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<1>
Accession Number
2035156100
Title
Sex and gender considerations in randomized controlled trials in critical
care nephrology: a meta-epidemiologic study.
Source
BMC Medicine. 23(1) (no pagination), 2025. Article Number: 386. Date of
Publication: 01 Dec 2025.
Author
Lumlertgul N.; Wannakittirat A.; Kung J.Y.; Srisawat N.; Collister D.; See
E.J.; Pannu N.; Mehta R.L.; Soranno D.E.; Ostermann M.; Bagshaw S.M.
Institution
(Lumlertgul, Wannakittirat, Srisawat) Division of Nephrology, Department
of Medicine, Faculty of Medicine, Chulalongkorn University; Excellence
Centre for Critical Care Nephrology, King Chulalongkorn Memorial Hospital;
Centre of Excellence in Critical Care Nephrology, Chulalongkorn
University, Bangkok, Thailand
(Wannakittirat) Division of Nephrology, Department of Medicine, Faculty of
Medicine, Naresuan University Hospital, Phitsanulok, Thailand
(Kung) Geoffrey & Robyn Sperber Health Sciences Library, University of
Alberta, Edmonton, AB, Canada
(Collister, Pannu) Division of Nephrology, Department of Medicine,
University of Alberta, Edmonton, AB, Canada
(See) Department of Critical Care, the University of Melbourne, Parkville,
VIC, Australia
(See) Department of Medicine, the University of Melbourne, Parkville, VIC,
Australia
(See) Department of Intensive Care, Royal Melbourne Hospital, Melbourne,
VIC, Australia
(See) Department of Nephrology, Royal Melbourne Hospital, Melbourne, VIC,
Australia
(Mehta) Department of Medicine, University of California San Diego, United
States
(Soranno) Division of Nephrology, Department of Pediatrics, Indiana
University School of Medicine, Indianapolis, IN, United States
(Ostermann) Department of Critical Care, Guy's and St Thomas' NHS
Foundation Trust, King's College, London, United Kingdom
(Bagshaw) Department of Critical Care Medicine, Faculty of Medicine and
Dentistry, University of Alberta and Alberta Health Services, Edmonton,
AB, Canada
Publisher
BioMed Central Ltd
Abstract
Background: How sex and gender are considered in randomized controlled
trials (RCTs) in critical care nephrology is unclear. We aimed to perform
a meta-epidemiologic study to describe the representation, sex and gender
reporting, and sex- and gender-based analyses (SGBA) in high-impact RCTs
in critical care nephrology. Method(s): We searched the Web of
Science Core Collection for critical care nephrology papers from 2000 to
2024. We included trials published in high-impact journals in general
medicine, pediatrics, critical care, and nephrology. The main outcome was
the proportion of female/woman participants enrolled and the association
with trial characteristics, findings, and women authorship. We estimated
the participation-to-prevalence ratio (PPR) to evaluate the
representativeness of females within identified RCTs and selected case-mix
and disease populations. Sex and gender reporting and SGBA were
investigated. Result(s): A total of 117 RCTs, including 106,057
participants, were included. Sex (54.7%), gender (26.5%), both (2.6%), or
none (16.2%) terminology were used for reporting. Male/female (82.1%),
men/women (11.1%), both (4.3%), boys/girls (0.9%) and none (1.7%) were
used as descriptors. Of the 115 RCTs with available sex/gender data, the
median proportion of female/women participants was 35.4% (interquartile
range (IQR) 31.2%-40.8%). Pediatric age group and process of care as an
intervention were independently associated with the proportion of
female/women participants. The median PPR was 0.89 (IQR 0.8-1.06), except
in major surgery, for which PPR was 0.67 (IQR 0.29-0.73). Twelve (10.9%)
and 49 (41.9%) studies used sex and/or gender as inclusion and exclusion
criteria, respectively; 5 (4.3%) studies used sex/gender-stratified
randomization; and 35 (29.9%) studies performed SGBA. RCTs with pregnancy,
lactation, or women of childbearing age as exclusion criteria had a lower
enrollment of female/women participants than RCTs that did not (33.6% vs.
36.8%, P = 0.04). Exclusion criteria of pregnancy, lactation, or
childbearing age were considered strongly justified, potentially
justified, and poorly justified in 36.1%, 14.9%, and 48.9%, respectively.
There were no changes in the representation of females/women and SGBA
across identified RCTs over the search range. Conclusion(s):
Females/women are less frequently represented in critical care nephrology
RCTs. Significant gaps exist in sex- and gender-specific eligibility
criteria, reporting, and analysis. Copyright © The Author(s)
2025.

<2>
Accession Number
2035211117
Title
Physical activity and health-related quality of life after lung cancer
surgery- cross-sectional analyses 3 and 12 months postoperatively.
Source
Health and Quality of Life Outcomes. 23(1) (no pagination), 2025. Article
Number: 69. Date of Publication: 01 Dec 2025.
Author
Jonsson M.; Hurtig-Wennlof A.; Ahlsson A.; Westerdahl E.
Institution
(Jonsson) Department of Physiotherapy, Faculty of Medicine and Health,
Orebro University, Orebro, Sweden
(Hurtig-Wennlof) Department of Clinical Diagnostics, School of Health and
Welfare, Jonkoping University, Jonkoping, Sweden
(Ahlsson) School of Medical Sciences, Faculty of Medicine and Health,
Orebro University, Orebro, Sweden
(Westerdahl) University Health Care Research Center, Faculty of Medicine
and Health, Orebro University, Orebro, Sweden
Publisher
BioMed Central Ltd
Abstract
Background: Lung cancer is one of the most frequently diagnosed cancers,
and the leading cause of cancer deaths worldwide. Surgical resection is
the primary curative treatment. The World Health Organization (WHO)
recommends that all adults, including cancer survivors, should engage in
at least 150 to 300 min of moderate-intensity aerobic physical activity
per week. Positive associations have been found between self-reported
physical activity and health-related quality of life (HRQoL) after lung
cancer surgery. However, there is a lack of studies concerning objectively
measured physical activity levels, and longer follow-ups are also missing.
This study investigated the relationship between objectively measured
physical activity levels and HRQoL in patients 3 and 12 months after lung
cancer surgery. Method(s): Utilizing a cross-sectional design,
patients were followed up 3 (n = 83) and 12 (n = 57) months after lung
cancer surgery. HRQoL was assessed with the cancer-specific questionnaire
EORTC QLQ-C30 and the lung-cancer-specific module LC13. Physical activity
was measured with a tri-axial accelerometer (ActiGraph GT3X+).
 Result(s): At 3 months after surgery, 51% (n = 42) of the patients
reached the level of physical activity recommended by the WHO; the
corresponding result at 12 months was 42% (n = 24). Patients who reached
the recommended level of physical activity reported a better HRQoL, with
better global health status and physical function as well as lower
symptoms of fatigue, at both 3 and 12 months postoperatively.
 Conclusion(s): Physical activity was positively associated with
HRQoL. Encouraging and supporting patients to engage in regular physical
activity could contribute to better HRQoL after lung cancer surgery. Trial
registration: The trial was registered at ClinicalTrials.gov
(NCT01961700), registration date 20,131,009. Copyright © The
Author(s) 2025.

<3>
Accession Number
2038352059
Title
Invasive management of unroofed coronary sinus: A systematic review.
Source
Trends in Cardiovascular Medicine. 35(6) (pp 394-403), 2025. Date of
Publication: 01 Aug 2025.
Author
Slingerland A.; Moolla M.; John K.; Dennett L.; Nagendran J.; Mathew A.
Institution
(Slingerland) Faculty of Medicine and Dentistry, University of Alberta,
Edmonton, AB, Canada
(Moolla, Mathew) Division of Cardiology, Department of Medicine,
Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB,
Canada
(John) Division of Internal Medicine, Department of Medicine, Tufts
University, Medford, MA, United States
(Dennett) University of Alberta Library, Edmonton, AB, Canada
(Nagendran) Division of Cardiac Surgery, Department of Surgery,
Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB,
Canada
Publisher
Elsevier Inc.
Abstract
Unroofed coronary sinus (UCS) is a rare congenital anomaly, constituting
under 1 % of atrial septal defects. Caused by partial or complete
deficiency of the coronary sinus roof, UCS is often difficult to diagnose.
While surgery remains the standard treatment, transcatheter approaches are
emerging. We conducted a systematic review to evaluate outcomes of
surgical and transcatheter approaches to UCS repair. Studies from MEDLINE,
Embase, SCOPUS, and Web of Science were screened and selected based on
predefined criteria. We extracted data on patient demographics, operative
techniques, associated defects, and outcomes. Thirteen studies involving
293 patients with UCS were included. Majority (66.4 %) were male, with a
mean age of 17.5 +/- 11.5 years. UCS type 1A, marked by the presence of a
persistent left superior vena cava and absent coronary sinus, was the most
common subtype (50.4 %). Surgical repair was performed in 95.2 % of
patients, with intracardiac baffle (34.1 %) and patch repair (21.9 %)
being the predominant techniques. The remaining 4.8 % of patients
underwent transcatheter repair, typically using Amplatzer Septal Occluder
device, with no reported procedural complications. In-hospital mortality
rate was 2.7 %, and 30-day mortality was 3.0 %. Postoperative
complications were rare, including residual defects (0.42 %), atrial
fibrillation (2.9 %), and complete heart block requiring pacemaker (1.2
%). There were no cases of ischemic stroke. Surgical repair of UCS is
associated with low postoperative mortality and complication rates,
affirming its status as the standard of care. Transcatheter techniques may
be feasible for select patients, though further studies are needed to to
assess long-term outcomes and optimize criteria for patient
selection. Copyright © 2025 The Authors

<4>
Accession Number
2038253991
Title
Effectiveness of Point-of-Care High-Sensitivity Troponin Testing in the
Emergency Department: A Randomized Controlled Trial.
Source
Annals of Emergency Medicine. 86(2) (pp 124-135), 2025. Date of
Publication: 01 Aug 2025.
Author
Thulin V.I.L.; Jordalen S.M.F.; Myrmel G.M.S.; Lekven O.C.; Krishnapillai
J.; Steiro O.T.; Body R.; Collinson P.; Apple F.S.; Cullen L.; Norekval
T.M.; Wisloff T.; Vikenes K.; Bjorneklett R.O.; Omland T.; Aakre K.M.
Institution
(Thulin, Jordalen, Lekven, Krishnapillai, Bjorneklett) Emergency Care
Clinic, Haukeland University Hospital, Bergen, Norway
(Myrmel, Lekven, Krishnapillai, Steiro, Norekval, Vikenes, Aakre)
Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
(Body) Division of Cardiovascular Sciences, Faculty of Biology, the
University of Manchester, Manchester, United Kingdom
(Body) Emergency Department, Manchester University NHS Foundation Trust,
Manchester, United Kingdom
(Collinson) St George's University of London, London, United Kingdom
(Apple) Department of Laboratory Medicine and Pathology, Hennepin
Healthcare/HCMC, Minneapolis, MN, United States
(Apple) Department of Laboratory Medicine and Pathology, University of
Minnesota, Minneapolis, MN, United States
(Cullen) Department of Emergency Medicine, Royal Brisbane and Women's
Hospital, Brisbane, Australia
(Cullen) School of Medicine, University of Queensland, Brisbane, Australia
(Cullen) Faculty of Health, Queensland University of Technology, Brisbane,
Australia
(Norekval, Vikenes, Aakre) Department of Clinical Science, University of
Bergen, Bergen, Norway
(Wisloff) Health Services Research Unit, Akershus University Hospital,
Lorenskog, Norway
(Wisloff, Omland) Institute of Clinical Medicine, University of Oslo,
Oslo, Norway
(Bjorneklett) Department of Clinical Medicine, University of Bergen,
Bergen, Norway
(Omland) Department of Cardiology, Akershus University Hospital,
Lorenskog, Norway
(Aakre) Department of Medical biochemistry and Pharmacology, Haukeland
University Hospital, Bergen, Norway
Publisher
Elsevier Inc.
Abstract
Study objective: To compare the effectiveness of high-sensitivity cardiac
troponin (hs-cTn) point-of-care testing to central laboratory hs-cTn
measurements when investigating patients presenting to the emergency
department (ED) with symptoms of acute coronary syndrome. Method(s):
The WESTCOR point-of-care study was a single-center prospective randomized
controlled trial where we randomized patients presenting with possible
acute coronary syndrome in a 1:1 fashion to receive either 0/1-hour
centralized hs-cTnT measurements (control) or 0/1-hour point-of-care
hs-cTnI testing (intervention). We defined length of stay (LOS) in the ED
as the primary endpoint and the minimum clinically meaningful difference
as 15 minutes. Result(s): We included 1,494 patients in the final
analysis, 728 in the point-of-care group, and 766 in the control group.
The median (interquartile range) age was 61 (22) years, and 635 (42.5%)
were women. Median LOS in the ED was 174 (95% confidence interval [CI] 167
to 181) and 180 (95% CI 175 to 189) minutes in the point-of-care and
control group, respectively, resulting in a reduction in median LOS of 6
minutes (95% CI -4 to 17). Acute myocardial infarction, death, or acute
revascularization occurred in 83/728 (11.4%) of point-of-care and 72/766
(9.4%) of control patients. Conclusion(s): We found that implementing
point-of-care hs-cTnI testing in the ED with a 0/1-hour diagnostic
algorithm did not lead to a clinically meaningful reduction in ED LOS. We
observed no difference in the incidence of myocardial infarction, acute
coronary revascularization, or death during 30 days
follow-up. Copyright © 2025 American College of Emergency
Physicians

<5>
Accession Number
2035162158
Title
Immunosuppressant management in palliative care: a systematic review.
Source
BMC Palliative Care. 24(1) (no pagination), 2025. Article Number: 187.
Date of Publication: 01 Dec 2025.
Author
Birchler K.M.; Hertler C.; Pfrunder T.; Blum D.; Schettle M.
Institution
(Birchler) Institute of Biomedical Ethics and History of Medicine
University of Zurich, University of Zurich, Winterthurerstrasse 30,
Zurich, Switzerland
(Birchler, Pfrunder) Department of Political Science, University of
Zurich, Affolternstrasse 56, Zurich, Switzerland
(Hertler, Blum, Schettle) Competence Center for Palliative Care,
Department of Radiation Oncology, University Hospital and University of
Zurich, Zurich, Switzerland
Publisher
BioMed Central Ltd
Abstract
Background: To summarize the available literature on the management of
immunosuppressive therapy in palliative care patients at the end-of-life
stage, highlighting challenges associated with decision-making in this
context and the current lack of clear clinical guidelines. Method(s):
A systematic search was conducted in the PubMed, EMBASE, and Medline
databases for studies evaluating the application of immunosuppressive
therapy in patients nearing the end of life or patients who have allograft
failure without plans for retransplantation and thus are candidates for
palliative care. The search strategy followed PRISMA guidelines.
 Result(s): We screened 2892 studies, assessed 23 records for
eligibility, and included 9 publications in the systematic review. These
studies cover different immunosuppressive strategies in palliative care
for patients with solid organ or stem cell transplants. The evidence
suggests that it is common practice to discontinue immunosuppression for
patients with allograft failure who do not have any plans for
retransplantation. Corticosteroids can be used to ameliorate the negative
effects that arise from immunosuppressant discontinuation.
 Conclusion(s): The management of immunosuppression after allograft
failure requires a careful balance between minimizing drug-related risks
and preserving future transplant eligibility. Discontinuing
immunosuppression may be appropriate for many patients nearing the end of
life, provided that symptom management and ethical considerations are
prioritized. Standardized guidelines and multidisciplinary approaches are
needed to optimize immunosuppression withdrawal, reduce complications, and
ensure patient-centered care. Copyright © The Author(s) 2025.

<6>
Accession Number
2034994561
Title
Non-bacterial Thrombotic Endocarditis in Lung Cancer: A Systematic Review.
Source
Current Cardiology Reviews. 21(4) (no pagination), 2025. Article Number:
E1573403X343187. Date of Publication: 2025.
Author
Kamel M.; Hussain F.; Leung C.; Paracha A.; Sathe P.; Jassal A.; Huba M.;
Durrani U.; Ammari N.; Copeland-Halperin R.S.; Seetharamu N.
Institution
(Kamel, Hussain, Leung, Paracha, Sathe, Jassal, Ammari, Copeland-Halperin,
Seetharamu) Department of Medicine, North Shore University Hospital,
Manhasset, NY, United States
(Huba) Department of Medicine, Medical University of South Carolina,
Charleston, SC, United States
(Durrani) Department of Medicine, School of Medicine, Saint Louis
University, Saint Louis, MO, United States
Publisher
Bentham Science Publishers
Abstract
Introduction: Non-bacterial Thrombotic Endocarditis (NBTE) is a rare
condition characterized by aseptic vegetations of the heart valves,
predisposing to valvular dysfunction and end-organ infarction. Lung Cancer
(LC) is amongst the most common malignancies associated with NBTE.
 Method(s): PubMed/MEDLINE was searched from database inception until
January 2024, pairing Non-bacterial Thrombotic Endocarditis (NBTE) and
related terms with "Lung Cancer (LC)". Reports were included if patients
had both NBTE and lung cancer. The risk of bias was assessed using Mixed
Methods Analysis Testing (MMAT). Results and Discussion: 32 patients with
an average age of 59y +/- 11.6 were included from 31 peer-reviewed
publications, with significant findings as below: * The majority (47%) of
patients were admitted with stroke. * The most commonly affected valve was
aortic (51%), followed by mitral (43%), and tricuspid (5%). * At diagnosis
of NBTE, 86% of patients had stage IV cancer. * Multi-organ infarct was
common (61%), with the brain most often affected (40%). * Treatment of
NBTE included antibiotics (86%), anticoagulation (50%), and cardiac
surgery (6%). * Treatment of LC included traditional chemotherapy (30.7%),
radiation (16%), tyrosine kinase inhibitors (11.5%), lobectomy (6%), and
immunotherapy (3.8%). * Overall mortality rate was 77%. * Mortality rate
was 38% in patients treated with chemotherapy and 91% in patients who did
not receive chemotherapy. * Mortality rate stratified by anticoagulant:
unfractionated heparin (85.7%), DOAC (75%), and LMWH (20%).
 Conclusion(s): High clinical suspicion for NBTE in patients
presenting with LC and thromboembolic phenomena can lead to changes in
treatment and improved clinical outcomes. Copyright © 2025
Bentham Science Publishers.

<7>
Accession Number
2033891643
Title
Cardiovascular Safety Profile of Semaglutide and Variations by Sex, Race,
and Kidney Function: A Systematic Review and Meta-analysis.
Source
American Journal of Cardiovascular Drugs. 25(4) (pp 479-489), 2025. Date
of Publication: 01 Jul 2025.
Author
Hamayal M.; Akhtar C.H.; Ahmad N.; Awwab M.; Shahid W.; Abbasi H.S.;
Nadeem E.; Siddiqui E.; Zafar W.; Hussain S.
Institution
(Hamayal, Akhtar, Ahmad, Shahid, Abbasi, Nadeem) Al-Farabi Center, Federal
Medical and Dental College, Hanna Road, G-8/4, Islamabad, Pakistan
(Awwab) Quaid-e-Azam Medical College, Circular Road, Bahawalpur, Pakistan
(Siddiqui) Jinnah Sindh Medical University, Rafiqui H.J, Iqbal Shaheed Rd,
Karachi Cantonment, Karachi, Pakistan
(Zafar) Khyber Medical College, University of Peshawar, Road No. 2,
Peshawar, Pakistan
(Hussain) University of Regina Saskatoon, The Concourse, Innovation Place,
Saskatoon, SK, Canada
Publisher
Adis
Abstract
Background: Patients with diabetes mellitus and its complications are at
increased risk for cardiovascular diseases. Semaglutide is efficacious for
glycemic control and reducing the risk of major adverse cardiovascular
outcomes. Although trials have provided data about cardiovascular outcomes
with this agent, a meta-analysis regarding its cardiovascular safety and
variations in outcomes according to sex, race and estimated glomerular
filtration rate was necessary. Material(s) and Method(s): We searched
the PubMed, Cochrane Library, and Clinicaltrials.gov databases and
included randomized controlled trials (RCTs) where semaglutide was the
intervention and major adverse cardiovascular events (MACE) or expanded
MACE was the outcome. We assessed the quality of the RCTs using the
Cochrane Risk of Bias tool and used the statistical software RevMan 5.4.
The protocol for this review was registered on PROSPERO (CRD42024580784).
 Result(s): Of 5387 articles, four RCTs were included. The risk of
MACE with semaglutide was significantly lower in patients with established
or a risk of cardiovascular disease (risk ratio [RR] 0.81; 95% confidence
interval [CI] 0.74-0.88; p < 0.00001). The risk of expanded MACE also
reduced significantly with semaglutide (RR 0.80; 95% CI 0.75-0.86; p <
0.00001). MACE risk reduction was significant in males (RR 0.78; 95% CI
0.70-0.87; p < 0.00001) and in Asian (RR 0.61; 95% CI 0.44-0.83; p =
0.002) and white (RR 0.82; 95% CI 0.73-0.90; p = 0.0001) populations.
 Conclusion(s): Semaglutide provides significant advantages in terms
of lowering the risk of MACE and expanded MACE and could possibly be used
as a crucial component of cardiovascular risk management, particularly in
populations that respond well, such as men and Asian and white
populations. Registration: PROSPERO identifier number
CRD42024580784. Copyright © The Author(s), under exclusive
licence to Springer Nature Switzerland AG 2025.

<8>
Accession Number
2037940938
Title
Optimal timing for percutaneous coronary intervention in patients
undergoing transcatheter aortic valve replacement: A network
meta-analysis.
Source
Cardiovascular Revascularization Medicine. 76 (pp 56-63), 2025. Date of
Publication: 01 Jul 2025.
Author
Carvalho P.E.P.; Nascimento B.R.; Gewehr D.M.; Rivera A.; Clemente M.;
Braga M.A.P.; Pansani L.N.; Almeidinha L.; Felix N.; Veiga T.M.A.;
Barbanti M.; Lemos P.A.; Marino M.A.; Taramasso M.; Garot P.
Institution
(Carvalho) Center for Coronary Artery Disease, Minneapolis Heart
Institute, Minneapolis, United States
(Gewehr) Department of Internal Medicine, Federal University of Minas
Gerais, Belo Horizonte, Brazil
(Rivera) Interventional Cardiology Department, Hospital Madre Teresa, Belo
Horizonte, Brazil
(Clemente) Curitiba Heart Institute, Curitiba, Brazil
(Braga) Department of Medicine, Nove de Julho University, Sao Bernardo do
Campo, Brazil
(Pansani) Department of Medicine, Petropolis School of Medicine,
Petropolis, Brazil
(Almeidinha) Department of Medicine, Federal University of Rio de Janeiro,
Rio de Janeiro, Brazil
(Nascimento) Department of Cardiovascular Surgery, Faculty of Medicine of
Sao Jose do Rio Preto, Sao Jose do Rio Preto, Brazil
(Nascimento, Marino) Department of Internal Medicine, Rochester General
Hospital, Rochester, United States
(Felix) Department of Medicine, Federal University of Campina Grande,
Campina Grande, Brazil
(Veiga) Department of Medicine, Federal University of Minas Gerais, Belo
Horizonte, Brazil
(Barbanti) Universita degli Studi di Enna "Kore", Enna, Italy
(Barbanti) Ospedale Umberto I, ASP 4 di Enna, Enna, Italy
(Lemos) Hospital Israelita Albert Einstein, Sao Paulo, Brazil
(Lemos) Heart Institute - InCor, University of Sao Paulo Medical School,
Sao Paulo, Brazil
(Taramasso) Cardiovascular Surgical Department, University Hospital of
Zurich, Zurich, Switzerland
(Garot) Institut Cardiovasculaire Paris Sud (ICPS), Hopital Jacques
Cartier, Ramsay-Sante, Massy, France
Publisher
Elsevier Inc.
Abstract
Background: The optimal timing for percutaneous coronary intervention
(PCI) in patients undergoing transcatheter aortic valve replacement (TAVR)
is uncertain. Objective(s): To compare different PCI timings in
patients with CAD undergoing TAVR. Method(s): MEDLINE, Embase, and
Cochrane were systematically searched for studies comparing different
timings of PCI in patients with aortic stenosis and coronary artery
disease (CAD) undergoing TAVR. PCI in a staged procedure to TAVR and PCI
concomitantly to TAVR were compared with TAVR alone without PCI. A
frequentist random-effects network meta-analysis calculates the odds ratio
(OR) with a 95 % confidence interval (CI). Treatments were ranked using
P-score analysis. Result(s): Two randomized controlled trials and 24
observational studies comprising 10,901 patients with aortic stenosis and
CAD were included. Compared with PCI and concomitant TAVR, staged PCI was
associated with lower rates of stroke (OR 0.54; 95 % CI 0.37-0.78),
myocardial infarction (OR 0.54; 95 % CI 0.31-0.91), and all-cause
mortality at 30 days (OR 0.62; 95 % CI 0.41-0.95). In addition, a subgroup
analysis showed that staged PCI performed after TAVR is associated with
the lowest rates of all-cause mortality of all strategies. In P-score
analysis, staged PCI presented the highest likelihood of preventing stroke
and myocardial infarction. Conclusion(s): In patients with aortic
stenosis and CAD undergoing TAVR, staged PCI is associated with lower
rates of stroke, myocardial infarction, and short-term mortality compared
with other timings. Copyright © 2025 Elsevier Inc.

<9>
Accession Number
2035184251
Title
The efficacy and safety of antithrombotic therapy in patients undergoing
TAVI: a network meta-analysis.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
474. Date of Publication: 01 Dec 2025.
Author
Han J.; Liu K.; Li Y.; Han D.; Liang P.; Zhao N.; Hu S.; Yan X.
Institution
(Han, Liu, Li, Han, Zhao, Hu, Yan) Department of Emergency Medicine, the
Affiliated Hospital of Xuzhou Medical University, Jiangsu Province,
Xuzhou, China
(Han, Liu, Li, Han, Zhao, Hu, Yan) Laboratory of Emergency Medicine,
Second Clinical Medical College of Xuzhou Medical University, Jiangsu
Province, Xuzhou, China
(Liang) Department of Emergency Medicine, Central Hospital of Baoji City,
Shanxi, Baoji, China
Publisher
BioMed Central Ltd
Abstract
Background: Severe aortic stenosis (SAS) is a critical condition with high
morbidity and mortality if left untreated. Transcatheter aortic valve
implantation (TAVI) has emerged as a transformative therapy, especially
for patients at high or intermediate surgical risk. However, the optimal
post-TAVI antithrombotic therapy remains a subject of debate due to the
need to balance thromboembolic prevention with bleeding risks. Current
guidelines provide weak recommendations for dual antiplatelet therapy
(DAPT) and anticoagulation regimens, reflecting the lack of consensus and
robust comparative data. Objective(s): This network meta-analysis
(NMA) aimed to compare the efficacy and safety of five antithrombotic
regimens, including single antiplatelet therapy (SAPT), dual antiplatelet
therapy (DAPT), oral anticoagulants (OAC), new oral anticoagulants (NOAC),
and OAC combined with SAPT (OAC + SAPT) in patients undergoing TAVI. The
primary outcomes were all-cause mortality and major bleeding, while
secondary outcomes included cardiovascular mortality, stroke/transient
ischemic attack (TIA), and myocardial infarction (MI). Method(s): A
comprehensive systematic search was conducted in PubMed, Embase, and Web
of Science up to Nov 2024. 11 studies involving 6,547 patients were
included in this NMA. Outcomes were analyzed using a frequentist NMA
approach, and treatments were ranked using surface under the cumulative
ranking curve (SUCRA) probabilities. Result(s): SAPT was the most
effective regimen in reducing all-cause mortality (OR 0.57, 95% CI
0.38-0.85; SUCRA 85.0%) and major bleeding events (SUCRA 93.8%). DAPT
ranked highest for reducing cardiovascular mortality (SUCRA 68.7%), while
OAC + SAPT showed superiority in preventing stroke/TIA (SUCRA 76.1%). SAPT
also ranked highest in reducing MI risk (SUCRA 69.2%). In contrast, NOAC
and OAC were associated with higher bleeding risks and limited mortality
benefits, positioning them as less favorable options in this analysis.
 Conclusion(s): This study provides compelling evidence supporting
SAPT as the preferred antithrombotic regimen for most TAVI patients, given
its consistent performance in reducing all-cause mortality, MI, and major
bleeding events. DAPT may be a suitable alternative for patients at
elevated risk of cardiovascular death, while OAC + SAPT offers potential
benefits in reducing stroke/TIA risks but requires careful consideration
due to its higher bleeding risk. NOAC and OAC alone were associated with
increased bleeding complications and limited efficacy, highlighting the
need for cautious application in specific patient subgroups. Copyright
© The Author(s) 2025.

<10>
Accession Number
2039442839
Title
Extent of coronary artery disease and clinical outcomes with ticagrelor
monotherapy versus aspirin after coronary artery bypass grafting: Insights
from the TiCAB trial.
Source
European Journal of Cardio-thoracic Surgery. 67(7) (no pagination), 2025.
Article Number: ezaf175. Date of Publication: 01 Jul 2025.
Author
Arnreiter M.; Von Scheidt M.; Albes J.M.; Attmann T.; Boening A.; Choi
Y.-H.; Conradi L.; Danner B.C.; Fach A.; Friedrich I.; Grubitzsch H.; Heck
R.; Joost A.; Knosalla C.; Misfeld M.; Oberhoffer M.; Riebandt J.;
Schaefer A.; Siepe M.; Walther T.; Wimmer-Greinecker G.; Zeymer U.;
Schunkert H.; Kastrati A.; Sandner S.
Institution
(Arnreiter, Riebandt, Sandner) Department of Cardiac and Thoracic Aortic
Surgery, Medical University of Vienna, Vienna, Austria
(Von Scheidt, Schunkert, Kastrati) German Heart Centre Munich, TUM
University Hospital, School of Medicine and Health, Technical University
of Munich, Munich, Germany
(Von Scheidt, Schunkert, Kastrati) German Center for Cardiovascular
Research (DZHK E. V.), Partner Site Munich Heart Alliance, Munich, Germany
(Albes) Department of Cardiovascular Surgery, Heart Center Brandenburg,
University Hospital Brandenburg Medical School, Faculty of Health Sciences
Brandenburg, Bernau, Germany
(Attmann) Department of Cardiac Surgery, University Hospital
Schleswig-Holstein, Campus Kiel, Kiel, Germany
(Boening) Department of Adult and Pediatric Cardiovascular Surgery,
University Hospital of Giessen and Marburg, Giessen, Germany
(Choi) Department of Cardiac Surgery, Kerckhoff Klinik Bad Nauheim, Bad
Nauheim, Germany
(Conradi) Department of Cardiovascular Surgery, University Heart &
Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf,
Hamburg, Germany
(Danner) Department of Thoracic and Cardiovascular Surgery, University
Hospital of Goettingen, Goettingen, Germany
(Fach) Bremen Institute for Heart and Circulation Research (BIHKF),
Bremen, Germany
(Friedrich) Department of Cardiothoracic Surgery, Herzzentrum Trier,
Krankenhaus der Barmherzigen Bruder Trier, Trier, Germany
(Grubitzsch, Heck, Knosalla) Department of Cardiothoracic and Vascular
Surgery, Charite - Universitatsmedizin Berlin, Berlin, Germany
(Joost) Medical Clinic II, University Heart Center Lubeck, Lubeck, Germany
(Misfeld) Department of Cardiothoracic Surgery, Royal Prince Alfred
Hospital, Sydney, NSW, Australia
(Oberhoffer) Department of Cardiovascular Surgery, University Hospital of
Johannes Gutenberg-Universitat Mainz, Mainz, Germany
(Schaefer) Department of Cardiovascular Surgery, University Heart Center
Hamburg, Hamburg, Germany
(Siepe) Department of Cardiac Surgery, Inselspital, Bern University
Hospital, University of Bern, Bern, Switzerland
(Walther) Department of Cardiovascular Surgery, University Hospital
Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
(Wimmer-Greinecker) Department for Cardiothoracic Surgery, Heart and
Vessel Center Bad Bevensen, Bad Bevensen, Germany
(Zeymer) Department of Cardiology, Klinikum Ludwigshafen and Institut fur
Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES Patients with extensive coronary artery disease (CAD) have a
higher risk of cardiovascular events. This post hoc analysis of the
Ticagrelor in CABG (TiCAB) trial examined the association of ticagrelor
monotherapy versus aspirin with clinical outcomes after coronary artery
bypass grafting (CABG) in relation to the extent of CAD. METHODS The TiCAB
trial randomized CABG patients to ticagrelor (90 mg twice daily) or
aspirin (100 mg daily) for 12 months. Patients were stratified by SYNTAX
score terciles: low (<=22), intermediate (23-32) and high (>=33). The
primary end-point was major adverse cardiac and cerebrovascular events
(MACCE) at 12 months, including cardiovascular death, myocardial
infarction, stroke or repeat revascularization. Secondary end-points
included individual MACCE components and major bleeding events. Cox
proportional hazards models were used to assess treatment effects. RESULTS
Among 752 patients, 33.4% had low, 36.0% intermediate and 30.6% high
SYNTAX scores (median 26.5 [20.0-33.0]). MACCE rates were similar across
groups (low: 7.8%; intermediate: 9.2%; high: 8.8%; P = 0.87), though the
incidence of repeat revascularization differed significantly among SYNTAX
score groups (P = 0.02). Ticagrelor did not show a significant MACCE
benefit over aspirin in any SYNTAX score group (low: HR 2.27, 95% CI
0.87-5.94; intermediate: HR 1.02, 95% CI 0.46-2.27; high: HR 1.76, 95% CI
0.70-4.46; Pint=0.41). Secondary outcomes, including bleeding, aligned
with overall trial results. CONCLUSIONS This analysis did not find a
differential benefit of ticagrelor versus aspirin across CAD complexity
levels as measured by the SYNTAX score. Further studies are warranted to
refine antiplatelet strategies for patients with complex CAD undergoing
CABG. Copyright © 2025 - The Author(s). Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery.

<11>
Accession Number
2039571755
Title
Physiotherapeutic guidance on functional independence and quality of life
after coronary artery bypass grafting: Clinical trial.
Source
Journal of Bodywork and Movement Therapies. 44 (pp 708-713), 2025. Date of
Publication: 01 Oct 2025.
Author
Gomes Da Silva D.J.; Martins D.O.; Egidio K.F.; Assuncao Carneiro L.C.;
Santos da Silva Santana L.; Franca Guimaraes A.R.; Lisboa Cordeiro A.L.
Institution
(Gomes Da Silva, Martins, Egidio, Assuncao Carneiro, Santos da Silva
Santana, Lisboa Cordeiro) Centro Universitario Nobre, Bahia, Feira de
Santana, Brazil
(Franca Guimaraes) Instituto Nobre de Cardiologia, Bahia, Feira de
Santana, Brazil
(Lisboa Cordeiro) Escola Bahiana de Medicina e Saude Publica, Bahia,
Salvador, Brazil
Publisher
Churchill Livingstone
Abstract
Introduction: Patients undergoing coronary artery bypass graft(CABG) are
exposed to a decline in functional capacity, increasing the risk of
pulmonary complications, worsening the quality of life. Often, this
decline is associated with not understanding the activities that can be
performed postoperatively. In this scenario, orienting patients can be an
effective strategy. Objective(s): To evaluate the impact of
physiotherapy guidance on functional capacity, functionality,
postoperative complications and quality of life. Method(s): This is a
randomized controlled trial. Preoperatively and at hospital discharge
patients had their functional capacity assessed by the 6-min walk
test(6MWT), functionality by the functional independence measure(FIM), sit
and stand test(SST), quality of life by the SF-36 and postoperative
pulmonary complications. The patients were to either the Guidance
Group(GO) or the Control Group(CG). During their hospital stay, patients
in the orientation group received verbal guidance and later a booklet
containing instructions to raise awareness about their conditions and how
to prevent immobility by becoming active during their hospital stay.
 Result(s): Were evaluated with 57 in each group. The GO had
superiority in 6MWT95 %CI46(25.53-66.47) meters FIM12(9.30-14.70),
SST-2(-4.31to-1.69) seconds when compared to the preoperative value at
hospital discharge. The quality of life showed no difference between the
groups. Regarding postoperative pulmonary complications, the guidance
group had a lower rate of atelectasis 15(26 %) in GO group versus 26(46 %)
in CG(p = 0.02). Conclusion(s): Postoperative physiotherapeutic
guidance was effective in reducing the loss of functional capacity,
functionality and the atelectasis rate. On the other hand, quality of life
and other complications had no difference. Copyright © 2025
Elsevier Ltd

<12>
Accession Number
2035157639
Title
Endocarditis Presenting as Arthritis With Positive Autoantibodies
Mimicking Rheumatoid Arthritis.
Source
International Journal of Rheumatic Diseases. 28(7) (no pagination), 2025.
Article Number: e70339. Date of Publication: 01 Jul 2025.
Author
Mansoor C.A.; Alserr A.H.K.; Mohamed A.I.A.L.; Wazir H.A.B.
Institution
(Mansoor, Mohamed) Department of General Medicine, Sultan Qaboos Hospital,
Salalah, Oman
(Alserr) Department of Vascular Surgery, Sultan Qaboos Hospital, Salalah,
Oman
(Wazir) Department of Infectious Diseases, Sultan Qaboos Hospital,
Salalah, Oman
Publisher
John Wiley and Sons Inc

<13>
Accession Number
2035152115
Title
Impact of antihypertensive drug classes on cardiovascular outcomes:
insights from the STEP study.
Source
BMC Medicine. 23(1) (no pagination), 2025. Article Number: 365. Date of
Publication: 01 Dec 2025.
Author
Peng X.; Olsen M.H.; Pareek M.; Bai J.; Liu Y.; Song Q.; Cai J.
Institution
(Peng, Song, Cai) State Key Laboratory of Cardiovascular Disease of China,
National Center for Cardiovascular Diseases of China, Hypertension Center,
Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union
Medical College, Beilishi Rd. 167, Xicheng District, Beijing, China
(Peng, Bai, Cai) Beijing Institute of Heart, Lung and Blood Vessel
Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing,
China
(Olsen) Department of Clinical Medicine, University of Copenhagen,
Copenhagen, Denmark
(Olsen) Department of Internal Medicine 1 and Steno Diabetes Center
Zealand, Holbaek Hospital, Holbaek, Denmark
(Pareek) Department of Cardiology, Copenhagen University
Hospital-Rigshospitalet, Copenhagen, Denmark
(Pareek) Center for Translational Cardiology and Pragmatic Randomized
Trials, Department of Cardiology, Copenhagen University Hospital-Herlev
and Gentofte, Hellerup, Denmark
(Liu) Department of Epidemiology and Biostatistics, School of Public
Health, Peking University, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background: The optimal class of antihypertensive drugs for reducing
cardiovascular risk remains unclear. This study investigated whether
prolonged exposure to specific antihypertensive drug classes is associated
with lower cardiovascular risk in individuals with well-controlled blood
pressure. Method(s): This study utilised data from the STEP trial,
which enrolled elderly, hypertensive Chinese patients with no history of
stroke. After excluding 234 patients lost to follow-up and 20 patients
without blood pressure records after randomisation, 8257 patients were
included. The relative time on each antihypertensive drug (medication
time/event time) was calculated. The primary outcome was a composite of
the first occurrence of stroke, acute coronary syndrome (ACS), acute
decompensated heart failure, coronary revascularisation, atrial
fibrillation, and cardiovascular death. Secondary endpoints included
individual components of the primary outcome. Cox regression analysis was
used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs)
for each outcome. Result(s): Over a median 3.34 years follow-up,
primary outcome analysis revealed that longer relative exposure to
angiotensin II receptor blockers (ARBs) or calcium channel blockers (CCBs)
significantly reduced cardiovascular risk. Each unit increase in relative
time on ARBs was associated with a 45% lower risk of the primary outcome
(HR 0.55, 95% CI 0.43-0.70), whereas CCBs reduced risk by 30% (HR 0.70,
95% CI 0.54-0.92). Diuretics demonstrated neutral results. Conversely,
longer relative time on beta-blockers was linked to a higher primary
outcome risk (HR 2.20, 95% CI 1.81-2.68). Regarding secondary outcomes,
extended exposure to both ARBs and CCBs was significantly associated with
lower risks of all-cause and cardiovascular mortality. Longer exposure to
ARBs produced additional benefits by reducing risks of stroke, ACS, and
major adverse cardiac events (MACE). The HRs for ARBs per-unit increase in
relative time remained consistently lower than those of CCBs across the
primary outcome, MACE, and stroke (all P < 0.05). Conclusion(s): This
post hoc analysis suggested that ARBs and CCBs might be more favourable
for composite cardiovascular outcomes than diuretics and beta-blockers.
ARBs appeared to offer greater cardiovascular benefits than CCBs. Longer
exposure to beta-blockers was associated with a higher cardiovascular
risk, which might reflect a selection bias based on medical indications.
Trial registration: STEP ClinicalTrials.gov number, NCT03015311.
Registered 2 January 2017. Copyright © The Author(s) 2025.

<14>
Accession Number
2035130666
Title
Effect of dynamic lung compliance-guided positive end-expiratory pressure
on postoperative pulmonary complications following thoracoscopic
lobectomy: a randomized controlled trial.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 306. Date
of Publication: 01 Dec 2025.
Author
Zhou Y.; Song Z.; Cai J.; Huang S.; Zhu M.; Jiang Y.; Bao Q.; Zhang L.;
Jin R.; Gu L.; Tan J.
Institution
(Zhou, Song, Cai, Huang, Bao, Jin, Gu, Tan) The Affiliated Cancer Hospital
of Nanjing Medical University, Jiangsu, Yangzhou, China
(Cai, Zhu, Zhang, Gu, Tan) Jiangsu Province Key Laboratory of
Anesthesiology, Xuzhou Medical University, Jiangsu, Yangzhou, China
(Jiang) Department of Anesthesiology, Northern Jiangsu People's Hospital,
Jiangsu, Yangzhou, China
Publisher
BioMed Central Ltd
Abstract
Background: The risk of postoperative pulmonary complications is
significantly increased in patients undergoing video-assisted thoracic
surgical lobectomy. Individualized positive end-expiratory pressure (PEEP)
is extensively employed to optimize respiratory mechanics and enhance
oxygenation during one-lung ventilation (OLV). However, there is no
consensus regarding the optimal level of positive end-expiratory pressure
and its effects during OLV. Therefore, we designed a randomized controlled
trial to assess whether titrating PEEP to the maximum dynamic lung
compliance in patients undergoing lung resection surgery impacts the
occurrence of postoperative pulmonary complications (PPCs).
 Method(s): In this randomized controlled trial, patients undergoing
thoracoscopic lobectomy were randomly assigned to either a dynamic lung
compliance group that received individualized PEEP guided by the maximum
dynamic pulmonary compliance or a conventional ventilation group with a
fixed PEEP of 5 cm H<inf>2</inf>O. The primary outcome was a composite of
PPCs occurring within seven days, as defined by the European Perioperative
Clinical Outcome criteria. Secondary outcomes included PEEP, Cdyn,
PaO<inf>2</inf>, serum concentrations of IL-6 and TNF-alpha, and the
duration of postoperative hospital stays. Result(s): One hundred
patients were enrolled. The optimal PEEP obtained in the dynamic lung
compliance group was 9.04 +/- 1.83 cm H<inf>2</inf>O. Patients in the
conventional ventilation group experienced 38% postoperative pulmonary
complications versus 20% in the dynamic lung compliance group compared
with the control group (P < 0.01). The serum Interleukin-10 concentrations
at T<inf>5</inf> in the dynamic lung compliance group were higher than
those in the ventilation group (P = 0.046), and the serum Interleukin-1
concentrations at T<inf>5</inf> and T<inf>6</inf> in the dynamic lung
compliance group were lower than those in the ventilation group (P <
0.01). Conclusion(s): In patients undergoing video-assisted
thoracoscopic lobectomy for lung resection with maximum dynamic
compliance-guided positive end-expiratory pressure (PEEP), the incidence
of postoperative pulmonary complications (PPCs) within 7 days was
significantly lower compared to those receiving a PEEP of 5 cm
H<inf>2</inf>O. Trial registration: This study was registered at the
Chinese Clinical Trials Registry on 04/07/2021 with registration number
ChiCTR2100048201. Copyright © The Author(s) 2025.

<15>
Accession Number
2039418631
Title
A Scoping Review of Validated Echocardiographic Methods for Grading Right
Ventricular Dysfunction: Proposal for an Evidence-Based Multiparametric
Framework.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Olive J.K.; Yaport M.; Al-Qudsi O.; Cutrone M.; Abramson L.; Ledbetter L.;
Alvin A.; Vatsaas C.J.; Milano C.A.; Bronshteyn Y.S.
Institution
(Olive, Milano) Division of Thoracic and Cardiovascular Surgery,
Department of Surgery, Duke University School of Medicine, Durham, NC,
United States
(Olive, Vatsaas) Division of Trauma, Acute, and Critical Care Surgery,
Department of Surgery, Duke University School of Medicine, Durham, NC,
United States
(Yaport, Al-Qudsi, Cutrone, Bronshteyn) Division of Critical Care
Medicine, Department of Anesthesiology, Duke University School of
Medicine, Durham, NC, United States
(Cutrone) Division of Cardiothoracic Anesthesiology, Department of
Anesthesiology, Duke University School of Medicine, Durham, NC, United
States
(Abramson) Division of Geriatrics, Department of Medicine, Duke University
School of Medicine, Durham, NC, United States
(Abramson) Geriatric Research Education and Clinical Center, Durham
Veterans Affairs Health Care System, Durham, NC, United States
(Ledbetter, Alvin) Duke University Medical Center Library and Archives,
Duke University School of Medicine, Durham, NC, United States
(Bronshteyn) Department of Anesthesiology, Durham Veterans Affairs Health
Care System, Durham, NC, United States
Publisher
W.B. Saunders
Abstract
Assessing the severity of right ventricular (RV) dysfunction using
echocardiography (echo) remains subjective, in part because current
guidelines do not recommend how to synthesize various echo parameters to
form a global assessment of RV dysfunction. To address this unmet need,
this scoping review aimed (1) to identify all multiparametric RV
dysfunction scoring systems that use routine echo parameters and (2) to
synthesize these models with 2025 guidelines to create a multiparametric
framework for RV dysfunction assessment. MEDLINE, EMBASE, and Web of
Science databases were searched for studies in adult patients that propose
and validate a multiparametric scoring system for grading RV dysfunction.
All studies underwent independent review during abstract and full-text
screening. Screening of 2,229 initial citations yielded 10 observational
studies consisting of diverse cohorts, including, but not limited to,
patients with heart failure, undergoing cardiac surgery, and admitted to
the intensive care unit. Six validated echo parameters were identified: RV
dilation, RV systolic dysfunction (represented by tricuspid annular plane
systolic excursion, S', or fractional area change), tricuspid
regurgitation, elevated right atrial pressure, RV-pulmonary artery
uncoupling (ratio of tricuspid annular plane systolic excursion to
pulmonary artery systolic pressure), and paradoxical interventricular
septal motion. The studies demonstrated that multiparametric RV
dysfunction scores had greater clinical prognostic value than did any
individual RV echo parameter alone. Our proposed simple framework for
assessing RV dysfunction enables clinicians to use routinely obtained echo
data to identify high-risk or subtle RV phenotypes and to guide clinical
decision-making in a variety of perioperative, intensive, and emergency
care settings. Copyright © 2025 Elsevier Inc.

<16>
Accession Number
2035129972
Title
Analgesic efficacy and serum ropivacaine concentration of postoperative
programmed intermittent bolus infusion with serratus anterior plane block
in patients undergoing minimally invasive cardiac surgery: A randomized,
double-blind, controlled trial.
Source
Journal of Anesthesia. (no pagination), 2025. Date of Publication: 2025.
Author
Kumagai M.; Kaiho Y.; Sugino S.; Sekine T.; Taguri M.; Inoue H.; Ito J.;
Sato Y.; Sato T.; Maekawa M.; Yamauchi M.
Institution
(Sato, Kaiho, Sugino, Sekine, Yamauchi) Department of Anesthesiology and
Perioperative Medicine, Tohoku University Graduate School of Medicine,
2-1, Seiryo-Machi, Aoba-Ku, Sendai, Japan
(Kumagai) Department of Anesthesiology, Japan Red Cross Ishinomaki
Hospital, Ishinomaki, Japan
(Taguri) Department of Health Data Science, Tokyo Medical University,
Shinjuku City, Japan
(Inoue) Department of Anesthesiology, Southern Tohoku General Hospital,
Iwanuma, Japan
(Ito) Department of Anesthesiology, Sendai Kousei Hospital, Sendai, Japan
(Sato, Sato, Maekawa) Department of Pharmaceutical Sciences, Tohoku
University Hospital, Sendai, Japan
Publisher
Springer
Abstract
Purpose: Minimally invasive cardiac surgery (MICS) involves fewer
complications than median sternotomy. However, difficulties in post-MICS
analgesia can undermine these advantages. The serratus anterior plane
block (SAPB), an effective analgesic for thoracic surgery, could benefit
post-MICS analgesia using programmed intermittent bolus infusion (PIBI).
We investigated whether PIBI with SAPB can reduce post-MICS fentanyl
administration and evaluated its safety profile. Method(s): This
randomized, double-blind, controlled trial included 20 patients (age 20-80
years; Eastern Cooperative Oncology Group Performance Status 0-II;
scheduled for elective MICS) randomly allocated to two groups (SAPB or
control). All patients underwent preoperative SAPB with catheterization,
followed by either 20 mL 0.25% ropivacaine or saline bolus every 6 h
postoperatively. All patients received intravenous fentanyl via
patient-controlled analgesia. Blood samples were collected 10, 20, 30, and
60 min after preoperative ropivacaine infusion; during and after
cardiopulmonary bypass; and on postoperative days 1-5. The primary outcome
was cumulative fentanyl consumption up to postoperative day 5. Secondary
outcomes included numerical rating scale scores, rehabilitation
preoperatively and postoperatively, postoperative nausea and vomiting,
ropivacaine toxicity, and PIBI with SAPB complications. Result(s):
After excluding three patients, data from 17 patients were analyzed. No
significant difference in cumulative fentanyl consumption on postoperative
day 5 was observed (SAPB: median [interquartile range], 512 microg
[457-753] vs. control: 654 microg [439-982], P = 0.96). Serum ropivacaine
concentration remained below the toxicity threshold. Conclusion(s):
PIBI with SAPB did not reduce post-MICS fentanyl consumption, and serum
ropivacaine concentration did not reach the toxicity
threshold. Copyright © The Author(s) 2025.

<17>
[Use Link to view the full text]
Accession Number
2039231020
Title
Colchicine for prevention of major adverse cardiovascular events: A
meta-analysis of randomized clinical trials.
Source
Journal of Cardiovascular Medicine. 26(7) (pp 359-368), 2025. Date of
Publication: 01 Jul 2025.
Author
Ballacci F.; Giordano F.; Conte C.; Telesca A.; Collini V.; Imazio M.
Institution
(Ballacci, Giordano, Conte, Telesca, Collini, Imazio) Cardiothoracic
Department, University Hospital Santa Maria della Misericordia, Udine,
Italy
(Imazio) Department of Medicine, University of Udine, Udine, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
AimsInflammation is a main pathophysiological driver in atherosclerotic
cardiovascular diseases (ASCVD). Low-dose long-term colchicine for
secondary prevention in patients with established ASCVD has been studied
in multiple randomized trials in the last decade.This meta-analysis aimed
to evaluate the efficacy and safety of long-term low-dose colchicine for
secondary prevention in patients with established ASCVD.MethodsWe
conducted a systematic review and meta-analysis following PRISMA
guidelines to evaluate studies reporting long-term outcomes in patients
with ASCVD. We systematically searched PubMed, EMBASE and Scopus databases
for relevant studies up to 1 December 2024. The primary outcome was the
occurrence of major adverse cardiovascular events (MACE), a composite of
cardiovascular death (CVD), myocardial infarction (MI) and stroke.
Random-effects models were used to calculate pooled risk ratios
(RRs).ResultsTen randomized clinical trials enrolling 22 532 patients were
identified. Addition of colchicine to standard medical treatment in
patients with established ASCVD reduced the risk for MACE by 27% [RR 0.73,
95% confidence interval (CI) 0.57-0.95], with a number needed to treat of
52. Colchicine was found to significantly reduce the risk of MI (RR 0.83,
95% CI 0.72-0.96) and coronary revascularization (RR 0.79, 95% CI
0.65-0.94). There were no significant differences between the two groups
concerning cardiovascular and noncardiovascular mortality, risk of serious
gastrointestinal events, infections requiring hospitalization and
cancer.ConclusionsThese findings support the use of long-term low-dose
colchicine for secondary prevention of MACE in clinical
practice. Copyright © 2025 Italian Federation of Cardiology -
I.F.C.

<18>
Accession Number
2033981818
Title
Intra-operative ventilation strategies and their impact on clinical
outcomes: a systematic review and network meta-analysis of randomised
trials.
Source
Anaesthesia. 80(8) (pp 973-987), 2025. Date of Publication: 01 Aug 2025.
Author
Jivraj N.K.; Lakbar I.; Sadeghirad B.; Muller M.M.; Sohn S.Y.; Peel J.K.;
Jaffer A.; Phoophiboon V.; Trivedi V.; Chaudhuri D.; Lu C.; Liu Y.;
Giammarioli B.; Einav S.; Burns K.E.A.
Institution
(Jivraj) Department of Anesthesiology and Pain Medicine and Department of
Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON,
Canada
(Jivraj, Burns) Interdepartmental Division of Critical Care Medicine,
Temerty School of Medicine, University of Toronto, Toronto, ON, Canada
(Lakbar) Anesthesiology and Intensive Care; Anesthesia and Critical Care
Department B, Saint Eloi Teaching Hospital, PhyMedExp, University of
Montpellier, Montpellier, France
(Sadeghirad) Department of Anesthesia and Department of Health Research
Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
(Sadeghirad) Michael DeGroote Institute for Pain Research and Care,
Hamilton, ON, Canada
(Muller) Institute of Intensive Care Medicine, University Hospital Zurich,
Zurich, Switzerland
(Sohn) Department of Anesthesiology, Perioperative and Pain Medicine,
Brigham and Women's Hospital, Boston, MA, United States
(Peel) Department of Anesthesiology and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Jaffer) Cumming School of Medicine, University of Calgary, Calgary, AB,
Canada
(Phoophiboon, Giammarioli) Division of Critical Care Medicine, Unity
Health Toronto - St. Michael's Hospital, Li Ka Shing Knowledge Institute,
Toronto, ON, Canada
(Phoophiboon, Burns) Division of Critical Care Medicine, Department of
Medicine, Chulalongkorn University, Bangkok, Thailand
(Trivedi) Institute for Better Health, Trillium Health Partners,
Mississauga, ON, Canada
(Chaudhuri) Division of Critical Care, Intensive Care Unit, Department of
Medicine, McMaster University, St Joseph's Healthcare Hamilton, Hamilton,
ON, Canada
(Lu) Keenan Research Centre for Biomedical Science, St. Michael's
Hospital, Toronto, ON, Canada
(Liu) Department of Laboratory Medicine and Pathobiology, University of
Toronto, ON, Canada
(Einav) Maccabi Healthcare Services Sharon Region, Hebrew University
Faculty of Medicine and Medint Medical Intelligence, Jerusalem, Israel
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Postoperative pulmonary complications are common and
associated with significant morbidity and mortality; however, the optimal
intra-operative ventilation strategy to prevent postoperative pulmonary
complications remains unclear. The aim of this study was to evaluate the
effect of intra-operative ventilation strategy, including tidal volumes,
positive end-expiratory pressure (PEEP) and use of recruitment manoeuvres
on the incidence of postoperative pulmonary complications in adults having
non-cardiothoracic surgery. Method(s): Relevant databases were
searched to identify randomised controlled trials that directly compared
intra-operative ventilation strategies among surgical patients who were
followed up for > 24 hours postoperatively and reported at least one
outcome of interest. Result(s): A total of 51 randomised controlled
trials were included. Compared with a high tidal volume/zero PEEP
strategy, low tidal volume strategies likely reduced the risk of
postoperative pulmonary complications when combined with: high PEEP (risk
ratio (RR) 0.44, 95%CI 0.22-0.87); high PEEP with recruitment manoeuvres
(RR 0.60, 95%CI 0.49-0.75); personalised PEEP with recruitment manoeuvres
(RR 0.53, 95%CI 0.42-0.69); low PEEP (RR 0.63, 95%CI 0.50-0.78); and low
PEEP with recruitment manoeuvres (RR 0.65, 95%CI 0.46-0.93) (all moderate
certainty evidence). Compared with a low tidal volume/low PEEP strategy, a
low tidal volume strategy with personalised PEEP likely reduces the risk
of postoperative pulmonary complications (RR 0.85, 95%CI 0.73-0.99,
moderate certainty). Discussion(s): Among patients undergoing
non-cardiothoracic surgery, the use of intra-operative low tidal volume
ventilation with a range of acceptable PEEP levels likely reduced the risk
of postoperative pulmonary complications compared with high tidal volumes
and zero PEEP. This study highlights the need for implementation research
at both the provider and system levels to improve intra-operative
adherence to lung protective ventilation strategies. Copyright ©
2025 The Author(s). Anaesthesia published by John Wiley & Sons Ltd on
behalf of Association of Anaesthetists.

<19>
[Use Link to view the full text]
Accession Number
2038682231
Title
Perioperative Nitric Oxide Conditioning Reduces Acute Kidney Injury in
Cardiac Surgery Patients with Chronic Kidney Disease (the DEFENDER Trial):
A Randomized Controlled Trial.
Source
Anesthesiology. 143(2) (pp 287-299), 2025. Date of Publication: 01 Aug
2025.
Author
Kamenshchikov N.O.; Tyo M.A.; Berra L.; Kravchenko I.V.; Kozlov B.N.;
Gusakova A.M.; Podoksenov Y.K.
Institution
(Kamenshchikov, Tyo, Kravchenko, Kozlov, Gusakova, Podoksenov) Cardiology
Research Institute, Tomsk National Research Medical Center, Russian
Academy of Sciences, Tomsk, Russian Federation
(Berra) Department of Anaesthesia Critical Care and Pain Medicine,
Massachusetts General Hospital, Boston, MA, United States
(Berra) Department of Anaesthesia, Harvard Medical School, Boston, MA,
United States
(Berra) Respiratory Care Service, Patient Care Services, Massachusetts
General Hospital, Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Postoperative acute kidney injury (AKI) is a significant
concern for cardiac surgery patients with chronic kidney disease (CKD).
Effective pharmacologic interventions to mitigate these risks are urgently
needed. This study aimed to evaluate the efficacy and safety of
perioperative nitric oxide (NO) administration in preventing AKI and
limiting CKD progression in patients undergoing cardiac surgery.
 Method(s): A total of 136 patients with CKD undergoing elective
cardiac surgery with cardiopulmonary bypass were randomized into two equal
groups: the NO group (n = 68), receiving 80 parts per million NO during
the intraoperative period and for 6 h postsurgery, and the control group
(n = 68), receiving a sham treatment. The primary outcome was AKI
incidence within 7 days postsurgery. Result(s): AKI incidence was
significantly lower in the NO group (16 of 68 patients, 23.5%) compared to
the control group (27 of 68 patients, 39.7%) with a relative risk of 0.59
(95% CI, 0.35 to 0.99; P = 0.043). Six months postsurgery, the glomerular
filtration rate was higher in the NO group (50 ml min-1 1.73 m-2 [45; 54])
compared to the control group (45 ml min-1 1.73 m-2 [41; 51]; P = 0.038).
Postoperative pneumonia was significantly less frequent in the NO group:
10 of 68 (14.7%) versus 20 of 68 (29.4%) with a relative risk of 0.5 (95%
CI, 0.25 to 0.99; P = 0.039). NO administration was safe: methemoglobin
and nitrogen dioxide levels remained within acceptable ranges,
oxidative-nitrosyl stress did not increase, and there were no significant
differences between the groups in blood transfusion requirements, platelet
counts, or postoperative blood loss volumes Conclusion(s):
Perioperative NO administration in CKD patients undergoing cardiac surgery
with cardiopulmonary bypass is safe, reduces the incidence of AKI, and
slows the progression of renal dysfunction. Copyright © 2025
American Society of Anesthesiologists.

<20>
Accession Number
2033728323
Title
Hemodynamic Effects of Altering Tidal Volume During Positive Pressure
Ventilation in the Fontan Circulation: A Randomized Crossover Trial.
Source
Paediatric Anaesthesia. 35(8) (pp 607-618), 2025. Date of Publication: 01
Aug 2025.
Author
Navaratnam M.; Schmidt A.R.; Kaplinski M.; De Souza E.; Beattie M.J.; Rowe
E.V.; Punn R.; Ramamoorthy C.
Institution
(Navaratnam, Rowe, Ramamoorthy) Department of Anesthesiology,
Perioperative and Pain Medicine, Stanford Children's Hospital, Stanford
University Medical Center, Palo Alto, CA, United States
(Schmidt) Department of Pediatric Anesthesiology, University Children's
Hospital Zurich-Eleonore Foundation, Zurich, Switzerland
(Kaplinski, Beattie, Punn) Department of Pediatric Cardiology, Stanford
Children's Hospital, Stanford University Medical Center, Palo Alto, CA,
United States
(De Souza) Department of Anesthesiology, Perioperative and Pain Medicine,
Stanford University School of Medicine, Stanford, CA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Primary determinants of pulmonary blood flow in the Fontan
circulation are low transpulmonary gradient and pulmonary vascular
resistance (PVR). Changes in intrathoracic pressure during intermittent
positive pressure ventilation can influence the transpulmonary gradient,
PVR, pulmonary blood flow, and cardiac output. The aim of this study was
to evaluate the effect of low (5 mL/kg) versus high (10 mL/kg) tidal
volume (V<inf>T</inf>) ventilation on Fontan circulation hemodynamics.
 Method(s): Postoperative patients with a Fontan circulation were
enrolled in this single-center, randomized crossover trial. Patients,
randomized to group 1 or 2, underwent a ventilation study sequence
(baseline ventilation [7 mL/kg], then high V<inf>T</inf> [10 mL/kg] or low
V<inf>T</inf> [5 mL/kg], then washout ventilation [7 mL/kg], followed by
low [5 mL/kg] or high V<inf>T</inf> [10 mL/kg]) in the operating room at
the end of the cardiac surgical procedure. Respiratory, hemodynamic, and
transesophageal (TEE) measurements were recorded after 5 min in each
ventilation condition. The primary aim of this study was to evaluate the
effect of low V<inf>T</inf> ventilation (5 mL/kg) versus high
V<inf>T</inf> ventilation (10 mL/kg) on transpulmonary gradient (Fontan
pressure minus left atrial pressure). The secondary aim was to compare TEE
measurements of pulmonary blood flow, stroke volume, and Fontan flow
between low and high V<inf>T</inf> ventilation. We also compared standard
hemodynamic and ventilation parameters for all ventilation conditions.
Analysis was of paired data, calculating the between-treatment difference
within participants across ventilation conditions. Result(s): Eleven
patients were included in the final data analysis with a median [IQR] age
of 5 [4, 11] years and weight of 16.3 [13.8, 31.6] kg. The mean (+/-SD)
peak inspiratory pressure during low and high V<inf>T</inf> ventilation
was 15.3 (+/-2.9) cmH<inf>2</inf>O and 22.2 (+/-3.7) cmH<inf>2</inf>O,
respectively (difference -6.9, 95% CI -7.8, -5.9, p < 0.001). The mean
airway pressure during low and high V<inf>T</inf> ventilation was 7.3 +/-
0.8 and 8.7 +/- 0.9 (difference -1.5, 95% CI -2.1, -0.8, p = 0.001) with a
mean inspiratory time of 0.62 (+/-0.22) s and 1.21 (+/-0.55) s (difference
-0.59, 95% CI -0.84, -0.34, p < 0.001), respectively. During low
V<inf>T</inf> ventilation, the mean Fontan pressure was 13.3 (+/-1.8) mmHg
compared to 12.3 (+/-2.5) mmHg for high V<inf>T</inf> ventilation
(difference 0.8, 95% CI -0.5, 2.1, p = 0.18). The mean transpulmonary
gradient was 7.0 +/- 1.3 mmHg compared to 6.8 +/- 1.2 mmHg during low and
high V<inf>T</inf> ventilation, respectively (difference 0.2, 95% CI -0.2,
0.6, p = 0.21). We found no significant differences between low and high
V<inf>T</inf> ventilation in TEE measures of pulmonary blood flow, stroke
volume, and Fontan flow. Conclusion(s): This randomized, crossover
pilot trial of Fontan patients showed that a low V<inf>T</inf> ventilation
(5 mL/kg) resulted in significantly lower peak and mean airway pressure
compared with a high V<inf>T</inf> ventilation (10 mL/kg). However, there
were no significant changes in transpulmonary gradient, mean Fontan
pressure, or TEE parameters of stroke volume, pulmonary blood flow, or
Fontan flow. Clinical Trials Registration Number: NCT04633343. Principal
Investigator: Manchula Navaratnam. Date of Registration: November 11,
2020. Clinical Trials Registration Registry URL:
https://clinicaltrials.gov/study/NCT04633343?term=Fontan%20ventilation&ran
k=3. Prior Presentations: Congenital Cardiac Anesthesia Society Annual
Meeting Top Oral Abstract Presentation. Presenter: Alexander R Schmidt,
March 30th, 2023. Copyright © 2025 John Wiley & Sons Ltd.

<21>
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. 34(7) (pp 674-692), 2025. Date of Publication:
01 Jul 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. Copyright © 2025 The Author(s)

<22>
Accession Number
2035040178
Title
Exploring Use-Rates of and Scientific Evidence on Sutureless Devices in
Aortic Valve Replacement: A Bibliographic Meta-Analysis and Clinical
Considerations.
Source
Journal of Clinical Medicine. 14(12) (no pagination), 2025. Article
Number: 4049. Date of Publication: 01 Jun 2025.
Author
Spadaccio C.; Dimagli A.; Agler C.J.; Paneitz D.C.; Wolfe S.B.; Nenna A.;
Osho A.A.; Rose D.
Institution
(Spadaccio, Agler) Department of Cardiac Surgery, University of Cincinnati
College of Medicine, 231 Albert Sabin Way, MSB 2474, Cincinnati, OH,
United States
(Dimagli) Department of Surgery, Columbia University, New York, NY, United
States
(Paneitz) Department of Surgery, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
(Wolfe) Department of Cardiothoracic Surgery, West Virginia University,
Morgantown, WV, United States
(Nenna) Department of Cardiac Surgery, Ospedale Maggiore Della Carita,
Novara, Italy
(Osho) Department of Cardiothoracic Surgery, Harvard Medical School,
Massachusetts General Hospital, Boston, MA, United States
(Rose) Department of Cardiothoracic Surgery, Blackpool Teaching Hospital,
Blackpool, United Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Sutureless aortic valve replacement (SuAVR) has emerged as a potential
alternative to conventional surgical aortic valve replacement (SAVR),
particularly in minimally invasive settings. However, its global adoption
remains limited, with a notable concentration of use and scientific
production in select European countries. This bibliographic meta-analysis
systematically reviewed 538 studies to assess the evidence landscape
surrounding SuAVR, highlighting a predominance of observational data,
sparse randomized controlled trials (1.3%), and significant geographical
imbalances in research output. Europe accounted for 80% of publications,
while North America contributed less than 10%. Key structural
factors-including reimbursement policies, earlier regulatory approvals,
and population characteristics-appear to influence SuAVR adoption. Despite
procedural advantages such as reduced cross-clamp times, concerns over
cost, pacemaker implantation rates, and uncertain long-term durability
persist. Importantly, SuAVR may offer its greatest clinical value by
facilitating minimally invasive surgery, a niche still underutilized
worldwide. The limited randomized data and industrial focus on
transcatheter approaches have further hindered widespread acceptance. Our
findings underscore the need for high-quality comparative trials and
standardized guidelines to define the role of SuAVR in modern valve
therapy. Copyright © 2025 by the authors.

<23>
Accession Number
2039302074
Title
Plasma levels of NO-related pathway molecules to predict
post-transcatheter aortic valve implantation major adverse cardiovascular
events: a prospective, multicenter study.
Source
Postepy w Kardiologii Interwencyjnej. 21(2) (pp 211-220), 2025. Date of
Publication: 2025.
Author
Gasecka A.; Krajewska N.; Rajewska B.; Suleja A.; Kisielewska W.; Lomiak
M.; Budzianowski J.; Olasinska-Wisniewska A.; Kochman J.; Ufnal M.
Institution
(Gasecka, Krajewska, Rajewska, Suleja, Kisielewska, Lomiak, Kochman) 1st
Chair and Department of Cardiology, Medical University of Warsaw, Warsaw,
Poland
(Budzianowski) Department of Interventional Cardiology and Cardiac
Surgery, University of Zielona Gora, Collegium Medicum, Zielona Gora,
Poland
(Olasinska-Wisniewska) Department of Cardiac Surgery and Transplantology,
Poznan University of Medical Sciences, Poznan, Poland
(Ufnal) Department of Experimental Physiology and Pathophysiology, Medical
University of Warsaw, Warsaw, Poland
Publisher
Termedia Publishing House Ltd.
Abstract
Introduction: Aortic stenosis (AS) is associated with alterations in the
concentrations of nitric oxide (NO)-related pathway molecules, including
arginine, asymmetric dimethylarginine (ADMA), and symmetric
dimethylarginine (SDMA). Aim(s): We aimed to determine the effect of
transcatheter aortic valve implantation (TAVI) on the concentrations of
arginine, ADMA, and SDMA and to evaluate their predictive value for
post-TAVI outcomes. Material(s) and Method(s): In total, 128 patients
with AS referred for TAVI were enrolled in the study. Blood samples were
collected 1 day before TAVI and at hospital discharge. Concentrations of
arginine, ADMA, and SDMA were measured using ultra performance liquid
chromatography coupled with mass spectrometry. Result(s): Plasma
concentrations of arginine, ADMA, and SDMA did not change after TAVI,
compared to baseline (p >= 0.70 for all). The median time of follow-up was
13.5 months. Arginine, ADMA, and SDMA did not predict post-TAVI MACE
during the follow-up time (p >= 0.88). There were significant negative
correlations between the concentrations of ADMA and SDMA and
echocardiographic parameters of AS severity before TAVI (p < 0.01 for
all). Conclusion(s): Plasma concentrations of arginine, ADMA, and
SDMA were not affected by TAVI and did not predict post-TAVI MACE. ADMA
and SDMA negatively correlated with AS severity, which might indicate
alterations in the NO/L-arginine pathway in patients with
AS. Copyright © 2025 Termedia Publishing House Ltd.. All rights
reserved.

<24>
Accession Number
2035145315
Title
Understanding gastrointestinal bleeding in patients with cardiac disease:
an interdisciplinary approach.
Source
Expert Review of Cardiovascular Therapy. 23(5) (pp 197-207), 2025. Date of
Publication: 2025.
Author
Gries J.J.; Virk H.U.H.; Birnbaum Y.; Jneid H.; Virani S.S.; Sharma S.;
Krittanawong C.
Institution
(Gries) Department of Internal Medicine, Geisinger Medical Center,
Danville, PA, United States
(Virk) Harrington Heart & Vascular Institute, Case Western Reserve
University, University Hospitals Cleveland Medical Center, Cleveland, OH,
United States
(Birnbaum, Jneid) Section of Cardiology, Baylor College of Medicine,
Houston, TX, United States
(Jneid) Division of Cardiology, University of Texas Medical Branch,
Houston, TX, United States
(Virani) Office of the Vice Provost (Research), The Aga Khan University,
Karachi, Pakistan
(Virani) Section of Cardiology and Cardiovascular Research, Department of
Medicine, Baylor College of Medicine, Houston, TX, United States
(Sharma) Cardiac Catheterization Laboratory of the Cardiovascular
Institute, Mount Sinai Hospital, New York, NY, United States
(Krittanawong) HumanX, Delaware, DE, United States
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Cardiovascular disease remains the leading cause of global
mortality and a significant contributor to disability. The incidence of
gastrointestinal bleeding (GIB) varies across cardiac conditions, with
notable risks observed in patients undergoing complex antiplatelet or
anticoagulant therapy, acute coronary syndrome, hypertrophic
cardiomyopathy, percutaneous coronary interventions, mechanical cardiac
support, acute decompensated heart failure, and post-cardiac surgery.
Areas covered: A comprehensive search of the PubMed/Medline database was
conducted to retrieve articles related to GIB and cardiovascular disease
from 2014 to 2024. The authors then synthesized a narrative review that
endorses an interdisciplinary approach to this challenging paradigm,
drawing from cardiology and gastroenterology perspectives to provide a
comprehensive overview of the current understanding of the risk of GIB in
cardiac patients. Expert opinion: In acute coronary syndrome, upper GIB
significantly increases mortality risk, with early endoscopic intervention
proving beneficial. Post-coronary revascularization presents a low GIB
incidence but a high mortality rate when it occurs. Decompensated heart
failure patients frequently experience GIB due to concomitant conditions.
Cardiogenic shock and mechanical cardiac support also show notable GIB
risks, with mechanical support patients facing higher mortality. Following
transcatheter aortic valve implantation, GIB incidence is low, but
hospitalization rates are significant. Copyright © 2025 Informa
UK Limited, trading as Taylor & Francis Group.

<25>
Accession Number
2034368399
Title
Vascular Closure Devices for Large Bore Femoral Access After Transfemoral
Transcatheter Aortic Valve Replacement: A Network Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 106(1) (pp 423-432),
2025. Date of Publication: 01 Jul 2025.
Author
Upadhaya S.; Upreti A.; Gupta K.; Gonzalez-Perez B.; Ksayer R.; Cox-Alomar
P.; Sanina C.; Irimpen A.; Farhan S.; Wiley J.
Institution
(Upadhaya, Gonzalez-Perez, Ksayer, Sanina, Wiley) Department of Internal
Medicine, Section of Cardiology, Tulane University School of Medicine, New
Orleans, LA, United States
(Upreti) Department of Biomedical Sciences, Tulane University School of
Medicine, New Orleans, LA, United States
(Gupta, Irimpen) Department of Internal Medicine, Case Western Reserve
University, Cleveland, OH, United States
(Cox-Alomar) Department of Medicine, Section of Cardiology, University of
Miami, Miami, FL, United States
(Farhan) Department of Medicine, Division of Cardiology, Lenox Hill
Hospital, Northwell Health, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background and Aims: Large-bore femoral access is commonly required in
transfemoral transcatheter aortic valve replacement (TF-TAVR), but
vascular access complications remain prevalent, impacting patient
outcomes. Various vascular closure devices (VCDs) are used for hemostasis,
including the suture-based Prostar XL, Perclose ProGlide, and ProStyle,
and the plug-based MANTA device. However, comprehensive comparative
evidence on these VCDs, particularly single Perclose strategies, is
lacking. Method(s): A systematic review and network meta-analysis
were conducted according to PRISMA guidelines. We included randomized and
observational studies comparing the safety and efficacy of VCDs for
large-bore femoral access closure in TF-TAVR patients. Primary outcomes
included major vascular complications; secondary outcomes included major
and minor bleeding, minor vascular complications, VCD failure, and
all-cause mortality. Frequentist and Bayesian analyses were performed
using a random-effects model, with additional subgroup analyses of single
Perclose strategies. Result(s): Thirty-five studies comprising 16,503
patients met inclusion criteria. The single Perclose strategy, with or
without adjunct Angio-Seal or FemoSeal, significantly reduced major
vascular complications compared to dual Perclose (RR: 1.9, 95% CI
[1.2-3.01]), MANTA (RR: 1.89, 95% CI [1.03-3.48]), and Prostar XL (RR:
3.46, 95% CI [1.94-6.18]). Among secondary outcomes, single Perclose also
ranked highest in reducing minor complications and bleeding.
 Conclusion(s): Single Perclose strategies, especially when combined
with Angio-Seal, demonstrated superior safety and efficacy for large-bore
femoral access closure following TF-TAVR. These findings support the need
for further randomized trials to validate single Perclose as a primary
approach in TF-TAVR vascular closure. Copyright © 2025 Wiley
Periodicals LLC.

<26>
Accession Number
2035129901
Title
The impact of surgeon specialty and technique on outcomes after esophageal
dilation: a systematic review.
Source
Esophagus. (no pagination), 2025. Date of Publication: 2025.
Author
Wilkins S.G.; Omiunu A.; Haynes C.V.; Simmons K.; Hayashi C.; Malik D.;
Elzamzami A.; Brackett A.; Verma A.; Kohli N.
Institution
(Wilkins, Haynes, Simmons, Hayashi, Malik, Elzamzami, Verma, Kohli) Yale
University School of Medicine, 333 Cedar Street, New Haven, CT, United
States
(Omiunu, Verma, Kohli) Division of Otolaryngology-Head and Neck Surgery,
Department of Surgery, Yale University School of Medicine, New Haven, CT,
United States
(Brackett) Harvey Cushing/John Hay Whitney Medical Library, Yale
University, 333 Cedar Street, New Haven, CT, United States
Publisher
Springer
Abstract
To conduct a systematic review across four article databases to understand
whether outcomes after esophageal dilation are affected by dilator type or
physician specialty. Dilation of the upper esophagus is a commonly used
technique to manage esophageal stenosis, which most commonly manifests as
progressive dysphagia. Strictures arise from a multitude of etiologies; as
such, they are treated by a variety of specialists, including
otolaryngology, gastroenterology, and thoracic surgery. Dilations are
commonly performed using either bougienage or balloon dilators, and there
is a paucity of literature analyzing whether complications differ based on
dilator type or physician specialty. A total of 3491 abstracts were
initially screened using the Covidence reviewer platform. 433 full texts
were assessed, and 15 studies met inclusion criteria. Four studies used
balloon dilators, 8 studies used bougie dilators, and 3 studies used both
techniques. When comparing adverse events between studies using either
balloon or bougie dilators, half of each group (2/4 and 4/8) reported no
perforations. Additional adverse outcomes, such as mediastinitis or
bleeding, remained low with both bougie and balloon dilation; only one
study reported mediastinitis as a complication, and only two studies
reported significant postoperative bleeding (one bougie, one balloon).
While technical success was heterogeneously defined, all studies reported
significant improvement after dilation. While this study was limited by
data heterogeneity, adverse outcomes after esophageal dilation remain low,
regardless of dilation method or physician specialty. Copyright ©
The Author(s) under exclusive licence to The Japan Esophageal Society
2025.

<27>
Accession Number
2039444702
Title
Evaluating Outcomes of Over-Expanding Versus Conventional Sizing in
transcatheter aortic valve replacement for Borderline Aortic Annulus: A
Meta-Analysis.
Source
Critical Pathways in Cardiology. (no pagination), 2025. Article Number:
10.1097/HPC.0000000000000392. Date of Publication: 2025.
Author
Mustafa A.; Kaple R.; Kliger C.; Wei C.; Dudiy Y.; Sung-Han Y.; Wengrofsky
P.; Jelnin V.; Batsides G.; Spallone R.; Elman E.; Anderson M.; Landers
D.; Basman C.
Institution
(Mustafa, Kaple, Kliger, Wei, Dudiy, Sung-Han, Wengrofsky, Jelnin,
Batsides, Spallone, Elman, Anderson, Landers, Basman) Department of
Cardiology and Cardiothoracic Surgery, Hackensack University Medical
Center, New Jersey, United States
(Mustafa, Kaple, Kliger, Wei, Dudiy, Sung-Han, Wengrofsky, Jelnin,
Batsides, Spallone, Elman, Anderson, Landers, Basman) Department of
Cardiology and Cardiothoracic Surgery, Northwell Health, New York, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
Approximately 20-40% of patients that present for transcatheter aortic
valve replacement (TAVR) with a balloon-expandable (BE) transcatheter
heart valve (THV) fall into a borderline aortic annulus size (BAAS). There
are potential benefits to over-expanding an under-sized THV (OE-THV) in
such cases that include reduced electrical disturbances and annular injury
at the expense of increased paravalvular leak (PVL). We conducted a
meta-analysis of data comparing conventional sized vs OE-THV strategy for
BAAS and review the literature for BE-THV in such cases. 9 non-randomized
studies that compared a conventional strategy to OE-THV in patients with
BAAS were included in our study. Our findings suggest that there is no
difference in mortality, stroke, mean gradient or significant PVL. There
was a trend towards less pacemakers in patients receiving an OE-THV.
Borderline aortic annulus measurements are common in patients undergoing
TAVR and there appears to be equipoise between conventional sizing vs
OE-THV. Future detailed studies are required to evaluate short- and
long-term outcomes amongst strategies. Copyright © 2025
Lippincott Williams and Wilkins. All rights reserved.

<28>
Accession Number
2035114637
Title
Clinical outcomes of anti-inflammatory therapies inhibiting the
NLRP3/IL-1beta/IL-6/CRP pathway in coronary artery disease patients: a
systemic review and meta-analysis of 37,056 individuals from 32 randomized
trials.
Source
Inflammation Research. 74(1) (no pagination), 2025. Article Number: 99.
Date of Publication: 01 Dec 2025.
Author
Pan Y.; Fan F.; Jiang J.; Zhang Y.
Institution
(Pan, Fan, Jiang, Zhang) Department of Cardiology, Peking University First
Hospital, No.8 Xishiku Street, Xicheng District, Beijing, China
(Fan, Jiang, Zhang) Institute of Cardiovascular Disease, Peking University
First Hospital, Beijing, China
(Zhang) State Key Laboratory of Vascular Homeostasis and Remodeling,
Peking University, Beijing, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Treatment effects of anti-inflammatory therapies inhibiting
the NLRP3/IL-1beta/IL-6/CRP pathway in coronary artery disease (CAD) had
conflicting results. The study aims to evaluate efficacy and safety
outcomes of treatments inhibiting this pathway. Method(s): Cochrane
Library, Embase, Pubmed, and ClinicalTrials.gov were searched for
randomized controlled trials evaluating therapies inhibiting the
NLRP3/IL-1beta/IL-6/CRP pathway in CAD patients. Relative risks (RR) with
95% confidence intervals (CI) were calculated. Result(s): 32 studies
and 37,056 individuals were included. Anti-inflammatory therapies
inhibiting the pathway reduced the risks of myocardial infarction (MI) (RR
0.85, 95% CI 0.78-0.93) and coronary revascularization (RR 0.80, 95% CI
0.74-0.86), with no benefits in major adverse cardiovascular events
(MACE), heart failure (HF), stroke, cardiovascular or all-cause mortality.
Colchicine reduced the risks of MACE, MI, and coronary revascularization.
IL-1 inhibitors reduced the risks of coronary revascularization, with
potential benefits in MI and HF. Increased risks of infections,
gastrointestinal adverse effects, and injection site reactions were found.
Meta-regression analysis demonstrated that post-treatment hsCRP/CRP was
correlated with MACE (p < 0.001) and MI (p = 0.048) and post-treatment
IL-6 was associated with MI (p = 0.033). Conclusion(s):
Anti-inflammatory therapies inhibiting the NLRP3/IL-1beta/IL-6/CRP pathway
had satisfying safety profiles and were beneficial in preventing MI and
coronary revascularization in CAD patients despite no benefits in stroke,
cardiovascular, or all-cause mortality. Copyright © The Author(s)
2025.

<29>
Accession Number
2039328246
Title
Comparing non-ischaemic heart preservation (NIHP) with ischaemic static
cold storage of donor hearts in adult cardiac transplantation: study
protocol for a randomised controlled trial.
Source
BMJ Open. 15(6) (no pagination), 2025. Article Number: e100553. Date of
Publication: 25 Jun 2025.
Author
Pigot H.; Steen S.; Nilsson J.
Institution
(Pigot, Nilsson) Department of Translational Medicine, Artificial
Intelligence and Bioinformatics in Cardiothoracic Sciences, Lund
University, Lund, Sweden
(Steen, Nilsson) Department of Clinical Sciences in Lund Thoracic Surgery,
Lund University, Lund, Sweden
(Nilsson) Department of Thoracic and Vascular Surgery, Skane University
Hospital Lund, Lund, Sweden
Publisher
BMJ Publishing Group
Abstract
Introduction Ischaemia-reperfusion (I/R) injury remains a major challenge
in heart transplantation, with mortality risk increasing significantly
when allograft ischaemic time exceeds 4 hours. Non-ischaemic heart
preservation (NIHP), using continuous hypothermic perfusion, has shown
promise in preliminary studies for reducing I/R injury and improving
outcomes. This randomised controlled trial aims to compare NIHP with
standard static cold storage (SCS) in adult heart transplantation. Methods
and analysis The trial is a prospective, open-label, multicentre,
single-blinded, randomised controlled trial including 66 adult heart
transplant recipients across four Swedish hospitals. Participants will be
randomised into 1:1 ratio to NIHP or SCS preservation groups and undergo a
12-month follow-up period. The primary outcome is 1-year survival free
from acute cellular rejection or retransplantation. Secondary outcomes
include quality of life, I/R injury markers, graft function and adverse
events. Substudies will evaluate renal function using MRI and continuously
monitor physical activity and heart rhythm via wearable devices. Analysis
will follow intention-to-treat principles, with time-to-event analysis
using Cox proportional hazard models and Kaplan-Meier estimates. Ethics
and dissemination The study has been approved by the Swedish Ethical
Review Authority. It will be conducted according to the Declaration of
Helsinki and relevant local and international regulations. Results will be
published in peer-reviewed journals following Consolidated Standards of
Reporting Trials guidelines. Copyright © 2025 Author(s).

<30>
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. 35(8) (pp 668-683), 2025. Date of Publication: 01
Aug 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. 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. 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. 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. Copyright © 2025 John
Wiley & Sons Ltd.

<31>
Accession Number
2035123986
Title
Transcatheter Versus Surgical Approach for the Treatment of Aortic
Stenosis in Patients With Concomitant Coronary Artery Disease: A
Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Bacha Z.; Javed J.; Khattak F.; Qadri M.; Shoaib M.; Shah I.M.; Khan N.A.;
Ali M.A.; Mattumpuram J.; Tariq M.D.; Fakhar M.; Afridi A.; Kakakhel M.Z.;
Rath S.; Henna F.
Institution
(Bacha, Khattak, Shoaib, Shah, Khan, Ali, Afridi) Khyber Medical College,
Peshawar, Pakistan
(Javed, Qadri) Jinnah Sindh Medical University, Karachi, Pakistan
(Mattumpuram) Department of Medicine, University of Louisville School of
Medicine, Louisville, KY, United States
(Tariq, Fakhar) Department of Medicine, Mary Washington Healthcare,
Fredericksburg, VA, United States
(Kakakhel) Rehman Medical College, Peshawar, Pakistan
(Rath) All India Institute of Medical Sciences, Bhubaneswar, India
(Henna) Dubai Medical College for Girls, Dubai, United Arab Emirates
Publisher
John Wiley and Sons Inc
Abstract
Aortic stenosis (AS) with concomitant coronary artery disease (CAD)
requires an approach that addresses both valvular and coronary pathology.
While surgical aortic valve replacement (SAVR) with coronary artery bypass
graft (CABG) has long been the standard treatment, transcatheter aortic
valve replacement (TAVI) with percutaneous coronary intervention (PCI) has
become a less invasive alternative. This meta-analysis compares the
clinical outcomes of TAVI + PCI versus SAVR + CABG in patients with AS and
concomitant CAD. A systematic review and meta-analysis were conducted
according to PRISMA guidelines. Fourteen studies, including two randomized
controlled trials (RCTs) and 12 observational studies, with a total of
187,189 patients (31,298 in the TAVI + PCI group and 155,891 in the SAVR +
CABG group) were included. Outcomes analyzed included 30-day mortality,
stroke, major adverse cardiovascular and cerebrovascular events (MACCE),
coronary reintervention, atrial fibrillation, major bleeding, vascular
complications, acute kidney injury (AKI), perioperative myocardial
infarction MI), permanent pacemaker implantation (PPI), length of hospital
stay, and long-term survival. Patients undergoing TAVI + PCI were
generally older (ranging from 76.3 +/- 3.7 to 83.6 +/- 3.7 years) and had
higher rates of chronic kidney disease (CKD) compared to the SAVR + CABG
group. Other comorbidities, such as diabetes and hypertension, were
comparable between groups. The EuroSCORE varied widely (3 +/- 2.2 to 36.1
+/- 18.1), reflecting a mix of surgical risk profiles. TAVI + PCI was
associated with a lower 30-day mortality rate (OR: 0.63, 95% CI:
0.37-1.07, p = 0.09), though the result was not statistically significant.
Stroke rates were comparable between the two groups (OR: 0.89, 95% CI:
0.70-1.14, p = 0.36). There was no significant difference in MACCE (OR:
0.96, 95% CI: 0.50-1.84, p = 0.91). However, coronary reintervention was
significantly higher in the TAVI + PCI group (OR: 4.32, 95% CI: 2.58-7.23,
p < 0.00001). TAVI + PCI was associated with an 82% lower risk of atrial
fibrillation (OR: 0.18, 95% CI: 0.11-0.30, p < 0.00001) but a similar risk
of major bleeding (OR: 0.71, 95% CI: 0.38-1.31, p = 0.27). Vascular
complications were significantly higher in the TAVI + PCI group (OR: 3.01,
95% CI: 1.52-5.93, p = 0.002), while perioperative AKI was lower (OR:
0.46, 95% CI: 0.21-0.99, p = 0.05). There was no significant difference in
perioperative MI (OR: 0.78, 95% CI: 0.34-1.78, p = 0.55). However, TAVI +
PCI was associated with a higher likelihood of PPI (OR: 2.14, 95% CI:
1.88-2.43, p < 0.00001). The length of hospital stay was significantly
shorter in the TAVI + PCI group (mean difference: -3.45 days, 95% CI:
-5.79 to -1.12, p = 0.004). Long-term survival favored TAVI + PCI (OR:
0.63, 95% CI: 0.49-0.80, p = 0.0002). TAVI + PCI appears to be a viable
alternative to SAVR + CABG, particularly in elderly or high-risk patients,
with advantages such as lower long-term mortality, reduced atrial
fibrillation, shorter hospital stays, and lower AKI rates. However, it
carries a higher risk of coronary reintervention, vascular complications,
and the need for PPI. These findings highlight the importance of
individualized patient selection to balance risks and
benefits. Copyright © 2025 Wiley Periodicals LLC.

<32>
Accession Number
2039189407
Title
Efficacy of subanaesthetic esketamine on the prevention of postoperative
delirium in older adult patients after cardiovascular surgery: protocol
for a single-centre, randomised, double-blind, placebo-controlled trial
(SEPDOC trial) in China.
Source
BMJ Open. 15(6) (no pagination), 2025. Article Number: e089719. Date of
Publication: 16 Jun 2025.
Author
Yan J.-M.; Liu Q.-R.; Zhao L.; Yang J.-J.; Lin H.-Q.; Wen Z.-Y.; Zhang
H.-R.; Mei Y.-X.; Zhang W.; Wang R.-D.
Institution
(Yan, Yang) Department of Anesthesiology, Pain and Perioperative Medicine,
The First Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou,
China
(Yan, Zhao, Lin, Wen, Zhang, Mei, Zhang, Wang) Department of
Anesthesiology and Perioperative Medicine, Central China Branch of
National Center for Cardiovascular Diseases, Henan Cardiovascular Disease
Center, Fuwai Central-China Hospital, Central China Fuwai Hospital of
Zhengzhou University, Henan Province Clinical Research Center for
Cardiovascular Disease, Henan, Zhengzhou, China
(Liu) Department of Anesthesiology, Wuxi Xishan People's Hospital,
Jiangsu, Wuxi, China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative delirium (POD) is a common and serious
complication in older adult patients undergoing cardiovascular surgery.
Esketamine is known for its anti-inflammatory and neuroprotective
properties. While it has shown preventive effects on POD in those not
undergoing cardiovascular surgery, its efficacy in older adult patients
undergoing cardiovascular surgery remains uncertain. Therefore, we herein
aimed to evaluate the preventive effect of intraoperative subanaesthetic
esketamine on POD in this specific population. Methods and analysis This
single-centre, randomised, double-blind, placebo-controlled trial will
enrol 778 patients aged 60-80 years undergoing open-heart cardiovascular
surgery in China, from September 2023 to December 2025. The participants
will be randomly assigned in a 1:1 ratio to the following groups: the
esketamine group and the control group. In the esketamine group,
esketamine (2mg/mL) will be administered intravenously at a dosage of
0.3mg/kg over 10min following tracheal intubation, followed by a
continuous infusion at 0.15mg/kg/h until the end of the surgery. Patients
in the control group will receive a placebo following the same dosage and
regimen. The incidence of POD will be the primary outcome and will be
assessed twice daily from the first to the seventh postoperative day. The
postoperative sleep quality, duration of postoperative mechanical
ventilation, and length of hospital and intensive care unit stay will be
the secondary outcomes. Ethics and dissemination Ethical approval was
obtained from the Institutional Review Board of Fuwai Central China
Cardiovascular Hospital (No. 2023068). Public disclosure is guaranteed
post-trial, and the results will be published in a peer-reviewed
scientific journal. Copyright © Author(s) (or their employer(s))
2025.

<33>
Accession Number
2039289223
Title
The Impact of Depth of Anaesthesia Monitoring on Postoperative Cognitive
Dysfunction.
Source
International Journal of Current Pharmaceutical Review and Research. 17(5)
(pp 1192-1195), 2025. Date of Publication: 2025.
Author
Dubey N.; Chandra K.N.; Dutta P.K.
Institution
(Dubey) Department of Anaesthesia, MGM Medical College & Hospital,
Jharkhand, Jamshedpur, India
(Chandra) Department of Anaesthesia, MGM Medical College & Hospital,
Jharkhand, Jamshedpur, India
(Dutta) Department of Anaesthesia, MGM Medical College & Hospital,
Jharkhand, Jamshedpur, India
Publisher
Dr. Yashwant Research Labs Pvt. Ltd.
Abstract
Background: Elderly surgical patients often develop postoperative
cognitive dysfunction (POCD), which is adjustable by anaesthetic depth.
Anaesthesia depth monitoring may reduce neurocognitive impairment.
 Objective(s): To evaluate the impact of intraoperative DOA monitoring
using the bispectral index (BIS) on the incidence of POCD in elderly
patients undergoing non-cardiac surgery. Material(s) and Method(s): A
prospective, randomised study at MGM Medical College examined 100 patients
aged >=50 years receiving elective surgery under general anaesthesia.
Group A was BIS-monitored while Group B was conventional anaesthesia
without BIS. Preoperative and postoperative MMSE and Trail Making Tests
investigated cognitive function on days 3 and 7. Result(s): Group A
showed significantly lower POCD incidence on day 3 (20%) and day 7 (12%)
compared to Group B (42% and 32%, respectively). BIS-monitored patients
had better MMSE scores and lower anaesthetic consumption.
 Conclusion(s): BIS-guided anaesthesia significantly reduces the
incidence of POCD and improves cognitive recovery in elderly
patients. Copyright © 2025 Dr. Yashwant Research Labs Pvt. Ltd..
All rights reserved.

<34>
[Use Link to view the full text]
Accession Number
2039265598
Title
Stellate ganglion block for visceral pain in elderly patients undergoing
video-assisted thoracoscopic lung cancer surgery: a randomized, controlled
trial.
Source
International Journal of Surgery. 110(11) (pp 6996-7002), 2024. Date of
Publication: 01 Nov 2024.
Author
Xiang X.-B.; Wu Y.-Y.; Fang Z.; Tang X.; Wu Y.-L.; Zhou J.; Cheng X.-Q.
Institution
(Xiang, Tang, Wu, Zhou) Department of Anesthesiology, Zhejiang Cancer
Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of
Sciences, Zhejiang, Hangzhou, China
(Wu, Fang, Cheng) Department of Anesthesiology, First Affiliated Hospital
of Anhui Medical University, Key Laboratory of Anesthesiology,
Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical
University, Hefei, China
Publisher
Wolters Kluwer Health Inc
Abstract
Background: Visceral pain occurs commonly following thoracic surgery, but
an effective method to relieve visceral pain in thoracic surgery remains
controversial. The authors test the effect of stellate ganglion blocks
(SGB) on perioperative visceral pain following video-assisted
thoracoscopic surgery (VATS). Method(s): A prospective, randomized,
controlled trial enrolled 77 elderly patients undergoing VATS. Patients
were randomized to SGB followed by modified intercostal nerve block (Group
S, n=37); or modified intercostal nerve block only (Group C, n=40).
Remifentanil 0.02-0.2 mug.kg -1 .min -1 was titrated to keep pain
threshold index values between 40 and 65 and maintain mean arterial
pressure or heart rate values around 20% of baseline values.
Patient-controlled intravenous analgesia with sufentanil was used in the
postoperative period. The co-primary outcomes were the perioperative
cumulative opioid consumption and pain scores on movement at 24 h after
surgery. Result(s): Compared with the control group, SGB greatly
reduced the intraoperative remifentanil consumption [300.00
(235.00-450.00)mug versus 710.00 (500.00-915.00)mug; P<0.01], with no
difference in cumulative sufentanil consumption to 48 h postsurgery. There
was a statistically significant difference in pain scores on movement at
24 h between groups [4.00 (3.00-4.00) versus 4.00 (3.25-5.00); P=0.01].
Further exploratory analyses showed a significant difference in intrachest
pain on movement at 24 h [3.00 (2.00-3.00) versus 3.00 (2.25-4.00);
P=0.01]. No significant difference was observed in nausea/vomiting, time
to pass flatus, and postoperative length of stay. Conclusion(s):
Preoperative SGB for elderly patients could effectively blunt
intraoperative visceral stress and reduce postoperative visceral pain
extending 24 h after VATS. This initial finding deserves further
investigation. Copyright © 2024 The Author(s). Published by
Wolters Kluwer Health, Inc.

<35>
Accession Number
2037618835
Title
Chloroquine and hydroxychloroquine induced cardiomyopathy: A systematic
review of literature.
Source
REC: CardioClinics. 60(3) (pp 193-203), 2025. Date of Publication: 01 Jul
2025.
Author
Devesa Neto V.; Gouveia Fiuza J.; Pires I.; Ferreira Santos L.; Costa A.
Institution
(Devesa Neto, Gouveia Fiuza, Pires, Ferreira Santos, Costa) Cardiology
Department, Unidade Local de Saude Viseu Dao-Lafoes, Viseu, Portugal
(Devesa Neto) Faculty of Health Sciences, University of Beira Interior,
Covilha, Portugal
Publisher
Elsevier Espana S.L.U
Abstract
Introduction and objectives: Chloroquine (CQ) and hydroxychloroquine
(HCQ), initially developed for malaria prophylaxis, are now widely used in
rheumatic diseases, such as systemic lupus erythematosus and rheumatoid
arthritis. Despite their therapeutic benefits, these drugs can induce
cardiotoxicity, particularly cardiomyopathy. This systematic review
evaluates the prevalence, clinical features, and diagnostic challenges of
CQ/HCQ-induced cardiomyopathy. Method(s): A comprehensive literature
search was conducted in PubMed, EMBASE, and Cochrane databases,
identifying 60 studies reporting 79 cases of CQ/HCQ-induced
cardiomyopathy. Inclusion criteria required histopathological confirmation
via endomyocardial biopsy. Data on clinical presentations, diagnostic
findings, and outcomes were extracted and analyzed. Result(s):
Patients were predominantly female (76%), with a median age of 56 years.
The cardiomyopathies observed included hypertrophic, dilated, and
restrictive forms, frequently presenting with heart failure and conduction
disorders, such as atrioventricular block and arrhythmias. Cardiac
magnetic resonance imaging and endomyocardial biopsy revealed
characteristic toxicological changes, including myocyte vacuolization and
fibrosis. Management often involved discontinuation of therapy, but severe
cases progressed to cardiac transplantation or resulted in mortality
(19%). Conclusion(s): CQ/HCQ-induced cardiomyopathy is an
underrecognized complication with significant morbidity and mortality.
Early detection through continuous cardiac monitoring in patients on
long-term CQ/HCQ therapy is crucial. Effective management, including
timely drug discontinuation, may improve outcomes, although prognosis
remains guarded in advanced stages. Copyright © 2025 Sociedad
Espanola de Cardiologia

<36>
Accession Number
2038647665
Title
Exploring the influence of extra-corporeal membrane oxygenation (ECMO)
support on neurodevelopmental outcomes in paediatric cardiac patients: a
systematic review.
Source
Cardiology in the Young. 35(5) (pp 888-899), 2025. Date of Publication: 01
May 2025.
Author
Francis J.; Chandiramani A.; George A.; George J.; Jones T.
Institution
(Francis) Department of Cardiothoracic Surgery, Aberdeen Royal Infirmary,
Aberdeen, United Kingdom
(Chandiramani) Department of Cardiothoracic Surgery, Royal Papworth
Hospital, Cambridge, United Kingdom
(George) Department of Anaesthesia, Aberdeen Royal Infirmary, Aberdeen,
United Kingdom
(George, Jones) Department of Paediatric Cardiac Surgery, Birmingham
Women's and Children's Hospital, Birmingham, United Kingdom
Publisher
Cambridge University Press
Abstract
Background: Mechanical circulatory support, and specifically
extra-corporeal membrane oxygenation, plays a critical role in managing
paediatric cardiac patients with severe heart failure. Whilst these
technologies are vital for bridging patients to recovery or heart
transplantation, it is imperative to study the influence of
extra-corporeal membrane oxygenation on neurodevelopmental outcomes.
 Objective(s): This systematic review aimed to evaluate the influence
of extra-corporeal membrane oxygenation on neurodevelopmental outcomes in
paediatric cardiac patients, both post-cardiotomy and non-cardiotomy
patients were included. Methodology: A comprehensive search was conducted
using PubMed, EMBASE, and PsychInfo to identify primary research articles
exploring the effects of extra-corporeal membrane oxygenation on
neurodevelopmental outcomes in paediatric heart patients from inception to
June 2024. Result(s): Our search yielded 5488 papers of which eight
papers were included featuring 302 patients. Conclusion(s): The
discussion highlights the considerable variability in neurodevelopmental
outcomes and how they are measured among extracorporeal membrane
oxygenation survivors. Outcomes vary by patient factors, with recovery
potential influenced by the duration and timing of follow-up. We
emphasised the importance of standardised assessment tools and extended
follow-ups to gain a clearer understanding of these
outcomes. Copyright © The Author(s), 2025.

<37>
Accession Number
2039096448
Title
Concomitant Atrial Fibrillation Ablation in Surgical Aortic Valve
Replacement: A Systematic Review and Meta-Analysis.
Source
CJC Open. 7(7) (pp 887-896), 2025. Date of Publication: 01 Jul 2025.
Author
Polat E.; Kharbanda R.K.; Ghafar M.; Schoones J.W.; Klautz R.J.M.; de Riva
M.; Palmen M.; Girdauskas E.; Tomsic A.
Institution
(Polat, Girdauskas, Tomsic) Department of Cardiothoracic Surgery, Augsburg
University Medical Centre, Augsburg, Germany
(Kharbanda, Ghafar, Klautz, Palmen) Department of Cardiothoracic Surgery,
Leiden University Medical Centre, Leiden, Netherlands
(Schoones) Directorate of Research Policy, Leiden University Medical
Centre, Leiden, Netherlands
(de Riva) Department of Cardiology, Leiden University Medical Centre,
Leiden, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Atrial fibrillation (AF) is common in patients undergoing
surgical aortic valve replacement; however, surgical ablation remains
underused due to limited data on its efficacy. Method(s): We
conducted a systematic review of the literature by searching PubMed,
Embase, Web of Science, Emcare, and the Cochrane Library for studies
reporting outcomes of concomitant surgical AF ablation in patients
undergoing surgical aortic valve replacement. The primary outcomes
included freedom from AF recurrence, overall survival, and complications.
We analyzed outcomes using traditional meta-analysis at specific time
points, alongside pooled Kaplan-Meier curves. Result(s): Nine studies
were included, encompassing a total of 12,683 patients. Concomitant
ablation reduced the risk of postoperative AF but increased the risk of
permanent pacemaker implantation (risk ratio 1.36, 95% confidence interval
[CI] 1.16-1.60, P < 0.01) and postoperative renal failure (RR 1.38, 95% CI
1.11-1.71, P < 0.01). During follow-up, concomitant ablation effectively
restored and maintained sinus rhythm, with up to 80% of patients remaining
free from recurrent AF 2-4 years post-surgery. Moreover, improved late
survival was observed with concomitant ablation (unadjusted hazard ratio
0.84, 95% CI 0.73-0.96, P = 0.013). Conclusion(s): Surgical ablation
during surgical aortic valve replacement was effective in restoring and
maintaining sinus rhythm after surgery. Preoperative rhythm status may
play an important role in guiding treatment plans, potentially enhancing
the clinical outcomes for patients scheduled for aortic valve
intervention. Copyright © 2025 The Authors

<38>
Accession Number
2035190004
Title
Drug-Induced Eyelid Edema: A Systematic Review.
Source
Dermatologic Therapy. 2025(1) (no pagination), 2025. Article Number:
5577128. Date of Publication: 2025.
Author
Tartaglia J.; Tudurachi I.; Cassalia F.; Gnesotto L.; Boemo D.G.;
Piaserico S.
Institution
(Tartaglia, Tudurachi, Cassalia, Gnesotto, Piaserico) Unit of Dermatology,
Department of Medicine, University of Padova, Padua, Italy
(Boemo) Department of Directional Hospital Management, University of
Padova, Padua, Italy
Publisher
John Wiley and Sons Inc
Abstract
Eyelid edema is a common clinical presentation with multiple etiologies,
some of which can pose life-threatening risks to patients. Isolated eyelid
edema, without additional significant signs or symptoms, presents a
diagnostic challenge. A growing number of drugs are associated with the
development of eyelid edema, particularly new-generation small molecules.
To identify the most frequently implicated drugs in this clinical
scenario, we conducted a systematic review following the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
criteria. Forty-three studies met the inclusion criteria, identifying the
drug groups most frequently associated with isolated eyelid edema:
mammalian target of rapamycin (mTOR) inhibitors (sirolimus and
everolimus), atypical antipsychotics (clozapine, risperidone, and
olanzapine), fillers (hyaluronic acid and polyalkylimide), and oncologic
drugs (imatinib and pemetrexed). The epidemiological characteristics of
the patients in each group were highly variable and reflected the use of
the aforementioned drugs in heterogeneous populations. The response to
eyelid edema treatments also varied significantly. Patients with eyelid
edema induced by atypical antipsychotics showed the highest response to
conservative therapy, with a 100 percent response following either dose
reduction or drug discontinuation. On the other hand, the response to
conservative treatments for eyelid edema caused by oncologic drugs was
inconsistent, with cases of persistent edema even after drug cessation. In
these cases, blepharoplasty proved to be an effective and long-lasting
solution. Lastly, in most filler-induced cases, an excellent response was
observed following treatment with intralesional
hyaluronidase. Copyright © 2025 J. Tartaglia et al. Dermatologic
Therapy published by John Wiley & Sons Ltd.

<39>
Accession Number
2035039530
Title
Embolic Protection Devices in Transcatheter Aortic Valve Implantation: A
Narrative Review of Current Evidence.
Source
Journal of Clinical Medicine. 14(12) (no pagination), 2025. Article
Number: 4098. Date of Publication: 01 Jun 2025.
Author
Latsios G.; Ktenopoulos N.; Apostolos A.; Koliastasis L.; Kachrimanidis
I.; Vlachakis P.K.; Katsaros O.; Mantzouranis E.; Tsalamandris S.;
Drakopoulou M.; Synetos A.; Aggeli C.; Tsioufis K.; Toutouzas K.
Institution
(Latsios, Ktenopoulos, Apostolos, Koliastasis, Kachrimanidis, Vlachakis,
Katsaros, Mantzouranis, Tsalamandris, Drakopoulou, Synetos, Aggeli,
Tsioufis, Toutouzas) First Department of Cardiology, National and
Kapodistrian University of Athens, Hippokration General Hospital of
Athens, Athens, Greece
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Transcatheter aortic valve implantation (TAVI) has emerged as a
transformative therapy for patients with severe aortic stenosis (AS)
across all surgical risk groups. However, periprocedural cerebrovascular
events (CVEs), including overt stroke and silent cerebral embolism, remain
significant complications. As a result, the use of embolic protection
devices (EPDs) during TAVI has been proposed to mitigate this risk. Our
aim was to provide a comprehensive review of the current evidence on the
efficacy, safety, and clinical utility of embolic protection devices in
TAVI procedures. According to the existing literature, EPDs are effective
in capturing embolic debris during TAVI and are associated with a
reduction in silent cerebral lesions as detected by diffusion-weighted
MRI. While some RCTs and meta-analyses demonstrate a potential benefit in
reducing disabling stroke, evidence for a consistent reduction in overall
stroke or mortality remains inconclusive. Subgroup analyses suggest the
greatest benefit in patients at elevated stroke risk, while
current-generation EPDs demonstrate high technical success and an
acceptable safety profile. Subsequently, EPDs represent a promising
adjunct to TAVI, particularly in high-risk populations. However, routine
use in all patients is not yet supported by consistent clinical evidence.
Further large-scale trials and long-term outcome data are needed to
clarify their role in improving neurological outcomes and to guide
selective patient application. Copyright © 2025 by the authors.

<40>
Accession Number
2039485391
Title
Effectiveness of ultrasound-guided alveolar recruitment in thoracic
surgery with one-lung ventilation: A randomized-controlled trial.
Source
European Journal of Cardio-thoracic Surgery. 67(7) (no pagination), 2025.
Article Number: ezaf204. Date of Publication: 01 Jul 2025.
Author
Kim B.R.; Lim L.; You J.; Yoon S.; Park J.-B.; Bahk J.-H.; Seo J.-H.
Institution
(Kim) Department of Anesthesiology and Pain Medicine, Asan Medical Center,
University of Ulsan, College of Medicine, Seoul, South Korea
(Lim, You, Yoon, Park, Bahk, Seo) Department of Anesthesiology and Pain
Medicine, Seoul National University Hospital, Seoul National University,
College of Medicine, Seoul, South Korea
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES Although alveolar recruitment strategy (ARS) before one-lung
ventilation (OLV) is beneficial in intraoperative oxygenation, the optimal
protocol remains unestablished. As lung ultrasound (LUS) has been used
recently, we designed a randomized controlled trial to compare preemptive
LUS-guided ARS with conventional ARS in thoracic surgery. METHODS Patients
aged 20-80 years scheduled to undergo lung resection surgery with OLV were
randomized into 2 groups: (i) control group receiving conventional ARS and
(ii) LUS group receiving LUS-guided ARS. ARS and modified LUS scoring were
performed 5 min after intubation and before emergence. Arterial blood
samples and respiratory parameters were collected every 30 min during OLV.
The primary outcome was the incidence of intraoperative hypoxaemia (SpO2 <
95%). RESULTS In total, 166 patients were included. The incidence of
intraoperative hypoxaemia was 1.2% in the LUS group and 14.3% in the
control group [risk ratio (95% CI) 0.09 (0.01-0.64), P = 0.002]. However,
the incidence of intraoperative severe hypoxaemia (SpO2 < 90%) was not
significantly different [1.2% vs 6.0%, risk ratio (95% CI) 0.20
(00.02-1.72), P = 0.213]. In the LUS before emergence, higher atelectasis
score (P = 0.005) and more significant atelectasis (P = 0.031) was
observed in the control group. Postoperative adverse outcomes were
comparable between both groups. CONCLUSIONS LUS-guided ARS before OLV was
more effective than conventional ARS in preventing intraoperative
hypoxaemia during thoracic surgery. Copyright © 2025 The
Author(s). Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<41>
Accession Number
647794757
Title
Association of Subclinical Liver Fibrosis With Death in Patients With
Coronary Artery Disease: A Post Hoc Analysis of the ISCHEMIA Trial.
Source
Journal of the American Heart Association. 14(13) (pp e040848), 2025. Date
of Publication: 01 Jul 2025.
Author
Caldonazo T.; Rahouma M.; Sandner S.; Redfors B.; Harik L.; Richter M.;
Kirov H.; Doenst T.; Gaudino M.F.L.
Institution
(Caldonazo, Richter, Kirov, Doenst) Department of Cardiothoracic Surgery
Jena University Hospital, Friedrich-Schiller-University Jena Germany,
Germany
(Caldonazo, Rahouma, Sandner, Harik, Gaudino) Department of Cardiothoracic
Surgery Weill Cornell Medicine New York NY USA
(Sandner) Department of Cardiac Surgery Medical University of Vienna
Vienna Austria, Austria
(Redfors) Department of Population Health Sciences Weill Cornell Medicine
New York NY USA
(Redfors) Department of Molecular and Clinical Medicine Institute of
Medicine, Gothenburg University Gothenburg Sweden, Sweden
(Redfors) Department of Cardiology Sahlgrenska University Hospital
Gothenburg Sweden, Sweden
Abstract
BACKGROUND: The fibrosis-4 index (FIB-4) score, a noninvasive marker of
subclinical liver fibrosis, has shown prognostic utility in general
surgical populations. Current risk assessment models for patients with
coronary artery disease undergoing percutaneous coronary intervention or
coronary artery bypass grafting do not account for liver dysfunction apart
from overt liver cirrhosis. We analyzed the distribution of the baseline
FIB-4 score and its association with all-cause death in patients with
coronary artery disease using data from the International Study of
Comparative Health Effectiveness With Medical and Invasive Approaches
(ISCHEMIA) trial. METHOD(S): The baseline FIB-4 score was calculated
for all ISCHEMIA randomized participants with laboratory data (platelet
count, aspartate aminotransferase, and alanine aminotransferase). The
primary outcome was the association between baseline FIB-4 and all-cause
death. Secondary outcomes were cardiovascular death, heart failure,
myocardial infarction, and stroke. Multivariable Cox regression was
performed adjusting for key risk factors. RESULT(S): The FIB-4 score
was calculated for 3735 participants. Baseline FIB-4 score was
significantly associated with an increased risk of all-cause (hazard ratio
[HR], 1.19 [95% CI, 1.07-1.32]; P=0.001) and cardiovascular death (HR,
1.19 [95% CI, 1.04-1.36]; P=0.011). This association was consistent across
the overall population and within subgroups of patients treated with
percutaneous coronary intervention, coronary artery bypass grafting, and
medical therapy. There was no significant association regarding heart
failure, myocardial infarction, and stroke. CONCLUSION(S): The FIB-4
score may be a significant predictor of death in patients with coronary
artery disease. Preprocedural hepatic assessment should be considered to
stratify risk in patients undergoing invasive cardiac procedures.

<42>
Accession Number
2034649754
Title
The utility of real-time transthoracic 3-dimensional echocardiography in
congenital heart disease in current clinical practice.
Source
International Journal of Cardiovascular Imaging. 41(7) (pp 1389-1395),
2025. Date of Publication: 01 Jul 2025.
Author
Saengsin K.; Intamul K.; Sittiwangkul R.
Institution
(Saengsin, Intamul, Sittiwangkul) Division of Cardiology, Department of
Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai,
Thailand
Publisher
Springer Science and Business Media B.V.
Abstract
To evaluate the utility of three-dimensional transthoracic
echocardiography (3D TTE) in the assessment and management of congenital
heart disease (CHD). The use of three-dimensional TTE with both pediatric
and adult patients has helped to clarify the cardiac anatomy and
hemodynamic physiologic lesions in CHD. However, few practical aspects of
3D TTE have undergone systematic review. A retrospective study of CHD
patients from January-December 2022 who underwent 3D TTE was conducted to
determine the utility of 3D TTE with respect to answering the primary
diagnostic question, adding diagnostic information to 2D imaging,
concordance with 2D TTE or cardiac CT, and impact on management. During
the study period, 76 CHD patients underwent 3D TTE at a median age of 104
months (IQR 29-175.5). The common cardiac segment under investigation was
related to the atrioventricular valve. The mean heart rate was 89 +/- 20
BPM. The mean volume rate was 17 +/- 5. The single beat acquisition was
used in all cases. Sedation use was infrequent (22.67%). Three-dimensional
TTE answered the primary diagnostic question and added diagnostic
information to 2D TTE imaging in all cases (100%). Additionally, 3D TTE
impacted the management of the following: provided guided intervention
(3/76, 4%), provided information before cardiac surgery (27/76, 36%), and
increased understanding of the cardiac anatomy (76/76, 100%).
Three-dimensional TTE can be applied in simple to complex CHD cases,
across all age groups, from infants to adults. It provides real-time
performance, requires no radiation, and infrequent use of sedation. This
study showed that 3D TTE was accurate, answered the diagnostic questions
in all cases, and frequently added diagnostic information that impacted
management. Copyright © The Author(s) 2025.

<43>
Accession Number
2035157880
Title
Intracardiac echocardiography versus transesophageal echocardiography
guidance on left atrial appendage occlusion in patients with atrial
fibrillation: A systematic review and meta-analysis.
Source
Journal of Arrhythmia. 41(4) (no pagination), 2025. Article Number:
e70115. Date of Publication: 01 Aug 2025.
Author
Khan U.; Amin A.M.; Majeed Z.; Khan M.H.; Shaaban Abdelgalil M.; Mubariz
M.; Ramadan S.; Imran M.; Raza A.; Rehman M.N.U.; Bukhari S.H.Z.; Asif
A.T.; Gunjial F.H.; Ali J.; Nawaz A.
Institution
(Khan) Division of Cardiology, University of Maryland School of Medicine,
Baltimore, MD, United States
(Amin) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Majeed, Asif, Gunjial) Department of Medicine, King Edward Medical
University, Lahore, Pakistan
(Khan) Department of Medicine, Saidu Medical College, Swat, Pakistan
(Shaaban Abdelgalil, Ramadan) Faculty of Medicine, Ain Shams University,
Cairo, Egypt
(Mubariz) Department of Medicine, Akhtar Saeed Medical College, Lahore,
Pakistan
(Imran) Department of Medicine, University College of Medicine and
Dentistry, The University of Lahore, Lahore, Pakistan
(Raza) Department of Medicine, Services Institute of Medical Sciences,
Lahore, Pakistan
(Rehman) Department of Medicine, Mayo Hospital, Lahore, Pakistan
(Bukhari) Clinical Development Fellow, King's Mill Hospital Sherwood
Forest Hospitals NHS Foundation Trust, Nottinghamshire, United Kingdom
(Ali) Department of Medicine, Saint Peter's University Hospital, New
Brunswick, NJ, United States
(Nawaz) Department of Radiology, Pakistan Atomic Energy Commission
Hospital, Islamabad, Pakistan
Publisher
John Wiley and Sons Inc
Abstract
Background: Intracardiac echocardiography (ICE) is an innovative technique
that has emerged as an alternative to transesophageal echocardiography
(TEE) to guide the implantation of a left atrial appendage occlusion
(LAAO) device in patients with nonvalvular atrial fibrillation (AF) who
cannot tolerate anticoagulants. Purpose(s): We aim to review the
clinical efficacy and safety of ICE compared to TEE to guide the
implantation of LAAO devices in patients with AF. Method(s): We
conducted comprehensive searches across PubMed, CENTRAL, Web of Science,
Scopus, and EMBASE until March 2024. Pooled data were reported using risk
ratio (RR) for dichotomous outcomes and mean difference (MD) for
continuous outcomes, along with a 95% confidence interval (CI). This
systematic review and meta-analysis was registered with PROSPERO ID:
CRD42024542537. Result(s): We included 19 studies involving 44,706
patients. ICE was associated with a statistically significant high
procedure success rate compared to TEE (RR: 1.0055 with 95% CI [1.0006,
1.0104], p = 0.01), but there was no difference in procedure duration (MD:
3.07 with 95% CI [-4.67, 10.80], p = 0.44) between the two groups.
However, compared to the ICE group, patients undergoing LAAO under TEE
guidance required more than one device more often (RR: 1.39 with 95% CI
[1.23, 1.57], p < 0.01). The TEE group also reported a reduced incidence
of pericardial effusion compared to the ICE group (RR: 0.65 with 95% CI
[0.50, 0.85], p < 0.01). Conclusion(s): Our meta-analysis concluded
that ICE can be a viable alternative to TEE for guiding LAAO, particularly
in patients unsuitable for general anesthesia. It can also reduce the need
for GA and adverse effects and resources associated with it, require fewer
devices, and demonstrate comparable safety and efficacy outcomes, though
it may increase the risk of pericardial effusion. Further prospective
trials are warranted. Copyright © 2025 The Author(s). Journal of
Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of
Japanese Heart Rhythm Society.

<44>
[Use Link to view the full text]
Accession Number
2037328674
Title
Role of Renin-Angiotensin System Inhibitors After Transcatheter Aortic
Valve Replacement: A Systematic Review and Meta-analysis.
Source
American Journal of Therapeutics. 32(4) (pp e382-e385), 2025. Date of
Publication: 29 Jan 2025.
Author
Burhan M.; Noor S.; Ahmed M.; Shafiq S.; Ahmed R.; Shahid F.
Institution
(Burhan, Noor, Ahmed, Shafiq) Rawalpindi Medical University, Rawalpindi,
Pakistan
(Ahmed) Department of Cardiology, Royal Brompton Hospital, London, United
Kingdom
(Ahmed) National Heart and Lung Institute, Imperial College London, United
Kingdom
(Shahid) Department of Interventional Cardiology, Queen Elizabeth
Hospital, Birmingham, United Kingdom
Publisher
Lippincott Williams and Wilkins

<45>
Accession Number
2038149667
Title
Association between dietary inflammatory or oxidative stress indices and
biomarkers in cardiometabolic and related conditions: a systematic
literature review.
Source
British Journal of Nutrition. 133(8) (pp 1090-1106), 2025. Date of
Publication: 28 Apr 2025.
Author
Peake C.G.; Odgers-Jewell K.; De Sousa C.J.; English C.J.; Ingabire A.;
Mayr H.L.; Reidlinger D.P.
Institution
(Peake, Odgers-Jewell, De Sousa, English, Ingabire, Mayr, Reidlinger)
Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD,
Australia
(Mayr) Department of Nutrition and Dietetics, Princess Alexandra Hospital,
Brisbane, QLD, Australia
(Mayr) Greater Brisbane Clinical School, Faculty of Health, Medicine and
Behavioural Sciences, The University of Queensland, Brisbane, QLD,
Australia
Publisher
Cambridge University Press
Abstract
Inflammation and oxidative stress contribute to the progression of chronic
diseases, and the volume of research in this area is rapidly expanding.
Various dietary indices have been developed to determine the overall
inflammatory or oxidative stress potential of a diet; however, few have
been validated in cardiometabolic disease populations. This review aimed
to explore the association between dietary indices and biomarkers of
inflammation and oxidative stress in adults with cardiometabolic
conditions. Four databases were systematically searched for literature in
any language (Embase, CINAHL, CENTRAL and MEDLINE) with 12,286
deduplicated records identified. Seventeen studies of adults with
metabolic syndrome, cardiovascular disease, type 2 diabetes, non-alcoholic
fatty liver disease or chronic kidney disease were included. Fourteen
studies were observational studies, one study was a clinical trial, and
one was a randomised controlled trial. Four dietary indices were reported
on with most studies (n 11) reporting on the dietary inflammatory index.
The most reported biomarker was C-reactive protein. The findings were
narratively synthesised. Results were inconclusive due to the
heterogeneity of dietary indices and their use, disease states and
biomarkers reported. Only one study reporting on the dietary inflammatory
index assessed all 45 parameters. Observational studies, particularly
retrospective designs (n 7), are subject to recall and selection biases,
potentially presenting overestimated results. Further research is required
to determine the relationship between dietary indices and biomarkers of
inflammation and oxidative stress in cardiometabolic disease populations.
Future research should be prospective, utilise rigorous research methods,
assess the full range of index parameters, and examine biomarkers the tool
was developed for. Copyright © The Author(s), 2025.

<46>
Accession Number
2035109961
Title
Urine Output Response to a Furosemide Infusion in Infants After
Cardiopulmonary Bypass as a Predictor of Acute Kidney Injury.
Source
Pediatric Cardiology. (no pagination), 2025. Date of Publication: 2025.
Author
Pierick A.R.; Luckritz K.E.; Huebschman A.; Duimstra A.; Yu S.;
Sznycer-Taub N.
Institution
(Pierick, Duimstra, Yu, Sznycer-Taub) Divison of Pediatric Cardiology,
Department of Pediatrics, University of Michigan, Ann Arbor, MI, United
States
(Luckritz) Division of Pediatric Nephrology, Department of Pediatrics,
University of Michigan, Ann Arbor, MI, United States
(Huebschman) Department of Pediatric Pharmacy, University of Michigan, Ann
Arbor, MI, United States
Publisher
Springer
Abstract
Acute kidney injury (AKI) is a common complication in infants after
cardiac surgery. Prior studies have demonstrated that urine output
response to bolus dose furosemide correlates with AKI development but have
excluded infants receiving a furosemide infusion. We sought to determine
if urine output in response to a furosemide infusion in infants after
cardiac surgery predicts AKI development. Single center retrospective
cohort study of infants post cardiac surgery requiring cardiopulmonary
bypass and received a post-operative furosemide infusion. A furosemide
response score (FRS) (urine output [mL]/furosemide delivered [mg/kg]) was
calculated. The FRS was used to determine optimal cut-offs to predict
clinically significant AKI (CS-AKI), defined as stage 2 or 3 AKI. A
furosemide infusion was started at a median of 9.4 h (interquartile range
6.6-13.6 h) after intensive care unit (ICU) admission in 155 infants. The
post-operative incidence of AKI was 76.8%, with 44.5% having CS-AKI. The
optimal FRS cut-off to correlate with AKI was 11.3 mL/mg/kg at 4 h (area
under the curve [AUC] = 0.75), 25.5 mL/mg/kg at 10 h (AUC = 0.70), and
53.3 mL/mg/kg at 24 h (AUC = 0.70) post-infusion initiation, and
independently associated with the development of AKI. Lower FRS also
correlated with increased mechanical ventilation days and ICU/hospital
length of stay. Urine output in response to a furosemide infusion in
infants following cardiac surgery is associated with post-operative
CS-AKI. The FRS can be used to predict AKI and potentially improve
hemodynamics while minimizing risks. Copyright © The Author(s)
2025.

<47>
Accession Number
2033200332
Title
Impact of GDMT on outcomes after mitral valve edge-to-edge repair
stratified by SMR proportionality.
Source
Clinical Research in Cardiology. 114(7) (pp 939-941), 2025. Date of
Publication: 01 Jul 2025.
Author
Stolz L.; Kalbacher D.; Koell B.; Karam N.; Puscas T.; Metra M.; Adamo M.;
Spieker M.; Horn P.; Thiele H.; Kister T.; von Bardeleben R.-S.; Lurz P.;
Kresoja K.-P.; Iliadis C.; Pfister R.; Kassar M.; Praz F.; Melica B.;
Trenkwalder T.; Xhepa E.; Neuss M.; Butter C.; Grayburn P.; Hausleiter J.
Institution
(Stolz, Hausleiter) Medizinische Klinik Und Poliklinik I, Klinikum Der
Universitat Munchen, Marchioninistr. 15, Munich, Germany
(Stolz, Hausleiter) German Center for Cardiovascular Research (DZHK),
Partner Site Munich Heart Alliance, Munich, Germany
(Kalbacher, Koell) Department of Cardiology, University Heart and Vascular
Centre Hamburg, Hamburg, Germany
(Kalbacher, Koell) German Center of Cardiovascular Research (DZHK),
Partner Site, Hamburg/Kiel/Lubeck, Germany
(Karam, Puscas) Department of Cardiology, European Hospital Georges
Pompidou, and Paris Cardiovascular Research Center (INSERM U970), Paris,
France
(Metra, Adamo) Cardiac Catheterization Laboratory and Cardiology, ASST
Spedali Civili and University of Brescia, Brescia, Italy
(Spieker, Horn) Heart Center, Department of Cardiology, University
Hospital of Dusseldorf, Dusseldorf, Germany
(Thiele, Kister) Department of Cardiology, Heart Center Leipzig at
University of Leipzig, Leipzig, Germany
(von Bardeleben, Lurz, Kresoja) Zentrum Fur Kardiologie,
Johannes-Gutenberg-Universitat, Mainz, Germany
(Iliadis, Pfister) Department III of Internal Medicine, Heart Center,
University of Cologne, Cologne, Germany
(Kassar, Praz) Universitatsklinik Fur Kardiologie, Inselspital Bern, Bern,
Switzerland
(Melica) Centro Hospitalar Vila Nova de Gaia, Espinho, Portugal
(Trenkwalder, Xhepa) Deutsches Herzzentrum Munchen, Technische Universitat
Munchen, Munich, Germany
(Neuss, Butter) Herzzentrum Brandenburg, Medizinische Hochschule
Brandenburg Theodor Fontane, Bernau, Germany
(Grayburn) Division of Cardiology, Department of Internal Medicine, The
Heart Hospital, Baylor Scott & White, Dallas, TX, United States
Publisher
Springer Science and Business Media Deutschland GmbH

<48>
Accession Number
2036725765
Title
Effect of Mannitol on Renal Function during Cardiac Surgery and Immediate
Post-Operative in Selected Private Hospitals in Nablus City/ Palestine.
Source
Jordan Journal of Pharmaceutical Sciences. 18(2) (pp 377-388), 2025. Date
of Publication: 25 Jun 2025.
Author
Rahhal B.; Salah H.; Abdoh L.A.; Almasri N.; Al-Tarsha S.; Bsharat S.;
Najjar J.
Institution
(Rahhal, Salah) Department of Biomedical Sciences, Faculty of Medicine and
Health Sciences, An-Najah National University, Nablus, Palestine
(Abdoh, Almasri, Al-Tarsha, Bsharat, Najjar) Division of cardiac perfusion
technology, Department of Medical Allied sciences, Faculty of Medicine and
Health Sciences, An-Najah National University, Nablus, Palestine
Publisher
University of Jordan,Deanship of Scientific Research
Abstract
Background: Cardiopulmonary bypass (CPB) is a common technique in cardiac
surgery, however, it is associated with acute kidney injury. The type of
solution in the CPB circuit can potentially affect surgery outcome through
affecting several organs and body homeostasis. The optimal prime solution
for the CPB) circuit in adult cardiac surgery has not yet been defined.
Mannitol is widely used in the priming solution for CPB even though there
is no clear consensus on the role of mannitol in cardiac surgery.
 Purpose(s): The purpose of this study was to investigate the effect
of mannitol in the CPB prime solution on renal function during cardiac
surgery and post-operative in selected private hospitals in Nablus City
Design and method: prospective cohort study design conducted at An-Najah
National University Hospital and specialized Arab hospital. A sample of
120 patients was studied. The patients had cardiac surgery and they had
preoperative normal renal function. Result(s): The use of mannitol in
the CPB prime solution was associated with a decrease in creatinine and
BUN readings levels in the postoperative period (postoperative period mean
=0.7692 +/- 0.26068, and 18.3917 +/- 7.56629mg/dl, respectively;
p-value<0.001) and an increase in GFR levels in the postoperative period
(postoperative period mean = 112.27861 +/- 1.43604, p-value<0.001)
indicating and improvement in renal function following cardiac
surgery. Copyright © 2025 DSR Publishers/The University of
Jordan. All Rights Reserved.

<49>
Accession Number
2035123226
Title
Comparing the effect of three levels of end-expiratory pressure during
facemask ventilation on gastric insufflation in patients with obesity: a
randomized controlled trial.
Source
Journal of Anesthesia. (no pagination), 2025. Date of Publication: 2025.
Author
Mostafa M.; Hasanin A.; Zakaria M.M.; Kandel H.; Hamimy W.; Abougabal A.;
Elshal M.M.
Institution
(Mostafa, Hasanin, Zakaria, Kandel, Hamimy, Abougabal) Department of
Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
(Elshal) Department of Anesthesia and Critical Care Medicine, National
Cancer Institute, Cairo University, Cairo, Egypt
Publisher
Springer
Abstract
Background: We compared the effect of three levels of end-expiratory
pressure on the incidence of gastric insufflation during face-mask
ventilation in patients with obesity. Method(s): This randomized
controlled trial included adult obese patients undergoing elective
non-cardiac surgery under general anesthesia with neuromuscular blockade.
Patients were randomized to receive either zero-end-expiratory pressure
(ZEEP group), 4-cmH<inf>2</inf>O positive end-expiratory pressure (PEEP)
(low-PEEP group), or 8-cmH<inf>2</inf>O PEEP (high-PEEP group) during
volume-controlled mask ventilation. Gastric antral cross-sectional area
(CSA) was assessed using ultrasonography before induction of anesthesia
and after intubation. The percentage of change (delta) in the CSA was
calculated and gastric insufflation was considered significant when the
delta CSA was > 30%. The primary outcome was the incidence of gastric
insufflation. Secondary outcomes were antral CSA before induction of
anesthesia and after intubation in addition to ventilatory variables
(end-tidal CO<inf>2</inf>, peak airway pressure, and tidal volume) during
face-mask ventilation. Result(s): We analyzed data from 160 patients.
The antral CSA increased after intubation in all groups. The incidence of
gastric insufflation was higher in the high-PEEP group (32/54[59%]) than
that in the ZEEP group (6/52[12%]) and low-PEEP group (15/54[28%]). Delta
CSA, antral CSA after intubation, and incidence of gastric insufflation
were not significantly different between the ZEEP and low-PEEP groups.
Ventilatory variables were comparable between the groups.
 Conclusion(s): In obese paralyzed patients, gastric insufflation can
occur during face-mask ventilation whatever the level of end-expiratory
pressure; however, the use of ZEEP or 4-cmH<inf>2</inf>O PEEP was
associated with lower incidence of gastric insufflation compared to
8-cmH<inf>2</inf>O PEEP. Clinical trial registration: Clinical trial
registration at clinicaltrials.gov NCT05979129.
https://classic.clinicaltrials.gov/ct2/show/NCT05979129 Copyright
© The Author(s) 2025.

<50>
Accession Number
2039109938
Title
Impact factor, indexing in PubMed and new monographs in Cardiovascular
Surgery.
Source
Cirugia Cardiovascular. 32(4) (pp 189), 2025. Date of Publication: 01 Jul
2025.
Author
Garcia Fuster R.
Institution
(Garcia Fuster) Editor Jefe de CIRUGIA CARDIOVASCULAR. Consorcio Hospital
General Universitario de Valencia, Facultad de Medicina, Universidad
Catolica de Valencia, Valencia, Spain
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)

<51>
Accession Number
645791120
Title
Multisensory stimulation to reduce procedural pain in retinopathy of
prematurity: A randomized controlled trial.
Source
Nursing in critical care. 30(4) (pp e13200), 2025. Date of Publication: 01
Jul 2025.
Author
Tasdemir H.I.
Institution
(Tasdemir) Burdur Health Services Vocational School, Burdur Mehmet Akif
Ersoy University, Burdur, Turkey
Abstract
BACKGROUND: Retinopathy is frequently seen in the neonatal intensive care
unit (NICU), and its examination is a painful procedure for infants. AIM:
This randomized active-controlled trial aimed to investigate the impact of
multisensory stimulation (MSS) on neonatal pain during retinopathy of
prematurity (ROP) examinations, in comparison with a white noise (WN) and
control group receiving standard care. STUDY DESIGN: Conducted as a
three-arm, randomized controlled trial, the study was implemented in the
NICU of a local university hospital. Recruitment spanned from July 2023 to
November 2023, with preterm infants (gestational age < 37 weeks) randomly
assigned to either a MSS, WN or a control group. MSS components included
visual, auditory, tactile, olfactory and gustatory stimuli, all designed
to create a synergistic, comforting environment for the infant during the
procedure. Procedural pain, heart rate and oxygen saturation were assessed
at various stages before and after ROP examinations. RESULT(S):
Analysis of 90 participants revealed that the MSS group exhibited lower
Premature Infant Pain Profile (PIPP) scores than the WN and control groups
(mean difference: -2.12, 95% confidence interval [CI]: -2.62 to -1.62;
odds ratio [OR]: 0.004, 95% CI [0.001, 0.012], p < 0.001). Additionally,
heart rates were significantly lower in the MSS group (mean difference:
-15.3 beats/min, 95% CI: -20.5 to -10.1; OR: 0.025, 95% CI [0.008, 0.073],
p < .001) and oxygen saturation levels were higher (mean difference: 3.2%,
95% CI: 1.8% to 4.6%; OR: 1.12, 95% CI [1.05, 1.20], p < .001) than in the
other groups. CONCLUSION(S): MSS emerges as a favourable, safe and
non-pharmacological intervention for pain management in ROP and similar
procedures. RELEVANCE TO CLINICAL PRACTICE: Multisensory stimulation can
be effectively integrated into the routine care provided by critical care
nurses during retinopathy of prematurity examinations in preterm infants.
This non-pharmacological intervention offers a practical approach for
critical care nurses to reduce procedural pain and improve physiological
stability in this vulnerable population. Copyright © 2024 British
Association of Critical Care Nurses.

<52>
Accession Number
647771002
Title
The Role of Artificial Intelligence in the Advancement of Mechanical
Circulatory Support: A Systematic Review.
Source
ASAIO Journal. Conference: 71st Annual Meeting of the American Society for
Artificial Internal Organs, ASAIO 2025. New Orleans, LA United States.
71(Supplement 3) (pp 149), 2025. Date of Publication: 01 May 2025.
Author
Woodland E.R.; Matlis G.C.; Palazzolo T.C.; Throckmorton A.L.
Institution
(Woodland, Matlis, Palazzolo, Throckmorton) Biomedical Engineering, Drexel
University, School of Biomedical Engineering, Science, and Health Systems,
North Wales, PA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: In recent years, there has been a notable surge in the ability
of machines to perform complex and intelligent human-centered tasks,
particularly within the domain of cardiovascular health. Transformative
advancements in artificial intelligence (AI) and machine learning (ML)
algorithms reflect the tremendous potential for such analyses to
meaningfully extend into design, translational development, and clinical
usage of medical devices, including mechanical circulatory support (MCS)
therapies. Here, we investigate and report the devices, applications,
limitations, and strategies in which AI is currently being employed in MCS
and the new opportunities of AI approaches to transform the field of MCS.
 Method(s): To effectively assess the scope and impact of AI in MCS,
we conducted a systematic literature review. A comprehensive search of
four recognized research databases (Google Scholar, OVID Medline,
ProQuest, and PubMed) was performed using the following Boolean string:
"(Artificial Intelligence) AND AI AND (Mechanical Circulatory Support) AND
MCS NOT (Heart Transplant) NOT (Cardiogenic Shock) NOT (Critical Care)."
This strategy was designed to identify the application of AI in MCS only.
Database search results were then screened by titles and abstracts to
remove sources that could be identified as beyond the scope of the review
or as duplicates. 271 of the 295 papers were removed during the screening
process, leaving 24 remaining. These were reviewed in their entirety.
 Result(s): The majority of relevant publications covered two main
subjects: the prediction and management of postoperative outcomes, and the
development of personalized device-patient matching and timing. AI
modeling has been instrumental in successful predictions of complications,
recovery trajectories, and long-term survival. It has also been employed
to inform clinical decision-making. Barriers to broad implementation of AI
include the need for sizable, high-quality datasets to achieve algorithm
training benchmarks, the lack of organized and incomplete databases, such
as INTERMACS, and limited computational resources. Emerging frontiers of
MCS recognize the potential for AI and ML techniques to refine and improve
image recognition capabilities, diagnostic assessment, device placement,
and post-implantation monitoring approaches in the future.
 Conclusion(s): AI-driven advancements demonstrate a promising
convergence of computational power and clinical expertise, offering
personalized, efficient, and informed clinical management of MCS patients.
In order to realize broad implementation, we must overcome challenges and
address limitations, including data integrity, model accuracy, resource
access, and clinical acceptance.

<53>
Accession Number
647770915
Title
Predictors of new-onset right bundle branch block after heart
transplantation: a systematic review and meta-analysis.
Source
ASAIO Journal. Conference: 71st Annual Meeting of the American Society for
Artificial Internal Organs, ASAIO 2025. New Orleans, LA United States.
71(Supplement 3) (pp 136), 2025. Date of Publication: 01 May 2025.
Author
Mostafa N.; Almaadawy O.; Hamed B.; Dervis M.; Asad A.; Zreigh S.; Mostafa
H.A.; Elbenawi H.; Ahmed M.M.
Institution
(Ahmed) Cardiovascular Medicine, University of Florida, Gainesville, FL,
United States
(Mostafa) Ain Shams University, Cairo, Egypt
(Almaadawy) MedStar Health, Baltimore, MD, United States
(Hamed, Mostafa) Al Azhar University, Cairo, Egypt
(Dervis, Asad, Zreigh) Ankara Yilidirim Beyazit University, Ankara, Turkey
(Elbenawi) Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: New right bundle branch block (RBBB) has a high prevalence
among heart transplant recipients with several studies finding an
association between RBBB and poor clinical outcomes. Crucially, the
predictors of RBBB development after heart transplantation are not yet
well established. Our study aims to evaluate the pre-operative hemodynamic
and demographic predictors associated with increased risk of new-onset
RBBB following heart transplantation. Method(s): A systematic
literature search was conducted on PubMed, Scopus, Web of Science, and
Cochrane Library to identify studies comparing heart transplant patients
with RBBB and without RBBB from inception to 15 November 2024.
Random-effects models were used to estimate the pooled mean difference
with 95% confidence interval (CI) using OpenMeta[Analyst] software.
 Result(s): Seven studies incorporating 1310 patients were included in
our meta-analysis. Compared to patients who did not develop conduction
abnormalities, patients who developed RBBB had significantly higher graft
ischemia time (mean difference 10.0; 95% CI: 2.00 - 17.91; P = 0.01) and
pulmonary vascular resistance (mean difference 0.44; 95% CI: 0.21 - 0.68;
P < 0.001) at preoperative catheterization. There was no difference
between the two groups in terms of preoperative mean pulmonary artery
pressure (mean difference 1.83; 95% CI: -0.86 - 4.53; P = 0.18) or the
mean age of donors (mean difference 1.51; 95% CI: -0.30 - 3.31; P = 0.10)
[Figure 1]. There was no statistically significant heterogeneity between
the studies. Conclusion(s): Our meta-analysis identified that
patients with RBBB after heart transplantation had a prolonged graft
ischemia time and higher pulmonary vascular resistance. There was no
association between RBBB and mean pulmonary artery pressure or donor age.
Larger-scale studies on the pre-operative hemodynamics present before
heart transplantation are needed to support our findings and exclude the
impact of possible confounders. (Figure Presented).

<54>
Accession Number
2039457879
Title
Dexmedetomidine for delirium prevention after cardiac surgery: An updated
systematic review and meta-analysis with trial sequential analysis.
Source
Anaesthesia Critical Care and Pain Medicine. 44(5) (no pagination), 2025.
Article Number: 101578. Date of Publication: 01 Sep 2025.
Author
Caetano da Silva L.; Tapioca V.; Viana P.; Pereira E.M.; Gibicoski T.;
Amaral S.
Institution
(Caetano da Silva) Department of Medicine, Federal University of Paraiba,
Brazil
(Tapioca) Department of Medicine, Bahiana School of Medicine and Public
Health, Brazil
(Viana) Department of Medicine, University of the Extreme South of Santa
Catarina, Brazil
(Pereira) Department of Medicine, Federal University of Minas Gerais,
Brazil
(Gibicoski) Department of Medicine, Federal University of Health Sciences
of Porto Alegre, Brazil
(Amaral) Department of Anesthesiology, Duke University Medical Center,
Durham, NC, United States
Publisher
Elsevier Masson s.r.l.
Abstract
Background: Postoperative delirium remains a common complication after
cardiac surgery. The impact of dexmedetomidine (DEX) on preventing
postoperative delirium is still controversial as recent randomized
controlled trials (RCTs) have presented conflicting results.
 Method(s): We conducted an updated systematic review and
meta-analysis of RCTs evaluating DEX efficacy in preventing delirium after
cardiac surgery. A systematic search of MEDLINE, Embase, and Cochrane
databases identified RCTs comparing DEX with placebo or other treatments
in patients aged >=18 years. Sensitivity, subgroup analyses, and trial
sequential analysis (TSA) assessed the robustness of the findings.
 Result(s): A total of 31 RCTs including 5628 patients were analyzed,
50.1% of them receiving DEX. Delirium incidence was significantly lower in
the DEX group (RR 0.61; 95% CI, 0.49-0.75; P < 0.001). This protective
effect remained across subgroup analyses based on age, control type,
delirium assessment method, and after excluding trials at high risk of
bias. DEX use was associated with a shorter intensive care unit length of
stay (MD -0.14 days; 95% CI, -1.28 to -0.04; P < 0.01). TSA confirmed the
result's robustness. However, DEX increased bradycardia risk (RR 1.53; 95%
CI, 1.05-2.21; P = 0.02). No significant differences were found in
mortality, intubation duration, hospital length of stay, atrial
fibrillation, or hypotension. Conclusion(s): Dexmedetomidine
significantly reduces postoperative delirium following cardiac surgery,
with moderate evidence confirmed by TSA. While it demonstrates clinical
benefits, careful bradycardia monitoring is warranted. Systematic review
protocol: PROSPERO (CRD42024593472). Copyright © 2025 Societe
Francaise d'Anesthesie et de Reanimation (SFAR)

<55>
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.
 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. 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. 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. Copyright © 2025 The Authors

<56>
Accession Number
2039394785
Title
Time-to-event analysis of the long-term outcome in trials comparing
transcatheter and surgical aortic valve implantation: A meta-analysis.
Source
International Journal of Cardiology. 438 (no pagination), 2025. Article
Number: 133524. Date of Publication: 01 Nov 2025.
Author
Barili F.; Pollari F.; Marin-Cuartas M.; Anselmi A.; de la Cuesta M.;
Brophy J.M.; Boden W.E.; De Caterina R.; Dayan V.; Roda J.R.; Uva M.S.;
Almeida R.M.S.; Tomasi J.; Verhoye J.-P.; Musumeci F.; Mandrola J.; Kaul
S.; Papatheodorou S.; Parolari A.
Institution
(Barili) University Cardiac Surgery Unit, IRCCS Ospedale Galeazzi
Sant'Ambrogio, Milan, Italy
(Barili) Department of Epidemiology, Harvard T.H. Chan School of Public
Health, Boston, MA, United States
(Pollari) Cardiac surgery, Klinikum Nurnberg-Paracelsus Medical
University, Nuremberg, Germany
(Pollari) University of Milan, Milan, Italy
(Marin-Cuartas, de la Cuesta) University Department of Cardiac Surgery,
Leipzig Heart Center, Leipzig, Germany
(Anselmi, Tomasi, Verhoye) Department of Thoracic and Cardiovascular
Surgery, University Hospital of Rennes, France
(Brophy) Department of Medicine, McGill University Health Center,
Montreal, Canada
(Boden) Boston University School of Medicine and Lecture in Medicine,
Harvard Medical School, Boston, MA, United States
(De Caterina) Department of Cardiology, University of Pisa, Pisa, Italy
(Dayan) National Institute of Cardiac Surgery, Montevideo, Uruguay
(Roda) Department of Cardiovascular Surgery, University Hospital Ramon y
Cajal, Madrid, Spain
(Uva) Department of Cardiac Surgery, Hospital Santa Cruz, Carnaxide,
Portugal
(Uva) Department of Cardiac Surgery and Physiology, Porto University
Medical School, Porto, Portugal
(Almeida) University Center Assis Gurgacz Foundation, Parana, Cascavel,
Brazil
(Musumeci) Department of Cardiac Surgery, ISMETT, Palermo, Italy
(Mandrola) Baptist Health Louisville, Louisville, KY, United States
(Kaul) Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
(Papatheodorou) Rutger Health, School of Public Health, New Brunswick,
United States
(Parolari) Department of University Cardiac Surgery, IRCCS Policlinico San
Donato, San Donato, Italy
(Parolari) Department of Biomedical Sciences for Health, University of
Milan, Milan, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Objective: Indications for TAVI have been widened, although long-term
device efficacy is still unclear. We aimed to compare the effectiveness of
transcatheter aortic valve implantation (TAVI) vs. surgical aortic valve
replacement (SAVR) on a composite of death from any cause or stroke at
5-year follow-up according to risk profiles. Method(s): We performed
a systematic literature review for randomized control trials (RCTs)
comparing TAVI or SAVR. The primary endpoint was the composite of
all-cause mortality or stroke at follow-up. Hazard ratios (HRs) and
restricted mean survival time (RMST) differences within high, intermediate
and low-risk profiles were estimated by reconstructing time-to-event data
from these Kaplan-Meier curves. Result(s): Eight trials were included
(9811 participants). The incidence of composite endpoint increased
concordantly with higher baseline risk profiles for both treatments. A
time-variant effect was present with transcatheter superior to surgery
early, as supported by a cumulative additional time-to-event of 0.77
months at 4 years driven by the high-risk group that is attenuated at 60
months. The benefit of the transcatheter approach increased over time up
to 5 years in high-risk patients (RMST difference = 2.39; 95 %CI =
-0.23;5.02; p-value = 0.07), while the benefit of the transcatheter
approach in intermediate and low-risk patients showed a quadratic
association with a smaller increase and attenuation of the observed
benefit after 60 months postintervention (low-risk = 0.86; 95 %CI =
-0.11,1.84; p-value 0.09; intermediate = 0.45; 95 %CI = -0.66;1.56;
p-value = 0.42). Conclusion(s): Although an initial benefit of TAVI
over SAVR, there are no significant differences at 5 years follow-up
independently from the risk profile. Copyright © 2025 The Authors

<57>
Accession Number
2034331376
Title
Efficacy and Safety of the LifeTechTM Multifunctional Occluder (Konar-MFO)
in Transcatheter Closure of Ventricular Septal Defects: A Systematic
Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 106(1) (pp 325-335),
2025. Date of Publication: 01 Jul 2025.
Author
Kabadayi B.; Eren Z.B.; Odemis E.
Institution
(Kabadayi, Eren) Koc University School of Medicine, Istanbul, Turkey
(Odemis) Department of Pediatric Cardiology, Koc University School of
Medicine, Istanbul, Turkey
Publisher
John Wiley and Sons Inc
Abstract
Ventricular septal defect (VSD) constitutes nearly 40% of congenital heart
defects, and around 60% are perimembranous in origin. Transcatheter
closure of VSDs has gained popularity in recent years due to its less
invasiveness, shorter duration of hospital stays, and avoidance of
complications associated with cardiopulmonary-bypass-related conditions.
The main emerging issues with the transcatheter closure approach are the
development of complete atrioventricular block and valvular injury.
LifeTechTM Multifunctional Occluder (Konar-MFO) is a novel device,
recently approved by CE in 2018, that affirms to minimize damage to
adjacent structures and reduces rhythm complications compared to its
counterparts. There have been studies evaluating efficacy and safety of
Konar-MFO, but a meta-analysis of these studies has not been conducted
yet. Hence, the study aims to close this gap in literature. According to
PRISMA guidelines, Pubmed, Cochrane Library, Medline (OVID), Scopus, Web
of Science and CINAHL databases were searched for original studies
published from January, 2018 to November, 2024 by using appropriate
Medical Subject Headings (MeSH) terms and keywords related to VSD closure
and Konar-MFO occluder. Peer-reviewed articles on Konar-MFO use in closure
of perimembranous and/or muscular VSD across all age groups were
considered eligible. A total of 19 studies comprising 839 patients were
included in this study. The overall estimated device implementation
success rate was 94.2% (95% CI: 90.1-96.5; Q test: p < 0.001;
I2 = 63.1). Device embolization was observed in 4.1% (95% CI:
2.8-6.0; Q test: p = 0.710 I2 = 0%) of procedures. On follow-up
of the patients after the procedure, complete atrioventricular block was
observed in 2.3% (95% CI: 2.3-5.6; Q test: p = 0.697; I2 = 0%)
of the patients. The incidence of new-onset aortic valve regurgitation
(AR) and tricuspid valve regurgitation (TR) after the procedure was 4.4%
(95% CI: 3.0-6.4; Q test: p = 0.684; I2 = 0% and 3.7% (95% CI:
1.9-7.3; Q test: p = 0.000; I2 = 64.3%) respectively. The
pooled incidence of other arrhythmias, including RBBB, LBBB, 1st and 2nd
atrioventricular block, were 4.5% (95% CI: 6.3-16.1; Q test: p < 0.001;
I2 = 82.9%). The incidence of complete atrioventricular (cAVB)
block observed in follow-up was low. The prevalence of new onset aortic
valve regurgitation (AR) and tricuspid valve regurgitation (TR) seen after
the procedure is important due to the risk of progression associated with
these defects and may require follow-up if detected. Even though the
estimated incidence rate is low, bundle branch blocks and other fascicular
blocks require attention due to the potential risk of causing ventricular
dysfunction. Copyright © 2025 Wiley Periodicals LLC.

<58>
Accession Number
2038596146
Title
Effect of Esketamine on Postoperative Delirium and Inflammatory Response
in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting: A
Randomized Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(8) (pp 2079-2087),
2025. Date of Publication: 01 Aug 2025.
Author
Ju L.-Y.; Liu G.-Q.; Yuan L.; Lyu L.; Su Y.; Liu A.-J.
Institution
(Ju, Liu, Yuan, Lyu, Su, Liu) Department of Anesthesiology, The Affiliated
Hospital of Qingdao University, Qingdao, China
Publisher
W.B. Saunders
Abstract
Objectives: To investigate whether continuous intravenous infusion of
esketamine during surgery can improve postoperative delirium (POD) and
inflammatory response in patients undergoing off-pump coronary artery
bypass grafting (OPCAB). Design(s): Prospective, triple-blind,
randomized controlled trial. Setting(s): A single tertiary center.
 Participant(s): 140 adult patients undergoing elective OPCAB.
 Intervention(s): Patients in Group S (esketamine group) received an
infusion of esketamine at a dose of 0.25 mg/kg/h, while those in Group P
(placebo group) received an equal volume of saline. Measurements and
Main Results: The main outcome was the incidence of POD within the first 7
days after surgery. The incidence of POD within 7 days after surgery was
significantly lower in Group S compared with Group P (relative risk:
0.474, 95% confidence interval: 0.231-0.970, p = 0.034). Furthermore, the
levels of interleukin-6 (IL-6) at 12th and 72nd postoperative hours were
significantly lower in Group S than in Group P (Z = -2.697, p = 0.007; Z =
-2.022, p = 0.043). The C-reactive protein level at 72nd postoperative
hour was also significantly lower in Group S (Z = -2.134, p = 0.003).
 Conclusion(s): Esketamine can decrease the incidence of POD, reduce
postoperative inflammatory levels, and alleviate short-term inflammatory
responses in OPCAB patients. Copyright © 2025 Elsevier Inc.

<59>
Accession Number
2034507852
Title
Drug-Coated Balloons Versus Non-Coated Balloons for Side Branch Treatment
in Bifurcation Lesions: A Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 106(1) (pp 530-539),
2025. Date of Publication: 01 Jul 2025.
Author
Rocchetti M.; Tua L.; Cereda A.; Conconi B.; Gabriele Franchina A.; Carla
M.; Spangaro A.; Lucreziotti S.
Institution
(Rocchetti, Tua, Cereda, Conconi, Gabriele Franchina, Carla, Spangaro,
Lucreziotti) Division of Cardiology, Cardio-Thoracic Department, San Carlo
Borromeo Hospital (ASST Santi Paolo e Carlo), Milan, Italy
(Rocchetti, Spangaro) University of Milan, Milan, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: Coronary bifurcation lesions (CBL) account for ~20% of
percutaneous coronary interventions (PCI). When using provisional
stenting, optimal management of a diseased side branch (SB) remains
debated. Drug-coated balloons (DCBs) are an emerging option, but data on
their role in CBL PCI are limited. Aim(s): We conducted a
meta-analysis to compare DCBs and non-compliant balloons (NCBs) for SB
treatment. Method(s): A systematic search of MEDLINE, CENTRAL, and
EmBase (until November 2024) identified studies comparing DCBs and NCBs
for treating the SB. From 1451 studies, five were included (two randomized
controlled trials [RCTs], three observational), with 1762 patients,
predominantly male with acute coronary syndrome (ACS). The primary outcome
was major adverse cardiac events (MACE); secondary outcomes included
myocardial infarction (MI), target lesion revascularization (TLR), and
target vessel revascularization (TVR). Result(s): DCBs significantly
reduced MACE (pooled OR 0.48, 95% CI 0.34-0.68, p < 0.0001, I2 = 0%) and
MI (pooled OR 0.39, 95% CI 0.25-0.62, p < 0.001, I2 = 0%) compared to
NCBs. No significant differences were observed in TLR or TVR. Subgroup
analysis confirmed consistency across observational studies and RCTs for
MACE and MI. Conclusion(s): DCBs in SB treatment during CBL PCI are
associated with reduced MACE and MI compared to NCBs, with no significant
differences in vessel-specific outcomes. These findings suggest a
potential clinical benefit of DCBs in reducing ischemic events, while
limiting stenting in CBL. Further research is needed to refine patient
selection and optimize outcomes. Copyright © 2025 The Author(s).
Catheterization and Cardiovascular Interventions published by Wiley
Periodicals LLC.

<60>
Accession Number
2039318632
Title
Surgical revascularization of chronic coronary total occlusions - A
systematic review and meta-analysis.
Source
Revista Portuguesa de Cardiologia. 44(7) (pp 427-439), 2025. Date of
Publication: 01 Jul 2025.
Author
Silva A.L.; Costa G.F.; Martins J.L.; Leite L.; Goncalves L.
Institution
(Silva, Costa, Martins, Leite, Goncalves) Cardiology Department, Unidade
Local de Saude de Coimbra, Coimbra, Portugal
(Costa, Leite, Goncalves) Faculty of Medicine of the University of
Coimbra, Coimbra, Portugal
(Costa, Leite, Goncalves) ICBR, Coimbra Institute for Clinical and
Biomedical Research, Coimbra, Portugal
Publisher
Sociedade Portuguesa de Cardiologia
Abstract
Introduction and objectives: Chronic coronary total occlusion (CTO)
optimal therapeutic management remains a topic of debate despite its
association with adverse clinical outcomes. This study aimed to compare
clinical outcomes of patients with CTOs treated with coronary artery
bypass graft (CABG) versus medical therapy (MT), assessing the effect of
CTO revascularization in patients with multivessel disease undergoing
CABG. Method(s): In July 2023, PubMed, Embase, Cochrane, and Web of
Science databases were systematically searched for studies comparing CTOs
treated with CABG versus MT. A sub-analysis of CABG patients, comparing
complete surgical revascularization, including CTO bypass, to CABG without
CTO bypass, was performed. A pooled odds ratio meta-analysis assessed four
main outcomes: mortality, myocardial infarction (MI), stroke, and major
adverse cardiovascular events (MACE). The primary outcome was all-cause
mortality. Result(s): Ten observational studies (6458 patients)
comparing CABG-CTO with MT-CTO showed lower all-cause mortality in the
CABG group (OR 0.31, 95% CI 0.24-0.40, p<0.001, I2=36%).
Despite heterogeneity, CABG exhibited reduced CV mortality and MACE (OR
0.37, 95% CI 0.24-0.57, p<0.001, I2=59%; OR 0.37, 95% CI
0.15-0.92, p=0.03, I2=80%, respectively). The MI rate was lower
in the CABG group (OR 0.41, 95% CI 0.30-0.56, p<0.001, I2=0%).
Comparing bypassed to non-bypassed CTO groups (5 studies, 1949 patients),
the bypassed-CTO group had considerably lower MACE (OR 0.49, 95% CI
0.30-0.81, p=0.005, I2=44%). Conclusion(s): This study
suggests a clinical benefit of bypassing a CTO in multivessel disease
patients during CABG, with significantly lower MACE. The improved outcomes
of CABG over MT further underscore these findings, warranting careful
consideration by the Heart Team during their decision-making
process. Copyright © 2025 Sociedade Portuguesa de Cardiologia

<61>
Accession Number
2034208084
Title
Invasive Versus Conservative Strategies in Older Adults With Non-ST
Elevation Acute Coronary Syndrome: An Updated Meta-Analysis of Randomized
Controlled Trials.
Source
Catheterization and Cardiovascular Interventions. 106(1) (pp 223-232),
2025. Date of Publication: 01 Jul 2025.
Author
Goyal A.; Shoaib A.; Khan M.T.; Salim N.; Ajaz I.; Fareed A.; Sulaiman
S.A.; Sheikh A.B.; AlJaroudi W.
Institution
(Goyal) Department of Internal Medicine, Seth GS Medical College and KEM
Hospital, Mumbai, India
(Shoaib, Khan, Salim, Ajaz, Fareed) Department of Internal Medicine,
Karachi Medical and Dental College, Karachi, Pakistan
(Sulaiman) School of Medicine, University of Jordan, Amman, Jordan
(Sheikh) Department of Internal Medicine, University of New Mexico Health
Sciences Center, Albuquerque, NM, United States
(AlJaroudi) Division of Cardiovascular Medicine, Wellstar MCG Health,
Augusta, GA, United States
Publisher
John Wiley and Sons Inc
Abstract
Non-ST-elevation acute coronary syndrome (NSTE-ACS) is a common condition
among older adults. However, due to frailty and comorbidities, older
adults are often underrepresented in clinical trials, making the decision
between an invasive or conservative approach for optimal management
controversial. Our meta-analysis seeks to address this issue by focusing
exclusively on randomized controlled trials (RCTs). A systematic database
literature search was conducted via PubMed, the Cochrane Central Register
of Controlled Trials, Embase, and ClinicalTrials.gov to identify RCTs
comparing invasive and conservative management strategies in older adults
with NSTE-ACS. Data on unplanned revascularization, myocardial infarction
(MI), bleeding, all-cause mortality, composite of major adverse outcomes,
and stroke were extracted and pooled. Random-effects models to calculate
pooled risk ratios (RR) with 95% confidence intervals (CI) were analyzed
using the Review Manager software. A total of seven RCTs and a total of
2997 patients were included in the meta-analysis. The invasive approach
demonstrated a lower risk of unplanned revascularization (RR: 0.36; 95%
CI: 0.23, 0.55; p < 0.00001; I2 = 28%) and MI (RR: 0.72; 95% CI: 0.56,
0.94; p = 0.01; I2 = 34%). No significant differences were found for major
bleeding episodes (RR: 1.40; 95% CI: 0.93, 2.14; p = 0.11), all-cause
mortality (RR: 1.01; 95% CI: 0.91, 1.12; p = 0.49), composite of major
adverse events (RR: 0.87; 95% CI: 0.73, 1.05; p = 0.14) and risk of stroke
(RR: 0.84; 95% CI: 0.59, 1.20; p = 0.34) between the two strategies. Our
findings reveal that, in older adults with NSTE-ACS, an invasive strategy
reduces the risk of subsequent MI and unplanned revascularization.
However, no significant differences in mortality, bleeding, or stroke were
observed between the two groups. Copyright © 2025 Wiley
Periodicals LLC.

<62>
Accession Number
2036716040
Title
Contemporary Multi-modality Imaging of Prosthetic Aortic Valves.
Source
Reviews in Cardiovascular Medicine. 26(1) (no pagination), 2025. Article
Number: 25339. Date of Publication: 01 Jan 2025.
Author
Abadie B.Q.; Wang T.K.M.
Institution
(Abadie, Wang) Section of Cardiovascular Imaging, Department of
Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States
Publisher
IMR Press Limited
Abstract
With the aging of the general population and the rise in surgical and
transcatheter aortic valve replacement, there will be an increase in the
prevalence of prosthetic aortic valves. Patients with prosthetic aortic
valves can develop a wide range of unique pathologies compared to the
general population. Accurate diagnosis is necessary in this population to
generate a comprehensive treatment plan. Transthoracic echocardiography is
often insufficient alone to diagnose many prosthetic valve pathologies.
The integration of many imaging modalities, including transthoracic
echocardiography, transesophageal echocardiography, cardiac computed
tomography, cardiac magnetic resonance imaging, and nuclear imaging, is
necessary to care for patients with prosthetic valves. The purpose of this
review is to describe the strengths, limitations, and contemporary use of
the different imaging modalities necessary to diagnose prosthetic valve
dysfunction. Copyright © 2025 The Author(s). Published by IMR
Press.

<63>
Accession Number
2039334175
Title
Impact of Cardiopulmonary Bypass Duration on the Renal Effects of Amino
Acids Infusion in Cardiac Surgery Patients.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Pontillo D.; Rong L.Q.; Pruna A.; Pisano A.; Monaco F.; Bruni A.; Baiardo
Redaelli M.; Ti L.K.; Belletti A.; Bradic N.; Massaro C.; Barucco G.;
Viscido C.; Losiggio R.; Federici F.; Marmiere M.; Silvetti S.; Marchetti
C.; Carmosino M.; Manazza M.; Oliva F.M.; Cortegiani A.; Guarracino F.;
Ranucci M.; Paternoster G.; Landoni G.; Zangrillo A.; Gaudino M.F.L.;
Bellomo R.; Bonaccorso A.; D'Amico F.; D'Andria Ursoleo J.; Lombardi G.;
Marzaroli M.; Mongardini E.; Vietri S.; Ferrod F.; Porta S.; Prezzi L.;
Vignale R.; Gallicchio F.; Neri G.; Mellace F.; Venditto M.; Baryshnikova
E.; Re M.R.; Rocco M.; Baldassarri R.; Salsano A.; Angeletti P.M.
Institution
(Pontillo, Pruna, Monaco, Belletti, Barucco, Losiggio, Marmiere,
Marchetti, Manazza, Oliva, Landoni, Zangrillo) Department of Anesthesia
and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
(Rong) Department of Anesthesiology, Weill Cornell Medicine, New York, NY,
United States
(Pisano) Cardiac Anesthesia and ICU, AORN "Dei Colli", Monaldi Hospital,
Naples, Italy
(Bruni) Anesthesia and Intensive Care Unit, Department of Medical and
Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro,
Italy
(Baiardo Redaelli) Anesthesia and Intensive Care, Department of
Biotechnologies and Life Sciences, University of Insubria, Varese, Italy
(Baiardo Redaelli) Intensive Care Unit, Circolo Hospital, Varese, Italy
(Ti) Department of Anaesthesia, National University Hospital, Singapore
(Bradic) Clinic of Anesthesiology, Resuscitation and Intensive Medicine,
University Hospital Dubrava, Zagreb, Croatia
(Bradic) Department of Nursing, University North, Varazdin, Croatia
(Massaro, Viscido) Department of Cardiovascular Anesthesia and Intensive
Care, A.O. Ordine Maurizio Umberto I di Torino, Turin, Italy
(Federici) Department of Anesthesia and Intensive Care, Azienda
Ospedaliero-Universitaria Sant' Andrea, Rome, Italy
(Silvetti) Department of Cardiac Anesthesia and Intensive Care, Ospedale
Policlinico San Martino IRCCS, IRCCS Cardiovascular Network, Genova, Italy
(Carmosino, Paternoster) Department of Health Science School of Medicine,
University of Basilicata, Potenza, Italy
(Cortegiani) Department of Precision Medicine in Medical, Surgical and
Critical Care Area, University of Palermo, Palermo, Italy
(Cortegiani) Department of Anesthesia Analgesia Intensive Care and
Emergency, University Hospital Policlinico "Paolo Giaccone", Palermo,
Italy
(Guarracino) Department of Cardiothoracic Anaesthesia and Intensive Care,
Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
(Ranucci) Department of Cardiovascular Anesthesia and Intensive Care,
IRCCS Policlinico San Donato, Milan, Italy
(Paternoster) Anesthesia and ICU, San Carlo Hospital, Potenza, Italy
(Landoni, Zangrillo) School of Medicine, Vita-Salute San Raffaele
University, Milan, Italy
(Bellomo) Department of Critical Care, The University of Melbourne,
Melbourne, Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, Australia
(Bellomo) Data Analytics Research and Evaluation Centre, Austin Hospital,
Melbourne, Australia
(Bellomo) Department of Intensive Care, Austin Hospital, Melbourne,
Australia
(Bellomo) Department of Intensive Care, Royal Melbourne Hospital,
Melbourne, Australia
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Bonaccorso, D'Amico, D'Andria Ursoleo, Lombardi, Marzaroli, Mongardini,
Vietri) Departmentof Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Venditto) CardiacAnesthesia and ICU, AORN "Dei Colli", Monaldi Hospital,
Naples, Italy
(Neri, Mellace) Anesthesiaand Intensive Care Unit, Department of Medical
and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro,
Italy
(Ferrod, Porta, Prezzi) S.C.Anestesia, e Rianimazione Cardiovascolare,
A.O. Ordine Maurizio Umberto I di Torino, Turin, Italy
(Rocco) UOCAnestesia e Rianimazione, Azienda Ospedaliero-Universitaria
Sant'Andrea, Azienda Ospedaliero-Universitaria Sant'Andrea, Rome, Italy
(Re) Departmentof Anesthesia Analgesia Intensive Care and Emergency,
University Hospital Policlinico "Paolo Giaccone", Palermo, Italy
(Vignale, Gallicchio) Departmentof Cardiovascular Anesthesia and ICU, San
Carlo Hospital, Potenza, Italy
(Baryshnikova) Departmentof Cardiovascular Anesthesia and Intensive Care,
IRCCS Policlinico San Donato, Milan, Italy
(Baldassarri) Departmentof Cardiothoracic Anaesthesia and Intensive Care,
Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
(Salsano) Divisionof Cardiac Surgery, Ospedale Policlinico San Martino,
Genoa, Italy
(Salsano) Departmentof Integrated Surgical and Diagnostic Sciences,
University of Genoa, Genoa, Italy
(Angeletti) CardiovascularDepartment, UO of Cardiac Anesthesia, IRCCS
Humanitas Research Hospital, Rozzano, Italy
Publisher
W.B. Saunders
Abstract
Objective: To test whether the duration of cardiopulmonary bypass (CPB)
affects the nephroprotective effect of amino acids (AA) infusion in
decreasing the occurrence of acute kidney injury (AKI) among cardiac
surgery patients. Design(s): A post hoc study of the PROTECTION
multicenter randomized double-blind placebo-controlled trial aiming to
assess the effect of CPB duration on the differential impact of AA
infusion on both the absolute and relative risk reduction in AKI incidence
by comparing medians of CPB duration and CPB duration as a continuous
variable. Setting(s): International, multicenter.
 Participant(s): The entire population of the PROTECTION trial,
comprising 3511 adult patients undergoing cardiac surgery with CPB.
 Intervention(s): Intravenous AA infusion at a dosage of 2 g/kg/day,
up to a maximum of 100 g/day. Measurements and Main Results: Compared
with patients with CPB duration above the median (prolonged [P]-CPB
group), patients with CPB duration below the median (brief [B]-CPB group)
had a significantly lower incidence of AKI (23% [n/N =391/1716] vs 36%
[n/N = 617/1723]; relative risk [RR], 0.64; 95% confidence interval [CI],
0.57-0.71; p <0.001). However, in the P-CPB group, AA infusion achieved an
8% absolute risk reduction (32% vs 40%) and a 0.79 RR reduction (95% CI,
0.70-0.90; p < 0.001; number needed to treat, 14). Moreover, AA also
decreased the occurrence of AKI stage 3 (2.2% [n = 19] vs 5.0% [n = 43];
RR, 0.45; 95% CI, 0.26-0.76; p < 0.001) with a >95% probability of this
effect being significantly greater in the P-CPB group compared to the
B-CPB group. Conclusion(s): Cardiac surgery patients with prolonged
CPB exposure had a significantly higher incidence of AKI. Notably, the
P-CPB group received a greater benefit from AA therapy with an absolute
risk and relative risk reduction of both any and severe AKI compared with
the B-CPB group. Patients with prolonged CPB may be the specific targets
of future studies. Copyright © 2025 Elsevier Inc.

<64>
[Use Link to view the full text]
Accession Number
2039383459
Title
Comparison of analgesic efficacy and safety of caudal dexmedetomidine
versus intranasal dexmedetomidine in paediatric infraumbilical surgeries:
A randomised controlled trial.
Source
European Journal of Anaesthesiology. (no pagination), 2025. Article
Number: 2228. Date of Publication: 2025.
Author
Agarwal A.; Shah S.B.; Sinha R.; Prasad G.; Prakash K.; Goel P.
Institution
(Agarwal, Shah, Sinha, Prasad, Prakash) Department of Anaesthesiology,
Pain Medicine and Critical Care, All India Institute of Medical Sciences,
New Delhi, India
(Goel) Department of Paediatric Surgery, All India Institute of Medical
Sciences, New Delhi, India
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND The established analgesic efficacy and safety of
dexmedetomidine in children has demonstrated a rise in its use and various
administration routes have been explored. However, clinical comparisons
between caudal and intranasal dexmedetomidine are lacking. OBJECTIVES We
aimed to compare the analgesic efficacy, postanaesthesia recovery
characteristics and side effects associated with caudal versus intranasal
dexmedetomidine as an adjunct to a single-shot caudal block in paediatric
infraumbilical surgeries. DESIGN A noninferiority randomised controlled
trial. SETTING A tertiary care hospital from November 2022 to May 2024.
PATIENTS Sixty-four children aged 1 to 8 years undergoing infraumbilical
surgeries under general anaesthesia supplemented with caudal analgesia.
INTERVENTIONS Patients were randomised to receive either caudal
dexmedetomidine (1 ml kg-1 caudal 0.2% ropivacaine + 1 mug
kg-1 caudal dexmedetomidine) or intranasal dexmedetomidine (1
ml kg-1 caudal 0.2% ropivacaine + 1 mug kg-1
intranasal dexmedetomidine). MAIN OUTCOME MEASURES The primary outcome was
the duration of postoperative analgesia. Other outcomes assessed included
postoperative pain scores, peri-operative analgesic consumption,
peri-operative haemodynamics, postoperative recovery profile and adverse
events for 24 h postoperatively. RESULTS The duration of postoperative
analgesia in caudal and intranasal group was 527 +/- 83 and 545 +/- 90
min, respectively (P = 0.422). There was a comparable decrease in the
intra-operative heart rate. The greater number of episodes of
intra-operative hypotension in the caudal group (P = 0.016) did not
warrant vasopressors. Children in the caudal group were more sedated until
2 h postsurgery following which the sedation scores in both the groups
were equivalent. Postoperative pain scores, peri-operative analgesic
consumption and the incidence of emergence delirium was comparable. No
adverse events were reported in either group. CONCLUSION Intranasal
dexmedetomidine can be considered a feasible analgesic adjunct to a
single-injection caudal block in children undergoing infraumbilical
surgeries associated with a smooth recovery profile and no associated
adverse effects. CLINICAL TRIAL REGISTRATION Clinical Trial Registry of
India (CTRI/2022/09/045492; http://www.ctri.nic.in). Copyright ©
2025 European Society of Anaesthesiology and Intensive Care.

<65>
[Use Link to view the full text]
Accession Number
2039383451
Title
Continuous positive airway pressure to prevent reintubation in patients
recovering from cardiac surgery: A multicentre randomised clinical trial.
Source
European Journal of Anaesthesiology. (no pagination), 2025. Article
Number: 2229. Date of Publication: 2025.
Author
Pasero D.; Costamagna A.; Filippini C.; Blangetti I.; Cattaneo S.;
Baiocchi M.; Balata A.; Bottiroli M.; Dambruoso P.; De Paulis S.; Grazioli
L.; Locatelli A.; Lorini F.L.; Mascotti A.; Mondino M.G.; Paparella D.;
Salvi L.; Tonetti T.; Tritapepe L.; Ranieri V.M.
Institution
(Pasero, Mascotti) Department of Medicine Surgery and Pharmacy, University
of Sassari, Italy
(Pasero, Costamagna) Cardiac Anesthesia Unit, 'Citta della Salute e della
Scienza' Hospital, Turin, Italy
(Costamagna, Filippini) Department of Surgical Science, University of
Turin, Italy
(Blangetti, Locatelli) Cardiovascular Anesthesia and Intensive Care Unit,
'Santa Croce e Carle' Hospital, Cuneo, Italy
(Blangetti) Ospedale Regina Montis Regalis' ASL CN1 Mondovi, Cuneo, Italy
(Cattaneo) Cardiac Anesthesia Unit, 'Spedali Civili', Brescia, Italy
(Baiocchi) Department of Anaesthesia and Intensive Care, Cardiothoracic
and Vascular Department, IRCSS Sant'Orsola, Bologna, Italy
(Balata) Cardiac Anesthesia Unit, 'AOU Sassari' Hospital, Sassari, Italy
(Bottiroli) Department of Anesthesia and Critical Care Beth Israel
Deaconess Medical Center, Harvard Medical School, Boston, MA, United
States
(Bottiroli, Mondino) Cardiothoracic and Vascular Anesthesia and Intensive
Care Unit, ASST G.O.M. Niguarda, Milan, Italy
(Dambruoso) Cardiac Anesthesia and Intensive Care, 'Santa Maria' Hospital,
GVM Care and Research, Bari, Italy
(De Paulis) Cardiac Anesthesia, 'IRCSS Policlinico Gemelli' Hospital,
Rome, Italy
(Grazioli, Lorini) Department of Anesthesia, Critical Care and Emergency
Medicine, 'Papa Giovanni XXIII' Hospital, Bergamo, Italy
(Locatelli) Anesthesia and Postoperative Intensive Care Unit, 'Fondazione
IRCCS Policlinico San Matteo' Hospital, Pavia, Italy
(Paparella) Department of Medical and Surgical Science, University of
Foggia, Foggia, Italy
(Paparella) Cardiac Surgery, 'Santa Maria' Hospital, GVM Care and
Research, Bari, Italy
(Salvi) Department of Anaesthesia & ICU, IRCCS Centro Cardiologico
Monzino, Milan, Italy
(Tonetti) Department of Medical and Surgical Sciences (DIMEC), Alma Mater
Studiorum University of Bologna, Bologna, Italy
(Tritapepe) Cardiac Anesthesia, 'Umberto 1' Hospital, Sapienza University
of Rome, Rome, Italy
(Tritapepe) Department of Anesthesia and Intensive Care Medicine, 'San
Camillo' Hospital, Rome, Italy
(Ranieri) University of Bari (VMR), Department of Anesthesia and Critical
Care, Policlinico di Bari, Bari, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND Pulmonary complications, including atelectasis and
reintubation, are common after cardiac surgery and are associated with
increased morbidity and mortality. Postoperative continuous positive
airway pressure (CPAP) may reduce these risks, but its effectiveness
remains uncertain. OBJECTIVES To assess whether CPAP reduces the need for
reintubation in hypoxaemic patients after cardiac surgery, and to evaluate
its effect on other postoperative pulmonary complications. DESIGN
Multicentre, open-label, randomised clinical trial. The study was
prematurely terminated due to funding constraints, leading to an
underpowered sample. SETTING Ten university-affiliated hospitals across
Italy. PATIENTS Adults undergoing cardiac surgery with cardiopulmonary
bypass who developed a P<inf>a</inf>O<inf>2</inf>/FiO<inf>2</inf> ratio
200 or less within 1 h of extubation. Exclusion criteria included severe
COPD, previous mechanical ventilation and lack of consent. MAIN OUTCOME
MEASURES The primary endpoint was reintubation within 28 days of surgery.
Secondary endpoints included atelectasis, pneumonia, sepsis, mortality and
oxygenation. RESULTS The incidence of reintubation was 10.8% (95%
confidence interval [CI], 6.52 to 15.15) in the control group and 8.3%
(95% CI, 4.51 to 12.16) in the treatment group (P = 0.3908). In contrast,
the occurrence of atelectasis was significantly higher in the control
group at 24.1% (95% CI, 18.20 to 30.07) compared with 14.2% (95% CI, 9.38
to 19.05) in the treatment group (P = 0.0110). At 48 h, the incidence of
reintubation was significantly lower in the CPAP group 2.94% (95% CI, 0.60
to 5.28) compared with the control group, 7.39% (95% CI, 3.76 to 11.02), P
= 0.0425. No significant differences in pneumonia, sepsis or mortality
were observed. CPAP significantly improved oxygenation (P < 0.0001).
CONCLUSION CPAP did not significantly reduce 28-day reintubation rates
compared with oxygen therapy via Venturi mask. However, CPAP was
associated with a significant reduction in atelectasis and early
reintubation at 48 h. Further research is warranted to confirm these
findings and compare CPAP with other noninvasive support strategies. TRIAL
REGISTRATION ClinicalTrials.gov Identifier: NCT01726140. Copyright
© 2025 The Author(s). Published by Wolters Kluwer Health, Inc.

<66>
Accession Number
2039378011
Title
Intracardiac versus transesophageal echocardiographic guidance for left
atrial appendage occlusion: Design and rationale of the ICE-TEE trial.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Al-Azizi K.; Thomas S.; Hajar M.B.A.; Pickering T.; McCullough K.; Dorton
C.; Moubarak G.; Ma T.-W.; Banwait J.; Hale S.; Gupta S.; DiMaio J.M.;
Szerlip M.; Matar R.; Aqtash O.; Baig I.; Trehan S.; Potluri S.
Institution
(Al-Azizi, Thomas, Szerlip, Matar, Aqtash, Baig, Trehan, Potluri)
Department of Cardiology, Baylor Scott and White The Heart Hospital,
Plano, TX, United States
(Hajar, Pickering, McCullough, Dorton, Moubarak, Ma, Banwait, Hale, Gupta,
DiMaio) Baylor Scott & White Research Institute, Plano, TX, United States
(Moubarak) Department of Internal Medicine, Baylor University Medical
Center, TX, United States
Publisher
Elsevier Inc.
Abstract
Left atrial appendage occlusion (LAAO) has emerged as an alternative to
long-term anticoagulation for stroke prevention in patients with
non-valvular atrial fibrillation deemed high risk for bleeding. LAAO is
performed via a transseptal approach with the placement of an occlusion
device in the left atrial appendage (LAA) to seal it. Intraoperative
imaging with echocardiography is needed to guide and complete the
procedure. Historically, Transesophageal echocardiography (TEE) has been
the most frequently used modality for intraprocedural guidance. Recently,
there has been a growing interest in the use of intracardiac
echocardiography (ICE) as an adjunct to, or even an alternative to,
transesophageal echocardiography (TEE), with several unique advantages and
potential challenges. Several publications have highlighted the safety and
feasibility of ICE in LAAO (Hemam et al., 2019; Morcos et al., 2022; Zhang
et al., 2023 [2, 5, 7]). The most recent SCAI/HRS consensus statement
recommends using TEE or ICE in procedural guidance (Saw et al., 2023 [8]).
To date, no prospective randomized controlled trials have addressed the
safety and feasibility of ICE-guided LAAO, compared to TEE guidance. The
ICE TEE trial is a single-center, prospective, randomized,
parallel-controlled, open-label clinical trial that will assess the
efficacy and safety of ICE-guided LAAO compared to traditional TEE-guided
LAAO. Patients are randomized in a 1:1 fashion. The primary endpoint of
the study is the procedural success of LAAO device implantation, defined
as the appropriate device implantation as per the IFU, without
device-related complications, and no peri-device leaks >5 mm on color
Doppler, according to the Munich consensus. Secondary endpoints include
periprocedural complications, procedural characteristics, and cost of
hospitalization. Patients will be assessed at 45 days with a TEE to
evaluate for any peri-device leak (PDL). The trial aims to assess the
efficacy and potential complications of using ICE to guide the
implantation of percutaneous left atrial appendage occlusion (LAAO)
devices compared to the traditional transesophageal echocardiography
(TEE)- guided LAAO. Copyright © 2025 Elsevier Inc.

<67>
Accession Number
2034605509
Title
Continuation Versus Interruption of Oral Anticoagulation During TAVI: A
Systematic Review and Meta-Analysis Oral Anticoagulation Management in
TAVI.
Source
Catheterization and Cardiovascular Interventions. 106(1) (pp 644-653),
2025. Date of Publication: 01 Jul 2025.
Author
Borges Martins J.M.; dos Santos Borges R.; Gosch Berton G.; Ferreira
Vieira P.L.; Machado Gomes de Sousa P.A.; Chaves Vieira A.L.; Ken Fukunaga
C.; Karlinski Vizentin V.; Rodrigues Macedo E.M.; Guida C.M.
Institution
(Borges Martins, Ferreira Vieira, Chaves Vieira, Rodrigues Macedo)
Department of Medicine, Federal University of Para, Belem, Brazil
(dos Santos Borges) Department of Medicine, Federal University of Minas
Gerais, Belo Horizonte, Brazil
(Gosch Berton) School of Medicine, University of Passo Fundo, Passo Fundo,
Brazil
(Gosch Berton) Department of Neurology, Mater Misericordiae University
Hospital - University College Dublin, Dublin, Ireland
(Machado Gomes de Sousa) Department of Medicine, Federal University of
Uberlandia, Uberlandia, Brazil
(Ken Fukunaga, Guida) Department of Medicine, FMABC University Centre,
Santo Andre, Brazil
(Karlinski Vizentin) Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, MN, United States
(Guida) Department of Cardiology, Dante Pazzanese Institute of Cardiology,
Sao Paulo, Brazil
Publisher
John Wiley and Sons Inc
Abstract
Patients undergoing transcatheter aortic valve implantation (TAVI) often
require long-term oral anticoagulation (OAC), but it is unclear whether to
continue or interrupt OAC during the procedure. This meta-analysis
compares clinical outcomes of continuing versus interrupting OAC during
TAVI. PubMed, Embase, and Cochrane Central databases were searched from
inception to September 2024 for studies comparing continuation versus
interruption of OAC in patients undergoing TAVI with an indication for
OAC, including vitamin K antagonists and direct oral anticoagulants. Risk
ratios (RR) with 95% confidence intervals (CI) were pooled using a
random-effects model. Sensitivity analysis was performed using the
Hartung-Knapp-Sidik-Jonkman method. Three studies were included, one
randomized controlled trial and two cohort studies, with 2773 patients, of
whom 1314 (47.4%) continued OAC during TAVI. At a 30-day follow-up after
TAVI, there were no significant differences between groups in all-cause
mortality (RR 0.74; 95% CI 0.45-1.20; p = 0.22), any bleeding (RR 1.08;
95% CI 0.81-1.43; p = 0.60), and major bleeding (RR 0.90; 95% CI
0.67-1.21; p = 0.48). However, the continued OAC group was associated with
a lower stroke rate (RR 0.65; 95% CI 0.42-1.01; p = 0.053), also attested
after a sensitivity analysis (RR 0.65; 95% CI 0.47-0.90; p < 0.03). In
patients with an indication for OAC undergoing TAVI, uninterrupted
anticoagulation is associated with similar thrombotic and hemorrhagic
outcomes compared to interrupted OAC. Stroke risk was lower in the
continued OAC group, with a significant reduction, as demonstrated in
sensitivity analysis. Copyright © 2025 Wiley Periodicals LLC.

<68>
Accession Number
2034636587
Title
Impact of Periprocedural Statin Therapy on Mortality and Cardiovascular
Outcomes in Transcatheter Aortic Valve Replacement: A Meta-Analysis and
Meta-Regression.
Source
Catheterization and Cardiovascular Interventions. 106(1) (pp 720-729),
2025. Date of Publication: 01 Jul 2025.
Author
Goyal A.; Maheshwari S.; Mashkoor Y.; Singh A.; Rafique F.; Sheikh A.B.;
Bansal K.
Institution
(Goyal) Department of Internal Medicine, Cleveland Clinic Foundation,
Cleveland, OH, United States
(Maheshwari) Department of Internal Medicine, University of Alabama at
Montgomery, Montgomery, AL, United States
(Mashkoor, Singh, Rafique) Department of Internal Medicine, Dow University
of Health Sciences, Karachi, Pakistan
(Sheikh) Department of Internal Medicine, University of New Mexico,
Albuquerque, NM, United States
(Bansal) Department of Family and Community Medicine, Baylor College of
Medicine, Houston, TX, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Transcatheter aortic valve replacement (TAVR) stands as a
notable alternative to surgical valve replacement for severe aortic
stenosis (AS). Despite the established benefits of statins in
cardiovascular pathologies, their specific impact in patients with severe
AS undergoing TAVR remains uncertain. Aim(s): Our meta-analysis aims
to assess whether periprocedural statin therapy improves survival and
outcomes post-TAVR, thus addressing this gap in literature.
 Method(s): A comprehensive literature search using various databases
with relevant keywords terms was conducted to identify studies on the
impact of periprocedural statin therapy on TAVR outcomes. We assessed the
primary outcome of all-cause mortality alongside various secondary
outcomes including stroke/transient ischemic attack (TIA), myocardial
infarction, acute kidney injury (AKI), 30-day mortality, in-hospital
mortality, rehospitalization, cardiovascular complications, and pacemaker
requirement. A random-effects model using Comprehensive Meta Analysis
Software was employed to analyze the data for each outcome. Statistical
significance was set at a p < 0.05. Result(s): Our analysis of 19
observational studies revealed that periprocedural statin therapy
significantly reduces all-cause mortality following TAVR surgery (OR =
0.71, 95% CI: 0.61-0.83, p < 0.001). However, the influence of statins on
other outcomes remains inconclusive. These outcomes include stroke/TIA (OR
= 0.90, 95% CI: 0.68-1.19, p = 0.455), risk of MI (OR = 1.72, 95% CI:
0.73-4.04, p = 0.214), AKI (OR = 0.99, 95% CI: 0.75-1.31, p = 0.968),
30-day mortality (OR = 0.71, 95% CI: 0.46-1.10, p = 0.126), in-hospital
mortality (OR = 0.42, 95% CI: 0.13-1.38, p = 0.151), rehospitalization (OR
= 0.92, 95% CI: 0.66-1.29, p = 0.645), cardiovascular complications (OR =
1.12, 95% CI: 0.91-1.37, p = 0.297), and pacemaker requirement (OR = 0.83,
95% CI: 0.65-1.06, p = 0.133). Conclusion(s): Our meta-analysis
indicates a potentially promising role for periprocedural statin therapy
in enhancing patient outcomes post-TAVR surgery. We found a notable
association between statin therapy and a reduction in all-cause mortality.
However, the effects on secondary outcomes did not reach statistical
significance, which warrants further investigation through larger,
well-designed, randomized controlled trials. Copyright © 2025
Wiley Periodicals LLC.

<69>
Accession Number
2039465801
Title
Recurrent thrombosis in patients with mechanical prosthetic valves: 3-year
follow-up of a randomized controlled trial.
Source
Thrombosis Research. 253 (no pagination), 2025. Article Number: 109396.
Date of Publication: 01 Sep 2025.
Author
Pasebani Y.; Fashi Z.H.; Birgani A.H.; Mehdizadeh K.; Parsaee M.; Farrashi
M.; Rafati A.; Barati S.; Kohansal E.; Saedi S.; Naderi N.; Maleki M.;
Khajali Z.; De Caterina R.; Sadeghipour P.
Institution
(Pasebani, Mehdizadeh, Farrashi, Rafati, Barati, Kohansal, Naderi, Maleki,
Sadeghipour) Vascular Disease and Thrombosis Research Center, Rajaie
Cardiovascular Institute, Tehran, Iran, Islamic Republic of
(Fashi, Birgani) Rajaie Cardiovascular Medical and Research Center, School
of Medicine, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Parsaee, Farrashi) Echocardiography Research Center, Rajaie
Cardiovascular Institute, Tehran, Iran, Islamic Republic of
(Rafati) Department of Neurology, Johns Hopkins University, School of
Medicine, Baltimore, MD, United States
(Saedi, Khajali) Rajaie Cardiovascular Institute, Tehran, Iran, Islamic
Republic of
(De Caterina) University of Pisa and Cardiology Division, Pisa University
Hospital, Pisa, Italy
Publisher
Elsevier Ltd

<70>
Accession Number
2039309719
Title
Bedside vs Conventional Operating Room Surgery in Critically Ill Newborns:
Systematic Review and Meta-analysis.
Source
Journal of Pediatric Surgery. 60(9) (no pagination), 2025. Article Number:
162419. Date of Publication: 01 Sep 2025.
Author
Cassaro F.; Impellizzeri P.; Maiorana M.; Romeo C.; Arena S.
Institution
(Cassaro) Department of Biomedical and Dental Sciences and
Morpho-functional Imaging, University of Messina, Messina, Italy
(Cassaro, Impellizzeri, Maiorana, Romeo, Arena) Department of Human
Pathology of Adult and Childhood "Gaetano Barresi", Unit of Pediatric
Surgery, University of Messina, Messina, Italy
Publisher
W.B. Saunders
Abstract
Background: Surgical procedures in critically ill neonates are typically
performed in the operating room, though transferring unstable patients
from the NICU carries risks such as hypothermia and clinical
deterioration. Bedside surgery in the NICU has emerged as an alternative
for patients unfit for transport. This systematic review and meta-analysis
compared perioperative outcomes of bedside versus operating room surgery
in neonates. Method(s): Following PRISMA guidelines and PROSPERO
registration (CRD420251001354), we searched PubMed, Ovid, and CENTRAL
(1990-2025) for studies comparing neonatal surgeries performed in the
operating room or bedside. Primary outcomes were mortality and surgical
site infections; secondary outcomes included intra- and post-operative
hypothermia, operative time, and hospital length of stay. Risk of bias was
assessed with ROBINS-I and evidence certainty with GRADE. Result(s):
Nine studies (1098 neonates: 693 operating room and 405 bedside group)
were included. Mortality was significantly higher in the bedside group
(25.82 %) than operating room group (7.32 %) (p < 0.0001). Subgroup
analysis showed this difference was significant for congenital
diaphragmatic hernia, but not for patent ductus arteriosus. Surgical site
infections did not different significantly. Bedside was associated with
lower intra-operative hypothermia (p = 0.024), while no differences were
found in postoperative hypothermia, length of stay, or operative time.
 Conclusion(s): This meta-analysis found higher mortality in the
bedside surgery group, though infection risk, post-operative hypothermia,
operative time, and hospital stay were similar between groups. Bedside
surgery reduced intraoperative hypothermia. Due to study variability and
observational designs, surgical approach should be tailored to the
neonate's clinical condition and available resources. Copyright ©
2025 The Author(s)

<71>
Accession Number
2034317072
Title
The Impact of Concomitant Mitral Regurgitation on Echocardiography
Parameters After TransCatheter Aortic Valve Replacement: A Systematic
Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 106(1) (pp 367-376),
2025. Date of Publication: 01 Jul 2025.
Author
Darouei B.; Amani-Beni R.; Rabiee Rad M.; Ghasempour Dabaghi G.; Eshraghi
R.; Bahrami A.; Amini-Salehi E.; Hashemi S.M.; Mazaheri-Tehrani S.;
Movahed M.R.
Institution
(Darouei, Amani-Beni, Rabiee Rad, Ghasempour Dabaghi) Isfahan
Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Eshraghi) Social Determinants of Health Research Center, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Bahrami) Student Research Committee, Kashan University of Medical
Sciences, Kashan, Iran, Islamic Republic of
(Amini-Salehi) Guilan University of Medical Sciences, Rasht, Iran, Islamic
Republic of
(Hashemi) Cardiovascular Research Center, Hormozgan University of Medical
Sciences, Bandar Abbas, Iran, Islamic Republic of
(Mazaheri-Tehrani) Child Growth and Development Research Center, Research
Institute for Primordial Prevention of Non-Communicable Disease, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Movahed) Department of Medicine, University of Arizona College of
Medicine, Phoenix, United States
(Movahed) Department of Medicine, University of Arizona Sarver Heart
Center, Tucson, AZ, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Mitral regurgitation (MR) commonly coexists with aortic
stenosis (AS) and is a potential risk factor influencing outcomes
following transcatheter aortic valve replacement (TAVR). This
meta-analysis aimed to evaluate the mean changes in key echocardiographic
parameters before and after TAVR and to compare these changes between
patients with moderate-to-severe MR (MR >= 2) and those with none-to-mild
MR (MR < 2). Method(s): A comprehensive literature search was
conducted using six electronic databases. We included studies that
evaluated patients undergoing TAVR, classified them based on baseline MR
grade >= 2 (moderate/severe MR) or MR grade < 2 (none/mild MR), and
reported the mean difference (MD) in echocardiographic parameters before
and after TAVR in both groups. The primary outcomes included changes in
ejection fraction (EF), LV end-diastolic volume (LVEDV) index, LV
end-systolic volume (LVESV) index, LV end-diastolic diameter (LVEDD), LV
end-systolic diameter (LVESD), aortic valve area (AVA), and the mean
aortic gradient. Pooled MDs were analyzed using a random-effects model.
 Result(s): Thirteen studies with 7163 patients were included, of
which 2376 had an MR >= 2. The MR < 2 and MR >= 2 groups experienced
significant improvements in AVA and reductions in mean aortic gradient,
LVEDV index, LVESV index, LVEDD, and LVESD. Compared to MR < 2 patients,
those with MR >= 2 exhibited significantly greater improvements in EF (MD
= 2.03; 95% CI: 0.81, 3.24), LVEDV index (MD = -5.55; 95% CI: -7.85,
-3.26), LVESV index (MD = -5.43; 95% CI: -7.28, -3.58), LVESD (MD = -2.23;
95% CI: -3.71, -0.26), and mean aortic gradient (MD = 1.43; 95% CI: 0.79,
2.07). However, the changes in LVEDD and AVA were not significantly
different between the groups. Conclusion(s): These findings suggest
that patients with moderate-to-severe baseline MR before TAVR showed
greater pronounced improvements in specific echocardiographic parameters
related to LV function and geometry, particularly in LVEF, LVEDV index,
LVESV index, and LVESD, compared to those with none-to-mild MR. Future
studies should focus on stratifying outcomes according to MR etiology and
using advanced imaging techniques to delineate better the mechanisms
underlying these improvements. Copyright © 2025 Wiley Periodicals
LLC.

<72>
Accession Number
2039302114
Title
Intensification of in-hospital rehabilitation in elective post-coronary
artery bypass grafting patients: both safe and effective.
Source
Postepy w Kardiologii Interwencyjnej. 21(2) (pp 229-236), 2025. Date of
Publication: 2025.
Author
Karaszewski D.; Cichon R.; Kusmierczyk M.; Marszalek M.; Wilimski R.
Institution
(Karaszewski, Kusmierczyk, Marszalek, Wilimski) Department of Cardiac,
Thoracic and Transplant Surgery, Medical University of Warsaw, Poland
(Cichon) Department of Cardiac Surgery, Medical University of Zielona
Gora, Poland
Publisher
Termedia Publishing House Ltd.
Abstract
Introduction: New standards for cardiac rehabilitation are currently being
established worldwide. Aim(s): To evaluate the effectiveness of
in-hospital rehabilitation models in patients after coronary artery bypass
grafting (CABG). Material(s) and Method(s): One hundred men with
stable coronary artery disease were randomly assigned to two groups:
standard model (SM) and intense model (IM). Subjects then underwent CABG
and were rehabilitated according to the assigned model. Effects were
verified by the 6-minute walk test (6MWT), which was performed before and
after the intervention. Result(s): In the initial 6MWT, subjects in
the SM group achieved a higher SpO<inf>2</inf> (Me: SM = 97%, 98%; IM =
96%, 97%). In the final 6MWT, subjects in the IM group achieved a higher
SpO<inf>2</inf> (Me: SM = 96%, 97%; IM = 97%, 98%), a lower initial HR
(Me: SM = 84; IM = 78) and a lower post-exercise HR (Me: SM = 92.5; IM =
84.5), a longer distance covered (Me: SM = 312 m; IM = 359 m), a lower
fatigue (Me: SM = 3; IM = 1) and a shorter hospitalization time. Group
differences between initial and final 6MWT; In IM: SBP and SpO<inf>2</inf>
in the initial 6MWT were higher than in the final 6MWT, HR in the initial
6MWT was lower than in the final 6MWT, distance travelled in the initial
6MWT was longer than in the final 6MWT, reported fatigue in the initial
6MWT was lower than in the final 6MWT. In IM: SBP in the initial 6MWT was
higher than in the final 6MWT, SpO<inf>2</inf> and HR in the initial 6MWT
were lower than in the final 6MWT. Conclusion(s): The intense model
showed a more favorable effect on the physical and functional status.
Increasing the load, extending the duration of training sessions, and
expanding the range of functionality are safe. Copyright © 2025
Termedia Publishing House Ltd.. All rights reserved.

<73>
[Use Link to view the full text]
Accession Number
2039349302
Title
Cardiac CT Versus Transesophageal Echocardiography Following Left Atrial
Appendage Closure: A Systemic Review and Meta-Analysis.
Source
Circulation: Cardiovascular Imaging. (no pagination), 2025. Article
Number: 018151. Date of Publication: 2025.
Author
Tan B.E.-X.; Baqai F.; Padilla F.; Nimri N.; Cheung J.W.; Kottam A.;
Medina H.M.
Institution
(Tan, Nimri, Kottam) Section of Cardiology, Department of Medicine, Baylor
College of Medicine, Houston, TX, United States
(Baqai, Padilla) Section of General Internal Medicine, Department of
Medicine, Baylor College of Medicine, Houston, TX, United States
(Cheung) Division of Cardiology, Department of Medicine, Weill Cornell
Medicine, New York, NY, United States
(Medina) Department of Cardiology, The Texas Heart Institute, Baylor
College of Medicine, Houston, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: In the landmark WATCHMAN trials, transesophageal
echocardiography (TEE) was used to evaluate peri-device leak (PDL) and
device-related thrombus (DRT) after percutaneous left atrial appendage
closure (LAAC). We aimed to investigate the diagnostic utility of cardiac
computed tomography angiography (CCTA) compared with TEE for post-LAAC
device surveillance. METHOD(S): We conducted a literature search of 5
electronic databases to identify studies that included patients who
underwent both CCTA and TEE after LAAC. We performed a meta-analysis by
pooling outcomes for residual leak (left atrial appendage patency), any
PDL, large PDL (>5 mm), and DRT. RESULT(S): We included 17 cohort
studies with 1313 patients who underwent both CCTA and TEE after LAAC.
CCTA was associated with higher odds of detecting residual leak (58.8%
versus 34.6%, odds ratio, 2.26 [95% CI, 1.48-3.44], P=0.0002;
I2=73%; 15 studies, 975 patients; moderate certainty) and any
PDL (51.6% versus 35.5%, odds ratio, 1.59 [95% CI, 1.01-2.51], P=0.04;
I2=73%; 12 studies, 870 patients; moderate certainty) when
compared with TEE. There were no significant differences in the detection
rates of large PDL (>5 mm) between CCTA and TEE (2.8% versus 0.8%, odds
ratio, 3.12 [95% CI, 0.73-13.36], P=0.13; I2=0%; 5 studies, 338
patients; moderate certainty). The incidence of DRT was low (1.7%), and
the detection rate did not differ between the 2 modalities (1.7% versus
1.7%, odds ratio, 1.0 [95% CI, 0.41-2.42], P=1.0; I2=0%; 6
studies, 584 patients; high-certainty). CONCLUSION(S): Following
LAAC, CCTA had higher odds of detecting residual leak and any PDL compared
with TEE, whereas there were no significant differences in the detection
of large PDL and DRT between the 2 modalities. The findings of this
meta-analysis should provide reassurance to patients and clinicians who
prefer CCTA over TEE after LAAC. While DRT and left atrial appendage
patency with visible PDL are known to be associated with thromboembolism,
the clinical significance of left atrial appendage patency without visible
PDL is uncertain and warrants further investigation. REGISTRATION: URL:
https://www.crd.york.ac.uk/PROSPERO/; Unique identifier:
CRD42024578802. Copyright © 2025 American Heart Association, Inc.

<74>
Accession Number
2034368361
Title
Fasting Versus Non-Fasting Before Cardiac Catheterization: A Systematic
Review and Meta-Analysis of Randomized Controlled Trials.
Source
Catheterization and Cardiovascular Interventions. 106(1) (pp 408-417),
2025. Date of Publication: 01 Jul 2025.
Author
Muniz J.; Goncalves Neto A.O.; Morais B.A.A.H.; Suciu-Bogdan C.; Ferreira
D.; Braghiroli J.; Camara S.F.; Ribeiro H.B.
Institution
(Muniz, Suciu-Bogdan) Internal Medicine Department, Schmieder Klinik
Heidelberg, Heidelberg, Germany
(Goncalves Neto) Federal University of Parana, Curitiba, Brazil
(Morais) Centro Universitario CESMAC, Maceio, Brazil
(Ferreira) Cardiovascular Department, John Hunter Hospital, Newcastle,
Australia
(Braghiroli) Department of Cardiology, Jackson Memorial Hospital, FL,
United States
(Camara, Ribeiro) Heart Institute of Sao Paulo (InCor), University of Sao
Paulo, Sao Paulo, Brazil
Publisher
John Wiley and Sons Inc
Abstract
Background: Current guidelines recommend routine fasting before cardiac
catheterization under conscious sedation. However, data supporting this
practice have been limited. Aim(s): We aimed to compare the safety
and patient well-being of a non-fasting strategy to standard fasting in
patients who undergo heart catheterization procedures. Method(s): We
conducted a meta-analysis of randomized studies comparing fasting versus
non-fasting before cardiac catheterization. We systematically reviewed
PubMed, Embase, and Cochrane databases until October 2024. We incorporated
unpublished subgroup data from the previously published SCOFF Trial,
exclusively on patients who underwent catheterization procedures.
 Result(s): We included 7 RCTs comprising 3289 patients who underwent
cardiac catheterization procedures. The pooled analysis demonstrated the
non-inferiority of the non-fasting strategy, with no significant
differences in the incidences of nausea/vomiting (RR 0.90; 95% CI
0.50-1.61; p = 0.72), hypoglycemia (RR 0.78; 95% CI 0.45-1.35, p = 0.38),
acute kidney injury (RR 1.45; 95% CI 0.77-2.75, p = 0.251), and length of
hospital stay (SMD 0.005, 95% CI -0.109 to 0.099, p = 0.92) compared to
the fasting strategy. The non-fasting strategy was significantly
associated with reduced rates of intraprocedural hypotension and showed a
statistically significant improvement in overall patient satisfaction (SMD
-0.749; 95% CI -1.26; -0.234, p = 0.004) when compared to the fasting
strategy. Conclusion(s): A non-fasting strategy before cardiac
catheterization procedures is as safe as the standard fasting protocol and
demonstrates a significant improvement of overall patient satisfaction.
These findings support the consideration of non-fasting protocols as a
patient-centered approach that maintains safety while enhancing the
patient experience. Copyright © 2025 Wiley Periodicals LLC.

<75>
[Use Link to view the full text]
Accession Number
2038848628
Title
Methylprednisolone for Infant Heart Surgery: Subpopulation Analyses of a
Randomized Controlled Trial.
Source
Critical Care Medicine. 53(7) (pp e1470-e1480), 2025. Date of Publication:
01 Jul 2025.
Author
Sunthankar S.D.; Hill K.D.; Jacobs J.P.; Baldwin H.S.; Jacobs M.L.; Li
J.S.; Graham E.M.; Blasiole B.; Husain S.A.; Bleiweis M.S.; Mettler B.;
Benscoter A.; Wald E.; Karamlou T.; Van Bergen A.H.; Eghtesady P.; Scott
J.P.; Anderson B.R.; Alfieris G.; Vener D.F.; Kannankeril P.J.
Institution
(Sunthankar, Baldwin, Kannankeril) Division of Pediatric Cardiology,
Center for Pediatric Precision Medicine, Department of Pediatrics, Monroe
Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University
Medical Center, Nashville, TN, United States
(Hill, Li) Division of Pediatric Cardiology, Duke University Medical
Center, Durham, NC, United States
(Jacobs, Bleiweis) Division of Cardiac Surgery, University of Florida,
Gainesville, FL, United States
(Jacobs, Mettler) Division of Cardiac Surgery, Johns Hopkins School of
Medicine, Baltimore, MD, United States
(Graham) Division of Pediatric Cardiology, Medical University of South
Carolina, Charleston, SC, United States
(Blasiole) Division of Pediatric Cardiac Anesthesiology, UPMC Children's
Hospital of Pittsburgh, Pittsburgh, PA, United States
(Husain) Division of Cardiac Surgery, Primary Children's Hospital, Salt
Lake City, UT, United States
(Benscoter) Division of Pediatric Cardiology, Cincinnati Children's
Hospital, Cincinnati, OH, United States
(Wald) Division of Pediatric Cardiology, Northwestern University Feinberg
School of Medicine, Chicago, IL, United States
(Karamlou) Division of Cardiac Surgery, Cleveland Clinic, Cleveland, OH,
United States
(Van Bergen) Division of Pediatric Cardiology, Advocate Children's
Hospital, Chicago, IL, United States
(Eghtesady) Division of Cardiac Surgery, Washington University School of
Medicine, St. Louis, MO, United States
(Scott) Division of Pediatric Cardiology, Medical College of Wisconsin,
Madison, WI, United States
(Anderson) Division of Pediatric Cardiology, Icahn School of Medicine at
Mt Sinai, New York, NY, United States
(Alfieris) Division of Cardiac Surgery, University of Rochester,
Rochester, NY, United States
(Vener) Division of Pediatric Cardiac Anesthesiology, Texas Children's
Hospital, Baylor College of Medicine, Houston, TX, United States
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: Evaluate benefits and harms of prophylactic intraoperative
methylprednisolone in subpopulations undergoing infant heart surgery.
DESIGN: Subpopulation analyses of The Steroids to Reduce Systemic
Inflammation after Infant Heart Surgery (STRESS) trial, a double-blind
randomized placebo-controlled trial. SETTING: Twenty-four congenital heart
centers. PATIENTS: Infants (< 1 yr old) undergoing heart surgery with
cardiopulmonary bypass. Patients stratified by Society of Thoracic
Surgeons-European Association for Cardio-Thoracic Surgery Congenital Heart
Surgery (STAT) mortality category, age, gestational age, and presence of
chromosomal or syndromic diagnosis (CSD). INTERVENTIONS:
Methylprednisolone (30mg/kg) vs. placebo administered into cardiopulmonary
bypass pump-priming fluid. MEASUREMENTS AND MAIN RESULTS: Six
postoperative outcomes: steroid use, acute kidney injury (AKI),
thrombosis, infections, prolonged mechanical ventilation, peak blood
glucose levels, and insulin exposure. One thousand two hundred patients
received methylprednisolone or placebo. Beneficial effects associated with
methylprednisolone included reduced use of postoperative hydrocortisone in
neonates (odds ratio [OR], 0.39 [0.25-0.60]), both STAT category groups
(1-3: OR, 0.64 [0.46-0.89]; 4-5: OR, 0.57 [0.34-0.97]), term infants (OR,
0.63 [0.47-0.83]), and those without CSD (OR, 0.63 [0.46-0.86]).
Methylprednisolone was associated with lower thrombosis occurrence among
neonates (OR, 0.37 [0.16-0.87]) and term infants (OR, 0.38 [0.19-0.75]).
Adverse associations included increased thrombosis among premature infants
(p = 0.005), increased AKI among neonates (OR, 1.55 [1.02-2.37]) and those
following STAT category 1-3 operations (OR, 1.34 [1.02-1.75]), and
increased peak blood glucose levels and insulin exposure (all subgroups; p
< 0.001). No increase in overall infection or reduction in prolonged
mechanical ventilation with methylprednisolone. CONCLUSION(S): Both
beneficial and adverse associations were observed with prophylactic
methylprednisolone. Reduction in postoperative hydrocortisone
administration and absence of increased infection rates are arguments
favoring prophylactic methylprednisolone use. Methylprednisolone was
associated with increased peak blood glucose levels and a neutral to
harmful association with odds of AKI. These data suggest certain
subpopulations may benefit from prophylactic intraoperative
methylprednisolone without significant harm. Copyright © 2025 by
the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All
Rights Reserved.

<76>
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. 7(7) (pp 860-870), 2025. Date of Publication: 01 Jul 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
(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. 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.
 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). 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 Copyright © 2025 The Authors

<77>
Accession Number
2035018749
Title
Does Green Brazilian Propolis Extract Improve Functional Capacity in
Symptomatic Chronic Coronary Disease?-A Pilot Randomized Trial.
Source
Pharmaceuticals. 18(6) (no pagination), 2025. Article Number: 827. Date of
Publication: 01 Jun 2025.
Author
Figueiredo C.S.; Passos L.C.S.; Cafezeiro C.R.F.; de Melo R.M.V.; Viana
T.T.; de Oliveira E.J.G.; Berretta A.A.; Silveira M.A.D.
Institution
(Figueiredo, Passos, de Melo, Viana) Programa de Pos-Graduacao em Medicina
e Saude (Graduate Program in Medicine and Health), Faculdade de Medicina
da Bahia, Universidade Federal da Bahia, BA, Salvador, Brazil
(Figueiredo, Passos, Cafezeiro, de Oliveira) Hospital Ana Nery, BA,
Salvador, Brazil
(de Melo, Viana, Silveira) D'Or Institute for Research and Education
(IDOR), Hospital Sao Rafael, Avenida Sao Rafael 2152, Sao Marcos, BA,
Salvador, Brazil
(Berretta) Development and Innovation Department, Apis Flora Indl. Coml.
Ltd., Rua Triunfo 945, Subsetor Sul 3, SP, Ribeirao Preto, Brazil
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Inflammation plays a critical role in the progression of
coronary heart disease (CHD). Low-dose colchicine has shown promise in
reducing cardiovascular events, and green Brazilian propolis extract
(EPP-AF (standardized Brazilian green propolis extract) was provided by
Apis Flora Indl. Coml. Ltda, Ribeirao Preto, SP, Brazil), known for its
anti-inflammatory properties, may offer additional therapeutic benefits.
This pilot study aimed to evaluate whether six weeks of EPP-AF
supplementation improves functional capacity assessed by treadmill
exercise testing. Method(s): This was a randomized, double-blind,
placebo-controlled pilot study conducted at a coronary disease clinic in
Brazil. Patients aged >= 18 years with stable CHD receiving optimized
medical therapy were randomized in a 2:1 ratio to receive either 200 mg of
EPP-AF or placebo twice daily for six weeks. The primary
outcome was the change in treadmill exercise duration (in seconds).
Secondary outcomes included total exercise time, functional capacity
(measured in metabolic equivalents of task [METs]), high-sensitivity
C-reactive protein (hs-CRP) levels, the Seattle Angina Questionnaire
(SAQ), and the Canadian Cardiovascular Society (CCS) angina
classification. Statistical analysis was performed on an
intention-to-treat basis. Result(s): A total of 59 patients were
randomized, with a median follow-up of 6.5 weeks. There was no significant
difference in the primary endpoint between groups: the median change in
treadmill test time was 39 s in the EPP-AF group versus 30 s in
the placebo group (p = 0.83). No improvements were observed in METs,
hs-CRP levels, SAQ scores, or CCS class in the EPP-AF group. No
major adverse cardiovascular events occurred during the study.
 Conclusion(s): EPP-AF did not improve functional capacity,
inflammatory markers, or angina symptoms in patients with stable CHD
compared to placebo. Copyright © 2025 by the authors.

<78>
Accession Number
2034316967
Title
Safety and Efficacy of Intravascular Lithotripsy in Calcified Left Main
Coronary Artery Disease: A Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 106(1) (pp 336-348),
2025. Date of Publication: 01 Jul 2025.
Author
Lingamsetty S.S.P.; Thyagaturu H.; Singh S.; Eswarsingh A.; Gopal S.;
Ludhwani D.; Ajibade A.; Sekar V.; Jagadeesan V.
Institution
(Lingamsetty) Internal Medicine, Mamata Medical College, Khammam, India
(Thyagaturu, Jagadeesan) Department of Cardiology, West Virginia
University Heart and Vascular Institute, Morgantown, WV, United States
(Singh) Internal Medicine, Sinai Hospital, Baltimore, MD, United States
(Eswarsingh) Department of cardiology, East Carolina University,
Greenville, NC, United States
(Gopal) Department of Cardiology, Bassett Medical Center, NY, United
States
(Ludhwani) University of Maryland Shore Regional Health, Easton, MD,
United States
(Ajibade) Department of Medicine, West Virginia University, Morgantown,
WV, United States
(Sekar) Department of Endocrinology, Lehigh Valley Health Network, PA,
United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Intravascular lithotripsy (IVL) has emerged as a novel
therapeutic modality for the management of calcified coronary lesions. The
effectiveness and safety of IVL specifically in the context of left main
disease remains uncertain and limited. We performed a meta-analysis to
consolidate existing data. Method(s): Online databases Medline,
Embase, Cochrane were searched for studies using IVL during percutaneous
coronary intervention (PCI) of calcified left main disease. The outcomes
of interest were procedural success, procedural complications and
cardiovascular (CV) events. Pooled proportions with 95% confidence
intervals (CI) were calculated using a random-effects model.
 Result(s): A total of 10 studies with 435 patients (mean age 73.1
years, 73.1% males) were included. The pooled outcomes were procedural
success 98.8% (95% CI 95.58-100), perforation 0.02% (95% CI 0.00-0.87),
major dissection 0.87% (95% CI 0.00-3.97), slow-flow/no-reflow 0.27% (95%
CI 0.00-1.47) and abrupt vessel closure 0.01% (95% CI 0.00-1.01).
In-hospital CV events were major adverse CV events (MACE) 2.14% (95% CI
0.64-4.21), death 0.96% (95% CI 0.00-2.98), CV death 0.46% (95% CI
0.00-2.17), myocardial infarction (MI) 0.94% (95% CI 0.04-2.56), stent
thrombosis 0.99% (95% CI 0.00-6.14) and target vessel revascularization 0%
(95% CI 0.00-0.32). Thirty-day outcomes were MACE 4.79% (95% CI
1.51-9.35), mortality 3.09% (95% CI 0.00-9.69) and MI 2.25% (95% CI
0.45-4.95). Conclusion(s): Use of IVL during PCI of calcified left
main disease is associated with a favorable procedural rates of success,
with low risk of procedural complications and ischemic
events. Copyright © 2025 Wiley Periodicals LLC.

<79>
Accession Number
2034086781
Title
Mitral Transcatheter Edge-to-Edge Repair (MTEER) in Heart Failure Patients
Refractory to Cardiac Resynchronization Therapy.
Source
Catheterization and Cardiovascular Interventions. 106(1) (pp 105-108),
2025. Date of Publication: 01 Jul 2025.
Author
Yasmin F.; Shaikh A.; Ali E.; Najeeb H.; Huda Z.; Naeem U.; Khan S.; Goel
S.S.
Institution
(Yasmin) Yale School of Medicine, New Haven, CT, United States
(Shaikh, Khan, Goel) Houston Methodist DeBakey Heart & Vascular Center,
TX, United States
(Ali, Najeeb, Huda, Naeem) Dow Medical College, Karachi, Pakistan
Publisher
John Wiley and Sons Inc

<80>
Accession Number
2015648971
Title
The effects of eye masks on post-operative sleep quality and pain in
school-Age children with CHD.
Source
Cardiology in the Young. 32(10) (pp 1575-1579), 2022. Date of Publication:
01 Oct 2022.
Author
Dai W.-S.; Xie W.-P.; Liu J.-F.; Chen Q.; Cao H.
Institution
(Dai, Xie, Liu, Chen, Cao) Department of Cardiac Surgery, Fujian Branch of
Shanghai Children's Medical Center, Fuzhou, China
(Dai, Xie, Liu, Chen, Cao) Department of Cardiac Surgery, Fujian
Children's Hospital, Fuzhou, China
(Dai, Xie, Liu, Chen, Cao) Department of Cardiac Surgery, Fujian Maternity
and Child Health Hospital, Affiliated Hospital of Fujian Medical
University, Fuzhou, China
(Dai, Xie, Liu, Chen, Cao) Fujian Key Laboratory of Women and Children's
Critical Diseases Research, Fujian Maternity and Child Health Hospital,
Fuzhou, China
Publisher
Cambridge University Press
Abstract
Objective: This study aimed to explore the effects of eye masks on the
sleep quality and pain of school-Age children with CHD after surgery.
 Method(s): Forty school-Age children with CHD who underwent
open-heart surgery in the Cardiac Surgery Department of a provincial
hospital in China from January 2020 to December 2020 were selected. The
children were randomly divided into the experimental group (n = 20) and
the control group (n = 20). Children in the control group were given
routine sleep care, and the children in the experimental group were given
a sleep intervention with eye masks for three nights following the removal
of tracheal intubation. The Pittsburgh Sleep Quality Index was used to
evaluate the sleep quality of the children. The Children's Pain Behaviour
Scale was used to evaluate the pain of the children. Result(s): After
three nights of receiving the eye masks intervention, the sleep quality
scores of the children in the experimental group were significantly lower
than those of the control group, the difference was statistically
significant (p < 0.05) and the sleep quality of the children in the
experimental group was higher. The pain scores of the children in the
experimental group were significantly lower than those of the children in
the control group, the difference was statistically significant (p <
0.05), and the children in the experimental group suffered less
post-operative pain. Conclusion(s): Eye masks are a simple, safe and
economical intervention, that is beneficial for improving the
post-operative sleep quality and relieving post-operative pain in
school-Age children with congenital heart disease. Copyright ©
The Author(s), 2021.

<81>
Accession Number
2035204568
Title
Resuscitative Mean Arterial Pressure Targets in Cardiovascular Disease: A
Narrative Review of Clinical Outcomes.
Source
Cardiovascular Drugs and Therapy. (no pagination), 2025. Date of
Publication: 2025.
Author
Kotta P.A.; Uppalapati L.; Elango M.; Triska J.; Senussi M.H.
Institution
(Kotta, Uppalapati, Triska) Department of Internal Medicine, Baylor
College of Medicine, Houston, TX, United States
(Elango) Department of General Surgery, Houston Methodist Hospital,
Houston, TX, United States
(Senussi) Section of Cardiology, Baylor College of Medicine, Texas Heart
Institute, Houston, TX, United States
Publisher
Springer
Abstract
Mean arterial pressure (MAP) is a commonly used hemodynamic proxy for
tissue perfusion. Continuous MAP monitoring and maintenance of MAP targets
remains a cornerstone for managing shock states. However, co-morbidities
and individual variations can complicate the relationship between MAP and
organ perfusion. Factors such as fluid balance, microvascular circulation,
and endothelial function all influence tissue perfusion. This review
examines the nuances of MAP management across various patient populations
with cardiovascular disease, including acute myocardial infarction
cardiogenic shock, non-acute myocardial infarction cardiogenic shock,
cardiac arrest, and cardiac surgery. We discuss the importance of
individualized MAP targets, considering underlying health conditions,
clinical scenarios, and individual shock physiology. Additionally, the
importance of monitoring end-organ autoregulation and perfusion is
emphasized to optimize shock management. We discuss a limited body of
literature which indicates that higher MAPs are associated with improved
outcomes in patients with cardiogenic shock, post-cardiac arrest, and
after cardiac surgery. However, owing to the post-hoc and retrospective
nature of most of these studies, whether higher MAPs truly lead to
improved clinical outcomes or whether patients with higher MAPs are
inherently less sick and therefore more likely to have better outcomes
cannot be discerned from the available data. Further research,
particularly prospective RCTs, is essential to define MAP targets that may
improve outcomes across different patient populations and clinical
settings. Copyright © The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2025.

<82>
Accession Number
2035204138
Title
Long-Term Outcomes in Sleeve Gastrectomy versus Roux-en-Y Gastric Bypass:
A Systematic Review and Meta-Analysis of Randomized Trials.
Source
Obesity Surgery. (no pagination), 2025. Date of Publication: 2025.
Author
Monteiro Delgado L.; Fabretina de Souza V.; Fontel Pompeu B.; de Moraes
Ogawa T.; Pereira Oliveira H.; Sacksida Valladao V.D.C.; Lima Castelo
Branco Marques F.I.
Institution
(Monteiro Delgado, Fabretina de Souza, de Moraes Ogawa, Pereira Oliveira)
Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
(Fontel Pompeu, Lima Castelo Branco Marques) Department of General
Surgery, Hospital Heliopolis, Sao Paulo, Brazil
(Sacksida Valladao) Universidade Federal de Santa Catarina, Florianopolis,
Brazil
Publisher
Springer
Abstract
Obesity is a global health concern linked to metabolic and cardiovascular
complications. Bariatric surgery is an effective treatment, with sleeve
gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) being the most
studied procedures. This systematic review and meta-analysis compare the
long-term efficacy and safety of SG and RYGB. We searched PubMed, Embase,
and the Cochrane Library until May 20, 2024, for randomized trials with >=
5 years of follow-up comparing SG and RYGB. Primary outcomes included
excess weight loss (EWL), total weight loss (TWL), and excess BMI loss
(EBL). Secondary outcomes included diabetes remission, HbA1c levels,
obesity-related comorbidities, complications, and mortality. Risk ratios
(RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were
pooled using a random-effects model. We included 9 randomized trials
encompassing 1,489 patients. RYGB resulted in significantly greater EWL
(MD -14.00%; 95% CI -20.65 to -7.35), TWL (MD -5.67%; 95% CI -8.81 to
-2.52), and EBL (MD -7.44%; 95% CI -10.54 to -4.34) compared to SG. T2DM
remission was higher in the RYGB group (RR 0.72; 95% CI 0.54-0.97),
although HbA1c levels were similar between groups. RYGB also led to
greater improvement in GERD symptoms (RR 0.48; 95% CI 0.31-0.74). No
significant differences were observed between SG and RYGB in dyslipidemia,
hypertension, obstructive sleep apnea syndrome (OSAS), or joint pain.
Regarding safety, SG was associated with significantly lower late major
complications (RR 0.41; 95% CI 0.20-0.85), while early minor (RR 0.55; 95%
CI 0.17-1.83), early major (RR 0.99; 95% CI 0.45-2.20), and late minor
complications (RR 0.77; 95% CI 0.39-1.54) did not differ significantly
between procedures. Only one surgery-related death was reported, occurring
in the early postoperative period in the SM-BOSS trial. RYGB is associated
with greater long-term weight loss, improved T2DM remission, and superior
GERD control compared to SG. However, SG showed a lower incidence of late
major complications. Both procedures were comparable for the remaining
outcomes. These findings highlight the importance of considering both
efficacy and safety in the context of individual patient characteristics,
rather than focusing solely on weight loss. Copyright © The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2025.

<83>
Accession Number
647862321
Title
Effectiveness of breathing relaxation exercises on pain due to chest tube
removal: a systematic review-meta-analysis.
Source
Journal of cardiothoracic surgery. 20(1) (pp 281), 2025. Date of
Publication: 02 Jul 2025.
Author
Kok A.Y.; Eyiler E.
Institution
(Kok) Burdur Mehmet Akif Ersoy University, Bucak Health School, Burdur,
Turkey
(Eyiler) Afyonkarahisar Health Science University, Faculty of Health
Sciences, Fundamentals of Nursing Department, Afyonkarahisar, Turkey
Abstract
BACKGROUND: Chest tube placement is essential for draining air or fluid
from the pleural cavity, often performed after cardiothoracic surgeries to
prevent complications. However, chest tube removal (CTR) can be painful
and stressful for patients. Proper pain management is crucial to enhancing
patient comfort. AIM: The aim of this systematic review and meta-analysis
was to asssess the effectiveness of breathing and relaxation exercises for
pain associated with CTR. METHOD(S): Database searches were carried
out in Pub med, Web of Science, MEDLINE, Academic Search Ultimate, CINAHL
Complete, Cochrane Library, Science Direct to December 2024. The Risk of
Bias 2 tool was used to assess the risk of bias. Heterogeneity and
publication bias were also assessed. FINDINGS: A total of 8 randomized
controlled trials were included. Findings indicated that breathing
relaxation exercises had a negative effect on chest tube removal. The mean
effect size for the effect of breathing relaxation exercises on CTR was -
1.46 Three of the studies included in the meta-analysis assessed outcomes
before CTR procedure. The mean effect size is 0.070 with a 95% confidence
interval of -0.208 to 0.348. Also, four of the studies included in the
meta-analysis assessed outcomes immediately after the procedure. The mean
effect size is -1.403 with a 95% confidence interval of -2.337 to -0.469.
The mean effect size in the universe of comparable studies could fall
anywhere in this interval. Q-value is 30.826 with 3 degrees of freedom and
p < 0.001. CONCLUSION(S): The results of this meta-analysis indicated
that breathing and relaxation exercises can be effective in reducing pain
associated with the CTR procedure. Copyright © 2025. The
Author(s).

<84>
Accession Number
2039572021
Title
COMPARISON OF INTRANASAL DEXMEDETOMIDINE AND MIDAZOLAM AS PREMEDICATION IN
CHILDREN UNDERGOING CARDIAC SURGERIES AND PROCEDURES.
Source
Acta Medica Bulgarica. 52(1) (pp 7-13), 2025. Date of Publication: 01 Mar
2025.
Author
Arora P.; Nayar P.; Choudhury A.; Kohli S.; Savithri H.
Institution
(Arora, Nayar, Choudhury, Kohli, Savithri) Anaesthesia and Intensive Care,
Vardhman Mahavir Medical College, Safdarjung Hospital, New Delhi, India
Publisher
Sciendo
Abstract
Aims and Objectives. To compare premedication with intranasal
dexmedetomidine and intranasal midazolam for their sedative effects and
ease of parental separation in children undergoing cardiac surgeries.
Materials and Methods. This prospective, interventional study was
conducted on 40 children aged 1-10 years undergoing cardiac procedures,
who were randomized into two groups of 20 each. Group D received 2 mcg/kg
intranasal dexmedetomidine, and Group M received 0.2 mg/kg intranasal
midazolam 30 minutes before the surgery. The sedation levels were assessed
by the Ramsay Sedation Scale (RSS), and ease of separation from parents by
Child-Parent Separation Score (CPSS) in both groups. Results. The CPSS
score was significantly lower with group D as compared to group M (scores
1 vs 2, p = 0.0002 prior to shifting of children to OT). Ramsay Sedation
Scale value was significantly higher in group D compared to group M after
15, 25 and 30 minutes (scores 3 vs 2, p < 0.0001). Conclusion. Intranasal
dexmedetomidine achieved significant as well as satisfactory sedation,
lower levels of anxiety, and better parent separation than intranasal
midazolam in pediatric patients undergoing cardiac
surgeries. Copyright © 2025 Sciendo. All rights reserved.

<85>
Accession Number
2035222170
Title
Sugammadex versus cholinesterase inhibitors to antagonize respiratory
dysfunction after neuromuscular blockade in patients undergoing pulmonary
surgery: a systematic review and meta-analysis.
Source
Perioperative Medicine. 14(1) (no pagination), 2025. Article Number: 72.
Date of Publication: 01 Dec 2025.
Author
Liu B.; Song K.; Wang P.; Li F.; Guo Q.
Institution
(Liu, Song, Li, Guo) Department of Anesthesiology, Zhoushan Hospital,
Zhejiang, Zhoushan, China
(Wang) Department of Anesthesiology, 905 Hospital of People's Liberation
Army Navy, Shanghai, China
Publisher
BioMed Central Ltd
Abstract
Objective: The incidence of respiratory dysfunction associated with
postoperative residual curarization (PORC) after thoracic surgery is high,
even affecting the prognosis. There is no consensus on whether sugammadex
is beneficial. This study aimed to elucidate the effect of sugammadex in
the management of PORC-related respiratory dysfunction following thoracic
surgery. Method(s): PubMed, Embase, Cochrane Library, and Web of
Science were searched from database inception to January 2025 for studies
on respiratory outcomes after thoracic surgery when sugammadex was used as
an antagonist. The pooled risk ratio or weighted mean difference was used
to evaluate the outcomes. Result(s): Among 1398 studies searched, 11
studies were finally included, involving 1445 subjects. The results showed
that sugammadex could reduce the incidence of postoperative respiratory
complications (RR = 0.77, 95% CI: 0.66-0.90), particularly atelectasis (RR
= 0.61, 95% CI: 0.47-0.79) and pneumonia (RR = 0.64, 95% CI: 0.46-0.91).
In addition, according to the subgroup analysis by age, surgery type,
anesthesia duration, and body mass index, sugammadex was associated with a
shortened extubation period (P <= 0.005). Conclusion(s): Compared
with traditional muscle relaxant antagonists, the use of sugammadex after
thoracic surgery can help reverse the respiratory dysfunction related to
residual muscle relaxants and reduce the risk of atelectasis, pneumonia,
and reintubation. However, there is no difference in the risk of pleural
effusion and pneumothorax. Except for post-anesthesia care unit duration,
the differences in hospitalization and chest tube dwelling duration
between the two groups remain to be clarified. Copyright © The
Author(s) 2025.

<86>
Accession Number
2039579064
Title
Perioperative dexmedetomidine reduces the risk of postoperative
complications in high-risk patients undergoing non-cardiac surgery: A
randomized controlled trial.
Source
Chinese Medical Journal. (no pagination), 2025. Article Number:
10.1097/CM9.0000000000003648. Date of Publication: 2025.
Author
Meng Z.; Ding T.; Zhao W.; Guo L.; Li M.; Zhao Z.; Zhang Y.; Li C.; Mu D.;
Wang D.
Institution
(Meng, Ding, Li, Li, Mu, Wang) Department of Anesthesiology, Peking
University First Hospital, Beijing, China
(Meng) Department of Anesthesiology, Beijing Friendship Hospital, Capital
Medical University, Beijing, China
(Zhao, Zhao) Department of Anesthesiology, The Fourth Hospital of Hebei
Medical University, Shijiazhuang, Hebei, China
(Guo, Zhang) Department of Anesthesiology, Liaocheng People's Hospital in
Shandong Province, Liaocheng, Shandong, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Dexmedetomidine may suppress the surgery-induced inflammatory
response, which is considered the underlying mechanism of postoperative
complications. This study was designed to investigate whether
perioperative dexmedetomidine could decrease the risk of postoperative
complications among high-risk patients. Method(s): This multicenter
randomized controlled trial is a superiority trial. Central randomization
was used. Elderly patients (age >=60 years) with revised cardiac risk
index (RCRI) >=3 and scheduled for major non-cardiac surgery were
enrolled. Patients in dexmedetomidine group received intraoperative
dexmedetomidine (a loading dose of 0.5 mug/kg followed by 0.3 mug kg-1
h-1) as adjuvant to general anesthesia and postoperative dexmedetomidine
(2 mug/h for 72 h) as supplementation to patient-controlled analgesia with
sufentanil. Patients in the control group received an equivalent dose of
normal saline as placebo during anesthesia and sufentanil only for
postoperative analgesia. The primary outcome was the incidence of major
postoperative complications including neurologic, cardiovascular, acute
kidney injury pulmonary, coagulation, infectious, and gastrointestinal
systems within postoperative 30 days. Secondary outcomes included pain
intensity, sleep quality, postoperative length of in-hospital stay, and
medical expenses during hospitalization. Neutrophil-to-lymphocyte ratio
(NLR) was used to monitor inflammatory response. Result(s): This
study included 272 patients, with similar median age (70 years vs. 69
years) and median RCRI (both 3) between dexmedetomidine and control
groups. The incidence of major postoperative complications in the
dexmedetomidine group was significantly lower than that in the control
group (38.2% [52/136] vs. 52.9% [72/136], relative risk [RR] = 0.722, 95%
confidence interval (CI) 0.554-0.942, P = 0.015). Postoperative
in-hospital stay was shorter in the dexmedetomidine group than that in the
control group (mean difference [MD] = -1 day, 95% CI: -2 to 0 days, P =
0.013). Other secondary outcomes were comparable between the two groups.
The highest NLR within postoperative first 3 days in the dexmedetomidine
group was lower than that in the control group (MD = -2.1, 95% CI: -4.1 to
-0.3, P = 0.037). The proportion of all drug-related adverse events were
comparable between the two groups. Conclusion(s): Dexmedetomidine,
infused from the beginning of anesthesia to postoperative 72 h, decreased
the risk of postoperative complications in high-risk elderly patients
undergoing non-cardiac surgery. Copyright © 2025 Lippincott
Williams and Wilkins. All rights reserved.

<87>
Accession Number
2039515202
Title
Inpatient prehabilitation for intestinal failure patients undergoing
surgery improves physical and non-physical recovery and reduces length of
stay.
Source
Clinical Nutrition ESPEN. Conference: BAPEN 2025 Annual Conference. ICC
Wales, Newport United Kingdom. 68 (pp 857-858), 2025. Date of Publication:
01 Aug 2025.
Author
Borthwick L.; Skladnikiewicz D.; Spencer D.; Keymer J.; Stammers M.;
Pepperrell S.; Richardson C.; Clarke E.
Institution
(Borthwick, Skladnikiewicz, Spencer, Keymer, Stammers, Pepperrell,
Richardson, Clarke) University Hospital Southampton NHS Trust,
Southampton, United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: Prehabilitation is a personalised, multimodal intervention
used to improve physical and psychological fitness pre-operatively,
positively impacting surgical outcomes (1,2). Current literature shows
High Intensity Interval Training (HIIT) is a safe and timely method to
improve cardiovascular fitness before surgery and reduces post-operative
complications (3). Evidence for its effectiveness with intestinal failure
(IF) patients is scarce. Previously a Physiotherapist and Occupational
Therapist provided a service for an Integrated IF centre. This focused on
post-operative recovery and adhoc prehabilitation for patients awaiting IF
surgery. The majority of IF patients are admitted electively from home for
recontinuity surgery. However, more complex patients are emergency
admissions and unable to be discharged home from their index admission
until they have undergone surgery. This sub- group are often highly
deconditioned. Aim(s): A 12-month uplift with one band 4 Therapy
Assistant, increasing the frequency of prehabilitation sessions for
emergency type 2 IF patients awaiting surgery, aimed to reduce length of
stay (LOS). Method(s): The IF therapists completed three specialised
HIIT sessions per week with selected patients. Personalised HIIT exercise
programmes were developed with a focus on ergometer cycling but also
included aerobic step or walking programmes and weights-based exercise.
Primary outcome measure was LOS, which was compared with pre uplift data
as a control. Median LOS with the interquartile range is given in
brackets. As the data was non-parametrically distributed, the Mann-Whitney
U test was used to calculate significance. Secondary outcome measures
included improvement in 6-minute walk test (6MWT). Results [Formula
presented] All LOS parameters showed a decreasing trend with the uplift,
reaching statistical significance in critical care LOS and therapy fit
LOS. Median improvement in 6MWT increased from 72.5 metres to 90 metres
with the uplift (p= 0.786). Conclusion(s): Increased therapy input
with a focus on HIIT exercise reduced hospital LOS and statistically
significantly reduced critical care and therapy fit LOS. This has a bed
capacity and cost saving impact as well as offering direct benefit to
patients. References 1. West M, Jack S, Grocott MPW. Prehabilitation
before surgery: Is it for all patients? Best Pract Res Clin Anaesthesiol
2021: published online Jan 27. https://doi.org/10.1016/j.bpa.2021.01.001
2. Preoperative Assessment and Optimisation for Adult Surgery. Centre of
Perioperative Medicine, 2021. (Accessed April 5, 2024, Microsoft Word -
Preoperative assessment and optimisation guidance_format.docx
(cpoc.org.uk)) 3. Clifford K, Woodfield JC, Tait W et al. Association of
Preoperative High-Intensity Interval Training with Cardiorespiratory
Fitness and Postoperative Outcomes Among Adults Undergoing Major Surgery:
A systematic review and meta-analysis. JAMA Netw Open 2023: published
online Jun 30.
https://doi.org/10.1001/jamanetworkopen.2023.20527 Copyright ©
2025

<88>
Accession Number
2039509814
Title
Inhaled Levosimendan Vs Inhaled Milrinone in children with congenital
heart disease with left to right shunt and pulmonary hypertension
undergoing surgical correction under cardiopulmonary bypass.
Source
European Journal of Cardiovascular Medicine. 15(7) (pp 98-108), 2025. Date
of Publication: 01 Jul 2025.
Author
Majumdar S.; Pal S.; De P.; Das S.; Dasgupta C.S.; Das P.K.
Institution
(Das, Majumdar) Dept of Cardiac Anaesthesiology, IPGMER, SSKM Hospital,
West Bengal, Kolkata, India
(Pal) Dept of Cardiac Anaesthesiology, R N Tagore International Institute
of Cardiac Sciences, Mukundapur, West Bengal, Kolkata, India
(De) Dept of Anaesthesiology, North Bengal Medical College and Hospital,
Sushrutanagar, West Bengal, Darjeeling, India
(Das) Dept Cardiac Anaesthesiology, Medical College & Hospital, West
Bengal, Kolkata, India
(Dasgupta) Dept of Cardiac Anaesthesiology, IPGMER, SSKM Hospital, 244
A.J.C. Bose Road, West Bengal, Kolkata, India
(Das) Dept of Psychiatry, Nil Ratan Sircar MedicalCollege & Hospital.,
West Bengal, Kolkata, India
Publisher
Healthcare Bulletin
Abstract
Background: Surgical closure of intracardiac left to right shunt in
children with pre-existing Pulmonary Atrial Hypertension (PAH) can
aggravate the elevated Pulmonary Atrial Pressure (PAP) and exacerbate
episodes of hypertensive crisis and acute right ventricular dysfunction.
Pulmonary vasodialators like Milrinone and Levosimendan when used in
systemic route also cause systemic hypotension and their feasibility as
selective pulmonary vasodialator when administered in inhaled route is
subject of investigation. Objective(s): To compare the efficacy of
inhaled milrinone and inhaled levosimendan in reducing elevated PAP in
such children. Method(s): In this one-way, parallel group,single
blinded, Randomised Trial, child of 1 to18 years of age with left to right
shunt with mean PAP more than 30mm Hg have been studied. They were
randomly allocated two equal groups, Group 1 received inhaled milrinone
(50 mug/kg) and group 2 received inhaled Levosimendan (24 mug/kg) after
arrival in the post-operative cardiac ICU room post-surgical correction
and evaluated for Transthoracic Echo variables like changes in Pulmonary
Artery Systolic Pressure (PASP) at different time points up to 6 hr after
completion of inhalation of study drug. Numerical variables have been
compared by Student's t-test. Result(s): Although both Inhaled
Milrinone and Inhaled Levosimendan are effective in reducing elevated
pulmonary artery systolic pressure without causing systemic hypotension in
children with congenital heart disease with left to right intra cardiac
shunt with pulmonary hypertension undergoing surgical correction under
CPB, inhaled levosimendan has longer duration of action.
 Conclusion(s): Inhaled levosimendan lowered pulmonary artery pressure
like inhaled milrinone in post-surgical closure in such children but for
longer duration making Inhaled Levosimendan a better option. Copyright
© 2025 Healthcare Bulletin. All rights reserved.

<89>
Accession Number
2039337037
Title
Effectiveness of Gentamicin-Collagen Sponges in Preventing Sternal Wound
Infections.
Source
Thoracic and Cardiovascular Surgeon. (no pagination), 2025. Date of
Publication: 2025.
Author
Glam R.; Ronai T.; Makhoul M.; Friedman T.; Raad M.; Adler Z.; Cohen O.;
Medalion B.; Bolotin G.
Institution
(Glam, Makhoul, Friedman, Raad, Adler, Cohen, Medalion, Bolotin)
Department of Cardiothoracic Surgery, Rambam Health Care Campus, Haifa,
Israel
(Ronai) Rappaport Faculty of Medicine, Technion - Israel Institute of
Technology, Haifa, Israel
Publisher
Georg Thieme Verlag
Abstract
Background This study aimed to evaluate whether the combined use of
gentamicin-collagen sponges and topical vancomycin reduces the incidence
of sternal wound infections (SWIs) in patients at high risk for infection
following cardiac surgery. Methods A single-center, retrospective study
compared two groups of high-risk cardiac surgery patients from June 2018
to September 2021. High-risk patients, identified through departmental
consensus, had multiple SWI risk factors. The study group (278 patients)
received gentamicin-collagen sponges plus topical vancomycin, whereas the
control group (309 patients) received only topical vancomycin. The primary
outcome was SWI incidence. Results The incidence of SWI was significantly
lower in the study group, with 2.8% (8/278) compared with 9% (28/309) in
the control group (p = 0.002). After adjusting for known risk factors, the
odds of infection in the control group were 4.64 times higher (95%
confidence interval [CI]: 1.63-13.21) than in the study group. The rate of
deep sternal wound infections (DSWI) was 1.8% in the study group versus
4.2% in the control group (p = 0.09), with adjusted odds of DSWI being 4.1
times higher in the control group (95% CI: 0.99-16.86). Although the
p-value was borderline (p = 0.05), no significant differences in mortality
rates were observed between the two groups. Conclusion The use of
gentamicin-collagen sponges as part of a prophylactic regimen
significantly reduces the incidence of SWI in high-risk cardiac surgery
patients, suggesting its potential benefit as an adjunctive treatment in
preventing postoperative infections. Copyright © 2025. Thieme.
All rights reserved.

<90>
Accession Number
647861112
Title
Posterior Pericardiotomy and Its Impact on Cardiac Tamponade and
Pericardial Effusion after Cardiac Surgery.
Source
Annals of thoracic and cardiovascular surgery : official journal of the
Association of Thoracic and Cardiovascular Surgeons of Asia. 31(1) (no
pagination), 2025. Date of Publication: 2025.
Author
Al-Shameri I.; Al-Ganadi A.A.; Noman T.; Kadry M.A.; Elsharkawy I.M.;
Al-Wsabi N.; Mohammed A.A.
Institution
(Al-Shameri, Al-Ganadi, Kadry, Al-Wsabi) Department of Cardiovascular
Surgery, Cardiovascular and Kidney Transplantation Center, Faculty of
Medicine, Taiz University, Yemen
(Noman) Department of Cardiovascular Surgery, Faculty of Medicine, Sana'a
University, Yemen
(Elsharkawy) Department of Cardiothoracic Surgery, Faculty of Medicine,
Cairo University, Cairo, Egypt
(Mohammed) Department of Cardiology, Faculty of Medicine, Taiz University,
Yemen
Abstract
PURPOSE: Pericardial effusion (PE), tamponade, and atrial fibrillation are
challenging complications after cardiac surgeries. This prospective
randomized study was conducted to evaluate the impact of posterior
pericardiotomy (PP) in the prevention of PE and cardiac tamponed after
adult cardiac surgery. METHOD(S): This single-center, prospective,
randomized controlled trial included 330 patients undergoing open-heart
surgery. They were randomly assigned to either a PP group or a control
group. RESULT(S): Of 703 screened patients, 330 were enrolled from
January 2022 to June 2024 (mean age: 50.2 +/- 14.7 years, 64.2% males).
Compared to controls, the PP group had significantly lower early and late
PE (19.4% vs. 44.8%, and 4.2% vs. 17%, respectively), tamponade (2.4% vs.
11.5%), and postoperative atrial fibrillation (10.3% vs. 19.4%). PP also
significantly reduced the need for surgical re-exploration, duration of
mechanical ventilation, and both intensive care unit and overall hospital
stays (all P <0.05). Adjusted multivariate analysis confirmed the benefits
of PP after correcting for baseline imbalances in left ventricular
ejection fraction and operative time. No adverse events directly
attributable to PP were noted. CONCLUSION(S): PP is a simple, safe,
and effective technique for reducing postoperative PE, and cardiac
tamponade after cardiac surgery.

<91>
Accession Number
2039555835
Title
The Effect of Continuous Magnesium Infusion to Prevent Postoperative
Atrial Fibrillation in Patients Undergoing Off-Pump Coronary Artery Bypass
Grafting.
Source
Annals of Cardiac Anaesthesia. 28(3) (pp 273-279), 2025. Date of
Publication: 01 Jul 2025.
Author
George R.; Rajmohan N.; Lobo R.P.; Nair S.G.; Govind L.J.; Menon L.P.
Institution
(George, Rajmohan, Lobo, Nair, Govind, Menon) Department of
Anaesthesiology and Critical Care, Aster Medcity, Kerala, Kochi, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Introduction: Postoperative atrial fibrillation (POAF), which occurs in
almost 20-40% of cardiac surgeries, is associated with life-threatening
complications. Serum hypomagnesemia, a frequent finding after cardiac
surgeries, is a predictor for POAF. In this study, we investigated the
effect of continuous magnesium infusion to prevent POAF in patients
undergoing off-pump coronary artery bypass grafting (OP-CABG).
 Material(s) and Method(s): A prospective, randomized controlled study
was conducted on 110 patients undergoing OP-CABG. Patients were classified
into two groups after reaching the intensive care unit (ICU). Group M was
started on magnesium (Mg) infusion at 750 mg/h for 3 days after an initial
bolus dose of 1.5 g of magnesium sulfate, to target a serum magnesium
level of 1.5 to 2 mmol/L. The control group (Group C) did not receive any
infusion. The incidence of POAF, magnesium values, duration of ICU stay,
number of patients who required pharmacotherapy and cardioversion, and
maximum vasoactive-inotropic score (VIS max) were recorded. A P <.05 was
taken as statistically significant. Result(s): 104 patients were
analyzed. The incidence of POAF (19.2% vs 1.9%, P = .008) and the number
of patients requiring pharmacotherapy other than magnesium (15.4% vs 1.9%,
P = .0310) were significantly higher in group C. Mean of peak magnesium
values (1.624 +/- 0.136 vs 0.710 +/- 0.147, P < .001) was significantly
higher in Group M. The number of patients requiring cardioversion (P =
.618), duration of ICU stay (P = .121), and the VIS max (P = .360) were
not significantly different between groups. Conclusion(s):
Postoperative continuous magnesium infusion after a bolus was effective in
preventing POAF in patients undergoing OP-CABG by maintaining serum
magnesium levels (1.5-2 mmol/). Copyright © 2025 Annals of
Cardiac Anaesthesia.

<92>
Accession Number
2039566352
Title
Impact of red blood cell transfusion on patient's quality of life: a
comprehensive narrative review.
Source
Annals of Blood. 10 (no pagination), 2025. Article Number: 11. Date of
Publication: 30 Jun 2025.
Author
Gupta G.K.; Patidar G.; Perez-Carrillo J.; Sromoski M.; Nair A.; Gammon
R.; Otrock Z.K.
Institution
(Gupta) Department of Pathology and Laboratory Medicine, Memorial Sloan
Kettering Cancer Center, New York, NY, United States
(Patidar) Department of Transfusion Medicine, All India Institute of
Medical Sciences, New Delhi, India
(Perez-Carrillo) Banco de Sangre, Laboratorio Clinico, Clinica Colsanitas,
D.C., Bogota, Colombia
(Perez-Carrillo) Estudiante de Doctorado, Doctorado en Enfermedades
Infecciosas, Universidad de Santander, Bucaramanga, Colombia
(Sromoski) Patient Blood Management, Center for Bloodless Medicine,
Danville, PA, United States
(Nair) Department of Transfusion Medicine, Sree Chitra Tirunal Institute
for Medical Sciences and Technology, Kerala, Thiruvananthapuram, India
(Gammon) Pathology Department, Moffitt Cancer Center, Tampa, FL, United
States
(Otrock) Division of Laboratory Medicine, Diagnostic Institute, Cleveland
Clinic, Cleveland, OH, United States
Publisher
AME Publishing Company
Abstract
Background and Objective: Red blood cell (RBC) transfusion is a key
intervention for managing anemia across various patient populations, with
the primary aim of alleviating symptoms such as fatigue and dyspnea to
enhance quality of life (QoL). Despite its widespread use, the effect of
RBC transfusion on QoL is not fully understood and appears to vary across
populations, depending on factors such as transfusion strategy, baseline
hemoglobin (Hgb) level, comorbidities, and disease context. Importantly,
existing studies often focus on short-term physiological outcomes, leaving
a gap in the understanding of long-term and patient-reported QoL benefits.
This narrative review aims to synthesize current evidence on the impact of
RBC transfusion on QoL in patient populations that frequently require
transfusion support, including those undergoing cardiac or hip surgery,
patients with sickle cell disease (SCD) or thalassemia, and individuals
with hematologic malignancies, gastrointestinal (GI) bleeding, postpartum
hemorrhage (PPH), and critically-ill patients-highlighting key knowledge
gaps and informing future research and clinical practice. Method(s):
A comprehensive literature search was conducted in PubMed, covering
English language studies published between 2000 and 2024, including
randomized controlled trials, observational studies, and reviews. Key
Content and Findings: This review summarizes current evidence on the
impact of RBC transfusion on QoL in patients that frequently require
transfusion support. In surgical settings, restrictive transfusion
strategies often yield comparable outcomes to liberal approaches. For
patients with chronic transfusion needs, such as those with thalassemia or
SCD, QoL outcomes are influenced by underlying disease severity and
transfusion-related complications. The review highlights the need for
standardized QoL measures and longer-term studies to clarify the true
impact of RBC transfusion on patient-centered outcomes.
 Conclusion(s): This review provides a comprehensive synthesis of
current evidence on the impact of RBC transfusion on QoL, offering
valuable insights to inform more patient-centered transfusion practices.
By identifying key knowledge gaps-particularly the lack of standardized
QoL measures and long-term outcome data-it lays the groundwork for future
research aimed at refining transfusion strategies and improving clinical
decision-making across diverse patient populations. Copyright ©
AME Publishing Company.

<93>
Accession Number
2039599399
Title
Valve in valve transcatheter versus redo surgical replacement of a failing
surgical bioprosthetic aortic valve: An updated systematic review and
meta-analysis.
Source
Journal of Cardiology. (no pagination), 2025. Date of Publication: 2025.
Author
Dimitriadis K.; Pyrpyris N.; Aznaouridis K.; Soulaidopoulos S.;
Koutsopoulos G.; Beneki E.; Tatakis F.; Adamopoulou E.; Tsioufis P.;
DeBiase C.; Milasinovic D.; De Backer O.; Vanhaverbeke M.; Aggeli K.;
Tsioufis K.
Institution
(Dimitriadis, Pyrpyris, Aznaouridis, Soulaidopoulos, Koutsopoulos, Beneki,
Tatakis, Adamopoulou, Tsioufis, Aggeli, Tsioufis) First Department of
Cardiology, School of Medicine, National and Kapodistrian University of
Athens, Hippokration General Hospital, Athens, Greece
(DeBiase) Clinique Pasteur, Toulouse, France
(Milasinovic) Department of Cardiology, University Clinical Center of
Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
(De Backer) The Heart Centre, Rigshospitalet, Copenhagen University
Hospital, Copenhagen, Denmark
(Vanhaverbeke) Department of Cardiology, AZ Delta, Roeselare, Belgium
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background: With the aging population, degeneration of surgical aortic
valves is an important clinical scenario. Currently, in most European
countries, both redo surgery [redo-surgical aortic valve replacement
(SAVR)] and valve-in-valve transcatheter aortic valve implantation
(ViV-TAVI) are established alternatives for treating such patients. This
meta-analysis aims to compare redo-SAVR and ViV-TAVI for treating a
failing bioprosthetic aortic valve. Method(s): A systematic search
was performed from inception to June 2023. After selecting all appropriate
trials according to the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses guidelines, a random effect meta-analysis was performed.
Clinical and echocardiographic outcomes were compared among the groups.
 Result(s): Twenty-six studies with a total of population of 17,581
patients were included [ViV-TAVI (n = 9163) or redo-SAVR (n = 8418].
ViV-TAVI was associated with lower 30-day mortality (RR: 0.55; 95%CI: 0,47
to 0,66) and 1-year mortality (RR: 0.85; 95%CI: 0.75 to 0.96), major
bleeding events (RR: 0.58; 95%CI: 0.42-0.79), and a trend towards lower
new pacemaker implantations (RR: 0.70; 95%CI: 0.49-1.01) at 30 days. On
the other hand, ViV-TAVI resulted in a higher mean transprosthetic
gradient and higher rates of severe patient-prosthesis mismatch (RR: 1.64;
95%CI: 1.01 to 2.65) and paravalvular leak (RR: 2.44; 95%CI: 1.73-3.45) as
compared to redo-SAVR. No significant difference was observed in 30-day
myocardial infarction (RR: 0.90; 95%CI: 0.56 to 1.46) or stroke (RR: 0.77;
95%CI:0.55 to 1.06). Conclusion(s): ViV-TAVI has a satisfying safety
profile with better short-term survival outcomes as compared to redo-SAVR.
However, adequate pre-procedural planning of VIV-TAVI cases is needed, in
order to minimize the risk of a suboptimal hemodynamic outcomes following
ViV-TAVI. Copyright © 2025 The Authors

<94>
Accession Number
2039556028
Title
A Comparative Study of the Efficacy and Safety Profile of Topical
Application of Tranexamic Acid in the Form of Mist to Reduce Postoperative
Bleeding in on-Pump CABG Procedures.
Source
Annals of Cardiac Anaesthesia. 28(3) (pp 287-291), 2025. Date of
Publication: 01 Jul 2025.
Author
Jagadish C.; Kumara V.; Aspari M.A.; Guruprasad Rai D.; Sumanth R.
Institution
(Jagadish, Kumara, Aspari) Department of Anesthesiology, Kasturba Medical
College, Manipal Academy of Higher Education, Karnataka, Manipal, India
(Guruprasad Rai, Sumanth) Department of Cardiothoracic and Vascular
Surgery, Kasturba Medical College, Manipal Academy of Higher Education,
Karnataka, Manipal, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Postoperative bleeding is a major concern in cardiovascular
surgery, leading to an increased need for blood transfusions and a longer
hospital stay. Between 30% and 70% of open-heart surgery patients will
require blood product transfusion. The use of the cardiopulmonary bypass
machine (CPB) often leads to bleeding due to complement activation,
platelet activation, and hyperfibrinolysis. Antifibrinolytic drugs, like
-aminocaproic acid, aprotinin, and tranexamic acid (TXA) are used to
decrease postoperative bleeding in cardiac surgery. According to the
Society of Thoracic Surgeons guidelines, TXA is class I recommendation to
reduce the risk of bleeding. Aim(s): Compare the efficacy and safety
of TXA in the mist form to reduce postoperative bleeding. Settings and
Design: Prospective, Randomized, Single-Centre, Interventional Study.
 Material(s) and Method(s): The study included sixty participants
undergoing on-pump CABG randomized into two groups. Group T and Group C
received topical TXA and 20 mL NS in mist form, respectively. The mist was
blown over the pericardium, LIMA bed, and sternotomy sites before chest
closure. The primary objectives were to compare the 48 th hour drain
collection and need for blood transfusion. Statistical Analysis Used:
Simple t-test, Chi-square test and Mann-Whitney U test. Result(s):
The experimental group had significantly less 48-hour drain (P value
0.001), reduced need of blood and blood products (P value 0.001) and less
duration of postoperative ventilation (P value 0.001). Conclusion(s):
The topical application of TXA in mist form significantly reduced
postoperative bleeding, the necessity for blood transfusion, and the
duration of mechanical ventilation in on-pump CABG
procedures. Copyright © 2025 Annals of Cardiac Anaesthesia.

<95>
Accession Number
2039555824
Title
The Role of Acetaminophen Use in Acute Kidney Injury Prevention in Cardiac
Surgery: A Systematic Review and Meta-Analysis.
Source
Annals of Cardiac Anaesthesia. 28(3) (pp 238-247), 2025. Date of
Publication: 01 Jul 2025.
Author
Ciconini L.E.; Perim V.; Beck T.; Carbonar M.F.; Ejikem M.M.; Zaky A.;
Neyra J.; Gosling A.F.
Institution
(Ciconini, Beck, Carbonar, Ejikem) Department of Anesthesiology, SUNY
Downstate, NY, United States
(Perim) Department of Surgery, University of Alabama, Birmingham, United
States
(Zaky) Division of Cardiothoracic and Critical Care Anesthesiology,
University of Alabama, Birmingham, United States
(Neyra) Department of Medicine, Division of Nephrology, University of
Alabama, Birmingham, United States
(Gosling) Department of Anesthesiology and Perioperative Medicine,
Division of Cardiothoracic Anesthesia and Critical Care, University of
Alabama, Birmingham, United States
Publisher
Wolters Kluwer Medknow Publications
Abstract
Acute kidney injury (AKI) is a common complication following cardiac
surgery, often leading to increased morbidity and mortality. Despite its
prevalence, the role of acetaminophen in preventing AKI after cardiac
surgery remains uncertain. This meta-analysis sought to clarify whether
perioperative administration of acetaminophen could reduce the risk of
postoperative AKI in adult patients undergoing cardiac procedures. To
address this question, a systematic review and meta-analysis were
performed by searching the MEDLINE, Cochrane, and Embase databases.
Studies comparing the effects of perioperative acetaminophen to those of
no acetaminophen in adult cardiac surgery patients were evaluated, with
risk of bias assessed for each study. Sensitivity analyses were also
conducted to strengthen the reliability of the findings. In total, 13
studies, including nine randomized controlled trials and four
observational studies, involving 11,583 patients, were analyzed. The
results showed that acetaminophen administration was associated with a
lower incidence of AKI [OR 0.62 (95% CI 0.40-0.97), P = 0.04].
Additionally, acetaminophen use was linked to reduced in-hospital
mortality, delirium rates, and shorter ICU stays, though it had no
significant effect on overall hospital length of stay. These findings
suggest that perioperative acetaminophen administration may play a
protective role in reducing both AKI incidence and in-hospital mortality
in patients undergoing cardiac surgery. Until large multicenter randomized
controlled trials confirm these results, acetaminophen may still be
considered as a preventive measure for patients both before
cardiopulmonary bypass initiation and in the postoperative
period. Copyright © 2025 Annals of Cardiac Anaesthesia.

<96>
Accession Number
2039603414
Title
Valve Underexpansion and Clinical Outcomes With ACURATE neo2: Findings
From the ACURATE IDE Trial.
Source
Journal of the American College of Cardiology. 86(4) (pp 225-238), 2025.
Date of Publication: 29 Jul 2025.
Author
Makkar R.R.; Chakravarty T.; Gupta A.; Soliman O.; Gnall E.; Ramana R.K.;
Ramlawi B.; Diamantouros P.; Potluri S.; Kleiman N.S.; Samy S.; Rassi A.;
Yadav P.; Thourani V.; Yakubov S.; Frawley C.; Patel D.; Kapadia S.;
Chalekian A.; Modolo R.; Sathananthan J.; Kim W.-K.; Reardon M.J.
Institution
(Makkar, Chakravarty, Gupta, Patel) Cedars-Sinai Medical Center, Los
Angeles, CA, United States
(Soliman) Department of Cardiology and Cardiovascular Research Institute
(CVRI) Dublin, Mater Private Network, Dublin, Ireland
(Soliman) School of Medicine, RCSI University of Medicine and Health
Sciences, Dublin, Ireland
(Gnall, Ramlawi) Lankenau Hospital, Wynnewood, PA, United States
(Ramana) Heart Care Centers of Illinois and Advocate Christ Medical
Center, Palos Park, IL, United States
(Diamantouros) London Health Sciences Centre, London, ON, Canada
(Potluri) Baylor Scott & White The Heart Hospital-Plano, Plano, TX, United
States
(Kleiman, Reardon) Houston Methodist Hospital, Houston, TX, United States
(Samy) Albany Medical Center, Albany, NY, United States
(Rassi) Kaiser Permanente, San Francisco, CA, United States
(Yadav, Thourani) Piedmont Hospital, Atlanta, GA, United States
(Yakubov) OhioHealth Research and Innovation Institute-Riverside Methodist
Hospital, Columbus, OH, United States
(Frawley, Chalekian, Modolo, Sathananthan) Boston Scientific Corporation,
Marlborough, MA, United States
(Kapadia) Cleveland Clinic Foundation, Cleveland, OH, United States
(Kim) Justus-Liebig University of Giessen, Giessen, Germany
Publisher
Elsevier Inc.
Abstract
Background: In the ACURATE IDE (Safety and Effectiveness Study of ACURATE
Valve for Transcatheter Aortic Valve Replacement) randomized controlled
trial, ACURATE neo2 failed to show noninferiority to commercially
available balloon-expandable (SAPIEN 3/3 Ultra) and self-expanding (Evolut
R/PRO/PRO+/FX) valves for the primary endpoint of all-cause mortality,
stroke, or rehospitalization at 1 year. A retrospective investigation was
undertaken to evaluate potential factors contributing to these outcomes.
 Objective(s): The goal of this study was to assess the impact of
ACURATE neo2 valve expansion on clinical outcomes in the ACURATE IDE
trial. Method(s): Post hoc case review identified angulated
(nonparallel) commissure posts in a few implanted ACURATE neo2 valves,
indicating valve underexpansion. Procedural angiograms for all ACURATE
neo2 valves implanted in the trial's main randomized cohort (n = 752) were
inspected by an independent core laboratory. An exploratory analysis was
performed to evaluate the association between valve expansion and clinical
outcomes. Result(s): Of the 624 patients who underwent implantation
with the ACURATE neo2 and had evaluable procedural angiograms, 135 (21.6%)
had underexpanded valves. Greater aortic valve leaflet and annulus
calcification at baseline was independently associated with ACURATE neo2
valve underexpansion (OR: 1.92; 95% CI: 1.27-2.91; P = 0.002). Procedural
techniques, including frequency of predilation (100% in both groups) and
postdilation (26.7% vs 25.2%; P = 0.72), and balloon sizing did not differ
between the underexpanded and expanded valve groups. ACURATE neo2
underexpansion was associated with a higher 1-year rate of death, stroke,
or rehospitalization (underexpanded: 18.7%; expanded: 11.8%; P = 0.04),
which was confirmed in a multivariable analysis (HR: 1.92; 95% CI:
1.27-2.91; P = 0.002). Conclusion(s): Underexpansion of the ACURATE
neo2 valve in the ACURATE IDE study was associated with a higher risk of
the composite endpoint of death, stroke, or rehospitalization. Given the
post hoc nature of these analyses, the study findings should be considered
hypothesis generating. Whether achieving optimal valve expansion of the
ACURATE neo2 valve with improvement in device design and procedural
iterations will translate into improved clinical outcomes remains to be
studied. Copyright © 2025 American College of Cardiology
Foundation

<97>
Accession Number
2039597528
Title
Improving Repair Durability in Severe Ischemic Mitral Regurgitation:
Revisiting Patient Selection and Adjunctive Repair Techniques.
Source
Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2025.
Date of Publication: 2025.
Author
Li R.; Hu M.; Fang J.; Wei X.; Wan S.
Institution
(Li, Hu, Fang, Wei, Wan) Division of Cardiovascular Surgery, Department of
Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of
Science and Technology, Wuhan, China
Publisher
W.B. Saunders
Abstract
Ischemic mitral regurgitation (IMR) is a complex heterogeneous
complication following myocardial infarction, characterized by left
ventricular (LV) remodeling and subsequent valvular distortion. The
primary mechanisms include papillary muscle displacement, mitral leaflet
tethering, and impaired coaptation following annular dilatation. IMR is
associated with poor prognosis and an increased incidence of heart
failure. We reviewed studies on the surgical management of IMR published
over the past 2 decades. While mitral valve repair has been favored for
its advantages of low perioperative mortality and LV function
preservation, high rates of mitral regurgitation recurrence limit its
long-term durability. Regarding repair strategy, apart from restrictive
mitral annuloplasty, the adjunctive techniques of papillary muscle
relocation, papillary muscle approximation, and leaflet augmentation have
been proposed. These approaches aim to address LV remodeling and improve
leaflet coaptation by mitigating subvalvular tethering. Moreover, the
application of true-size annuloplasty and "functional repair" strategies
in IMR patients with enlarged LV emphasizes the need to tailor
interventions to patients' LV dimensions and dynamic changes. Accumulating
clinical evidence highlights the importance of meticulous patient
selection and functional mitral valve repair, which remains a promising
approach contingent on enhanced understanding of IMR's pathophysiology and
its interplay with LV remodeling. The current review summarizes our
patient selection criteria and indications for surgical repair (including
the use of adjunctive techniques of subvalvular intervention) or mitral
valve replacement. Copyright © 2025 Elsevier Inc.

<98>
Accession Number
2039556033
Title
Intravenous Levosimendan versus Milrinone: Coronary Sinus Lactate and PA
Catheter Derived Parameters in Patients with Pulmonary Hypertension
Undergoing Elective Mitral Valve Replacement.
Source
Annals of Cardiac Anaesthesia. 28(3) (pp 298-304), 2025. Date of
Publication: 01 Jul 2025.
Author
Virmani S.; Garg S.; Malik I.; Dash A.C.; Naqvi S.E.H.; Wadhwa R.; Singh
H.
Institution
(Virmani, Garg, Wadhwa) Department of Anaesthesiology and Intensive Care,
G B Pant Institute of Postgraduate Medical Education and Research, New
Delhi, India
(Malik) Department of Cardiac Anaesthesia, PGIMS Rohtak, Haryana, India
(Dash) Department of Cardiac Anaesthesiology andIntensive Care, Manipal
Hospital, New Delhi, Dwarka, India
(Naqvi, Singh) Department of Cardiothoracic Surgery, G B Pant Institute of
Postgraduate Medical Education and Research, New Delhi, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Coronary sinus (CS) lactate level has been shown to
corroborate with changes in myocardial metabolism induced by ischaemia and
reperfusion, and hence can be used to indicate the effect on myocardial
metabolism. In patients with mitral stenosis (MS) undergoing valvuloplasty
or valve replacement, presence of severe pulmonary hypertension (PH),
indicates advanced disease state and development of right ventricular (RV)
failure, an important hallmark of bad prognosis. Levosimendan and
milrinone are increasingly being used as inodilators to treat PH and
improve RV function to varying degrees, but their effect on myocardial
metabolism awaits precise validation. Method(s): Thirty patients were
randomized into two groups of 15 patients each. Group L (received
levosimendan) and Group M (received milrinone). All the patients received
fentanyl (8-10 mug/kg), rocuronium bromide 0.8 mg/Kg for induction and
maintenance of anaesthesia. In addition to the routine intravenous and
invasive arterial access, a Cavafix (Certo 257, 45 cm, B Braun Melsungen
AG, Germany) was inserted via right IJV and positioned in the right atrium
(RA) to be later re-positioned in the CS before coming off cardiopulmonary
bypass (CPB), to obtain blood samples for measuring the CS lactate levels
postoperatively. At the commencement of rewarming, group L received
levosimendan 10 mu/kg bolus over 10 min, followed by an infusion (0.1
mu/kg/min) and group M received 50 mug/kg bolus over 10 min, followed by
infusion (0.5 mug/kg/min), till 24 hours post-operatively. CS lactate,
heart rate (HR), mean arterial pressure (MAP) and PA catheter derived data
[Cardiac index (CI), cardiac output (CO), PA pressure, systemic and
pulmonary vascular resistance indices (SVRI/PVRI)] and mixed venous oxygen
saturations (SvO2) were recorded at predetermined time points.
 Result(s): In both the groups the CS lactate levels increased
gradually till 6 hours after surgery followed by a decrease at 24 hours.
Comparison of CS lactate between the two groups revealed that the CS
lactate levels were significantly lower in group L at various time points
till 24 hours after surgery with a P value of < 0.05. HR and MAP were
comparable in both the groups at all time points. MAP was significantly
lower in the two groups, both after induction of anaesthesia and after
CPB. 7 patients in group M (46.7%) developed hypotension (MAP decreased by
> 20% of baseline) that was treated with norepinephrine. CO increased
significantly in both group M and group L, post CPB 10 min after surgery.
Patients in group L had a significantly higher CO and CI, compared to
group M, P < 0.05. PAP was significantly reduced compared to baseline
values after valve replacement in both the groups being lower in group L
compared to group M, but the difference was statistically not significant.
After valve replacement, SVRI decreased significantly in both the group
the decrease being significantly more in group L (P < 0.05).
 Conclusion(s): This study revealed that, in comparison to milrinone,
levosimendan was associated with comparable reduction in systolic and mean
pulmonary artery pressure, lesser incidence of hypotension, lesser
requirement of inotropic support and better myocardial
performance. Copyright © 2025 Annals of Cardiac Anaesthesia.

<99>
Accession Number
647828547
Title
Sentinel Cerebral Embolic Protection During Transcatheter Aortic Valve
Replacement: An Updated Meta-Analysis.
Source
JACC. Cardiovascular interventions. (no pagination), 2025. Date of
Publication: 17 Jun 2025.
Author
Goel S.; Khera S.; Krishnamoorthy P.; Hooda A.; Lerakis S.; Safi L.M.;
Kini A.S.; Sharma S.K.; Dangas G.D.; Tang G.H.L.
Institution
(Goel) Division of Cardiology, The Zena and Michael A. Wiener
Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New
York, New York; Division of Cardiology, Mount Sinai South Nassau,
Oceanside, New York
(Khera, Krishnamoorthy, Hooda, Lerakis, Safi, Kini, Sharma, Dangas)
Division of Cardiology, Zena and Michael A. Wiener Cardiovascular
Institute, Icahn School of Medicine at Mount Sinai, NY, United States
(Tang) Division of Cardiology, The Zena and Michael A. Wiener
Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New
York, New York; Department of Cardiovascular Surgery, Mount Sinai Health
System, New York, New York

<100>
Accession Number
2039501954
Title
Pig Models in Translational Surgery.
Source
European Surgical Research. 66(1) (pp 50-58), 2025. Date of Publication:
02 May 2025.
Author
Goutchtat R.; Beguier A.; Kasal-Hoc N.; Guerreschi P.; Fayoux P.; Rancan
L.; Pattou F.; Hubert T.
Institution
(Goutchtat) IMRB, Inserm, Universite Paris Est Creteil, Creteil, France
(Goutchtat) IMRB, AfterROSC Network, Ecole Nationale Veterinaire d'Alfort,
Maisons-Alfort, France
(Beguier, Pattou, Hubert) U1190 Translational Research for Diabetes,
Inserm, Institut Pasteur Lille, CHU Lille, University of Lille, Lille,
France
(Beguier) CNRS, INCIA, UMR 5287, Universite de Bordeaux, Bordeaux, France
(Kasal-Hoc) UE-1277-PFIE, INRAE, Centre Val de Loire, Nouzilly, France
(Guerreschi) Department of Plastic and Reconstructive Surgery Lille, CHU
Lille, Lille, France
(Guerreschi) Reference Center Rare Diseases, Clefts and Facial
Malformations Lille, Lille, France
(Fayoux) Department of Pediatric Otolaryngology-Head and Neck Surgery,
Jeanne de Flandre Hospital, CHU Lille, Lille, France
(Rancan) Department of Biochemistry and Molecular Biology, Faculty of
Medicine, Complutense University of Madrid, Madrid, Spain
(Hubert) Departement Hospitalo-Universitaire de Recherche et
d'Enseignement (Dhure), CHU Lille, University of Lille, Lille, France
Publisher
S. Karger AG
Abstract
Background: Because rodents are too small to perform surgical procedures
on people, large mammals are fre quently required for surgical studies.
Because of its similar overall anatomy and physiology, the pig has a very
high translational value and is thus frequently used as the first choice
in surgical research. Summary: In cardiovascular treatments, it
helped design stents, improve coronary bypass grafting, and perform heart
valve xenotransplants. Future efforts will be concentrated on improving
the models and, as a result, the trustworthiness of the pre clinical
findings. Pigs have been used in gastro-intestinal surgery for a variety
of purposes, including the development of meshes for abdominal defect
repair and the enhancement of surgical methods aimed at compensating
functional impairments. A special application has been made in liver
regeneration and transplantation procedures, which have promising future
prospects, as well as in metabolic surgical research for metabolic illness
interventional treatment. Pigs have mostly been used in endocrine surgery
to develop pancreatic and islets transplantation for type 1 diabetes
therapy, with little research on the other glands. Osteoarticular and
neurosurgery are two fields where the pig is increasingly being used: for
ethical reasons rather than non-human primate models in neurosurgery, and
because this species' rapid growth allows for the testing of the
biomechanical properties of orthopedic devices in the context of skeletal
growth. In general, the pig has a current and future role in testing novel
surgical equipment or bioengineering solutions, establishing new minimally
invasive techniques, and training in robotic surgery, regardless of
discipline. Finally, pig-to-human organ xenotransplantation poses a
significant translational surgical hurdle. If the research has reached a
milestone with some alive patients receiving heart or kidney transplants
from pigs with various genetic alterations, more evidence is needed to
demonstrate the safety and long-term effectiveness of the procedure, as
well as to expand it to other organs such as the liver. Key Messages: In
conclusion, the pig model has resulted in significant breakthroughs in
surgical research, with future prospects centered mostly on
xenotransplantation. The use of the pig in biomedical research will have
to deal with rising societal ethical standards. Copyright © 2025
The Author(s).

<101>
Accession Number
2039388466
Title
Routine Cerebral Embolic Protection during Transcatheter Aortic-Valve
Implantation.
Source
New England Journal of Medicine. 392(24) (pp 2403-2412), 2025. Date of
Publication: 26 Jun 2025.
Author
Kharbanda R.K.; Kennedy J.; Jamal Z.; Dodd M.; Evans R.; Bal K.K.; Perkins
A.D.; Blackman D.J.; Hildick-Smith D.; Banning A.P.; Baumbach A.; Ludman
P.; Palmer S.; Stables R.H.; Henderson R.; Appleby C.; Cotton J.; Curzen
N.; Ozkor M.; Byrne J.; Aggarwal R.; Das R.; Doshi S.; Watkins S.; Muir
D.F.; Anderson R.; Chowdhary S.; Varcoe R.; Dorman S.; Firoozi S.;
Chelliah R.; Owens C.; Redwood S.; Prendergast B.; Iqbal J.; Ratib K.;
Dospinescu C.; Suresh V.; Cruden N.; Rajathurai T.; Malik I.S.; Wiper A.;
Costopoulos C.; Khurana A.; Banning A.; Clayton T.
Institution
(Kharbanda) Department of Cardiovascular Medicine, John Radcliffe
Hospital, Oxford, United Kingdom
(Kennedy) Acute Multidisciplinary Imaging and Interventional Centre,
Radcliffe Department of Medicine, University of Oxford, Oxford, United
Kingdom
(Kharbanda) Oxford Biomedical Research Centre, Oxford, United Kingdom
(Jamal, Dodd, Evans, Bal, Perkins, Clayton) Clinical Trials Unit, London
School of Hygiene and Tropical Medicine, London, United Kingdom
(Blackman) United Kingdom, University of Leeds, Leeds Teaching Hospitals
NHS Trust, Leeds, United Kingdom
(Hildick-Smith) Sussex Cardiac Centre, University Hospitals Sussex,
Brighton, United Kingdom
(Banning) Oxford University Hospitals NHS Foundation Trust, Oxford, United
Kingdom
(Baumbach) William Harvey Research Institute, Centre for Cardiovascular
Medicine and Devices, Queen Mary University of London, London, United
Kingdom
(Baumbach, Ozkor) Barts Heart Centre, Barts Health NHS Trust, London,
United Kingdom
(Baumbach, Prendergast) Cleveland Clinic London, London, United Kingdom
(Ludman, Doshi) Institute of Cardiovascular Sciences, University of
Birmingham, Birmingham, United Kingdom
(Palmer) Centre for Health Economics, University of York, York, United
Kingdom
(Stables, Appleby) Liverpool Heart and Chest Hospital, Liverpool, United
Kingdom
(Stables) University of Liverpool, Liverpool, United Kingdom
(Henderson, Varcoe) Nottingham University Hospitals NHS Trust, Nottingham,
United Kingdom
(Cotton) Heart and Lung Centre, New Cross Hospital, Wolverhampton, United
Kingdom
(Cotton) University of Wolverhampton, Wolverhampton, United Kingdom
(Curzen) Faculty of Medicine, University of Southampton and University
Hospital Southampton, Southampton, United Kingdom
(Byrne) King's College Hospital Foundation Trust, London, United Kingdom
(Aggarwal) Essex Cardiothoracic Centre, Basildon, United Kingdom
(Das) Cardiothoracic Unit, Freeman Hospital, Newcastle upon Tyne, United
Kingdom
(Doshi) University College Birmingham, Birmingham, United Kingdom
(Watkins) Golden Jubilee University National Hospital, Dalmuir, United
Kingdom
(Watkins) University of Glasgow, Glasgow, United Kingdom
(Muir) James Cook University Hospital, Middlesbrough, United Kingdom
(Anderson) University Hospital of Wales, Cardiff, United Kingdom
(Chowdhary) Manchester Academic Health Sciences Unit, Wythenshawe
Hospital, Manchester, United Kingdom
(Dorman) Bristol Heart Institute, Bristol, United Kingdom
(Firoozi) St. George's Hospital University Foundation Trust, London,
United Kingdom
(Chelliah) Castle Hill Hospital, Cottingham, United Kingdom
(Owens) Royal Victoria Hospital, Belfast, United Kingdom
(Redwood) St. Thomas' Hospital, London, United Kingdom
(Iqbal) Sheffield Teaching Hospitals NHS Foundation Trust, University of
Sheffield, Sheffield, United Kingdom
(Ratib) Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
(Dospinescu) Aberdeen Royal Infirmary, Aberdeen, United Kingdom
(Suresh) University Hospitals Plymouth, Plymouth, United Kingdom
(Cruden) Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
(Rajathurai) University Hospital Coventry and Warwickshire NHS Trust,
Coventry, United Kingdom
(Rajathurai) University of Warwick, Warwick, United Kingdom
(Malik) Imperial College Healthcare NHS Trust, Hammersmith Hospital,
London, United Kingdom
(Wiper) Lancashire Cardiac Centre, Blackpool Victoria Hospital, Blackpool,
United Kingdom
(Costopoulos) Royal Papworth Hospital, Cambridge, United Kingdom
(Khurana) Swansea Bay University Health Board, Swansea, United Kingdom
(Banning) Leicester Cardiovascular Biomedical Research Centre, Glenfield
Hospital, University Hospitals of Leicester NHS Trust, Leicester, United
Kingdom
Publisher
Massachussetts Medical Society
Abstract
Background Transcatheter aortic-valve implantation (TAVI) is associated
with procedure-related stroke. Cerebral embolic protection (CEP) devices
may reduce embolization to the cerebral circulation and hence the
incidence of stroke. Methods We conducted a randomized, controlled trial
across 33 centers in the United Kingdom. We randomly assigned 7635
participants with aortic stenosis in a 1:1 ratio to undergo TAVI with a
CEP device (CEP group) or TAVI without a CEP device (control group). The
primary outcome was stroke within 72 hours after TAVI or before discharge
from the hospital (if discharge occurred sooner). Results A total of 3815
participants were assigned to the CEP group and 3820 to the control group.
A primary-outcome event occurred in 81 of 3795 participants (2.1%) in the
CEP group and in 82 of 3799 participants (2.2%) in the control group
(difference, -0.02 percentage points; 95% confidence interval, -0.68 to
0.63; P=0.94). Disabling stroke occurred in 47 participants (1.2%) in the
CEP group and in 53 (1.4%) in the control group. Death occurred in 29
participants (0.8%) in the CEP group and in 26 (0.7%) in the control
group. Overall access-site complications appeared to be similar in the two
groups (8.1% in the CEP group and 7.7% in the control group). A total of
24 serious adverse events occurred in 22 of 3798 participants (0.6%) in
the CEP group, and 13 serious adverse events occurred in 13 of 3803
participants (0.3%) in the control group. Conclusions Among participants
undergoing TAVI, routine use of CEP did not decrease the incidence of
stroke within 72 hours. Copyright © 2025 Massachusetts Medical
Society.

<102>
Accession Number
2039541225
Title
Long-term trials of colchicine for secondary prevention of vascular
events: a meta-analysis.
Source
European Heart Journal. 46(26) (pp 2552-2563), 2025. Date of Publication:
07 Jul 2025.
Author
Samuel M.; Berry C.; Dube M.-P.; Koenig W.; Lopez-Sendon J.; Maggioni
A.P.; Pinto F.J.; Roubille F.; Tardif J.-C.
Institution
(Samuel) University Medical Center Groningen, University of Groningen,
Groningen, Netherlands
(Samuel) Dalhousie University, Halifax, Canada
(Berry) School of Cardiovascular and Metabolic Health, University of
Glasgow, Golden Jubilee National Hospital, Clydebank, United Kingdom
(Dube, Tardif) Montreal Heart Institute, Universite de Montreal, 5000
Belanger Street, Montreal, QC, Canada
(Koenig) Technical University of Munich, School of Medicine and Health,
German Heart Centre, TUM University Hospital, Munich, Germany
(Koenig) German Centre for Cardiovascular Research (DZHK), Partner site
Munich Heart Alliance, Munich, Germany
(Koenig) Institute of Epidemiology and Medical Biometry, University of
Ulm, Ulm, Germany
(Lopez-Sendon) IdiPaz Research Institute, Hospital La Paz, Universidad
Autonoma de Madrid, Madrid, Spain
(Maggioni) ANMCO Research Center-Heart Care Foundation, Florence, Italy
(Pinto) Santa Maria University Hospital, ULSSM, Center of Cardiology,
University of Lisbon, Lisbon School of Medicine, Lisbon Academic Medical
Center, Lisboa, Portugal
(Roubille) PhyMedExp, Cardiology Department, University of Montpellier,
INSERM, CNRS UMR, INI-CRT, Montpellier, France
Publisher
Oxford University Press
Abstract
Background and Aims Colchicine has emerged as a safe and inexpensive
anti-inflammatory medication to target the residual risk of cardiovascular
events in the secondary prevention of coronary artery disease. Two
recently published randomized controlled trials (RCTs) investigating
colchicine in the post-stroke and post-myocardial infarction (MI)
populations warrant a re-evaluation of colchicine. New evidence was
synthesized in a systematic review and meta-analysis to determine the
long-term efficacy and safety of colchicine for the secondary prevention
of vascular disease. Methods Randomized controlled trials comparing the
incidence of cardiovascular events between patients with clinically
manifest vascular disease randomized to colchicine vs. placebo and
>=12-month follow-up were included. The primary efficacy endpoint is major
adverse cardiovascular events (MACE) and includes cardiovascular
mortality, MI, ischaemic stroke, and urgent coronary revascularization.
The DerSimonian and Laird random effects model was used to calculate
pooled effect estimates. Results Six RCTs, with a pooled sample size of 21
800 patients, were included (colchicine n = 10 871; placebo n = 10 929).
Over a follow-up of 12-34 months, colchicine reduced the incidence of MACE
compared with placebo [pooled hazard ratio. 75, 95% confidence interval
(CI). 56-.93]. The reduction in cardiovascular events among colchicine
patients was driven by reductions in MIs, ischaemic strokes, and urgent
coronary revascularizations (P <. 05 for all). No differences were
detected for safety outcomes (P >. 05 for all), including
non-cardiovascular deaths (risk ratio 1.08, 95% CI. 76-1.54). Conclusions
This updated meta-analysis of RCTs demonstrated a substantial reduction in
MACE, MI, ischaemic stroke, and recurrent coronary revascularization with
colchicine compared with placebo. Therefore, the results support the use
of colchicine to reduce recurrent cardiovascular events. Copyright
© 2025 The Author(s). Published by Oxford University Press on behalf
of the European Society of Cardiology.

<103>
Accession Number
647838509
Title
Percutaneous cannulation for minimally-invasive heart valve surgery:
results from a multicenter registry.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2025.
Date of Publication: 02 Jul 2025.
Author
Pausch J.; Weimann J.; Silaschi M.; Alaj E.; Seidiramool V.; Kofler M.;
Kempfert J.; Treede H.; Ghazy A.; Noack T.; Gadelkarim I.; Bleiziffer S.;
Gotte J.; Reichenspurner H.; Conradi L.
Institution
(Pausch, Reichenspurner, Conradi) Department of Cardiovascular Surgery,
University Heart and Vascular Center Hamburg, University Medical Center
Hamburg-Eppendorf, Germany
(Weimann) Department of Cardiology, University Heart and Vascular Center
Hamburg, University Medical Center Hamburg-Eppendorf, Germany
(Silaschi, Alaj, Seidiramool) Clinic and Polyclinic for Cardiac Surgery,
University Hospital Bonn, Germany
(Kofler, Kempfert) Department of Cardiothoracic and Vascular Surgery,
German Heart Center Berlin, Germany
(Kempfert) German Center for Cardiovascular Research, Partner Site Berlin,
Germany
(Treede, Ghazy) Clinic and Policlinic for Heart- and Vascular Surgery,
University Hospital Mainz, Germany
(Noack, Gadelkarim) University Clinic of Cardiac Surgery, Leipzig Heart
Center, Germany
(Bleiziffer, Gotte) Clinic for Thoracic and Cardiovascular Surgery, Heart
and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany
(Conradi) Department of Cardiac Surgery, University Hospital Cologne,
Germany
Abstract
OBJECTIVES: To avoid potential groin incision associated complications and
further streamline surgery percutaneous femoral cannulation using
different vascular closure devices (VCD) has emerged to establish
cardiopulmonary bypass during minimally-invasive heart valve surgery
(HVS). METHOD(S): The Percutaneous peRipheral cannulatiOn for
Minimally-InvaSive heart valve surgEry (PROMISE) multicenter registry
included patients, receiving percutaneous vascular access site (VAS)
closure during minimally-invasive HVS. Retrospective analyses were
performed to evaluate major and minor VAS-related complications of plug-
(group 1) vs suture-based (group 2) systems according to modified Valve
Academic Research Consortium (VARC) 3 criteria (ie retrograde dissection,
vascular injury, conversion to surgical cut-down or vascular
intervention). RESULT(S): In total 755 patients (66.1% (499/755)
male; median age 61.9years) were included and treated using a plug- (n =
450) or suture-based (n = 305) VCD. Most prevalent comorbidities were
hypertension (53.8%; 335/755) and atrial fibrillation (29.4%; 222/755),
resulting in a median STS Prom Score of 0.5%. Prevalence of peripheral
artery disease was 4.4% (33/450). Immediate hemostasis was significantly
higher in the plug-based group (99.8 (445/450 vs 77.7% (237/305); p <
0.001). Accordingly, application of a second VCD (0.0 (0/450) vs 34.8%
(106/305); p < 0.001) as well as conversion rates to surgical cut-down
(1.3 (6/450) vs 3.9% (12/305); p = 0.04) were significantly lower.
Prevalence of VAS-related complications (ie, arteriovenous (AV) fistula
(0.2 (1/450) vs 0% (0/305); p > 0.99), pseudoaneurysm (0.4 (2/450) vs 0%
(0/305); p = 0.66) or postoperative VAS-bleeding (1.6 (7/450) vs 0.7%
(2/305); p = 0.26)) was low in both groups (2.9 (13/450) vs 5.2% (16/305);
p = 0.14). CONCLUSION(S): VAS-related complications were favorably
low in both groups. Plug-based VCD are potentially associated with
significantly higher rates of immediate hemostasis and lower incidence for
additional VCD or surgical cut-down. Usage of dedicated VCD (plug- and
suture-based) for VAS closure after percutaneous cannulation is feasible,
safe and further decreases invasiveness in minimally-invasive
HVS. Copyright © The Author(s) 2025. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery.

<104>
Accession Number
2039520738
Title
Candida endocarditis: current perspectives on diagnosis and therapy.
Source
Clinical Microbiology and Infection. (no pagination), 2025. Date of
Publication: 2025.
Author
Ben-Ami R.; Bassetti M.; Bouza E.; Kosman A.; Vena A.
Institution
(Ben-Ami, Kosman) Infectious Diseases Unit, Tel Aviv Sourasky Medical
Center, Tel Aviv, Israel
(Ben-Ami, Kosman) Gray Faculty of Medical and Health Sciences, Tel Aviv
University, Tel Aviv, Israel
(Bassetti, Vena) Department of Health Sciences, University of Genoa,
Genoa, Italy
(Bassetti, Vena) Clinical Infectious Diseases Unit, San Martino Polyclinic
Hospital-IRCCS, Genoa, Italy
(Bouza) Clinical Microbiology and Infectious Diseases, Hospital General
Universitario Gregorio Maranon, Madrid, Spain
(Bouza) Medicine Department, School of Medicine, Universidad Complutense
de Madrid (UCM), Madrid, Spain
(Bouza) CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid,
Spain
(Bouza) Instituto de Investigacion Sanitaria Gregorio Maranon (IiSGM),
Madrid, Spain
Publisher
Elsevier B.V.
Abstract
Background: Candida infective endocarditis (CIE) is a rare but potentially
devastating condition. Although it accounts for only 1-1.5% of infective
endocarditis cases, CIE carries a high mortality rate (36-49%) and a
substantial risk of relapse. Despite advances in diagnostic and
therapeutic strategies, significant uncertainties persist regarding the
role and selection of imaging modalities and the most effective medical
and surgical management. Furthermore, the best follow-up strategy to
promptly detect recurrences in patients with a confirmed diagnosis remains
inadequately defined. Objective(s): This review explores the
diagnosis and management of CIE with a particular focus on: (a) optimal
use of cardiac imaging studies; (b) challenges associated with antifungal
therapy; (c) the limitations and real-world impact of surgical
intervention; and (d) strategies for long-term follow-up. Sources: A
comprehensive literature search was conducted in PubMed using the terms
Candida endocarditis, fungal biomarkers, echocardiography, antifungal
therapy, and surgical management. Additional studies were identified
through reference screening. Only clinically relevant articles, as judged
by the authors, were included. Content: Diagnosis remains difficult due to
intermittently negative blood cultures and limitations of standard
endocarditis criteria. Echocardiography is the primary diagnostic modality
for patients with candidaemia, and risk stratification to guide its use
remains exploratory. Novel diagnostic methods, including fungal biomarkers
(1,3-beta-D-glucan), molecular assays, and positron emission
tomography/computed tomography, may improve detection, but robust clinical
data are lacking. Management requires a multimodal approach, combining
prolonged antifungal therapy and, when feasible, surgical intervention.
Echinocandins or liposomal amphotericin B plus flucytosine are first-line
treatments, with fluconazole as a step-down option. Prosthetic valve
infections often require lifelong suppressive therapy due to high relapse
rates. Implications: Given the high mortality and recurrence rates, early
multidisciplinary involvement is crucial. With emerging antifungal
resistance, antibiofilm strategies and next-generation antifungals are
needed to improve outcomes. Copyright © 2025 European Society of
Clinical Microbiology and Infectious Diseases

<105>
Accession Number
2039442844
Title
Surgical ablation of atrial fibrillation with concomitant cardiac surgery:
a state-of-the-art review.
Source
European Journal of Cardio-thoracic Surgery. 67(7) (no pagination), 2025.
Article Number: ezaf187. Date of Publication: 01 Jul 2025.
Author
Kowalewski M.; Dabrowski E.J.; Kurasz A.; Swieczkowski M.; Raffa G.M.;
Kawczynski M.; Aerts L.; Kuzma L.; Wanha W.; Batko J.; Litwinowicz R.;
Urbanowicz T.; Stec S.; Lorusso R.; Hanke T.; Maesen B.; Meani P.; Ronco
D.; Pilato M.; Musumeci F.; Mccarthy P.; Cox J.L.; Pannone L.; Merino
J.L.; Purerfellner H.; Badhwar V.; La Meir M.; De Asmundis C.; Lip G.Y.H.;
Suwalski P.; Braczkowski J.; Fina D.; Gozdek M.; Chiarini G.; Jiritano F.;
Kolodziejczak M.M.; Kowalowka A.; Li T.; Marchese G.; Martucci G.; Massimi
G.; Kowalkowska M.; Matteucci M.; Makhoul M.; Malvindi P.G.; Mariani S.;
Ogorzelec N.; Olasinska A.; Pasierski M.; De Piero M.E.; Staromlynski J.;
Todaro S.
Institution
(Kowalewski, Kuzma, Wanha, Batko, Stec, Suwalski) Department of Cardiac
Surgery and Transplantology, National Medical Institute, Ministry of
Interior and Administration, Warsaw, Poland
(Kowalewski, Kawczynski, Aerts, Lorusso, Maesen) Cardio-Thoracic Surgery
Department, Heart and Vascular Centre, Maastricht University Medical
Centre (MUMC), Cardiovascular Research Centre Maastricht (CARIM),
Maastricht, Netherlands
(Kowalewski, Pilato, Musumeci) Department for the Treatment and Study of
Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS, ISMETT,
Palermo, Italy
(Kowalewski, Kuzma, Wanha, Batko, Litwinowicz, Urbanowicz, Meani, Ronco,
Suwalski) Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus
University, Innovative Medical Forum, Bydgoszcz, Poland
(Dabrowski, Kurasz, Swieczkowski, Kuzma) Department of Invasive
Cardiology, Medical University of Bialystok, Bialystok, Poland
(Raffa) Cardiac Surgery Unit, Department of Precision Medicine in Medical
Surgical and Critical Area (Me.Pre.C.C.), University of Palermo, Palermo,
Italy
(Wanha) Department of Cardiology and Structural Heart Diseases, Medical
University of Silesia, Katowice, Poland
(Batko, Litwinowicz) CAROL-Cardiothoracic Anatomy Research Operative Lab,
Department of Cardiovascular Surgery and Transplantology, Institute of
Cardiology, Jagiellonian University Medical College, Krakow, Poland
(Litwinowicz) Department of Cardiac Surgery, Wladyslaw Bieganski Regional
Specialist Hospital, Grudziadz, Poland
(Urbanowicz) Cardiac Surgery and Transplantology Department, Poznan
University of Medical Sciences, Poznan, Poland
(Stec) Division of Electrophysiology, Cardioneuroablation, Catheter
Ablation and Cardiac Stimulation, Subcarpathian Center for Cardiovascular
Intervention, Sanok, Poland
(Hanke) Department of Cardiac Surgery, Heart and Vascular Centre
Albertinen Krankenhaus, Hamburg, Germany
(Meani, Ronco) Department of Cardiothoracic and Vascular Anesthesia and
Intensive Care Unit, IRCCS Policlinico, San Donato Milanese, Milan, Italy
(Ronco) Cardiac Surgery Unit, ASST Grande Ospedale Metropolitano Niguarda,
Milan, Italy
(Mccarthy, Cox) Division of Cardiac Surgery, Northwestern University
Feinberg School of Medicine, Bluhm Cardiovascular Institute, Chicago,
United States
(Pannone, De Asmundis) Heart Rhythm Management Centre, Postgraduate
Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis
Brussel-Vrije Universiteit Brussel, European Reference Networks
Guard-Heart, Brussels, Belgium
(Merino) Arrhythmia and Robotic Electrophysiology Unit, La Paz University
Hospital, Madrid, Spain
(Purerfellner) Ordensklinikum Linz Elisabethinen, Department of Internal
Medicine II, Cardiology, Angiology, and Intensive Care Medicine, Linz,
Austria
(Badhwar) Department of Cardiovascular and Thoracic Surgery, West Virginia
University, Morgantown, WV, United States
(La Meir) Cardiac Surgery Department, Vrije Universiteit Brussel,
Universitair Ziekenhuis Brussel, Brussels, Belgium
(Lip) Liverpool Centre for Cardiovascular Science, University of
Liverpool, Liverpool John Moores University, Liverpool Heart & Chest
Hospital, Liverpool, United Kingdom
(Lip) Danish Center for Health Services Research, Department of Clinical
Medicine, Aalborg University, Aalborg, Denmark
(Lip) Department of Cardiology, Lipidology and Internal Medicine,
Intensive Coronary Care Unit, Medical University of Bialystok, Bialystok,
Poland
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Patients with preoperative atrial fibrillation (AF) undergoing cardiac
surgery face a heightened risk of complications and reduced survival.
Concomitant surgical ablation (SA) has shown promise in mitigating the
arrhythmic burden, prompting guideline upgrades by major scientific
societies. However, SA remains underutilized, with performance rates
varying between 22% and 48%, depending on the type of procedure. The goal
of this narrative review is to summarize current evidence to aid
physicians in decision making regarding AF management during cardiac
surgery. This review examines existing literature on the prevalence,
management and outcomes of AF in cardiac surgery. We assess
epidemiological data, summarize trends in clinical practice and review the
rationale and techniques for treating AF surgically. Emerging challenges,
including barriers to implementation and novel therapeutic advancements,
are also discussed. Evidence underscores the detrimental impact of
preoperative AF on perioperative and long-term outcomes, including higher
mortality, morbidity and thromboembolic risk. Concomitant SA, particularly
the Cox-maze IV procedure, significantly improves sinus rhythm
restoration, reduces mortality and mitigates complications like stroke.
However, the procedure remains underperformed due to concerns about
complexity, prolonged operative time and training gaps. Emerging hybrid
techniques, novel mapping systems and technologies like pulsed field
ablation may enhance outcomes and broaden SA adoption. Concomitant SA is
an effective yet underutilized therapy that can improve survival and
reduce AF-related complications in cardiac surgery patients. Addressing
implementation barriers and integrating advancements in technology and
surgical approaches are key to optimizing patient outcomes. Copyright
© 2025 The Author(s). Published by Oxford University Press on behalf
of the European Association for Cardio-Thoracic Surgery.

<106>
Accession Number
2035193571
Title
The organ-protective effects of nitric oxide in adult patients undergoing
cardiac surgery with cardiopulmonary bypass: a systematic review and
meta-analysis.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 335. Date
of Publication: 01 Dec 2025.
Author
Zhang J.; Zhang H.; Wang T.; Bian L.; Li Z.; Wang J.; Teng Y.; Liu G.; Yan
S.; Ji B.
Institution
(Zhang, Zhang, Wang, Wang, Bian, Li, Wang, Teng, Liu, Yan, Ji) Department
of Cardiopulmonary Bypass, National Center for Cardiovascular Disease,
Chinese Academy of Medical Sciences & Peking Union Medical College,
National Clinical Research Center for Cardiovascular Diseases, Fuwai
Hospital, Beijing, China
(Ji) Department of Cardiopulmonary Bypass, National Center for
Cardiovascular Disease and Fuwai Hospital, No. 167 Beilishi Road, Xicheng
District, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative organ dysfunction remains a major challenge in
adult cardiac surgery with cardiopulmonary bypass (CPB), frequently
involving the kidneys, heart, and lungs. These complications are primarily
driven by hemolysis, ischemia-reperfusion injury, and systemic
inflammation triggered by CPB. Nitric oxide (NO), known for its
vasodilatory, anti-inflammatory, and antioxidant properties, has been
proposed as a perioperative strategy to protect vital organs. However,
evidence regarding its efficacy remains inconclusive. Method(s): We
followed PRISMA guidelines and systematically searched PubMed, Embase,
Cochrane Library, and Web of Science for randomized controlled trials
(RCTs) published up to March 1, 2025. Subgroup analyses were conducted
based on NO dosage and timing of administration. To explore potential
effect modifiers and assess subgroup interaction, we performed
meta-regression analyses. The GRADE approach was used to assess the
certainty of evidence. Sensitivity analyses and publication bias
assessments (funnel plots and trim-and-fill method) were also conducted to
evaluate the robustness of the findings. Result(s): Ten RCTs
involving 838 patients were included. NO administration was associated
with a reduced incidence of acute kidney injury (AKI) (RR: 0.78; 95% CI:
0.64-0.94; p = 0.010), and the effect remained after trim-and-fill
adjustment. mechanical ventilation (MV) duration was slightly shortened
(SMD: - 0.17; 95% CI: - 0.31 to - 0.02; p = 0.025), particularly with
postoperative administration (SMD: - 0.39; 95% CI: - 0.67 to - 0.12; p =
0.005). NO also reduced cardiac troponin I (cTnI) levels. No significant
effects were observed for low cardiac output syndrome (LCOS), mortality,
intensive care unit (ICU) length of stay (LOS), or hospital LOS.
 Conclusion(s): Inhaled NO may offer organ-specific benefits in adults
undergoing cardiac surgery with CPB, such as reduced AKI incidence and
lower cTnI levels. However, these effects did not consistently translate
into improved clinical outcomes. The observed reduction in MV duration was
not significant after adjusting for publication bias, suggesting a
possible overestimation. Current evidence is limited by small sample sizes
and small-study effects. Further large, high-quality trials in high-risk
populations are needed to confirm these findings. PROSPERO registration:
This review was prospectively registered in PROSPERO (ID:
CRD42025649095). Copyright © The Author(s) 2025.

<107>
Accession Number
2039571015
Title
Navigating the silence: reconsidering treatment paradigms in asymptomatic
severe aortic stenosis.
Source
Hellenic Journal of Cardiology. (no pagination), 2025. Date of
Publication: 2025.
Author
Karampinos K.; Ktenopoulos N.; Apostolos A.; Koliastasis L.; Kachrimanidis
I.; Vlachakis P.; Katsaros O.; Tsalamandris S.; Karanasos A.; Drakopoulou
M.; Synetos A.; Latsios G.; Tsioufis K.; Toutouzas K.
Institution
(Karampinos, Ktenopoulos, Apostolos, Koliastasis, Kachrimanidis,
Vlachakis, Katsaros, Tsalamandris, Drakopoulou, Synetos, Latsios,
Tsioufis, Toutouzas) First Department of Cardiology, National and
Kapodistrian University of Athens, Hippokration General Hospital of
Athens, Athens, Greece
(Karanasos) Department of Cardiology, Patras University Hospital, Patras,
Greece
Publisher
Hellenic Cardiological Society
Abstract
Aortic stenosis (AS) remains the leading valvular heart disease worldwide,
affecting up to 5% of older adults and posing a significant risk if left
untreated. The evolution of transcatheter aortic valve replacement (TAVR)
and its expanding indications for symptomatic patients with severe AS,
coupled with the evolving understanding of the pathophysiology and natural
history of AS, have heightened the focus on asymptomatic patients with
severe AS. Although current clinical practice guidelines recommend aortic
valve replacement (AVR) therapy in asymptomatic severe aortic stenosis
(ASAS) only in specific clinical settings, recent studies have challenged
traditional treatment paradigms, advocating for a more individualized
strategy, particularly for patients exhibiting high-risk characteristics.
In this review, we provide an in-depth analysis of ASAS, focusing on the
intricacies of its clinical management, novel risk-stratification
modalities, and predictors of symptom onset and disease progression. We
also determine the role of echocardiography in assessing AS severity,
highlighting inconsistencies in diagnostic criteria and the need for
supplementary testing. Evolving and recently published randomized
controlled trials-namely EARLY-TAVR, EVoLVeD, and TAVR-UNLOAD-randomizing
asymptomatic patients to early intervention or a watchful waiting strategy
provide significant evidence that has the potential to change treatment
paradigms, lower the threshold for intervention, and pave the way for more
individualized management strategies in ASAS. Copyright © 2025
Hellenic Society of Cardiology

<108>
Accession Number
2035188051
Title
Effect of multimodal home-based prehabilitation on objectively measured
physical activity in patients undergoing elective cardiac or non-cardiac
major surgery: secondary outcomes from a randomised controlled trial.
Source
Perioperative Medicine. 14(1) (no pagination), 2025. Article Number: 69.
Date of Publication: 01 Dec 2025.
Author
Vetsch T.; Dueblin S.W.-S.; Eser P.; Beilstein C.M.; Wuethrich P.Y.;
Wilhelm M.; Engel D.
Institution
(Vetsch, Dueblin, Beilstein, Wuethrich, Engel) Department of
Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital,
University of Bern, Bern, Switzerland
(Vetsch, Eser, Wilhelm) Centre for Rehabilitation & Sports Medicine,
Inselspital, Bern University Hospital, University of Bern, Bern,
Switzerland
(Vetsch) Graduate School for Health Sciences, University of Bern, Bern,
Switzerland
Publisher
BioMed Central Ltd
Abstract
Objective: To assess physical activity (PA) measured in steps per day in
the preoperative period in high-risk cardiac and non-cardiac surgical
patients receiving home-based tele-supervised prehabilitation compared to
standard of care and to compare steps per day with raw acceleration
metrics. Study design: It is an analysis of secondary outcome data of a
prospective, two-arm parallel group, randomised controlled trial.
 Setting(s): It is a single university hospital in Switzerland.
 Participant(s): These are patients >= 65 years awaiting elective
cardiac or non-cardiac major surgery with a proven fitness deficit
measured by a cardiopulmonary exercise test (CPET). Analysis of PA data
after successfully enrolling 200 patients (167 with complete data) in the
trial. Average age was 73.8 years (SD 5.3) in cardiac and 76.0 years (SD
6) in non-cardiac patients. Intervention(s): The intervention arm
consists of a multimodal, home-based tele-supervised prehabilitation
programme over 2-4 weeks addressing deficits in physical fitness,
nutrition, and preoperative anaemia. Primary Outcome: Steps per day
are assessed by an open-source algorithm from wrist-worn accelerometer
data. Secondary outcome: Raw acceleration as overall Euclidean Norm Minus
One (ENMO) is expressed in milligravitational units (mg). Result(s):
Non-cardiac (n = 107) patients had more steps per day in the intervention
group versus standard of care (4662 [2817; 6807] vs 3378 [1919; 4831], p =
0.042). Overall, ENMO was higher in the intervention group but not
statistically significant. No significant differences in PA measures were
observed between randomisation groups in cardiac (n = 60) patients.
Cardiac patients had overall higher PA levels and were younger than
non-cardiac. The difference remained after adjusting for age. Steps per
day correlated strongly with overall ENMO. Conclusion(s): Simple
preoperative PA recommendations effectively improve steps per day in
high-risk non-cardiac surgery patients. To detect changes in PA in the
high-risk surgical patient, steps per day can be used as an intuitive
measure. To compare with other populations, overall ENMO is preferable.
Trial registration number: ClinicalTrials.gov Identifier:
NCT04461301. Copyright © The Author(s) 2025.

<109>
[Use Link to view the full text]
Accession Number
2039488488
Title
A review of novel structural heart procedures for the anesthesiologist.
Source
Current Opinion in Anaesthesiology. 38(4) (pp 409-417), 2025. Date of
Publication: 01 Aug 2025.
Author
Graham A.; Brovman E.Y.
Institution
(Graham, Brovman) Department of Anesthesiology, Tufts Medical Center,
Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review There has been significant growth in the volume,
complexity, and types of transcatheter cardiac interventions for valvular
heart disease over the last 10 years. This review is intended to cover
both common structural heart procedures, as well as recent advancements,
and the anesthetic considerations of these procedures. Recent findings
While contextualizing within a historical perspective, the review covers
mitral and tricuspid valve transcatheter edge-to-edge repair,
transcatheter mitral, and tricuspid valve replacement, with focus on
valve-in-valve, valve-in-ring, and valve-in-native procedures, laceration
of the anterior mitral leaflet to prevent outflow obstruction, septal
scoring along the midline endocardium, transcatheter aortic valve
implantation with focus on bioprosthetic, or native aortic scallop
intentional laceration to prevent iatrogenic coronary artery obstruction.
Procedures reviewed are summarized in Table 1. Summary To provide
comprehensive care, anesthesiologists should have an understanding of the
indications, population, and key procedural steps of novel structural
heart interventions. Copyright © 2025 Wolters Kluwer Health, Inc.

<110>
Accession Number
2035215299
Title
Efficacy and Safety of Bupivacaine Liposomal in Intercostal Nerve Block
for Postoperative Pain Management Following Uniportal Thoracoscopy: A
Randomized Trial.
Source
Pain Research and Management. 2025(1) (no pagination), 2025. Article
Number: 8816879. Date of Publication: 2025.
Author
Dong L.; Wang X.; Fu L.; Jiang Z.; Wang Y.; Chen A.; Ding J.; Yu G.
Institution
(Dong, Wang, Fu, Ding, Yu) Department of Thoracic Surgery, Shaoxing
People's Hospital, 568-Zhongxing North Road, Zhejiang, Shaoxing, China
(Jiang, Wang) Department of Anesthesiology, Shaoxing People's Hospital,
568-Zhongxing North Road, Zhejiang, Shaoxing, China
(Chen) Department of Nursing, Shaoxing People's Hospital, 568-Zhongxing
North Road, Zhejiang, Shaoxing, China
Publisher
John Wiley and Sons Ltd
Abstract
Background: Postoperative pain in thoracic surgery often requires opioids,
yet can be poorly managed with short-acting anesthetics. Liposomal
bupivacaine (LB) offers prolonged analgesia, potentially improving pain
control and reducing opioid use. This study evaluates LB's effectiveness
and safety in thoracic postoperative pain management, aiming to provide an
alternative to current practices. Method(s): In this single-center,
double-blind, prospective, randomized controlled trial, patients
undergoing uniportal lobectomy, segmentectomy, or wedge resection from
November 2023 to May 2024 were enrolled. Participants were randomly
assigned in a 1:1 ratio to receive either 0.375% ropivacaine (control
group, n = 57) or LB (LB group, n = 56) for intercostal nerve blocks
(ICNBs). Postoperative visual analog scale (VAS) scores, opioid
consumption, overall benefit of analgesia score (OBAS), chest tube
duration, length of hospital stay, and adverse events (AEs) were recorded
and analyzed. Result(s): Data from 57 patients in the control group
and 56 patients in the LB group were included in the analysis, with no
significant demographic differences between the groups. The LB group
demonstrated lower VAS scores at rest and during activity (p > 0.05),
reduced opioid consumption (p = 0.021), and higher OBAS (p < 0.01)
compared with the control group. No significant differences were observed
in chest tube duration, length of hospital stay, or AEs between the
groups. Conclusion(s): LB is safe and effective for ICNB, providing
significant postoperative pain relief for patients undergoing uniportal
thoracoscopic surgery. Trial Registration: Chinese Registry of Clinical
Trials: chiCTR2300075463. Copyright © 2025 Lingjun Dong et al.
Pain Research and Management published by John Wiley & Sons Ltd.

<111>
Accession Number
2039379151
Title
Intercostal or Paravertebral Block vs Thoracic Epidural in Lung Surgery: A
Randomized Noninferiority Trial.
Source
JAMA Surgery. (no pagination), 2025. Date of Publication: 2025.
Author
Spaans L.N.; Dijkgraaf M.G.W.; Susa D.; De Loos E.R.; Mourisse J.M.J.;
Bouwman R.A.; Verhagen Ad.F.T.M.; Van Den Broek F.J.C.; Meijer P.; Kuut
M.; Hanneman N.; Bousema J.; Franssen A.; Brokx H.; Van Duyn E.; Potters
J.-W.; Van Den Broek R.; Van Brakel T.; Rijna H.; Boom A.; Noyez V.;
Hendriks J.M.H.; Yogeswaran S.K.; Dickhoff C.; Van Dorp M.
Institution
(Spaans, Van Den Broek) Department of Surgery, Maxima Medical Center,
Veldhoven, Netherlands
(Spaans, Dijkgraaf) Amsterdam UMC Location University of
Amsterdam,Epidemiology and Data Science, Amsterdam, Netherlands
(Dijkgraaf) Amsterdam Public Health, Methodology, Amsterdam, Netherlands
(Susa, Brokx) Department of Surgery, Bravis Hospital, Bergen op Zoom,
Roosendaal, Netherlands
(De Loos, Franssen) Department of Surgery, Division of General Thoracic
Surgery, Zuyderland Medical Center, Heerlen, Netherlands
(Mourisse, Kuut) Department of Anesthesia,Pain and Palliative Medicine,
Radboud University Medical Center, Nijmegen, Netherlands
(Bouwman, Van Den Broek) Department of Anesthesiology and Pain Medicine,
Catharina Hospital, Eindhoven, Netherlands
(Bouwman) Department of Electrical Engineering, Eindhoven Technical
University, Signal Processing Systems, Eindhoven, Netherlands
(Verhagen) Department of Cardio-thoracic Surgery, Radboud University
Medical Center, Nijmegen, Netherlands
(Van Dorp) Department of Cardiothoracic Surgery, Amsterdam UMC Location
Vrije Universiteita Amsterdam, Amsterdam, Netherlands
(Meijer) Department of Anaesthesiology, Maxima Medical Center, Veldhoven,
Netherlands
(Hanneman, Bousema) Department of Surgery, Ikazia Hospital, Rotterdam,
Netherlands
(Van Duyn) Department of Surgery, Medisch Spectrum Twente, Enschede,
Netherlands
(Potters, Dickhoff) Department of Anesthesiology, Medisch Spectrum Twente,
Enschede, Netherlands
(Van Brakel) Department of Cardiothoracic Surgery, Catharina Hospital,
Eindhoven, Netherlands
(Rijna) Department of Surgery, Spaarne Gasthuis, Hoofddorp, Netherlands
(Boom) Department of Anesthesiology, Spaarne Gasthuis, Hoofddorp,
Netherlands
(Noyez) Department of Surgery, Algemeen Ziekenhuis Sint-Maarten, Mechelen,
Belgium
(Hendriks, Yogeswaran) Department of Vascular and Thoracic Surgery,
Antwerp University Hospital, Antwerp, Belgium
Publisher
American Medical Association
Abstract
Importance: Effective pain control after thoracic surgery is crucial for
enhanced recovery. While thoracic epidural analgesia (TEA) traditionally
ensures optimal analgesia, its adverse effects conflict with the
principles of enhanced recovery after thoracic surgery. High-quality
randomized data regarding less invasive alternative locoregional
techniques are lacking. Objective(s): To evaluate the efficacy of
continuous paravertebral block (PVB) and a single-shot intercostal nerve
block (ICNB) as alternatives to TEA. Design, Setting, and
Participant(s): This randomized clinical trial compared PVB and ICNB vs
TEA (1:1:1) in patients undergoing thoracoscopic anatomical lung resection
at 11 hospitals in the Netherlands and Belgium, enrolled from March 5,
2021, to September 5, 2023. The study used a noninferiority design for
pain and a superiority design for quality of recovery (QoR).
 Intervention(s): Continuous PVB and single-shot ICNB. Main
Outcomes and Measures: Primary outcomes were pain, defined as mean
proportion of pain scores 4 or greater during postoperative days (POD) 0
through 2 (noninferiority margin for the upper limit [UL] 1-sided 98.65%
CI, 17.5%), and QoR, assessed with the QoR-15 questionnaire at POD 1 and
2. Secondary measures included opioid consumption, mobilization,
complications, and hospitalization. Result(s): A total of 450
patients were randomized, with 389 included in the intention-to-treat
(ITT) analysis (mean [SD] age, 66 [9] years; 208 female patients [54%] and
181 male [46%]). Of these 389 patients, 131 received TEA, 134 received
PVB, and 124 received ICNB. The mean proportions of pain scores 4 or
greater were 20.7% (95% CI, 16.5%-24.9%) for TEA, 35.5% (95% CI,
30.1%-40.8%) for PVB, and 29.5% (95% CI, 24.6%-34.4%) for ICNB. While PVB
was inferior to TEA regarding pain (ITT: UL, 22.4%; analysis per-protocol
[PP]: UL, 23.1%), ICNB was noninferior to TEA (ITT: UL, 16.1%; PP: UL,
17.0%). The mean (SD) QoR-15 scores were similar across groups: 104.96
(20.47) for TEA, 106.06 (17.94; P =.641) for PVB (P =.64 for that
comparison), and 106.85 (21.11) for ICNB (P =.47 for that comparison).
Both ICNB and PVB significantly reduced opioid consumption and enhanced
mobility compared with TEA, with no significant differences in
complications. Hospitalization was shorter in the ICNB group.
 Conclusions and Relevance: After thoracoscopic anatomical lung
resection, only ICNB provides noninferior pain relief compared with TEA.
ICNB emerges as an alternative to TEA, although risks and benefits should
be weighed for optimal personalized pain control. Copyright ©
2025 American Medical Association. All rights reserved.

<112>
Accession Number
2039562564
Title
Effectiveness of ultrasound guided erector spinae plane block compared to
serratus anterior block in modified radical mastectomy: a randomized
comparative trial.
Source
Anaesthesia, Pain and Intensive Care. 29(3) (pp 430-435), 2025. Date of
Publication: 01 Jun 2025.
Author
Magdy M.; Zaghloul A.; Hamimy W.I.; Shaban A.; Elshamy F.H.
Institution
(Magdy, Shaban, Elshamy) Department of Anaesthesia, Surgical Critical Care
& Pain Management, National Cancer Institute, Cairo University, Cairo,
Egypt
(Zaghloul, Hamimy) Department of Anesthesia, ICU & Pain Management, Kasr
Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Background & objectives: Acute postoperative pain occurs in approximately
40-60% of patients undergoing breast surgeries. Multiple thoracic wall
blocks have been developed to reduce complications associated with
thoracic epidural and paravertebral block including erector spinae plane
block (ESPB) and serratus anterior plane block (SAPB). We evaluated and
compared ESPB versus SAPB, regarding safety and efficacy to relieve acute
postoperative pain in patients undergoing modified radical mastectomy
(MRM) under general anesthesia (GA). Method0ology: We recruited 60 female
patients, ASA II-III, undergoing MRM under GA, and assigned them into one
of the two equal groups: group 1 (SAPB group) and group 2 (ESPB group).
The primary outcome was postoperative morphine consumed in the first 24
hours. Secondary outcomes included intraoperative fentanyl consumption,
numeric pain rating scale (NRS) scores at rest and movement,
post-operative nausea, vomiting and overall patient satisfaction.
 Result(s): There was a significantly reduced consumption in
postoperative morphine in ESPB group compared to SAPB group (1.70 +/- 1.88
vs 4.50 +/- 3.03 mg). Intraoperative fentanyl consumption was
significantly lower in ESPB group compared to SAPB group (130.6 +/- 44.41
vs 160.0 microg +/- 53.18; P = 0.031). ESPB group showed significantly
lower scores of NRS scores at rest as well as on movement.
 Conclusion(s): Erector spinae plane block provides more effective
intraoperative as well as postoperative analgesia compared to serratus
anterior plane block in patients undergoing modified radical mastectomy
under general anesthesia. Copyright © 2025, Faculty of
Anaesthesia, Pain and Intensive Care, AFMS. All rights reserved.

<113>
Accession Number
2039449695
Title
Incidence and Risk Factors for Early Postoperative Arrhythmias in
Congenital Heart Disease - Systematic Review.
Source
Journal of Cardiovascular Emergencies. 11(2) (pp 43-53), 2025. Date of
Publication: 01 Jun 2025.
Author
Mayaya P.-C.; Tinica G.; Chistol R.O.; Moraru L.; Damian S.I.; Frasinariu
O.E.; Furnica C.
Institution
(Mayaya) Doctoral School, Grigore T. Popa University of Medicine and
Pharmacy, Iasi, Romania
(Mayaya, Chistol, Furnica) Department of Anatomy, Grigore T. Popa
University of Medicine and Pharmacy, Iasi, Romania
(Tinica) Department of Cardiac Surgery, Grigore T. Popa University of
Medicine and Pharmacy, Iasi, Romania
(Tinica, Chistol) Prof. Dr. George I.M. Georgescu Cardiovascular Diseases
Institute, Iasi, Romania
(Moraru) Department of Anatomy, Faculty of Medicine, George Emil Palade
University of Medicine, Pharmacy, Science and Technology, Targu Mures,
Romania
(Moraru) Cardiovascular and Transplant Emergency Institute of Targu Mures,
Targu Mures, Romania
(Damian) Department of Forensic Medicine, Grigore T. Popa University of
Medicine and Pharmacy, Iasi, Romania
(Damian, Furnica) Institute of Forensic Medicine, Iasi, Romania
(Frasinariu) Department of Mother and Child Medicine-Pediatric, Grigore T.
Popa University of Medicine and Pharmacy, Iasi, Romania
(Frasinariu) Sfanta Maria Emergency Clinical Hospital for Children, Iasi,
Romania
Publisher
Sciendo
Abstract
Postoperative arrhythmias are commonly seen in pediatric cardiac intensive
care units and are linked to higher rates of both morbidity and mortality
in children with congenital heart disease. However, the incidence of early
postoperative arrhythmias in the pediatric population is unclear, varying
from 7.3% to 48% in the literature. We searched the PubMed, Embase, and
Web of Science databases from 2000 to 2025 with the aim to perform a
systematic review of the existing literature on the incidence and risk
factors of early arrhythmias following heart surgery. A total of 16
cross-sectional observational studies, including 5,563 patients who
underwent surgery for congenital heart disease and 901 patients who
developed early postoperative arrhythmias, met the inclusion criteria.
Patients developing early postoperative dysrhythmias were younger, with a
lower body weight, and the duration of cardiopulmonary bypass was
significantly longer. Other incriminated risk factors for the occurrence
of early postoperative arrhythmias were hemodynamic instability,
complexity of the surgical procedure, and higher vasoactive-inotropic
scores. Pediatric patients with congenital heart disease who undergo
cardiac surgery face increased morbidity and mortality due to the risk
associated with the multifactorial complication of early postoperative
arrhythmias. The reported incidence of these arrhythmias varies greatly
among different studies and a better understanding of risk factors and
pathophysiological mechanisms would improve postoperative outcomes for
this notably exposed population. Copyright © 2025 Petra-Caroline
Mayaya et al., published by Sciendo.

<114>
Accession Number
2039570708
Title
Impact of superficial and deep parasternal blocks on recovery after
cardiac surgery with sternotomy: a randomised controlled trial.
Source
British Journal of Anaesthesia. (no pagination), 2025. Date of
Publication: 2025.
Author
Demarquette A.; Jeanneteau A.; Blanchard-Daguet A.; Fouquet O.;
Parot-Schinkel E.; Lasocki S.; Rineau E.; Leger M.
Institution
(Demarquette, Jeanneteau, Blanchard-Daguet, Lasocki, Rineau, Leger)
Departement d'Anesthesie Reanimation, Centre Hospitalier Universitaire
d'Angers, Angers, France
(Fouquet) Service de Chirurgie Cardiaque, Centre Hospitalier Universitaire
d'Angers, Angers, France
(Fouquet, Lasocki, Rineau) Univ Angers, INSERM, CNRS, MITOVASC, Equipe
CARME, SFR ICAT, Angers, France
(Parot-Schinkel) Departement de Biostatistique et Methodologie, Centre
Hospitalier Universitaire d'Angers, Angers, France
(Leger) INSERM UMR 1246 - SPHERE, Nantes University, Tours University,
Nantes, Centre Hospitalier Universitaire d'Angers, Angers, France
(Leger) UCSF Medical Center, Department of Anesthesia and Perioperative
Care, San Francisco, CA, United States
Publisher
Elsevier Ltd
Abstract
Background: Pain is common after cardiac surgery and can impair recovery.
Regional anaesthesia has been proposed to limit pain, but its impact on
recovery is unknown. This study compared the impact of superficial or deep
parasternal intercostal plane blocks (SPIP or DPIP) in addition to
standard care vs standard care alone on postoperative quality of recovery
(QoR) after cardiac surgery with sternotomy. Method(s): In this
single-centre, randomised, single-blind, controlled trial, adult patients
undergoing cardiac surgery with sternotomy were randomly assigned to one
of three groups (with a 1:1:1 allocation ratio): control group (standard
care without regional anaesthesia), SPIP group, or DPIP group. The primary
endpoint was QoR assessed using a French validated version of the Quality
of Recovery-15 questionnaire at 24 h after surgery. Secondary outcomes
included postoperative pain scores, analgesic consumption, ICU and
hospital length of stay, and adverse events. Result(s): Between July
1, 2022, and August 30, 2023, we randomised 254 patients (81.1% men, 65.5
[27-85] yr). The French validated version of the Quality of Recovery-15
scores did not significantly differ between any parasternal block group
(SPIP or DPIP) and the standard care group (P=0.248). Postoperative pain
and analgesic consumption were similar across groups, with low pain scores
(median [interquartile range] 24-h numerical rating scale: 2.0 [3.0-0.0]).
There were more pneumothoraces in the DPIP group (P=0.032). No significant
differences were observed for other complications. Conclusion(s):
Regional anaesthesia by parasternal intercostal plane blocks after
sternotomy did not improve QoR at 24 h compared with standard care.
Clinical trial registration: NCT05345639. Copyright © 2025
British Journal of Anaesthesia

<115>
Accession Number
2035198354
Title
Melatonin administered postoperatively lowers oxidative stress and
inflammation and significantly recovers heart function in patients
undergoing CABG surgery.
Source
European Journal of Medical Research. 30(1) (no pagination), 2025. Article
Number: 585. Date of Publication: 01 Dec 2025.
Author
Mohammadi N.; Alizadeh M.; Akbarzadeh S.; Rezaei M.; Mahmoodi M.;
Netticadan T.; Movahed A.
Institution
(Mohammadi) Department of Clinical Biochemistry, Bushehr University of
Medical Sciences, Bushehr, Iran, Islamic Republic of
(Alizadeh) Department of Clinical Biochemistry, Faculty of Medicine,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Akbarzadeh) Department of Endocrine and Metabolic Diseases, The Persian
Gulf Tropical Medicine Research Center, Bushehr University of Medical
Sciences, Bushehr, Iran, Islamic Republic of
(Rezaei) Department of Cardiovascular Surgery, Faculty of Medicine,
Bushehr University of Medical Sciences, Bushehr, Iran, Islamic Republic of
(Mahmoodi) Department of Environmental Health Engineering, Faculty of
Health and Nutrition, Bushehr University of Medical Sciences, Bushehr,
Iran, Islamic Republic of
(Netticadan) Canadian Centre for Agri-Food Research in Health and
Medicine, Winnipeg, MB, Canada
(Movahed) Department of Clinical Biochemistry, Faculty of Medicine,
Bushehr University of Medical Sciences, Bushehr, Iran, Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
Background: This study aimed to assess the effect of oral melatonin
consumption on improving heart function and reducing postoperative
complications in patients undergoing coronary artery bypass grafting
(CABG) surgery. Method(s): A total of 60 CABG patients in the
postoperative period were included in this randomized, double-blind,
placebo-controlled trial. The patients were divided into three groups:
Group 1 (n = 20, 5 mg melatonin), Group 2 (n = 20, 10 mg melatonin), and
the placebo group (n = 20). The patients were discharged about 8 to 10
days after the surgery. Blood samples were taken from all the patients
before and after the intervention (for 60 days), and Biochemical
parameters including creatine kinase-MB (CK-MB), lactate dehydrogenase
(LDH), malondialdehyde (MDA), tumor necrosis factor alpha (TNF-alpha),
total antioxidant capacity (TAC), nitric oxide (NO) assessed.
Echocardiography and the measurement of systolic and diastolic blood
pressure were also performed on participants. Result(s): Our results
showed that melatonin treatment significantly increased the ejection
fraction (%EF) and TAC levels in both the treatment groups compared to the
placebo group (P < 0.05). Moreover, the levels of inflammatory and
oxidative biomarkers, including TNF-alpha, MDA, and NO, decreased in the
intervention group significantly (P < 0.05). In the placebo group, %EF
decreased significantly (P = 0.042), while MDA increased (P < 0.001) and
TAC decreased (P = 0.002). No significant changes were observed in LDH and
CK-MB levels. The comparison of serum biomarkers between the two treatment
groups showed that 10 mg of melatonin was more effective than 5 mg, but
the difference was not significant (P > 0.05). Conclusion(s): The
present study showed that as a potential antioxidant, melatonin could
alleviate oxidative stress and inflammation associated with CABG and is
essential in improving overall heart function. Trial registration:
IRCT20111119008129N14, first trial registration date:
01/08/2023. Copyright © The Author(s) 2025.

<116>
Accession Number
2039572377
Title
COMPARATIVE EVALUATION OF ORAL ATENOLOL VERSUS ORAL CLONIDINE AS
PREMEDICANTS FOR HYPOTENSIVE ANAESTHESIA IN PATIENTS UNDERGOING FUNCTIONAL
ENDOSCOPIC SINUS SURGERY.
Source
International Journal of Academic Medicine and Pharmacy. 5(4) (pp
1957-1962), 2023. Date of Publication: 2023.
Author
Sumathi N.C.; Lalitha M.; Asmita V.C.; Sivaranjani P.
Institution
(Sumathi) Department of Anesthesiology, Dhanalakshmi Srinivasan Medical
College and Hospital, India
(Lalitha) Department of Anesthesiology, Dhanalakshmi Srinivasan Medical
College and Hospital, India
(Asmita, Sivaranjani) Department of Anesthesiology, Dhanalakshmi
Srinivasan Medical College and Hospital, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: Providing hypotensive anaesthesia results in good surgical
outcomes, reduced transfusion rates, decreased complications and reduced
time duration of surgery. The present study aimed to evaluate oral
atenolol versus oral clonidine as premedicants for hypotensive anaesthesia
in patients undergoing functional endoscopic sinus surgery (FESS).
 Material(s) and Method(s): This is a Prospective randomised
analytical study among 80 patients (randomly divided into two groups of 40
each, receiving oral atenolol 1 mg/kg and oral clonidine 2 microgram/kg,
respectively) for hypotension anaesthesia undergoing FESS. Hemodynamic
parameters (such as heart rate, systolic blood pressure, diastolic blood
pressure and mean arterial pressure), intraoperative complications (such
as hypotension, hypertension, tachycardia, bradycardia, arrhythmias),
Postoperative parameters (sedation, time of rescue analgesia), surgical
parameters (such as duration of surgery, quality of operating field) were
measured. Result(s): Baseline Demographic and anthropometric
parameters such as age, gender, and weight were not significantly
different between the groups. Hemodynamic parameters such as Systolic,
Diastolic, and mean arterial blood pressure were significantly lower among
the clonidine group throughout the surgery. Heart rate was significantly
lower among the atenolol group. The common side effect observed was
hypotension in both groups. Sevoflurane requirement and duration of
surgery were lower among the clonidine group but not statistically
significant. Postoperative analgesic requirement among the clonidine group
was significantly lower, and there were good sedation scores for the
clonidine group. Conclusion(s): Oral clonidine as premedication to
the patients undergoing FESS can be effective in producing hypotensive
anaesthesia, adequate sedation and lesser postoperative analgesia
requirement when compared with oral atenolol. Copyright © 2023
Society for Healthcare and Research Development. All rights reserved.

<117>
Accession Number
647799222
Title
Quality comparison of mediastinal lymph node dissection between
video-assisted thoracic surgery and open thoracotomy: a supplementary
analysis of the phase 3 Japan Clinical Oncology Group 1413 trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2025.
Date of Publication: 19 Jun 2025.
Author
Tsubokawa N.; Tsutani Y.; Hishida T.; Saji H.; Wakabayashi M.; Endo M.;
Mimae T.; Miyoshi T.; Isaka T.; Isaka M.; Hattori A.; Yoshioka H.;
Nakajima R.; Yotsukura M.; Maniwa T.; Sekino Y.; Fukuda H.; Nakagawa K.;
Aokage K.; Watanabe S.-I.; Okada M.
Institution
(Tsubokawa, Mimae, Okada) Department of Surgical Oncology, Hiroshima
University Hospital, Hiroshima, Japan
(Tsutani) Division of Thoracic Surgery, Kindai University Faculty of
Medicine, Osaka, Japan
(Hishida) Division of Thoracic Surgery, Keio University School of
Medicine, Tokyo, Japan
(Saji) Department of Chest Surgery, St Marianna University School of
Medicine, Kanagawa, Japan
(Wakabayashi, Sekino, Fukuda) JCOG Data Center/Operations Office, National
Cancer Center Hospital, Tokyo, Japan
(Endo) Department of Thoracic Surgery, Yamagata Prefectural Central
Hospital, Yamagata, Japan
(Miyoshi, Aokage) Division of Thoracic Surgery, National Cancer Center
Hospital East, Chiba, Japan
(Isaka) Department of Thoracic Surgery, Kanagawa Cancer Center, Kanagawa,
Japan
(Isaka) Department of Thoracic Surgery, Shizuoka Cancer Center Hospital,
Shizuoka, Japan
(Hattori) Department of General Thoracic Surgery, Juntendo University
School of Medicine, Tokyo, Japan
(Yoshioka) Department of Thoracic Oncology, Kansai Medical University
Hospital, Osaka, Japan
(Nakajima) Department of General Thoracic Surgery, Osaka City General
Hospital, Osaka, Japan
(Yotsukura, Watanabe) Department of Thoracic Surgery, National Cancer
Center Hospital, Tokyo, Japan
(Maniwa) Department of Thoracic Surgery, Osaka, Japan
(Nakagawa) Department of Thoracic Surgery, Tokyo Metropolitan Cancer and
Infectious Diseases Center Komagome Hospital, Tokyo, Japan
Abstract
OBJECTIVES: This study aimed to compare the quality of mediastinal lymph
node dissection (LND) during lobectomy for clinical stage I-II non-small
cell lung cancer (NSCLC) between video-assisted thoracic surgery (VATS)
and open thoracotomy, using data from the Japan Clinical Oncology Group
(JCOG) 1413 phase 3, randomized, controlled trial. METHOD(S): This
analysis draws information from JCOG1413, comparing the efficacy of
lobe-specific vs systematic LND with standardised LND protocols. A total
of 1,685 patients were included in this exploratory analysis (1,251 VATSs
and 434 open thoracotomies). Propensity score matching (PSM) ensured a
balanced distribution of patient characteristics. The study's end-point
was N2 upstaging, defined as the proportion of upstaging from clinical
N0-N1 to pathological N2. RESULT(S): Among 1,685 patients, 141 (8.3%)
and 118 (7.0%) had pathological N1 and N2, respectively. The PSM yielded
852 patients (426 per group). The N2 upstaging proportions (7.8% [VATS] vs
7.3% [open], p = 0.795) and the influence of the lobectomy type on N2
upstaging were not significantly different between the two groups. The
median number of N2 lymph nodes dissected per defined LND extent was
similar (systematic: 13 in both groups, p = 0.236; lobe-specific: 7 in
both groups, p = 0.720). Additionally, no significant difference in N2
upstaging was observed between hybrid and complete VATS groups (6.7% in
both groups, p =. 982). CONCLUSION(S): This study found no
significant differences in N2 upstaging proportions between the VATS and
open thoracotomy groups of patients with clinical stage I-II NSCLC. This
suggests comparable quality of mediastinal LND in both surgical
approaches.This study is a sub-analysis of the JCOG1413 randomized
controlled trial. The JCOG1413 trial is registered with the UMIN Clinical
Trials Registry (UMIN0000025530). Copyright © The Author(s) 2025.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved. For commercial re-use,
please contact reprints@oup.com for reprints and translation rights for
reprints. All other permissions can be obtained through our RightsLink
service via the Permissions link on the article page on our site-for
further informat

<118>
Accession Number
647813067
Title
EFFECTIVENESS OF REAL-TIME CONTINUOUS GLUCOSE MONITORING AMONG CARDIAC
SURGERY PATIENTS: A RANDOMISED CONTROLLED TRIAL.
Source
Diabetes Technology and Therapeutics. Conference: 18th International
Conference on Advanced Technologies and Treatments for Diabetes, ATTD
2025. Amsterdam Netherlands. 27(Supplement 2) (pp e377-e378), 2025. Date
of Publication: 01 Feb 2025.
Author
Moon S.J.; Lee S.; Kim M.S.; Lee H.-E.; Lee Y.-W.; Yang Y.; Choi D.; Chung
E.-S.; Park C.-Y.
Institution
(Moon, Lee, Park) Kangbuk Samsung Hospital, Sungkyunkwan University,
Department of Internal Medicine, Seoul, South Korea
(Lee) Kangbuk Samsung Hospital, Diabetes Center, Seoul, South Korea
(Kim, Lee, Chung) Kangbuk Samsung Hospital, Sungkyunkwan University,
Department of Cardiac Surgery, Seoul, South Korea
(Yang) Seoul St. Mary's Hospital, College of Medicine, Catholic University
of Korea, Seoul, South Korea
(Choi) Soonchunhyang University Bucheon Hospital, Soonchunhyang University
College of Medicine, Department of Internal Medicine, Bucheon, South Korea
Publisher
Mary Ann Liebert Inc.
Abstract
Background and Aims: Real-time continuous glucose monitoring (RT-CGM)
usage in surgical patients, particularly in cardiac surgery, is
underexplored. This study evaluated RT-CGM's efficacy in cardiac surgery
patients. Method(s): In this randomized controlled study,
participants were divided into RT-CGM and control groups one day after
cardiac surgery. Patients with diabetes or prediabetes were enrolled. The
RT-CGM group used Dexcom G6, while the control group used point-of-care
blood glucose and blinded CGM. The primary outcome was time in target
range (TIR) of 100-180 mg/dL for 7 days post-surgery. Secondary outcomes
included TIR of 70-180 mg/dL, time in tight target range (TTIR), time
below range (TBR), coefficient of variance (CV), mean glucose, and length
of hospital stay (LOS). Result(s): of 54 participants, 52 (27 RT-CGM,
25 control) completed the study. The mean age was 63.8+/-10.8 years, and
A1c 6.3+/-1.3%, with 31 (59.6%) having diabetes and 21 (40.4%)
prediabetes. The TIR of 100-180 mg/dL was 74.7+/-12.0% in the RT-CGM group
and 71.6+/-17.8% in the control group, not statistically significant
(p=0.379). However, the TIR of 70-180 mg/dL was significantly higher in
the RTCGM group (83.8+/-10.6%) compared to the control group
(75.8+/-18.9%) (p=0.036). The TTIR of 100-140 mg/dL and 70- 140 mg/dL were
also better in the RT-CGM group (p=0.026 and p=0.004, respectively). CV
and mean glucose significantly improved in the RT-CGM group (p=0.034 and
p=0.003, respectively). No significant differences were observed in TBR or
LOS among groups. Conclusion(s): RT-CGM is an effective and safe
strategy for glucose management in diabetes and prediabetes patients
undergoing cardiac surgery.

<119>
Accession Number
647813225
Title
WHAT ARE THE APPROPRIATE GLUCOSE TARGETS IN THE ICU?.
Source
Diabetes Technology and Therapeutics. Conference: 18th International
Conference on Advanced Technologies and Treatments for Diabetes, ATTD
2025. Amsterdam Netherlands. 27(Supplement 2) (pp e29), 2025. Date of
Publication: 01 Feb 2025.
Author
Hirsch I.
Institution
(Hirsch) University of Washington, Seattle, United States
Publisher
Mary Ann Liebert Inc.
Abstract
We don't have evidenced-based glycemic targets in the ICU for as the data
to date has been unclear (except for cardiac surgery). Society
recommendations suggest all patients, with or without diabetes, maintain
glucose in the 140-180 mg/dL range. These pragmatic targets consider
glycemic safety (hypoglycemia) and concerns for hyperglycemia resulting in
worse infection, wound healing, and inflammation. It has been noted
repeatedly since 2002 (including with COVID patients) that those without
diabetes have higher ICU mortality rates with hyperglycemia than those
with diabetes. The reason for this is unclear. In 2020, Krinsley et al
published a retrospective study where HbA1c levels were measured on each
ICU patient starting in 2011.With over 5500 patients, it was shown those
with HbA1c levels benefited from glucose levels 80-140 mg/dL and had a
3.5X higher mortality with glucose levels above 180 mg/dL. However, for
those with admission HbA1c levels > 8%, those with glucose levels 80-140
mg/dL had a 3X greater mortality than those with glucose levels above 180
mg/dL. A future study reported the exception to these observations were
those with HbA1c levels less than 6.5% receiving insulin. For this
population, mortality was almost twice as high with the well-controlled
glucose levels of 80- 140 mg/dL. While the etiology of these findings is
not known, there are several speculatory hypotheses, including brain
adaptation to pre-admission glycemia. This also explains why those with,
compared to without diabetes appear to be protected in the hospital from
hyperglycemia. This hypothesis has been replicated in a bone marrow
transplant population with graft vs. host disease. While the impact of
these findings could result in "precision glycemia" for those admitted to
the ICU, it is time to consider an appropriate randomized controlled trial
to test these findings.

<120>
Accession Number
647800847
Title
The prognostic impact of prevailing definitions of periprocedural
myocardial infarction in patients undergoing coronary artery bypass
grafting.
Source
European heart journal. Quality of care & clinical outcomes. (no
pagination), 2025. Date of Publication: 20 Jun 2025.
Author
Swinnen B.; Kawczynski M.J.; Mingels A.M.A.; Wildberger J.E.; Mihl C.;
Smulders M.W.; Maessen J.G.; Gollmann-Tepekoylu C.; Heuts S.
Institution
(Swinnen, Kawczynski, Maessen, Heuts) Department of Cardiothoracic
Surgery, Maastricht University Medical Centre (MUMC+), Maastricht,
Netherlands
(Swinnen, Wildberger, Mihl, Smulders) Department of Radiology and Nuclear
Medicine, Maastricht University Medical Centre (MUMC+), Maastricht,
Netherlands
(Swinnen, Kawczynski, Mingels, Wildberger, Mihl, Smulders, Maessen, Heuts)
Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University, Maastricht, Netherlands
(Mingels) Central Diagnostic Laboratory, Maastricht University Medical
Centre (MUMC+), Maastricht, Netherlands
(Smulders) Department of Cardiology, Maastricht University Medical Centre
(MUMC+), Maastricht, Netherlands
(Gollmann-Tepekoylu) Department of Cardiac Surgery, Innsbruck Medical
University, Innsbruck, Austria
Abstract
BACKGROUND AND AIMS: Several contradictory definitions have been proposed
for the diagnosis of periprocedural myocardial infarction (PMI) after
coronary artery bypass grafting (CABG). The aim of this study was to study
the prevalence of PMI and to identify the definition of PMI with the most
relevant prognostic impact. METHOD(S): In this systematic review and
meta-analysis, the search was conducted in thee electronic databases
(MEDLINE & PubMed Central, Cochrane Library, Embase). The primary
definitions of interest comprised the universal definition of myocardial
infarction (UDMI; UDMI-3/4) and Society for Cardiovascular Angiography and
Interventions (SCAI) definition. The primary outcomes were the prevalence
of PMI and its prognostic impact, expressed in hazard ratios (HRs) and 95%
confidence intervals (CIs). The frequentist framework was employed for the
primary analysis, and a secondary analysis was performed under a Bayesian
framework. RESULT(S): Ten studies were included (n=21203 patients).
The prevalence of PMI was 17.5% (95%CI 9.5-29.8%) according to SCAI, and
3.2% (95%CI 1.6-6.2%) according to UDMI-3/4. The pooled HR of the SCAI
definition for freedom from all-cause mortality was 1.60 (95%CI 1.18-2.16)
and the HR was 2.54 (1.62-4.00) for UDMI-3/4 (p-for-interaction=0.097).
The posterior probability of exceeding an HR of 1 was >99% for both
definitions, while the probability of the UDMI-3/4 exceeding the mean HR
of SCAI was 96.4%. The results were robust across sensitivity analyses.
 CONCLUSION(S): The prevalence of PMI is markedly higher when
diagnosed according to SCAI criteria in CABG patients. The UDMI criteria
define PMI with the most relevant prognostic impact in CABG
patients. Copyright © The Author(s) 2025. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<121>
Accession Number
647798904
Title
Valve replacement during pregnancy: literature review including new data
from the Registry of Pregnancy and Cardiac disease (ROPAC) III.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2025.
Date of Publication: 20 Jun 2025.
Author
van der Zande J.A.; Siromakha S.; Peters P.N.J.; Youssef G.; Galian-Gay
L.; Ladouceur M.; Wells G.; Takkenberg J.J.M.; Veen K.M.; Ramlakhan K.P.;
Hall R.; Johnson M.R.; Roos-Hesselink J.W.
Institution
(van der Zande, Peters, Ramlakhan, Roos-Hesselink) Department of
Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam,
Netherlands
(van der Zande, Ramlakhan) Department of Obstetrics and Gynecology,
Erasmus MC-Sophia Children's Hospital, University Medical Center
Rotterdam, Rotterdam, Netherlands
(Siromakha) Department of Obstetric Cardiology, Amosov National Institute
of Cardiovascular Surgery, Kyiv, Ukraine
(Youssef) Department of Cardiology, Cairo University Hospital, Cairo,
Egypt
(Galian-Gay) Department of Cardiology, University Hospital Vall d'Hebron,
Barcelona, Spain
(Ladouceur) Department of Cardiology, Hospital Europeen Georges Pompidou,
Paris, France
(Wells) Department of Cardiology, Gill Heart and Vascular Institute,
University of Kentucky, Lexington, United States
(Takkenberg, Veen) Department of Cardiothoracic Surgery, Erasmus MC,
University Medical Center Rotterdam, Rotterdam, Netherlands
(Hall) Department of Cardiology, University of East Anglia, Norwich,
United Kingdom
(Johnson) Department of Obstetric Medicine, Imperial College London,
Kensington, London, United Kingdom
Abstract
OBJECTIVES: Heart valve replacement during pregnancy is sometimes
unavoidable and the need for anticoagulation further complicates these
procedures. Our study describes cases of valve replacement in pregnancy
enrolled in the Registry of Pregnancy and Cardiac disease (ROPAC) III and
gives an overview of the published literature. METHOD(S): We
performed a systematic review with new data from the ROPAC III and data
available in the literature. ROPAC III is a global, prospective,
observational registry that included pregnant women with one or more
prosthetic valves between January 2018 and April 2023. Electronic
databases were searched for studies enrolling pregnant women who underwent
valve replacement during pregnancy with a fetus in-utero. The primary
outcomes were maternal and fetal death. Mixed-effect logistic regression
models were used to identify predictors for maternal and fetal mortality.
 RESULT(S): A valve replacement was performed in 11 pregnancies. The
mother and fetus died in one case, and in two cases reversible
postoperative complications occurred. We found 74 cases in the literature
and calculated an overall maternal and fetal death rate of 9% and 34%,
respectively. All maternal deaths occurred in women with a replacement of
a prosthetic valve in mitral position. We found valve replacement in the
first trimester (OR 10.0) and acute malfunctioning of an existing
prosthetic valve (OR 19.7) as predictors for maternal mortality, and
replacement of an existing prosthetic valve (OR 4.8) as predictor for
fetal mortality. CONCLUSION(S): Valve replacement during pregnancy
carries a high maternal and fetal death, especially in women who need a
replacement of an existing prosthetic valve. Copyright © The
Author(s) 2025. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery.

<122>
Accession Number
2039568049
Title
MSR140 Adapting PRISMA For System Dynamics Models In Healthcare: A Case
Study Of Transcatheter Aortic Valve Implantation In Canada.
Source
Value in Health. Conference: ISPOR 2025. Montreal Canada. 28(6 Supplement
1) (pp S301-S302), 2025. Date of Publication: 01 Jul 2025.
Author
Carapinha J.; Hutzul T.; Lech R.; Nichols S.; Lubbe C.; Pretorius R.
Institution
(Carapinha) Northeastern University, Researcher, Boston, MA, United States
(Hutzul, Lech) Edwards Lifesciences, Toronto, ON, Canada
(Nichols) Edwards Lifesciences, Quebec City, QC, Canada
(Lubbe) Syenza, Johannesburg, South Africa
(Pretorius) Syenza, Boston, MA, United States
Publisher
Elsevier Ltd
Abstract
Objectives: System dynamics models (SDMs) are frequently used in
healthcare decision-making to simulate complex systems, enabling
policymakers to predict outcomes, optimize resources, and make informed
decisions for better long-term health outcomes. Systematic literature
reviews to develop SDM in healthcare face challenges, as PRISMA primarily
synthesizes clinical evidence often overlooking the broader contextual and
systems-level data required for comprehensive modeling. This research
adapts the PRISMA checklist for SDM-specific systematic reviews. This
adapted approach leverages the introduction and methods items of the
PRISMA checklist to ensure a transparent and reproducible process for
identifying and extracting data relevant to SDM development. This approach
is demonstrated through a case study of a SDM for transcatheter aortic
valve implantation (TAVI) in Canada. Method(s): Systematic literature
searches for SDM development mirrors early review stages and includes a
multi-database search. The strategy incorporates both top-down
(disease-specific terms) and bottom-up (primary healthcare terms)
approaches. Titles and abstracts are screened for factors like disease
progression, diagnosis, treatment, and resource use. Full-text articles
are reviewed against predefined eligibility criteria, focusing on data
informing the model's structure and parameters. Data extraction uses a
customized tool to capture variables like definitions, sources, methods,
and study comparisons. The tool prioritizes quantifiable data, such as
time-to-event metrics (e.g., time from murmur detection to
echocardiogram), drop-off rates between stages, and resource utilization.
 Result(s): This approach yielded diverse studies for the TAVI SDM,
moving beyond traditional clinical evidence. It integrated broader data
for modeling the TAVI patient journey. The top-down and bottom-up strategy
identified quantifiable primary healthcare variables. This information
will contribute to a more comprehensive understanding of the factors
influencing early disease detection and referral patterns, ultimately
leading to more robust model parameterization. Conclusion(s): This
adapted PRISMA frameworksupportsstructured, transparent searches for SDM
development, enabling robust simulation models for
decision-making. Copyright © 2025

<123>
Accession Number
2035176326
Title
Cessation vs no cessation of acetylsalicylic acid preoperatively in
laparoscopic totally extraperitoneal inguinal hernia repair (CAPTAIN):
final report from a multi-center, single-blinded, randomized-controlled
trial.
Source
Hernia. 29(1) (no pagination), 2025. Article Number: 221. Date of
Publication: 01 Dec 2025.
Author
Tan L.; Yeow M.; Fatt S.L.K.; Parameswaran R.; Mahipal M.; Loo L.;
Wijerathne S.; Lomanto D.
Institution
(Tan, Yeow, Fatt, Parameswaran, Mahipal, Loo, Wijerathne, Lomanto)
Department of Minimally Invasive Surgery, National University Hospital,
Singapore, Singapore
(Wijerathne) Department of General Surgery, Alexandra Hospital, Singapore,
Singapore
(Wijerathne) Department of Surgery, Minimally Invasive Surgical Centre,
National University Hospital, 5 Lower Kent Ridge Road, Singapore,
Singapore
Publisher
Springer-Verlag Italia s.r.l.
Abstract
Title: Cessation vs No Cessation of Acetylsalicylic acid Preoperatively in
Laparoscopic Totally Extraperitoneal Inguinal Hernia Repair (CAPTAIN):
Final Report from a Multi-Center, Single-Blinded, Randomized-Controlled
Trial. The CAPTAIN trial is a prospective multi-center
randomized-controlled trial evaluating the safety of continuing
acetylsalicylic acid preoperatively in patients undergoing elective
laparoscopic inguinal hernia mesh repair (LIHR). Method(s): Patients
undergoing LIHR were eligible for inclusion. Patients unfit for general
anesthesia, patients who had obstructed hernias or patients who underwent
open operation were excluded. Participants were randomized by the trial
coordinator using allocation concealment to either acetylsalicylic
acid-cessation or continuation group, without the surgeon knowing.
 Outcome(s): Primary outcome was the incidence of bleeding
complications evidenced by the presence of postoperative hematomas before
the patient was discharged from hospital. Secondary outcomes include
incidence of major cardiovascular events, post-operative thromboembolic
events, seroma formation and length of hospital stay. Result(s): 100
patients were recruited between April 2016 and June 2024. 5 patients were
excluded because they 3 underwent open operation, 1 withdrew consent and 1
had their operation cancelled, leaving 45 patients in the acetylsalicylic
acid-continuation group and 50 patients in the cessation group.
 Outcome(s): We found that significantly more patients who continued
acetylsalicylic acid had hematomas in the index admission (11 vs 5, p =
0.018). There was no difference in the amount of intraoperative blood loss
between the two groups, 12.9 vs 9.3ml (p = 0.130). Both groups of patients
had short postoperative stay-an average of less than a day. There were no
postoperative thromboembolic events or major adverse cardiac events in
either group. The rates of postoperative seroma were similar between both
groups, 28.9% vs 26% (p = 0.755). At 30 days post operation, there were no
hernia recurrence or readmissions in either group. Conclusion(s): The
increase in the rate of postoperative hematomas formation in the
acetylsalicylic acid-continuation group though statistically significant;
was not clinically significant as no blood transfusion was required and
all hematomas resolved with conservative management by 90-days clinic
review despite no cessation of acetylsalicylic acid. Thus, this
randomized-controlled trial concludes that it is safe to continue
acetylsalicylic acid perioperatively in selected patients undergoing LIHR.
Larger scale randomized-controlled trials would be helpful to corroborate
these findings. Trial registration: Ethics approval was obtained from our
healthcare cluster's Domain Specific Review Board (reference number
2015/00512). The study protocol was registered on ClinicalTrials.gov
(registration number NCT02604732). Copyright © The Author(s),
under exclusive licence to Springer-Verlag France SAS, part of Springer
Nature 2025.

<124>
Accession Number
647821780
Title
The Cusp Overlap Technique Reduces Pacemaker Implantation in TAVR - A
systematic review and meta-analysis.
Source
The American journal of cardiology. (no pagination), 2025. Date of
Publication: 27 Jun 2025.
Author
Hazique M.; Jafar Z.; Lohana S.; Reyaz I.; Burhan M.; Narayan R.; Alraies
M.C.
Institution
(Hazique, Lohana) Department of Internal Medicine, Nuvance Health / Vassar
Brothers Medical Center, Poughkeepsie, NY, United States
(Jafar, Narayan) Department of Cardiology, Nuvance Health / Vassar
Brothers Medical Center, Poughkeepsie, NY, United States
(Reyaz) Department of Internal Medicine, Christian Medical College,
Ludhiana, India
(Burhan) Department of Internal Medicine, Rawalpindi Medical University,
Rawalpindi, Pakistan
(Alraies) Department of Cardiology, Detroit Medical Center, MI, United
States
Abstract
Transcatheter aortic valve replacement (TAVR) has become the preferred
treatment for symptomatic aortic stenosis, yet conduction disturbances
leading to permanent pacemaker implantation (PPI) remain a significant
complication, particularly with self-expanding valves (SEVs). The cusp
overlap view (COV) technique has been introduced to achieve a higher, more
controlled valve implantation compared to the conventional coplanar view
(CPV). We performed a systematic review and meta-analysis (14 studies;
5,266 TAVR patients) comparing the COV to the CPV. Data were pooled using
the DerSimonian-Laird random-effects model with I2 for heterogeneity. The
analysis demonstrated that the COV technique was associated with
significantly lower PPI rates (11.2% vs. 17.7%; OR = 0.63; p < 0.0001).
Additionally, patients in the COV group experienced a significantly
shorter hospital stay (SMD = -0.56; p = 0.016) and a modestly lower mean
transvalvular gradient (SMD = -0.10; p = 0.049). Although the depth
measured from the non-coronary cusp did not differ significantly between
groups, the arithmetic mean distance from the non-coronary and left
coronary cusps was significantly lower in the COV group (SMD = -0.21; p
<0.001), indicating a higher valve position. Our meta-analysis suggests
that the cusp overlap technique significantly reduces PPI rates and
improves procedural outcomes in TAVR with SEVs. In conclusion, these
findings suggest that COV not only enhances patient outcomes by reducing
conduction disturbances and shortening hospital stays but also optimizes
healthcare resource utilization. Future randomized controlled trials are
needed to confirm these benefits and further standardize TAVR protocols in
clinical practice. Copyright © 2025 Elsevier Inc. All rights
reserved.

<125>
Accession Number
647821575
Title
Gender disparities in authorship in European cardio-thoracic journals.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2025.
Date of Publication: 19 Jun 2025.
Author
Galeone A.; Cleuziou J.; Perrone F.; Maffei I.; Fiorinelli G.; Padua C.D.;
Duarte P.; Denora M.; Kluin J.; Pompili C.
Institution
(Galeone, Perrone, Maffei, Fiorinelli, Denora) Department of Surgery,
Dentistry, Pediatrics and Gynecology, Division of Cardiac Surgery,
University of Verona, Italy
(Cleuziou, Padua) Department of Congenital and Paediatric Heart Surgery,
German Heart Centre Munich, Technical University of Munich, Germany
(Duarte, Kluin) Hospital Israelita Albert Einstein, Sao Paulo, Brazil
(Pompili) Institute for Clinical and Applied Health Research (ICAHR),
Thoracic Surgery Unit, University of Hull, United Kingdom
Abstract
OBJECTIVES: To evaluate gender authorship in two cardio-thoracic surgical
journals. METHOD(S): We performed a bibliometric analysis of all
articles published from 2017 to 2022 in the European Journal of
Cardio-Thoracic Surgery and the Interdisciplinary Cardiovascular and
Thoracic surgery. For each article, the gender and academic rank of the
first, senior and corresponding author was verified by Internet search,
email contact or use of the application Genderize.io. Articles were
categorized based on topic, type and country of origin. The
Cochran-Armitage test was used to evaluate gender authorship trend over
time. RESULT(S): 5243 articles were included in the analysis. Women
represented 18% of first authors, 7% of senior authors and 13% of
corresponding authors and no trend was seen over time. Women represented
16% of first authors and 7% of senior authors in adult cardiac surgery,
23% of first authors and 9% of senior authors in congenital cardiac
surgery, and 19% of first authors and 8% of senior authors in thoracic
surgery. Male first authors were more frequently full professor (17% vs
5%) and associate professor (16% vs 8%) and male senior authors were more
frequently full professor (48% vs 31%) and associate professor (16% vs 8%)
compared to female. CONCLUSION(S): The proportion of female authors
is significantly lower than that of male authors in highest-impact
European cardio-thoracic surgery journals and no significant increase in
female authorship has been demonstrated in recent years. Increasing
awareness of gender disparities is essential to facilitate equal career
opportunities and academic advancement for women in cardio-thoracic
surgery. Copyright © The Author(s) 2025. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved. For commercial re-use, please contact
reprints@oup.com for reprints and translation rights for reprints. All
other permissions can be obtained through our RightsLink service via the
Permissions link on the article page on our site-for further informat

<126>
Accession Number
647821530
Title
Surgical vs. transcatheter treatment of aortic valve stenosis-A
meta-analysis of low-risk randomized trials with completed 5-year
follow-up.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2025.
Date of Publication: 28 Jun 2025.
Author
Doenst T.; Gregg A.C.; Kirov H.; Di Franco A.; Caldonazo T.; Rahouma M.;
Krieger K.; Pisano F.; Gaudino M.; Falk V.
Institution
(Doenst, Kirov, Caldonazo) Department of Cardiothoracic Surgery, Jena
University Hospital, Friedrich Schiller University of Jena, Jena, Germany
(Gregg, Di Franco, Caldonazo, Rahouma, Krieger, Pisano, Gaudino)
Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York,
NY, United States
(Falk) Department of Cardiothoracic and Vascular Surgery, Berlin, Germany
(Falk) DZHK (German Center of Cardiovascular Research), Partner Site
Berlin, Germany
(Falk) ETH Zurich, Department of Health Sciences and Technology, Zurich,
Switzerland
Abstract
OBJECTIVES: Transcatheter aortic valve implantation (TAVI) has shown
similar short-term outcomes when compared to surgical aortic valve
replacement (SAVR) in randomized controlled trials (RCTs). Longer-term
outcomes for low-risk cohorts are now emerging. Here, we analyze all
low-risk TAVI vs. SAVR RCTs that completed five-year follow-up.
 METHOD(S): A systematic MEDLINE database search was conducted through
May 6, 2025, identifying all low-risk RCTs comparing TAVI with SAVR that
had completed five-year follow-up. The primary outcomes were all-cause
mortality and the composite of all-cause mortality or disabling stroke.
Secondary outcomes included: stroke, cardiovascular death, aortic
reintervention, myocardial infarction, paravalvular leak, need for
permanent pacemaker and postprocedural atrial fibrillation.
 RESULT(S): Four RCTs, including 3,557 patients (TAVI: 1,829; SAVR:
1,728), were analyzed. There was no difference between cohorts in
all-cause mortality (IRR 1.01, 95% CI: 0.88-1.16, p = 0.88) or the
composite of all-cause mortality or disabling stroke (IRR 1.03, 95% CI:
0.92-1.17, p = 0.59). TAVI was associated with increased risk of mild or
greater paravalvular leak (IRR 7.63, 95% CI: 2.82-20.65, p < 0.001) and
permanent pacemaker implantation (IRR 2.12, 95% 1.5-2.98, p < 0.001) and a
decreased risk of postprocedural atrial fibrillation (IRR 0.44, 95% CI
0.28-0.71, p < 0.001). CONCLUSION(S): In published RCTs of low-risk
cohorts with completed five-year follow-up, there was no significant
difference between TAVI and SAVR neither in overall mortality nor in the
composite of mortality and stroke. Valve-related events (paravalvular
leaks and pacemaker need) were higher with TAVI, while atrial fibrillation
was more common with SAVR. Copyright © The Author(s) 2025.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved. For commercial re-use,
please contact reprints@oup.com for reprints and translation rights for
reprints. All other permissions can be obtained through our RightsLink
service via the Permissions link on the article page on our site-for
further informat

<127>
Accession Number
2039496873
Title
Role of Blended Learning in Enhancing Self-Efficacy and Medication
Adherence in Cardiac Rehabilitation for Individuals Undergoing Coronary
Artery Bypass Surgery: A Randomized Control Trial.
Source
Archives of Physical Medicine and Rehabilitation. (no pagination), 2025.
Date of Publication: 2025.
Author
Veisi G.; Pakrad F.; Gobbens R.; Mohammadi Y.; Majidi L.
Institution
(Veisi) Student Research Committee, Hamadan University of Medical
Sciences, Hamadan, Iran, Islamic Republic of
(Pakrad) Chronic Diseases (Home Care) Research Center, Institute of
Cancer, Avicenna Health Research Institute, Hamadan University of Medical
Sciences, Hamadan, Iran, Islamic Republic of
(Gobbens) Faculty of Health, Sport and Social Work, Inholland University
of Applied Sciences, Netherlands
(Gobbens) Zonnehuisgroep Amstelland, Amstelveen, Netherlands
(Gobbens) Department of Family Medicine and Population Health, Faculty of
Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
(Gobbens) Department of Tranzo Academic Centre Transformation in Care and
Welfare, Faculty of Behavioural and Social Sciences, Tilburg University,
Tilburg, Netherlands
(Mohammadi) Modeling of Noncommunicable Diseases Research Center,
Institute of Health Sciences and Technologies, Avicenna Health Research
Institute, Hamadan University of Medical Sciences, Hamadan, Iran, Islamic
Republic of
(Mohammadi) Department of Epidemiology, School of Public Health, Hamadan,
University of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Majidi) Department of Physical Medicine and Rehabilitation, Faculty of
Medicine, Hamadan University of Medical Sciences, Hamadan, Iran, Islamic
Republic of
Publisher
W.B. Saunders
Abstract
Objective: This study aimed to evaluate the effectiveness of a traditional
cardiac rehabilitation (CR) program compared with an augmented program
that integrates traditional CR with face-to-face training sessions and
remote assistance facilitated through an application based on the
knowledge, attitudes, and practices model for individuals undergoing
coronary artery bypass graft (CABG) surgery. Design(s): A randomized
controlled trial with a blinded outcome assessment was used
(IRCT20230902059333N1). Setting(s): A major heart center in a
middle-income country. Participant(s): Of the 80 patients referred to
the CR program during the study, 70 patients (N=70) were successfully
enrolled, reaching the target sample size. Participants were randomly
assigned in a 1:1 ratio, resulting in 35 patients per group.
 Intervention(s): In addition to traditional CR, patients participated
in 4 in-person training sessions throughout the rehabilitation process and
received 3 months of follow-up support via the app after completing the
program. Main Outcome Measure(s): Medication adherence and
self-efficacy were assessed before the initiation of CR, immediately after
its completion, and 3 months postcompletion. Result(s): There were no
significant demographic differences between the intervention and control
groups. However, throughout the study, significant differences emerged in
favor of the 3 groups concerning medication adherence and self-efficacy
(P<.001). The intervention group showed substantial and continuous
improvements in medication adherence and self-efficacy scores, which were
evident from the 1st month and persisted over time. Conclusion(s):
Implementing a blended learning approach in CR has demonstrated benefits
in medication adherence and self-efficacy, highlighting the necessity for
further research and clinical application. Copyright © 2025
American Congress of Rehabilitation Medicine

<128>
Accession Number
2039493671
Title
Prophylactic Intravenous Tranexamic Acid in Thoracic Surgery: A
Matched-pair Analysis From the German Thoracic Registry.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Schieren M.; Collaud S.; Bonberg L.; Welters J.; Wappler F.; Defosse J.
Institution
(Schieren, Wappler, Defosse) Department of Anesthesiology and Operative
Intensive Care Medicine, Witten/Herdecke University, Cologne, Germany
(Collaud) Department of Thoracic Surgery, Witten/Herdecke University,
Cologne, Germany
(Bonberg) Faculty of Health, Witten/Herdecke University, Witten, Germany
(Welters) University of Cologne, Department I of Internal Medicine, Center
for Integrated Oncology Aachen Bonn Cologne Dusseldorf (CIO ABCD),
University Hospital Cologne, Cologne, Germany
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate the effect of prophylactic intravenous tranexamic
acid (TXA) on bleeding complications, thromboembolic events, and hospital
stay in patients undergoing thoracic surgery. Design(s):
Retrospective matched-pair analysis of registry data. Setting(s):
German Thorax Registry data from multiple thoracic surgery centers across
Germany. Participant(s): A total of 1,034 adult patients undergoing
thoracic surgical procedures, matched 1:1 (517 received intravenous TXA,
517 did not). Intervention(s): Administration of prophylactic
intravenous TXA prior to thoracic surgery. Measurements and Main
Results: Postoperative bleeding complications, including reoperations for
bleeding and transfusion requirements, did not differ significantly
between groups. However, thromboembolic complications were significantly
less frequent in the TXA group (1.0% v 5.1%). Cardiac complications were
also less frequent in the TXA group. No significant differences were
observed in overall complication rates or length of hospital stay.
 Conclusion(s): Prophylactic intravenous TXA did not reduce bleeding
complications in thoracic surgery but was associated with a lower
incidence of thromboembolic and cardiac events. While no definitive
conclusions can be made about the efficacy of TXA in reducing bleeding
complications, the study offers insights into its potential role in
reducing thromboembolic and cardiac complications. A well-powered,
randomized controlled trial is needed to confirm these
results. Copyright © 2025 The Author(s)

<129>
Accession Number
2039499276
Title
Counterpoint: the design and interpretation of blood transfusion
randomized clinical trials.
Source
Blood. (no pagination), 2025. Date of Publication: 2025.
Author
Carson J.L.; Hebert P.C.; Alexander J.H.
Institution
(Carson) Division of General Internal Medicine, Department of Medicine,
Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United
States
(Hebert) Bruyere Health Research Institute, University of Ottawa, Ottawa,
ON, Canada
(Alexander) Division of Cardiology, Duke Clinical Research Institute, Duke
University, Durham, NC, United States
Publisher
Elsevier B.V.
Abstract
A recent perspective suggested that previous evidence from over a decade
ago established that a liberal rather than a restrictive blood transfusion
strategy results in better outcomes in patients with anemia and either
acute myocardial infarction or stable cardiovascular disease. Their
premise was that physiological evidence, and a different interpretation of
the Transfusion Requirements in Critical Care (TRICC) trial should have
been sufficient to establish clinical practice. They also suggest that a
more personalized approach to the administration of transfusions would
have been made possible by including a usual-care arm in all transfusion
trials. In this counterpoint perspective, we describe how and why 2
discrete and common blood transfusion thresholds were selected in the
TRICC, Functional Outcomes in Cardiovascular Patients Undergoing Surgical
Hip Fracture Repair, Restrictive and Liberal Transfusion Strategies in
Patients with Acute Myocardial Infarction, and Myocardial Ischemia and
Transfusion trials. We explain why a usual-care arm would have been
uninformative. We also propose that we still do not have evidence to
provide firm transfusion recommendations in several specific
subpopulations of patients, including those with stable atherosclerotic
coronary artery disease. Finally, we provide our perspective on the state
of existing evidence and on the clinical recommendations that should be
adopted in practice. Copyright © 2025 American Society of
Hematology

<130>
[Use Link to view the full text]
Accession Number
2039377886
Title
Multimodal Analgesia and Enhanced Recovery Outcomes in Cardiac Surgical
Patients: An Observational Cohort Study.
Source
Anesthesia and Analgesia. (no pagination), 2025. Date of Publication:
2025.
Author
Kleiman A.M.; Tsang S.; Walters S.M.; McNeil J.S.; Yarboro L.; Wu I.;
Kertai M.D.; Glance L.; Mazzeffi M.A.
Institution
(Kleiman, Tsang, Walters, McNeil, Mazzeffi) Department of Anesthesiology,
University of Virginia School of Medicine, Charlottesville, VA, United
States
(Yarboro) Department of Surgery, Division of Cardiothoracic Surgery,
University of Virginia School of Medicine, Charlottesville, VA, United
States
(Wu, Glance) Department of Anesthesiology, University of Rochester School
of Medicine, Rochester, NY, United States
(Kertai) Department of Anesthesiology, Vanderbilt University School of
Medicine, Nashville, TN, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Multimodal analgesia, the use of more than 1 pharmacologic
agent targeting different receptors, is a cornerstone of enhanced recovery
after cardiac surgery (ERACS), but there are limited studies to support
its efficacy. We aimed to explore associations between multimodal
analgesia and enhanced recovery outcomes after cardiac surgery.
 METHOD(S): We performed a retrospective cohort study using data from
the Society of Thoracic Surgeons database from 2020 to 2023. Adults
undergoing elective coronary artery bypass grafting (CABG), valve, or
combined CABG-valve surgery were included. Our primary hypothesis was that
multimodal analgesia would be associated with a lower maximum
postoperative pain score on postoperative day 3 (POD3). Secondarily, we
hypothesized that multimodal analgesia would be associated with reduced
mechanical ventilation hours, intensive care unit stay, delirium,
pneumonia, and reintubation. Linear mixed-effects regression models and
generalized linear mixed-effects regression models were used to examine
the extent the use of multimodal analgesia was associated with study
outcomes after controlling for confounders. RESULT(S): Over the
4-year study period, there were 17,371 eligible cardiac surgical cases and
15,515 patients (89.3%) received multimodal analgesia. There was no
association between multimodal analgesia use and maximum postoperative
pain score on POD3 (b = -0.07, 95% confidence interval [CI], -0.32 to
0.18, P =.57), after adjusting for confounders. There was an association
between multimodal analgesia use and initial mechanical ventilation hours
(b = 0.45 hours, 95% CI, 0.04-0.86, P =.03). Compared to patients who
received multimodal analgesia, those who did not receive multimodal
analgesia had approximately 30 minutes longer of initial mechanical
ventilation time on average. Initial mechanical ventilation time decreased
as the number of multimodal analgesic increased (b= -0.33 hours, 95% CI,
-76 to -0.10, P =.14) for 1 multimodal analgesic; Est = -1.98 hours, 95%
CI, -3.79 to -0.18, P =.03 for 5 multimodal analgesics). Acetaminophen use
was associated with a reduced likelihood of delirium (odds ratio [OR] =
0.75, 95% CI, 0.57-0.94, P =.02), while use of a regional nerve block was
associated with increased likelihood of unplanned reintubation (OR = 1.59,
95% CI, 1.12-2.27, P =.01). CONCLUSION(S): In this retrospective
study, multimodal analgesia was not associated with the primary outcome of
reduction in maximum pain score but was associated with more rapid
extubation. Larger prospective observational and randomized controlled
trials of individual analgesic drugs are needed to optimize ERACS
protocols. Copyright © 2025 International Anesthesia Research
Society.

<131>
Accession Number
2039520511
Title
Comparative effectiveness and safety of self-expanding versus
balloon-expandable transcatheter aortic valve replacement: A systematic
review and meta-analysis.
Source
American Journal of the Medical Sciences. (no pagination), 2025. Date of
Publication: 2025.
Author
Elkholy M.; Akkawi M.; Kidess G.G.; Abdulelah Z.; Rayyan A.; Al-Dqour
M.R.; Damlakhy A.; Bahar Y.; Alraies M.C.
Institution
(Elkholy, Akkawi, Damlakhy) Wayne State University School of Medicine,
Detroit Medical Center, Detroit, MI, United States
(Kidess) Wayne State University School of Medicine, Detroit, MI, United
States
(Abdulelah) Department of Cardiology, Royal Papworth Hospital, Cambridge,
United Kingdom
(Rayyan) School of Medicine, University of Jordan, Amman, Jordan
(Al-Dqour) Department of Internal Medicine, East Tennessee State
University, United States
(Bahar) Wayne State University, Detroit, MI, United States
(Alraies) Cardiovascular Institute, Detroit Medical Center, Detroit, MI,
United States
Publisher
Elsevier B.V.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is a safe
alternative to surgical aortic valve replacement for patients with
symptomatic severe aortic stenosis at increased surgical risk. However,
comparative data on self-expanding valves (SEV) versus balloon-expanding
valves (BEV) remain limited. Method(s): A comprehensive review of
PubMed and Embase was conducted through April 2024, identifying eight
studies (five randomized controlled trials and three propensity-matched
observational studies) comparing SEV and BEV in TAVR. Primary outcomes
included all-cause mortality, cardiovascular mortality, and device success
per Valve Academic Research Consortium criteria, while secondary outcomes
assessed bioprosthetic valve dysfunction and adverse events (annulus
rupture/dissection, coronary artery occlusion, valve
dislocation/embolization, valve thrombosis, moderate and severe
paravalvular aortic regurgitation, endocarditis, permanent pacemaker
implantation, major or life-threatening bleeding, acute kidney injury, and
stroke). Result(s): The analysis included 4032 patients (SEV = 2006;
BEV = 2017). SEV was associated with higher rates of moderate-to-severe
paravalvular aortic regurgitation [OR, 1.76; CI 1.13-2.74; P = 0.01] and
permanent pacemaker placement [OR, 1.57; CI, 1.23-2.00; P = 0.0002]
compared to BEV. No significant differences were observed in 30-day or
1-year all-cause mortality, cardiovascular mortality, device success,
bioprosthetic valve dysfunction, valve dislocation/embolization, valve
thrombosis, endocarditis, major or life-threatening bleeding, coronary
artery occlusion, stroke, rehospitalization, or acute kidney injury.
 Conclusion(s): SEV and BEV demonstrated comparable outcomes in
mortality and device success. However, the higher risk of
moderate-to-severe paravalvular aortic regurgitation and permanent
pacemaker placement with SEV should be considered when selecting the
optimal TAVR valve for individual patients. Copyright © 2025

<132>
Accession Number
647795308
Title
Heart Transplantation: Immunological Challenges Revisited.
Source
Current cardiology reviews. (no pagination), 2025. Date of Publication:
25 Jun 2025.
Author
Assadiasl S.; Safdel S.; Gheitasi M.; Nicknam M.H.
Institution
(Assadiasl, Safdel, Nicknam) Molecular Immunology Research Center, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Assadiasl) Iranian Tissue Bank and Research Center, Tehran University of
Medical Science, Tehran, Iran, Islamic Republic of
(Gheitasi) Department of Immunology, School of Medicine, Kerman University
of Medical Sciences, Kerman, Iran, Islamic Republic of
(Nicknam) Department of Immunology, School of Medicine, Tehran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
Abstract
INTRODUCTION: Immunologic responses to cardiac allografts initiate before
transplantation during brain-dead organ procurement and might persist for
years after transplantation, culminating in chronic allograft dysfunction.
Despite remarkable advances in post-transplant care and immunosuppressive
agents, acute cellular and antibody-mediated rejections as well as chronic
allograft vasculopathy significantly affect cardiac allograft and patient
survival. METHOD(S): Herein, recent findings of the molecular
mechanisms involved in the inflammatory responses before and after heart
transplantation, including brain death donor inflammation, acute cellular
rejection, antibody-mediated rejection, and chronic allograft dysfunction,
have been summarized, along with novel therapeutic approaches for their
treatment. Finally, recent developments in prognostic and diagnostic
biomarkers for immunological complications have been provided, with an
overview of the most promising biomarkers to date. RESULT(S): Due to
the recent developments in the description of molecular mechanisms
involved in the immunopathogenesis of cardiac allograft rejection, some
immune cells, proinflammatory cytokines, and adhesion molecules have been
proposed as therapeutic targets for the prevention or treatment of
alloimmune responses. In addition, several molecules derived from graft
tissue or immune cells, e.g. natriuretic peptides, cardiac troponins,
exosomal products, microRNAs, and donor-derived cell-free DNA, have been
suggested as potential biomarkers for the prediction or diagnosis of
cardiac transplant rejection. CONCLUSION(S): Considering the need to
design non-invasive, low-cost tests for early diagnosis of post-transplant
complications and convenient follow-up of the cardiac transplant
recipients, peripheral blood biomarkers could be appropriate candidates
for this purpose. Copyright© Bentham Science Publishers; For any
queries, please email at epub@benthamscience.net.

<133>
Accession Number
2036727309
Title
Comparison of Thick Biolimus A9-Eluting Stent and Thin Zotarolimus-Eluting
Stent in Multi-Vessel Percutaneous Coronary Intervention.
Source
Korean Circulation Journal. 55(5) (pp 396-407), 2025. Date of Publication:
01 May 2025.
Author
Lee C.H.; Lee H.J.; Chung T.-W.; Lee S.; Hwang J.; Kim I.-C.; Cho Y.-K.;
Yoon H.-J.; Hur S.-H.; Kim J.Y.; Kim Y.S.; Jang W.S.; Lee J.H.; Kim W.;
Lee J.B.; Hong Y.J.; Heo J.H.; Lee B.-R.; Doh J.-H.; Shin E.-S.; Koo
B.-K.; Nam C.-W.
Institution
(Lee, Lee, Chung, Lee, Hwang, Kim, Cho, Yoon, Hur, Kim, Kim, Jang, Nam)
Division of Cardiology, Department of Internal Medicine, Keimyung
University Dongsan Hospital, Daegu, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Kyungpook
National University Hospital, Daegu, South Korea
(Kim) Division of Cardiology, Department of Internal Medicine, Yeungnam
University Medical Center, Daegu, South Korea
(Lee) Department of Cardiology, Daegu Catholic University Medical Center,
Daegu, South Korea
(Hong) Department of Cardiology, Chonnam National University Hospital,
Chonnam National University Medical School, Gwangju, South Korea
(Heo) Division of Cardiology, Department of Internal Medicine, Kosin
University Gospel Hospital, Kosin University College of Medicine, Busan,
South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Daegu
Fatima Hospital, Daegu, South Korea
(Doh) Division of Cardiology, Department of Internal Medicine, Inje
University Ilsan Paik Hospital, Inje University College of Medicine,
Goyang, South Korea
(Shin) Department of Cardiology, Ulsan University Hospital, University of
Ulsan College of Medicine, Ulsan, South Korea
(Koo) Department of Internal Medicine and Cardiovascular Centre, Seoul
National University Hospital, Seoul, South Korea
Publisher
Korean Society of Cardiology
Abstract
Background and Objectives: There are limited randomized studies on
patients undergoing multi-vessel percutaneous coronary intervention (PCI)
comparing the outcomes between stent thickness and polymer types. To
compare the clinical outcomes of thick biodegradable polymer-based
biolimus A9-eluting stents (BESs) and thin durable polymer-based
zotarolimus-eluting stents (ZESs) in patients undergoing multi-vessel PCI.
 Method(s): A total of 936 patients who underwent multi-vessel
coronary artery stenting were randomly assigned to the BES (n=472) or ZES
(n=464) groups. The primary endpoint was 2-year major adverse cardiac
events (MACEs), a composite of all-cause death, myocardial infarction
(MI), and any revascularization at the 2-year follow-up. Result(s):
Fifty-two (11.2%) of 472 patients in BES group and 50 (10.9%) of the 464
patients in ZES group met the 2-year primary endpoint of MACE (hazard
ratio, 1.00; 90% confidence interval, 0.72, 1.38; p=0.994). All-cause
death (BES vs. ZES: 2.8% vs. 2.7%, p=0.758), MI (2.1% vs. 2.6%, p=0.483),
and repeat revascularization (6.7% vs. 6.9%, p=0.876) were not
significantly different between the 2 groups. Although there was no
significant outcome difference in any subgroup analysis, the technical
failure rate leading to the use of other stents was higher in BES than in
ZES (3.2% vs. 0.9%, p=0.023). Conclusion(s): In patients who
underwent multi-vessel PCI, BES and ZES showed comparable 2-year clinical
outcomes. However, BES was not established to demonstrate non-inferiority
to ZES in terms of the incidence of the primary endpoint at the 2-year.
The technical success rate of the index PCI with the assigned stent was
higher for thinner ZES. Copyright © 2025. The Korean Society of
Cardiology.

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