedures, is advocated. The prevailing consensus is that
synchronous surgery is safer than staged procedures. Carotid artery
stenting represents a less invasive alternative, but its role in high-risk
patients requires further investigation. In conclusion, the risk of
perioperative stroke in patients undergoing CABG involves different
factors, and carotid artery stenosis is involved in its pathogenesis only
in some patients. Therefore, individualized approaches and careful
consideration of patient risk factors are essential in determining the
need for carotid screening and revascularization before
CABG.<br/>Copyright &#xa9; The Author(s) 2024.

<75>
[Use Link to view the full text]
Accession Number
2038971724
Title
Evaluation of Bioprosthetic Valve Dysfunction in the SMART Randomized
Clinical Trial.
Source
Circulation: Cardiovascular Interventions. (no pagination), 2025. Article
Number: e015202. Date of Publication: 2025.
Author
Herrmann H.C.; Blackman D.J.; Attizzani G.F.; Abdel-Wahab M.; Batchelor
W.B.; Gillam L.D.; Rogers T.; Oh J.K.; Althouse A.D.; Mehran R.; Tchetche
D.
Institution
(Herrmann) Perelman School of Medicine, University of Pennsylvania,
Philadelphia, United States
(Blackman) Leeds Teaching Hospitals, United Kingdom
(Attizzani) Harrington Heart and Vascular Institute, University Hospitals
Cleveland Medical Center, OH, United States
(Abdel-Wahab) Heart Center Leipzig, University of Leipzig, Germany
(Batchelor) Inova Schar Heart and Vascular, Falls Church, VA, United
States
(Gillam) Morristown Medical Center/Atlantic Health System, NJ, United
States
(Rogers) MedStar Washington Hospital Center, DC, United States
(Oh) Echocardiography Core Laboratory, Mayo Clinic, Rochester, MN, United
States
(Althouse) Medtronic, Minneapolis, MN, United States
(Mehran) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Tchetche) Clinique Pasteur, Toulouse, France
Publisher
Lippincott Williams and Wilkins

<76>
Accession Number
2039005302
Title
98 Derivation and Validation of a Pharmacogenetic-guided Warfarin Dosing
Algorithm in an Arab Population Residing in Qatar.
Source
Research and Practice in Thrombosis and Haemostasis. Conference: Abstracts
from the Anticoagulation Forum 18th National Conference on Anticoagulation
Therapy. Washington, D.C. United States. 9(Supplement 1) (no pagination),
2025. Article Number: 102778. Date of Publication: 01 May 2025.
Author
Fahmi A.; El Bardissy A.; Saad M.; Nabil M.; Bader L.; Kassem M.; Mahfouz
A.; Abdelsamad O.; Elzouki A.; Elewa H.
Institution
(Fahmi, El Bardissy, Saad, Nabil, Kassem, Mahfouz, Abdelsamad, Elzouki)
Hamad Medical Corporation, Doha, Qatar
(Bader, Elewa) Qatar University College of Pharmacy, Doha, Qatar
Publisher
Elsevier B.V.
Abstract
Introduction: A number of studies have demonstrated the superiority of
genotype guided warfarin dosing when compared to other methods.
Internationally validated algorithms are also available and although
studied in diverse populations they were not validated in the Arab
population. This research aims to derive and validate a genotype-guided
warfarin dosing algorithm in an Arab population and compare its results to
an internationally validated genotype-guided warfarin dosing algorithm
(Gage et al. algorithm available at www.warfarindosing.org) in terms of
accuracy measures. <br/>Method(s): Arab patients newly starting on
warfarin provided saliva for genotyping of VKORC1 (-1639G>A), CYP2C9*2,
CYP2C9*3 and CYP4F2*3. The primary outcome was the calculated warfarin
maintenance dose. Patients were randomly assigned to a derivation or a
validation cohorts. Multiple linear regression was used to derive a
warfarin dosing model. The model was validated in an independent cohort.
Algorithm correlation with warfarin dose was assessed using Spearman
correlation coefficient. The median absolute error (MAE) was calculated
for our algorithm and compared to the MAE of Gage et al. algorithm.
<br/>Result(s): Multiple linear regression analysis in the derivation
cohort (n=164) showed that VKORC1 (-1639G>A), CYP2C9*2 & CYP2C9*3
genotypes, age, BSA and the use of prosthetic valve were significant
predictors of warfarin dose in our population. The model could explain 40%
of warfarin dose variability in our population (p < 0.001). In the
validation cohort, (n = 92), our model correlated well with warfarin dose
(Spearman's rho correlation coefficient = 0.66, p < 0.001). The derived
warfarin dosing model showed higher accuracy evident from a significantly
lower MAE compared to Gage et al. (9.1 mg/week vs 10.8 mg/week, p=0.02).
<br/>Conclusion(s): The derived model achieved the following factors: Age,
BSA, Prosthetic valve indication, CYP2C9 and VKORC1 as significant
predictors of warfarin dose. The model showed good association with
warfarin dose and higher accuracy compared to Gage et al algorithm.
Genetic and clinical factors explain around 40% of warfarin dose
variability and therefore future studies should focus on identifying
additional factors that affect warfarin dose.<br/>Copyright &#xa9; 2025

<77>
Accession Number
2034753704
Title
The clinical use of platelet transfusions: A systematic literature review
and meta-analysis on behalf of the International Collaboration for
Transfusion Medicine Guidelines.
Source
Transfusion. (no pagination), 2025. Date of Publication: 2025.
Author
Jug R.; La Rocca U.; Al-Riyami A.Z.; Bathla A.; Metcalf R.A.; White S.K.;
Stanworth S.J.; Nahirniak S.
Institution
(Jug) Department of Pathology, University of Cincinnati, Cincinnati, OH,
United States
(La Rocca) Italian National Blood Center, National Institute of Health,
Sapienza University of Rome, Rome, Italy
(Al-Riyami) Department of Hematology, Sultan Qaboos University Hospital,
University Medical City, Muscat, Oman
(Al-Riyami) College of Medicine and Health Sciences, Sultan Qaboos
University, Muscat, Oman
(Bathla) Canadian Blood Services, Toronto, Canada
(Metcalf, White) Department of Pathology, University of Utah, Salt Lake
City, UT, United States
(Stanworth) NHS Blood and Transplant, University of Oxford, Oxford, United
Kingdom
(Stanworth) Oxford University Hospitals NHS Trust, University of Oxford,
Oxford, United Kingdom
(Stanworth) Radcliffe Department of Medicine, University of Oxford,
Oxford, United Kingdom
(Nahirniak) Department of Laboratory Medicine and Pathology, University of
Alberta, Edmonton, AB, Canada
(Nahirniak) Alberta Precision Laboratories, Edmonton, AB, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Platelets are frequently transfused, but supply and potential
harms highlight the importance of appropriate use. Study Design and
Methods: Our systematic review (SR) followed a predefined protocol.
Eligible studies included SRs, randomized controlled trials (RCTs), and
matched cohort observational studies between 1946 and March 2025.
Populations included were hypoproliferative thrombocytopenia,
periprocedural prophylaxis, cardiovascular surgery, consumptive
thrombocytopenia, and intracranial hemorrhage. The intervention was
restrictive versus liberal platelet transfusion strategies on outcomes of
mortality and bleeding. Duplicate screening and data extraction occurred.
Meta-analysis used Mantel-Haenszel method of random effects model.
<br/>Result(s): Twenty-one RCTs, 24 observational studies, and 20 SRs were
included. The evidence quality varied. For hypoproliferative
thrombocytopenia, 11 RCTs were analyzed, with 9 RCTs at moderate risk of
bias (ROB). Two RCTs were identified for dengue, with high ROB for
bleeding. One RCT was identified each in cardiovascular surgery,
intracranial hemorrhage, and periprocedural prophylaxis. Meta-analyses
indicated no significant effect for outcomes of mortality or bleeding by
strategy, but confidence intervals (CIs) were wide. Effect estimates were
1.32 [0.93, 1.86] for all-cause mortality in hypoproliferative
thrombocytopenia, 0.80 [0.38, 1.70] in cardiovascular surgery, and 0.69
[0.47, 1.03] in critically ill neonates or dengue patients.
<br/>Discussion(s): A consistent lack of benefit with liberal platelet
transfusion was observed across analyzed populations, although wide
confidence intervals do not exclude clinically meaningful impacts.
Important research gaps are highlighted in areas where the RCT data is
limited.<br/>Copyright &#xa9; 2025 The Author(s). Transfusion published by
Wiley Periodicals LLC on behalf of AABB.

<78>
Accession Number
2034792526
Title
Combination of Suture-Plug Vascular Closure Devices Versus Suture-Only
Devices Following Transcatheter Aortic Valve Implantation: A Systematic
Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Haddad S.; Bashour G.; Mamas M.A.
Institution
(Haddad, Bashour) Faculty of Medicine, Tishreen University, Latakia,
Syrian Arab Republic
(Haddad, Bashour) Cancer Research Center, Tishreen University, Latakia,
Syrian Arab Republic
(Mamas) Keele Cardiovascular Research Group, Keele University, Keele,
United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is an effective
and safe intervention for severe symptomatic aortic stenosis regardless of
surgical risk. Vascular complications following TAVI are considered among
the most common and serious complications, with a higher risk of
mortality. <br/>Aim(s): We aimed to perform a systematic review and
meta-analysis to evaluate the safety and efficacy of the combination of
suture-collagen plug vascular closure devices (VCDs) compared with
suture-only devices. <br/>Method(s): We have systematically searched the
literature from inception until January 4, 2025, for cohort studies and
clinical trials comparing the combination of suture-collagen plug vascular
closure devices (VCDs) versus suture-only VCDs. <br/>Result(s): A total of
2064 patients across six studies were included in the analysis. All
studies compared dual Perclose ProGlide versus 1 Perclose ProGlide + 1
Angio-Seal, except one study that used either one Prostar or dual ProGlide
in the suture group. The combination group of suture-plug VCDs was
associated with a statistically significant reduction of VCDs failure (RR
= 0.14, CI 95% [0.09-0.23], p < 0.0001, I² = 58.6938%),
bleeding complications (RR = 0.35, CI95% [0.24-0.53], p < 0.0001, (Formula
presented.) 0.0%), major vascular complications (RR = 0.42, CI 95% [0.28,
0.63], p < 0.0001, I² = 50.4%), and minor vascular
complications (RR = 0.54, CI 95% [0.43, 0.66], p < 0.0001, I² =
0%). On the other hand, all-cause mortality did not have a statistically
significant difference between the two groups (RR = 0.54, CI 95% [0.28,
1.05], p = 0.0709, I² = 0%). <br/>Conclusion(s): In patients
undergoing TAVI, the combination strategy of suture-plug VCDs is superior
to suture-only devices regarding major and minor vascular complications,
bleeding complications, and VCD failure. The significantly higher VCD
failure of the suture-only group observed in our study led to the use of
additional closure devices to secure hemostasis, raising concerns about a
higher risk of peripheral ischemia.<br/>Copyright &#xa9; 2025 Wiley
Periodicals LLC.

<79>
Accession Number
647476428
Title
An adjustment of fraction of inspired oxygen using the oxygen reserve
index during one-lung ventilation in pediatric patients: a prospective,
randomized controlled trial.
Source
Korean journal of anesthesiology. (no pagination), 2025. Date of
Publication: 26 May 2025.
Author
Park J.-B.; Kang P.; Ji S.-H.; Jang Y.-E.; Kim E.-H.; Kim J.-T.; Kim
H.-S.; Lee J.-H.
Institution
(Park, Ji, Jang, Kim, Kim, Kim, Lee) Department of Anesthesiology and Pain
Medicine, Seoul National University College of Medicine, Seoul National
University Hospital, Seoul, South Korea
(Kang) Department of Anesthesiology and Pain Medicine, Korea University
Hospital, Seoul, South Korea
Abstract
Background: One-lung ventilation (OLV) during thoracic surgery frequently
requires approximately 100% oxygen, imposing the risk of hyperoxemia. This
study aimed to assess whether oxygen reserve index (ORI)-guided fraction
of inspired oxygen (FiO2) adjustment can reduce the incidence of
hyperoxemia in children undergoing lung resection. <br/>Method(s): This
prospective, randomized controlled trial enrolled children aged < 7 years
scheduled for thoracoscopic lung resection. The participants were randomly
assigned to either a conventional group (FiO2 adjusted based on arterial
blood gas analysis [ABGA]) or an ORI group (FiO2 titrated to maintain an
ORI target of 0.15). ABGA was performed 10 and 30 min after the start of
OLV (T1 and T2). The primary outcome was the incidence of hyperoxemia 30
min after OLV (T2). <br/>Result(s): Data from 64 children (31
conventional, 33 ORI groups) were analyzed. The incidence rate of
hyperoxemia at T2 was similar between the conventional and ORI groups
(54.8% vs. 60.6%; P = 0.801). However, partial pressure of arterial oxygen
at T1 was significantly lower in the ORI group than in the conventional
group (214.61 +/- 65.52 mmHg vs. 268.84 +/- 92.71 mmHg; P = 0.014). The
ORI group demonstrated a lower time-weighted average FiO2 during OLV (0.79
+/- 0.12 vs. 0.87 +/- 0.09; P = 0.004). The ORI group required more rescue
interventions than the conventional group and experienced fewer episodes
of hypoxia. <br/>Conclusion(s): ORI-guided FiO2 adjustment does not
significantly reduce the incidence of hyperoxemia in children undergoing
OLV but reduces time-weighted FiO2 and hypoxic events.

<80>
Accession Number
647492428
Title
Postoperative stellate ganglion block reduces high-sensitivity troponin T
release in patients undergoing off-pump coronary artery bypass surgery: a
randomized controlled trial.
Source
Minerva anestesiologica. (no pagination), 2025. Date of Publication: 29
May 2025.
Author
Zhu Y.; Zhu X.; Wang L.; Shen L.; Qi D.
Institution
(Zhu, Zhu, Wang, Shen) Key Laboratory of Anesthesiology, Xuzhou Medical
University, Xuzhou, China
(Zhu, Zhu, Wang, Shen, Qi) Department of Anesthesiology, Affiliated
Hospital of Xuzhou Medical University, Xuzhou, China
(Qi) Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou,
China
Abstract
BACKGROUND: The non-analgesic applications of stellate ganglion block
(SGB) are increasingly garnering scholarly and clinical interest. This
study aimed to investigate the myocardial protective effects of
postoperative SGB in patients undergoing off-pump coronary artery bypass
grafting (OPCABG). <br/>METHOD(S): In this double-blind, randomized
controlled trial, 62 adults scheduled for OPCABG were randomized to one of
two groups: the right stellate ganglion block group (RSGB group) and the
control group. Postoperation, participants had a right SGB. However,
controls were not blocked. The primary outcome was serum high-sensitivity
troponin T concentration measured within seven days after surgery.
Secondary outcomes included postoperative hemodynamics, postoperative pain
scores, postoperative incidence of atrial fibrillation, postoperative
dosage of vasoactive drugs, postoperative opioid consumption, incidence of
myocardial infarction, 30-day postoperative mortality, and length of
hospital stay. <br/>RESULT(S): At some point after the operation, the RSGB
group patients' serum high-sensitivity troponin levels were noticeably
lower than the control group, with means (standard deviation [SD]) of
146.1 (49.7) vs. 207.8 (50.6) at 12 hours; 132.7 (35.6) vs. 202.6 (43.8)
at 24 hours; 19.7 (9.2) vs. 41.7 (24.7) at 7 days; all P<0.001. Moreover,
the RSGB group showed significantly lower pain scores, a significantly
reduced postoperative rate-pressure product (RPP) value, and a
substantially lower incidence of atrial fibrillation. <br/>CONCLUSION(S):
In patients undergoing OPCABG, it was observed that postoperative right
SGB can reduce postoperative high-sensitivity cardiac troponin T levels.

<81>
Accession Number
2038941247
Title
The effects of a modified deep serratus anterior plane block on surgical
stress and perioperative neurocognitive disorders in elderly patients
undergoing thoracic surgery: a randomized clinical study.
Source
Journal of Thoracic Disease. 17(5) (pp 3238-3248), 2025. Date of
Publication: 30 May 2025.
Author
Lei W.; Cheng J.; Bignami E.; Gonzalez M.; Sun Q.; Sun J.; Cheng Y.
Institution
(Lei, Sun, Sun, Cheng) Department of Anesthesiology, Affiliated Hangzhou
First People's Hospital, School of Medicine, Westlake University,
Hangzhou, China
(Cheng, Sun) Department of Anesthesiology, The Second Affiliated Clinical
College of Wenzhou Medical University, Wenzhou, China
(Cheng) Department of Anesthesiology, Sir Run Run Shaw Hospital College of
Medicine Zhejiang University, Hangzhou, China
(Bignami) Anesthesiology, Critical Care and Pain Medicine Division,
Department of Medicine and Surgery, University of Parma, Parma, Italy
(Gonzalez) Department of Thoracic Surgery, Lausanne University Hospital,
University of Lausanne, Lausanne, Switzerland
(Sun) Department of Anesthesiology, The Second Affiliated Clinical College
of Wenzhou Medical University, 109 West Xuehua Road, Pujiao Street,
Lucheng District, Wenzhou, China
Publisher
AME Publishing Company
Abstract
Background: Perioperative stress response is an important risk factor for
perioperative neurocognitive disorder (PND) in elderly patients. This
study aimed to evaluate and compare the effects of a modified deep
serratus anterior plane block (DSPB) combined with general anesthesia on
surgical stress and PND in elderly patients undergoing thoracic surgery.
<br/>Method(s): A total of 66 patients undergoing thoracic surgery were
randomly assigned to receive either a single-shot DSPB or local block
after tracheal intubation using ropivacaine 0.5% (20 mL). The primary
outcomes were the visual analog scale (VAS) scores at each time point. The
secondary outcomes included the Montreal Cognitive Assessment (MoCA) score
before surgery and after discharge from the hospital (or seventh day
postoperatively), malondialdehyde (MDA), superoxide dismutase (SOD), and
serum cortisol levels, drug consumption, vital signs, and blood gas
analysis. <br/>Result(s): Ultimately, 60 patients were enrolled in the
study. The VAS scores were significantly lower in the DSPB group than the
local block group (all P<0.05). There was a statistically significant
difference in the blood gas analysis index total carbon dioxide
(TCO<inf>2</inf>) content (27.71+/-3.49 vs. 29.31+/-2.26 mmHg) between the
two groups (P<0.05). The length of hospitalization was shorter in the DSPB
group than the local block group (6.03+/-1.35 vs. 7.20+/-1.49 days), and
the difference was statistically significant (P<0.05). There were no
statistically significant differences between the two groups in terms of
the MoCA scores before surgery and after hospitalization (or the seventh
day postoperatively), stress indices, vital signs, bispectral index (BIS)
value, blood gas analysis (except TCO<inf>2</inf>), and drug use during
extubation at each time point (all P>0.05). <br/>Conclusion(s): Compared
with the local block, the elderly patients undergoing thoracic surgery who
received the DSPB had a superior analgesic effect, a lower VAS score, and
shorter length of hospitalization. As a DSPB does not require ultrasound
equipment, it is simpler and easier to operate than a local block, and is
especially suitable for widespread implementation in small
hospitals.<br/>Copyright &#xa9; AME Publishing Company.

<82>
Accession Number
2038974549
Title
Smoking, Colchicine and Postoperative Outcomes in Thoracic Surgery: Post
Hoc Analysis of the COP-AF Randomized Controlled Trial.
Source
CJC Open. (no pagination), 2025. Date of Publication: 2025.
Author
Ofori S.; Wang M.K.; Popova E.; McIntyre W.F.; Chan M.; Sessler D.I.;
Giulia V.; Warwas M.; Balasubramanian K.; Tandon V.; Finley C.; Anna G.T.;
Cata J.; Srinathan S.; Reimer C.; McLean S.; Trujillo J.C.; Fleischmann
E.; Voltolini L.; Cruz P.; Maziak D.E.; Gutierrez-Soriano L.; Amir M.;
Bossard M.; Wang C.Y.; Devereaux P.J.; Conen D.
Institution
(Ofori, Wang, McIntyre, Balasubramanian, Devereaux, Conen) Population
Health Research Institute, McMaster University, Hamilton, ON, Canada
(Ofori, Wang, McIntyre, Warwas, Tandon, Devereaux, Conen) Department of
Medicine, McMaster University, Hamilton, ON, Canada
(Popova) Institut de Recerca Sant Pau, Barcelona, Spain
(Popova) Centro Cochrane Iberoamericano, Barcelona, Spain
(Chan) The Chinese University of Hong Kong, Hong Kong Special
Administrative Region, Hong Kong, China
(Sessler) Outcomes Research Consortium, Houston, TX, United States
(Giulia) Department of Thoracic Surgery, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Giulia) School of Medicine, Vita-Salute San Raffaele University, Milan,
Italy
(Finley) Department of Surgery, McMaster University, Hamilton, ON, Canada
(Anna) Vall d'Hebron, Barcelona, Spain
(Cata) University of Texas, Houston, TX, United States
(Srinathan) University of Manitoba, Winnipeg, MB, Canada
(Reimer) Kingston General Hospital, Kingston, ON, Canada
(McLean) Vancouver Acute Department of Anesthesia and Perioperative
Medicine, Vancouver General Hospital, BC, Canada
(Trujillo) Thoracic Surgery Department, Hospital de la Santa Creu i Sant
Pau, Barcelona, Spain
(Fleischmann) Medical University of Vienna, Vienna, Austria
(Voltolini) University of Florence, Florence, Italy
(Cruz) Department of Anesthesiology, Reanimation and Pain treatment.
University General Hospital Gregorio Maranon, Madrid, Spain
(Maziak) University of Ottawa, Surgical Oncology, Division of Thoracic
Surgery, Ottawa, ON, Canada
(Maziak) Ottawa Hospital, General Division, Ottawa, ON, Canada
(Gutierrez-Soriano) Anesthesiology Department, Anesthesiology Research
Group, Fundacion Cardioinfantil-Instituto de Cardiologia, Bogota, Colombia
(Amir) Shifa International Hospital, Shifa Tameer-e-Millat University,
Islamabad, Pakistan
(Bossard) Cardiology Division, Heart Center, Luzerner Kantonsspital,
Lucerne, Switzerland
(Bossard) Faculty of Health Sciences and Medicine, University of Lucerne,
Lucerne, Switzerland
(Wang) Department of Anaesthesiology, Faculty of Medicine, Universiti
Malaya, Kuala Lumpur, Malaysia
Publisher
Elsevier Inc.
Abstract
Background: To determine, among patients who underwent major noncardiac
thoracic surgery, the association between smoking and perioperative atrial
fibrillation (AF) and myocardial injury after noncardiac surgery (MINS),
and whether the effect of colchicine use on these outcomes varied by
smoking status. <br/>Method(s): This study is a subgroup analysis of the
Colchicine for the Prevention of Perioperative Atrial Fibrillation
(COP-AF) randomized clinical trial. A total of 3209 participants who
underwent major noncardiac thoracic surgery were randomized to receive
colchicine, 0.5 mg twice daily, or identical placebo, for 10 days starting
2-4 hours before surgery. The co-primary outcomes were clinically
significant perioperative AF and MINS during the 14-day follow-up.
<br/>Result(s): A total of 687 (21.4%) were current smokers, 1577 (49.1%)
were former smokers, and 945 (29.5%) were never smokers. AF occurred in
7.7%, 7.6%, and 5.3%, and MINS occurred in 21.0%, 19.7%, and 17.6% of
current, former, and never smokers, respectively. Compared to never
smokers, the adjusted hazard ratio for AF was 1.72 (95% confidence
interval [CI] 1.07-2.77, P = 0.02) in current smokers and 1.46 (95% CI
0.99-2.16, P = 0.06) in former smokers, and the adjusted hazard ratio for
MINS was 1.16 (95% CI 0.87-1.54, P = 0.32) in current smokers and 1.02
(95% CI 0.81-1.28, P = 0.88) in former smokers. No interaction occurred
between smoking status and colchicine allocation for AF (interaction P,
0.82) or MINS (interaction P, 0.08). <br/>Conclusion(s): Current smoking
was associated with a small but increased risk of perioperative AF but not
MINS after thoracic surgery. The effect of colchicine use on either
outcome was not modified by smoking status. Clinical Trial Registration:
NCT03310125<br/>Copyright &#xa9; 2025 The Authors

<83>
Accession Number
2038976074
Title
Cardiovascular CT, MRI, and PET/CT in 2021: Review of Key Articles.
Source
Radiology. 305(3) (pp 538-554), 2022. Date of Publication: 01 Dec 2022.
Author
Tzimas G.; Ryan D.T.; Murphy D.J.; Leipsic J.A.; Dodd J.D.
Institution
(Tzimas, Leipsic) Department of Radiology, University of British Columbia,
St. Paul's Hospital Radiology, Vancouver, Canada
(Ryan, Murphy, Dodd) Department of Radiology, St. Vincent's University
Hospital, Elm Park, Dublin, Ireland
(Murphy, Dodd) School of Medicine, University College Dublin, Dublin,
Ireland
Publisher
Radiological Society of North America Inc.
Abstract
This review focuses on three key noninvasive cardiac imaging
modalities-cardiac CT angiography (CTA), MRI, and PET/CT-and summarizes
key publications in 2021 relevant to radiologists in clinical practice.
Although this review focuses primarily on articles published in Radiology,
important studies from other major journals are included to highlight
"must-know" articles in the field of cardiovascular imaging. Cardiac CTA
has been established as the first-line test for patients with stable chest
pain and no known coronary artery disease, and its value remains central
to the assessment of surgical or transcatheter aortic valve replacement.
Artificial intelligence continues to evolve in a number of applications in
cardiovascular disease. In cardiac MRI studies, 2021 has seen an emphasis
on nonischemic cardiomyopathies, valvular heart disease, and COVID-19
disease cardiac manifestations and the authors highlight the key articles
on these topics. A section featuring the increasing role of cardiac PET/CT
in the assessment of cardiac sarcoidosis and prosthetic valves is also
provided.<br/>Copyright &#xa9; RSNA, 2022.

<84>
Accession Number
2038927800
Title
Albumin Usage in Iran.
Source
Archives of Iranian Medicine. 22(12) (pp 722-727), 2019. Date of
Publication: 01 Dec 2019.
Author
Rezapour A.; Javan-Noughabi J.; Salehiniya H.; Kassani A.; Sadeghi A.
Institution
(Rezapour, Javan-Noughabi) Health Management and Economics Research
Center, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Javan-Noughabi) Department of Health Economics, School of Health
Management and Information Sciences, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Salehiniya) Zabol University of Medical Sciences, Zabol, Iran, Islamic
Republic of
(Salehiniya) Department of Epidemiology and Biostatistics, School of
Public Health, Tehran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Kassani) Department of Community Medicine, Dezful University of Medical
Sciences, Dezful, Iran, Islamic Republic of
(Sadeghi) Department of Public Health, Esfarayen Faculty of Medical
Sciences, Esfarayen, Iran, Islamic Republic of
Publisher
Academy of Medical Sciences of I.R. Iran
Abstract
Background: Human albumin is an expensive therapy with inappropriate use
in many clinical conditions. Inappropriate use of albumin imposes a
substantial economic burden on the healthcare system and society. Drug use
evaluation (DUE) is one method of assessing the appropriateness of drug
use which has been powered by increasing concern about the
cost-effectiveness of drugs. The objective of this study is to
systematically review the appropriateness of albumin utilization in
Iranian hospitals. <br/>Method(s): We searched the PubMed, MEDLINE,
EMBASE, SCOPUS, and Google Scholar for articles in English and SID,
Magiran, Medlib, and Irandoc for articles in Persian from 1997 to 2018.
Studies on the DUE of albumin in Iranian hospitals were included in this
study. Articles conducted outside Iran, editorials, letters and review
articles were excluded. <br/>Result(s): In total, eight studies were
selected for the final review. The majority of the papers were conducted
in Tehran. In most studies, the highest albumin consumption was related to
the intensive care unit. The most frequent reasons for prescribing albumin
were edema, hypoalbuminemia, volume expansion after heart surgery,
ascites, cardiac surgery and cirrhosis. Of the studies included, five
studies evaluated the costs of drug use. <br/>Conclusion(s): Our findings
show that inappropriate use of albumin imposes a relatively high
additional cost on the society. The included studies show that the
percentage of inappropriate use of albumin is relatively high in Iran and
this abuse is an essential problem in Iranian hospitals. Prescription
based on standard guidelines could improve rational use of albumin and
lead to savings in treatment costs.<br/>Copyright &#xa9; 2019 The
Author(s).

<85>
Accession Number
647482750
Title
Long-term risks of adverse kidney outcomes after acute kidney injury: a
systematic review and meta-analysis.
Source
Nephrology, dialysis, transplantation : official publication of the
European Dialysis and Transplant Association - European Renal Association.
(no pagination), 2025. Date of Publication: 27 May 2025.
Author
Veltkamp D.M.J.; Porras C.P.; Gant C.M.; Groenestege W.M.T.; Kok M.B.;
Verhaar M.C.; van Solinge W.W.; Haitjema S.; Vernooij R.W.M.
Institution
(Veltkamp, Porras, Gant, Verhaar, Vernooij) Department of Nephrology and
Hypertension, University Medical Center Utrecht, Utrecht University,
Utrecht, Netherlands
(Veltkamp, Groenestege, van Solinge, Haitjema, Vernooij) Central
Diagnostic Laboratory, University Medical Center Utrecht, Utrecht
University, Utrecht, Netherlands
(Porras, Vernooij) Julius Center for Health Sciences and Primary Care,
University Medical Center Utrecht, Utrecht University, Utrecht,
Netherlands
(Kok) UtrechtNetherlands
Abstract
BACKGROUND: Acute kidney injury (AKI) is associated with increased risks
of incidence or progression of chronic kidney disease (CKD), kidney
failure (KF), or major adverse kidney events (MAKE), however it remains
unclear which individuals have higher risks. Hence, we systematically
reviewed the literature to explore differences in kidney dysfunction risks
between AKI stages, AKI durations, and clinical settings. <br/>METHOD(S):
We performed a systematic search in PubMed and Embase to identify studies
that examined at least one outcome of interest in individuals with AKI
versus without AKI, with a minimum follow-up of one year. Hazard/odds
ratios (HR/OR) were pooled using random effects models. Heterogeneity
across patient- and disease-characteristics was examined using subgroup
and meta-regression analyses. <br/>RESULT(S): We comprised 70 studies,
encompassing 1,838,668 individuals, including 165,715 with AKI. All
studies were of moderate to high quality. Individuals with AKI had higher
risks of CKD incidence (AKI 25.8%/no AKI 8.7%; HR 2.36 (95% confidence
interval (CI) 1.77-2.94)), CKD progression (AKI 43.1%/no AKI 35.6%; HR
1.83 (95%CI 1.26-2.40)), KF (AKI 2.9%/no AKI 0.5%; HR 2.64 (95%CI
2.03-3.25)), and MAKE (AKI 59.0%/no AKI 32.7%; OR 2.77 (95%CI 2.01-3.53)).
The pooled effect estimates for CKD incidence after AKI lasting <3 days
remained significant (OR 2.37 (95%CI 1.68-3.07), even in individuals with
AKI stage 1 only (HR 1.49 (95%CI 1.44-1.55)). Diabetes mellitus,
hypertension, requiring acute dialysis, cardiovascular surgery, or
coronary artery disease were associated with higher CKD incidence or
progression risks. <br/>CONCLUSION(S): Risks for kidney dysfunction were
higher for all individuals with AKI. Risk estimates were heterogeneous
between patient subgroups, based on AKI stage, AKI duration and clinical
setting, yet even individuals with the lowest stage or shortest duration
of AKI remained at higher risk for CKD incidence or progression. This
highlights the need to develop tailored follow-up strategies to timely
recognize kidney function decline post-AKI and initiate kidney protective
measures.<br/>Copyright &#xa9; The Author(s) 2025. Published by Oxford
University Press on behalf of the ERA.

<86>
Accession Number
2038983378
Title
Platelet Transfusion: 2025 AABB and ICTMG International Clinical Practice
Guidelines.
Source
JAMA. (no pagination), 2025. Date of Publication: 2025.
Author
Metcalf R.A.; Nahirniak S.; Guyatt G.; Bathla A.; White S.K.; Al-Riyami
A.Z.; Jug R.C.; La Rocca U.; Callum J.L.; Cohn C.S.; Deanda A.; Desimone
R.A.; Dubon A.; Estcourt L.J.; Filipescu D.C.; Fung M.K.; Goel R.; Hess
A.S.; Hume H.A.; Kaufman R.M.; Kranke P.; Louw V.J.; Moller M.H.; Murphy
M.F.; Muszynski J.A.; O'kelly C.J.; Pagano M.B.; Patidar G.K.; Pavenski
K.; Poston J.N.; Saifee N.H.; Stolla M.; Szczepiorkowski Z.M.; Tobian
A.A.R.; Uberoi R.; Waters J.; Williams B.; Wood E.M.; Zantek N.D.; Zeller
M.P.; Grossman B.J.; Stanworth S.J.
Institution
(Metcalf, White) Department of Pathology, University of Utah, Salt Lake
City, United States
(Metcalf) ARUP Laboratories, Salt Lake City, UT, United States
(Nahirniak) Department of Laboratory Medicine and Pathology, University of
Alberta, Edmonton, AB, Canada
(Guyatt) Departments of Clinical Epidemiology and Biostatistics and
Medicine, McMaster University, Hamilton, ON, Canada
(Bathla) Canadian Blood Services, Toronto, ON, Canada
(Al-Riyami) Department of Hematology, Sultan Qaboos University Hospital,
University Medical City, Muscat, Oman
(Al-Riyami) College of Medicine and Health Sciences, Sultan Qaboos
University, Muscat, Oman
(Jug) Department of Pathology, University of Cincinnati, Cincinnati, OH,
United States
(La Rocca) National Blood Centre, Italian National Institute of Health,
Rome, Italy
(La Rocca) Sapienza University of Rome, Rome, Italy
(Callum) Department of Pathology and Molecular Medicine, Queen's
University and Kingston Health Sciences Centre, Kingston, ON, Canada
(Callum) Sunnybrook Research Institute, Toronto, ON, Canada
(Cohn, Zantek) Department of Laboratory Medicine and Pathology, University
of Minnesota, Minneapolis, United States
(Deanda) Cardiovascular Surgery Division, University of Texas Medical
Branch, Galveston, United States
(Desimone) Department of Pathology and Laboratory Medicine, Weill Cornell
Medicine, New York, NY, United States
(Dubon) Patient Partner, Salt Lake City, UT, United States
(Estcourt, Murphy, Stanworth) NHS Blood and Transplant, Oxford University
Hospitals NHS Trust, Radcliffe Department of Medicine, University of
Oxford, United Kingdom
(Filipescu) Department of Anesthesiology, University of Carol Davila,
Bucharest, Romania
(Fung, Poston) Department of Pathology and Laboratory Medicine, University
of Vermont, Burlington, United States
(Goel, Tobian) Department of Pathology, Johns Hopkins University,
Baltimore, MD, United States
(Goel) Department of Internal Medicine, Southern Illinois University,
Springfield, United States
(Hess) New Zealand Blood Service, Christchurch, New Zealand
(Hume) Centre Hospitalier Universitaire Ste-Justine, University of
Montreal, Montreal, QC, Canada
(Kaufman, Szczepiorkowski) Department of Pathology and Laboratory
Medicine, Dartmouth Geisel School of Medicine, Hanover, NH, United States
(Kranke) University of Wurzburg, Wurzburg, Germany
(Louw) Division of Clinical Haematology, Department of Medicine,
University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
(Louw) Department of Medicine, University of Stellenbosch and Tygerberg
Hospital, Cape Town, South Africa
(Moller) Department of Intensive Care University of Copenhagen -
Rigshospitalet and Department of Clinical Medicine, Copenhagen, Denmark
(Muszynski) Division of Critical Care Medicine, Nationwide Children's
Hospital, Columbus, OH, United States
(O'kelly) Department of Neurosurgery, University of Alberta, Edmonton, AB,
Canada
(Pagano) Department of Laboratory Medicine and Pathology, University of
Washington, Seattle, United States
(Patidar) Department of Transfusion Medicine, All India Institute of
Medical Sciences, New Delhi, India
(Pavenski) Department of Laboratory Medicine and Pathobiology, University
of Toronto, Toronto, ON, Canada
(Saifee) Department of Laboratory Medicine and Pathology, Seattle
Children's Hospital and University of Washington, Seattle, United States
(Stolla) Bloodworks Northwest Research Institute, Seattle, WA, United
States
(Uberoi) Interventional Radiology, Oxford University Hospitals, University
of Oxford, Oxford, United Kingdom
(Waters) Department of Anesthesiology, University of Pittsburgh,
Pittsburgh, PA, United States
(Waters) Department of Anesthesiology, University of Maryland, Baltimore,
United States
(Williams) Department of Haematology, Monash University, Melbourne, VIC,
Australia
(Wood) Division of Hematology and Thromboembolism and Michael G. DeGroote
Center for Transfusion Research, McMaster University, Hamilton, ON, Canada
(Zeller) Canadian Blood Services, Hamilton, ON, Canada
(Grossman) Department of Pathology and Immunology, Washington University,
St Louis, MO, United States
Publisher
American Medical Association
Abstract
Importance: Platelet transfusion is a frequent procedure with benefits and
risks. <br/>Objective(s): To provide recommendations in adult and
pediatric populations in whom platelet transfusions are commonly
performed. Evidence Review: Grading of Recommendations Assessment
Development and Evaluation (GRADE) methodology was applied to findings
from 21 randomized trials and 13 observational studies in contexts of
limited randomized clinical trial data. Transfusion strategies using fewer
(restrictive) vs greater (liberal) amounts of platelets were compared.
<br/>Finding(s): Evidence demonstrated that restrictive transfusion
strategies probably did not cause increases in mortality or bleeding
relative to liberal strategies across predefined clinical populations.
Exceedingly low incidence of spinal hematoma was identified in patients
with thrombocytopenia undergoing lumbar puncture. Because definitions of
restrictive strategies varied across trials, recommendations reflect
practical guidance. The following recommendations are strong
recommendations with high/moderate-certainty evidence. For
hypoproliferative thrombocytopenia in nonbleeding patients receiving
chemotherapy or undergoing allogeneic stem cell transplant, platelet
transfusion is recommended when platelet count is less than 10 x
10³/muL. For consumptive thrombocytopenia in neonates without
major bleeding, platelet transfusion is recommended when platelet count is
less than 25 x 10³/muL. In patients undergoing lumbar puncture,
platelet transfusion is recommended when platelet count is less than 20 x
10³/muL. In patients with consumptive thrombocytopenia due to
Dengue without major bleeding, platelet transfusion is not recommended.
The following recommendations are conditional recommendations with
low/very low-certainty evidence. For hypoproliferative thrombocytopenia in
nonbleeding adults undergoing autologous stem cell transplant or with
aplastic anemia, prophylactic platelet transfusion is not recommended. In
adults with consumptive thrombocytopenia without major bleeding, platelet
transfusion is recommended when platelet count is less than 10 x
10³/muL. In adults undergoing central venous catheter placement
in compressible anatomic sites, platelet transfusion is recommended when
platelet count is less than 10 x 10³/muL. In adults undergoing
interventional radiology, platelet transfusion is recommended when
platelet count is less than 20 x 10³/muL for low-risk
procedures and less than 50 x 10³/muL for high-risk procedures.
For adults undergoing major nonneuraxial surgery, platelet transfusion is
recommended when platelet count is less than 50 x 10³/muL. For
patients without thrombocytopenia undergoing cardiovascular surgery in the
absence of major hemorrhage, including those receiving cardiopulmonary
bypass, platelet transfusion is not recommended. For nonoperative
intracranial hemorrhage in adults with platelet count greater than 100 x
10³/muL, including those receiving antiplatelet agents,
platelet transfusion is not recommended. Conclusions And Relevance: A
consistent pattern of evidence supports the implementation of restrictive
platelet transfusion strategies. Restrictive strategies reduce risk of
adverse reactions, mitigate platelet shortages, and reduce costs. It is
good practice to consider overall clinical context and alternative
therapies in the decision to perform platelet transfusion.<br/>Copyright
&#xa9; 2025 American Medical Association. All rights reserved, including
those for text and data mining, AI training, and similar technologies.

<87>
Accession Number
2036544876
Title
The Effect of Intravenous Dexmedetomidine During Surgery in the Prevention
of Shivering After General Anesthesia in Patients Undergoing Spinal
Surgery: A Randomized Clinical Trial.
Source
Anesthesiology and Pain Medicine. 15(2) (no pagination), 2025. Article
Number: e159077. Date of Publication: 01 Apr 2025.
Author
Shokri M.; Bakhtiari Z.; Kargar B.; Hajialigol A.
Institution
(Shokri) School of Medicine, Tabriz University of Medical Sciences,
Tabriz, Iran, Islamic Republic of
(Bakhtiari) Tabriz University of Medical Sciences, Tabriz, Iran, Islamic
Republic of
(Kargar) Islamic Azad University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Hajialigol) Alborz Office of Universal Scientific Education and Research
Network (USERN), Alborz University of Medical Sciences, Karaj, Iran,
Islamic Republic of
Publisher
Brieflands
Abstract
Background: Postoperative shivering is an involuntary, spontaneous, and
repetitive contraction of skeletal muscles that causes patient
restlessness, increased oxygen consumption, wound infection, surgical
bleeding, and cardiac events. Patients undergoing spine surgery in the
prone position are particularly susceptible to hypothermia.
<br/>Objective(s): Given the importance of controlling postoperative
shivering in these patients, the present study aimed to investigate the
effect of intraoperative dexmedetomidine (Dex) infusion in preventing
shivering after general anesthesia in patients undergoing spine surgery in
the prone position. <br/>Method(s): In this double-blind randomized
clinical trial, 60 American Society of Anesthesiologists (ASA) class I or
II patients undergoing vertebral surgery in the prone position were
enrolled. Patients in the study group (n = 30) received Dex infusion
during surgery, while those in the placebo group (n = 30) received an
equivalent volume of 0.9% normal saline. Hemodynamic variables, frequency
and severity of shivering, and drug side effects were recorded.
<br/>Result(s): The mean arterial pressure (MAP) at 90 minutes (P =
0.022), immediately before extubation (P = 0.001), and after extubation (P
= 0.001), as well as HR values at 60 minutes (P = 0.020), 90 minutes (P =
0.001), immediately before extubation (P = 0.001), and after extubation (P
= 0.001), were significantly lower in the study group compared to the
placebo group. The frequency of bradycardia (26.7% vs. 0%, P = 0.002) and
hypotension (20% vs. 0%, P = 0.012) was significantly higher in the study
group. At all evaluated times, the mean body temperature in the study
group was significantly higher than in the placebo group (P < 0.05). The
frequency (10% vs. 30%, P = 0.003) and intensity (P = 0.001) of shivering
in the study group were significantly lower than in the placebo group.
<br/>Conclusion(s): This study demonstrated that the preventive use of Dex
infusion during surgery reduces the frequency and severity of
postoperative shivering in patients undergoing spinal surgery in the prone
position. However, this method was associated with hypotension and
bradycardia in some patients.<br/>Copyright &#xa9; 2025, Shokri et al.

<88>
Accession Number
647485341
Title
Effect of Continuous Intraoperative Dexmedetomidine on Interleukin-6 and
Other Inflammatory Markers After Coronary Artery Bypass Graft Surgery: A
Randomized Controlled Trial.
Source
Medicina (Kaunas, Lithuania). 61(5) (no pagination), 2025. Date of
Publication: 24 Apr 2025.
Author
Zdravkovic R.; Vickovic S.; Preveden M.; Drobnjak V.; Lukic-Sarkanovic M.;
Miljevic I.B.; Tatic M.; Tubic T.; Videnovic N.; Mladenovic N.; Komazec
N.; Dracina N.; Jerkovic M.; Djokovic A.; Jakovljevic A.; Kostic A.;
Mehmedi E.; Redzek A.
Institution
(Zdravkovic, Vickovic, Preveden, Lukic-Sarkanovic, Miljevic, Tatic, Tubic,
Mladenovic, Komazec, Dracina, Jerkovic, Redzek) Faculty of Medicine,
University of Novi Sad, Novi Sad, Serbia
(Zdravkovic, Preveden, Drobnjak, Miljevic, Mladenovic, Komazec, Dracina,
Redzek) Institute of Cardiovascular Diseases of Vojvodina, Serbia
(Vickovic, Lukic-Sarkanovic, Tubic, Jerkovic) Clinical Center of
Vojvodina, Novi Sad, Serbia
(Tatic) Institute of Oncology of Vojvodina, Serbia
(Videnovic, Jakovljevic, Kostic, Mehmedi) Faculty of Medicine, University
of Pristina, Serbia
(Djokovic) Clinic of Internal Medicine, Clinical Hospital Center Kosovska
Mitrovica, Serbia
Abstract
Background and Objectives: Coronary artery bypass graft (CABG) surgery is
the most common cardiac surgery. One of the main causes of postoperative
complications and increased mortality after CABG is the inflammatory
response. The aim of this study was to investigate whether continuous
intraoperative dexmedetomidine can reduce the increase of IL-6 and other
inflammatory markers after CABG surgery. <br/>Material(s) and Method(s):
The study is registered with ClinicalTrials.gov, NCT06378827, accessed on
23 April 2024. This prospective experimental study was conducted from
April to December 2024 and included 100 patients undergoing CABG surgery.
Patients in the experimental group (50 patients) received a continuous
infusion of dexmedetomidine (0.5 mug/kg/h) from anesthesia induction until
the end of surgery, while the patients in the control group (50 patients)
received the same volume of saline. The primary outcomes were the changes
in the values of interleukin-6 (IL-6), C-reactive protein (CRP), white
blood cells (WBC), and fibrinogen on the first postoperative day (POD1)
compared to the basal, preoperative values. <br/>Result(s): The patients
in the control group were on average 65.26 years old, and the patients in
the experimental group were 66.28 years old (p = 0.555). From the control
group, 40 (80%) patients were male compared to 37 (74%) patients from the
experimental group (p = 0.635). Median IL-6 before surgery was 2.0 pg/mL,
while on POD 1 it was 76.2 pg/mL (p < 0.001). Median CRP before surgery
was 2.5 mg/dL, while the POD1 value was 45.5 mg/dL (p < 0.001). Median WBC
values were 6.7 x 109/L before surgery and 13.6 x 109/L on POD1 (p <
0.001). The average value of fibrinogen was 3.19 g/L before surgery, while
on POD1 it was 3.37 g/L (p = 0.024). The increase in IL-6 on POD1
(DELTAIL-6) was 72.4 pg/mL in the control group and 73.0 pg/mL in the
experimental group (p = 0.427). DELTACRP was 41.2 mg/mL (control group)
and 38.0 mg/mL (experimental group) (p = 0.725). DELTAWBC was 7.45 x 109/L
(control group) and 6.81 x 109/L (experimental group) (p = 0.407).
DELTAfibrinogen was 0.16 g/L (control group) and 0.2 g/L (experimental
group) (p = 0.771). <br/>Conclusion(s): Intraoperative administration of
dexmedetodine during CABG surgery at a dose of 0.5 microg/kg/h without a
loading dose does not lead to a decrease in the intensity of the
inflammatory response after surgery.

<89>
Accession Number
647487941
Title
Tracheobronchial Replacement: A Systematic Review.
Source
JAMA surgery. (no pagination), 2025. Date of Publication: 28 May 2025.
Author
Martinod E.; Radu D.M.; Onorati I.; Chapalain X.; Santos Portela A.M.;
Peretti M.; Freynet O.; Uzunhan Y.; Chouahnia K.; Duchemann B.; Juvin C.;
Lebreton G.; Rouard H.; Van der Meersch G.; Galvaing G.; Chadeyras J.-B.;
Tronc F.; Kuczma P.; Tresallet C.; Venissac N.; Beloucif S.; Huet O.;
Vicaut E.
Institution
(Martinod, Radu, Onorati, Santos Portela, Peretti) Chirurgie Thoracique et
Vasculaire, Hopitaux Universitaires Paris Seine-Saint-Denis, Assistance
Publique-Hopitaux de Paris (AP-HP), Hopital Avicenne, Bobigny, France
(Martinod, Radu, Onorati) Hypoxie et Poumon, Faculte de Medecine SMBH,
Bobigny, France
(Martinod, Radu, Onorati) Laboratoire de Recherche Bio-chirurgicale,
Fondation Alain Carpentier, Hopital Europeen Georges Pompidou, AP-HP,
Paris, France
(Onorati, Rouard) Banque des Tissus, AP-HP, EFS Ile de France,
Ivry-sur-Seine, France
(Chapalain) Anesthesie-Reanimation, UFR de medecine, Centre Hospitalier
Universitaire de Brest, Universite de Bretagne occidentale, Brest, France
(Freynet, Uzunhan) Pneumologie, Hopitaux Universitaires Paris
Seine-Saint-Denis, AP-HP, Hopital Avicenne, Bobigny, France
(Chouahnia, Duchemann) Oncologie, Hopitaux Universitaires Paris
Seine-Saint-Denis, AP-HP, Hopital Avicenne, Bobigny, France
(Juvin, Lebreton) Chirurgie Cardiaque, Hopital La Pitie-Salpetriere,
AP-HP, Sorbonne Universite, Paris, France
(Van der Meersch) Medecine Intensive Reanimation, Hopitaux Universitaires
Paris Seine-Saint-Denis, AP-HP, Hopital Avicenne, Bobigny, France
(Galvaing, Chadeyras) Service de Chirurgie Thoracique et Endocrinienne,
Centre Jean Perrin, Clermont-Ferrand, France
(Tronc) Chirurgie Thoracique, Hopitaux Universitaires de Lyon, Lyon,
France
(Kuczma, Tresallet) Chirurgie Digestive et Endocrinienne, Hopitaux
Universitaires Paris Seine-Saint-Denis, AP-HP, Hopital Avicenne, Bobigny,
France
(Venissac) Chirurgie Thoracique, Hopitaux Universitaires de Lille, Lille,
France
(Beloucif) Anesthesie-Reanimation, Hopitaux Universitaires Paris
Seine-Saint-Denis, AP-HP, Hopital Avicenne, Bobigny, France
(Huet) Hopitaux Universitaires Paris Seine-Saint-Denis, AP-HP, UFR de
medecine, Universite de Bretagne occidentale, Hopital Avicenne, Bobigny,
Brest, France
(Vicaut) Unite de Recherche Clinique, AP-HP, Paris, France
Abstract
Importance: Tracheobronchial replacement remains a surgical and biological
challenge despite several decades of experimental and clinical research.
<br/>Objective(s): To compile a comprehensive state-of-the-science review
examining the current indications, techniques, and outcomes of
tracheobronchial replacement in human patients. Evidence Review: A
systematic review of the literature was conducted on July 1, 2024, to
identify studies examining tracheobronchial replacement. This review was
performed according to the Preferred Reporting Items for Systematic
Reviews and Meta-analyses (PRISMA) reporting guidelines and the PRISMA
2020 statement. We selected the following 3 databases: (1) PubMed via the
US National Library of Medicine's PubMed.gov; (2) Embase via Elsevier's
Embase.com; and (3) the Cochrane Central Register of Controlled Trials
(CENTER) via Wiley's Cochrane Library. An additional search was performed
using the following clinical trials registers: the World Health
Organization's International Clinical Trials Registry Platform and
ClinicalTrials.gov, provided by the US National Library of Medicine.
<br/>Finding(s): The initial search produced 6043 results, with a total of
126 publications included in the final review. Only 1 prospective cohort
study and 1 registry, both concerning the use of cryopreserved aortic
allografts, were identified. Most publications were case reports and
series. From July 1, 2002, to July 1, 2024, a total of 137 cases of
tracheobronchial replacement were published. Tracheobronchial replacement
was indicated for extensive neoplastic tumors (108 cases [78.8%]) or
benign stenoses (29 cases [21.2%]). The most common malignancies were
thyroid cancers and adenoid cystic carcinomas. The most frequent
resections involved the upper half of the trachea, with reconstructions
using muscle flaps, or, most notably, cryopreserved aortic allografts,
which have shown promising outcomes and have become the most widely used
method since 2022. In the only available registry, the 30-day
postoperative mortality and morbidity rates were 2.9% and 22.9%,
respectively. Long-term follow-up showed that mortality was related to
local recurrences and metastases in patients with cancer. <br/>Conclusions
and Relevance: This systematic review indicates that extensive malignant
lesions are the primary indication for tracheobronchial replacement, with
cryopreserved aortic allografts being the only scientifically evaluated
surgical technique. Postoperative outcomes were comparable to other major
thoracic surgical procedures, while long-term results depended on the
underlying disease, especially in cancer cases.

<90>
Accession Number
647478976
Title
Efficacy and safety of mechanical pulmonary valve replacement: a
comprehensive systematic review and meta-analysis.
Source
Journal of cardiothoracic surgery. 20(1) (pp 238), 2025. Date of
Publication: 26 May 2025.
Author
Rafati A.; Rashedi S.; Pasebani Y.; Vahedinejad M.; Ghoshouni H.;
Toloueitabar Y.; Mousavizadeh M.; Saedi S.; Jalali A.; Khajali Z.; Tatari
H.; Farrokhzadeh F.; Bakhshandeh H.; Dehaki M.G.; Ghadrdoost B.;
Sadeghipour P.
Institution
(Rafati, Rashedi, Pasebani, Vahedinejad, Ghoshouni, Jalali, Tatari,
Farrokhzadeh, Bakhshandeh, Ghadrdoost, Sadeghipour) Vascular Diseases and
Thrombosis Research Center, Rajaie Cardiovascular Institute, Vali-Asr Ave,
Tehran, Iran, Islamic Republic of
(Ghoshouni, Bakhshandeh) Cardiovascular Epidemiology Research Center,
Rajaie Cardiovascular Institute, Tehran, Iran, Islamic Republic of
(Toloueitabar, Saedi, Khajali, Dehaki) Congenital Heart Disease Research
Center, Rajaie Cardiovascular Institute, Tehran, Iran, Islamic Republic of
(Mousavizadeh) Heart valve Diseases Research Center, Rajaie Cardiovascular
Institute, Tehran, Iran, Islamic Republic of
Abstract
BACKGROUND: Pulmonary valve replacement (PVR) is the most common valve
replacement procedure for pulmonary valve dysfunction in congenital heart
diseases (CHD). Despite the long-term need for anticoagulation and
potential bleeding complications in mechanical PVR (MPVR), prosthetic
dysfunction and reoperation might occur less frequently. The major
guidelines on the CHD management have no recommendation on the valve type
for the PVR. So, we systematically reviewed the latest literature on the
efficacy and safety of MPVR with different etiologies. <br/>METHOD(S):
This study followed the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses guidelines. The protocol was registered with PROSPERO
(CRD42023425339). A systematic search was conducted in PubMed, Scopus, Web
of Science, and Embase. The primary outcomes evaluated include all-cause
mortality, reintervention for mechanical prostheses, valvular thrombosis,
thromboembolic events, prosthetic valve dysfunction, major bleeding
events, right ventricular failure, and infective endocarditis. A
random-effects model was employed for the meta-analysis. The quality of
the studies was assessed using the Newcastle-Ottawa Scale. <br/>RESULT(S):
The literature search was conducted up to June 12, 2023, and included 16
records in the qualitative synthesis, with 13 studies also included in the
quantitative synthesis. Our systematic review indicates that the
previously published patient-level analysis remains the most reliable
evidence to date on MPVR, with 91%, 97%, and 95% 5-year freedom from
valvular thrombosis, reintervention, and all-cause mortality,
respectively. Our meta-analysis indicated low pooled incidence proportions
of other outcomes as follows: Major bleeding (mean follow-up = 68.79
months, 16/336, 5% [95% CI 3-8]); Valvular dysfunction (mean follow-up =
68.89 months, 70/708, 10% [95% CI 8-12]); Thromboembolic events (mean
follow-up = 78.28 months, 9/293, 3% [95% CI 2-6]); and Infectious
endocarditis (mean follow-up = 42.03 months, 7/518, 1% [95% CI 1-3]).
<br/>CONCLUSION(S): Despite showing acceptable efficacy and safety in
MPVR, there is still a significant knowledge gap in choosing the most
appropriate prosthetic valve in patients undergoing PVR. High-quality
research is warranted to resolve the existing gap in
evidence.<br/>Copyright &#xa9; 2025. The Author(s).