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<1>
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.

<2>
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.

<3>
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.

<4>
Accession Number
2039599553
Title
Ultrasound-guided external oblique intercostal plane block versus thoracic
erector spinae block for post-thoracotomy pain: A randomised
double-blinded non-inferior clinical study.
Source
Indian Journal of Anaesthesia. 69(8) (pp 809-815), 2025. Date of
Publication: 01 Aug 2025.
Author
Moharam S.A.; Elsharkawy M.S.; Almohasseb M.A.; Hamama K.; Mahmoud M.A.;
Abogabal M.A.
Institution
(Moharam, Elsharkawy, Almohasseb, Hamama, Abogabal) Anesthesiology
Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta
University, Tanta, Egypt
(Mahmoud) Anesthesia Intensive Care and Pain Management, Faculty of
Medicine, Al-Azhar University, Asyut, Egypt
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Regional techniques are preferred for controlling
post-thoracotomy pain due to lower complication rates. This study aimed to
compare the analgesic efficacy and safety of ultrasound-guided external
oblique intercostal block (EOIB) with thoracic erector spinae plane block
(ESPB) for post-thoracotomy pain. Method(s): This randomised,
double-blind, non-inferior clinical study involved 60 cases scheduled for
thoracic surgery. Cases were randomly allocated into two groups: ESPB and
EOIB groups. Using 30 mL 0.25% bupivacaine at the level of the thoracic
vertebrae 5, both blocks were performed after induction of general
anaesthesia. The primary outcome was morphine consumption in the first 24
hours postoperatively. The secondary outcomes were time to first rescue
analgesic request postoperatively, numerical rating scale (NRS) score
during rest and with coughing, and occurrence of complications. The
non-parametric Wilcoxon test was used for non-normally distributed
variables, the Student's t-test was used for normally distributed
variables, and the Chi-square/Fisher's exact test was used for qualitative
variables. The significance level was set at P <= 0.05. Result(s):
Patients who required intraoperative fentanyl, time of first request for
analgesia, total morphine consumption, and pain score within the first 24
hours post-surgery were comparable between the two groups (P = 0.347,
0.085, and 0.354, respectively). Both groups exhibited comparable
incidences of hypotension and bradycardia (P = 0.353 and P > 0.99,
respectively). Local anaesthetic systemic toxicity (LAST) and pneumothorax
did not occur in any patient in either group. Conclusion(s): The
analgesic effect of EOIB was non-inferior to ESPB for post-thoracotomy
pain, as evidenced by comparable total opioid consumption, time of first
request for analgesia, and pain score in the first 24 hours post-surgery.
Additionally, EOIB demonstrated the same level of safety as
ESPB. Copyright © 2025 Wolters Kluwer Medknow Publications. All
rights reserved.

<5>
Accession Number
2039597097
Title
Surgical versus 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. 67(7) (no pagination), 2025.
Article Number: ezaf215. Date of Publication: 01 Jul 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, Deutsches
Herzzentrum der Charite, Berlin, Germany
(Falk) DZHK (German Center of Cardiovascular Research), Partner Site
Berlin, Berlin, Germany
(Falk) Department of Health Sciences and Technology, ETH Zurich, Zurich,
Switzerland
Publisher
European Association for Cardio-Thoracic Surgery
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 analyse all
low-risk TAVI versus SAVR RCTs that completed 5-year follow-up. METHODS A
systematic MEDLINE database search was conducted through 6 May 2025,
identifying all low-risk RCTs comparing TAVI with SAVR that had completed
5-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. RESULTS Four RCTs, including 3557
patients (TAVI: 1829; SAVR: 1728), were analysed. There was no difference
between cohorts in all-cause mortality [incidence rate ratio (IRR) 1.01,
95% confidence interval (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% CI: 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). CONCLUSIONS In published RCTs of low-risk cohorts
with completed 5-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 © 2025 The Author(s). 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 information please contact journals.permissions@oup.com.

<6>
Accession Number
2035230094
Title
Risk prediction in heart failure using invasive hemodynamics.
Source
Clinical Research in Cardiology. (no pagination), 2025. Date of
Publication: 2025.
Author
Kraus M.J.; Veshapeli A.; Reich C.; Hund H.; Hamed S.; Raake P.W.;
Kreusser M.M.; Frey N.; Lehmann L.
Institution
(Kraus, Veshapeli, Reich, Hund, Hamed, Kreusser, Frey, Lehmann) Department
of Internal Medicine III, Division of Cardiology, University of
Heidelberg, Im Neuenheimer Feld 410, Heidelberg, Germany
(Reich, Hund, Raake, Kreusser, Frey, Lehmann) DZHK (German Center for
Cardiovascular Research), Partner Site Heidelberg/Mannheim, Mannheim,
Germany
(Raake) Department of Cardiology, University Hospital of Augsburg,
Augsburg, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Aims: Risk stratification in patients with heart failure patients is
crucial. The prognostic value of invasive hemodynamic parameters measured
by right heart catheterization compared to established risk scores remains
unknown. Methods and Results: This retrospective analysis included
883 patients. The combined endpoint was all-cause mortality, heart
transplantation or left ventricular assist device implantation. A Cox
proportional hazards model assessed the impact of invasive parameters,
cardiac biomarkers, and patient characteristics, comparing them with the
Seattle Heart Failure Model (SHFM) and the Meta-Analysis Global Group in
Chronic Heart Failure (MAGGIC) Score. A new score was created including
mean pulmonary arterial (PA) pressure, mean right atrial pressure, mean
pulmonary artery wedge pressure (PAWP), age, N-terminal pro-brain
natriuretic peptide (NT-proBNP), high-sensitivity troponin T (hsTnT),
mixed venous oxygen saturation (SVO2), creatinine, and presence of
ischemic cardiomyopathy. Mean, diastolic, and systolic PA pressure, mean
right atrial pressure, mean PAWP, SVO2 and cardiac index were significant
predictors for the primary endpoint reached by 467/883 (53%) patients, in
a multiple Cox proportional hazards model (p < 0.001). The predictive
value was diminished in a subgroup of patients with ischemic
cardiomyopathy. We used invasive parameters, age, NT-proBNP,
hsTnT<inf>,</inf> creatinine presence of ischemic cardiomyopathy and sex
to develop a new model for risk stratification. This new score showed
better performance compared to the SHFM and MAGGIC score in predicting the
primary endpoint at 6, 12 and 24 months (area under the curve 0.76, 0.78
and 0.77 vs 0.71/0.69, 0.70/0.68 and 0.70/0.70). Conclusion(s):
Invasive hemodynamics provides valuable measurements for predicting
outcome in heart failure with reduced ejection fraction and show better
performance than established risk models when combined with cardiac
biomarkers and other clinical variables in this particular
cohort. Copyright © The Author(s) 2025.

<7>
Accession Number
2036869635
Title
Prognostic Value of Cardiovascular MRI in Asymptomatic Patients with
Moderate-to-Severe Aortic Regurgitation: A Network Meta-Analysis.
Source
Radiology: Cardiothoracic Imaging. 7(3) (no pagination), 2025. Article
Number: e240313. Date of Publication: 01 Jun 2025.
Author
Figliozzi S.; Stankowski K.; Maio S.D.; Pateras K.; Rojanathagoon T.;
Marchenko O.; Stylianidis V.; Francone M.; Monti L.; Cavalcante J.L.;
Georgiopoulos G.; Masci P.G.
Institution
(Figliozzi, Maio, Monti) Cardio Center, IRCCS Humanitas Research Hospital,
Milan, Rozzano, Italy
(Figliozzi, Maio, Francone, Monti) Department of Biomedical Sciences,
Humanitas University, Milan, Pieve Emanuele, Italy
(Stankowski) Department of Peri-Operative Cardiology and Cardiovascular
Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(Pateras) Department of Public and One Health, University of Thessaly,
Volos, Greece
(Rojanathagoon) School of Medicine, University of Nottingham, Nottingham,
United Kingdom
(Marchenko, Stylianidis, Georgiopoulos, Masci) School of Biomedical
Engineering and Imaging Sciences, King's College London, Westminster
Bridge Road, London, United Kingdom
(Francone) Department of Radiology, IRCCS Humanitas Research Hospital,
Milan, Rozzano, Italy
(Cavalcante) Allina Health Minneapolis Heart Institute, Minneapolis, MN,
United States
(Georgiopoulos) Department of Physiology, University of Patras, Patras,
Greece
Publisher
Radiological Society of North America Inc.
Abstract
Purpose: To determine the prognostic significance of cardiac MRI
parameters in patients with moderate-to-severe aortic regurgitation (AR)
and minimal or no symptoms through a network meta-analysis.
 Material(s) and Method(s): This systematic review and network
meta-analysis searched in PubMed, Embase, and Cochrane Library databases
for articles published from January 1, 2000, to March 1, 2024,
investigating the prognostic value of cardiac MRI parameters in patients
with moderate-to-severe AR. The composite outcome included all-cause
death, heart failure hospitalization, aortic valve replacement, new-onset
heart failure symptoms, New York Heart Association class progression, and
left ventricular ejection fraction less than 50%. Both pairwise and
network meta-analyses were performed. Result(s): Eight studies with
1579 patients (1187 male patients [75%]; mean age, 55 years +/- 5 [SD])
were included. Aortic regurgitant volume and regurgitant fraction were
associated with a higher incidence of adverse events (pooled hazard ratio
[HR], 1.04 per 1 mL increase [95% CI: 1.01, 1.06] and pooled HR, 1.09 per
1% increase [95% CI: 1.03, 1.16], respectively). Adverse remodeling,
reflected by increased end-diastolic or end-systolic volume (pooled HR,
1.02 per 1 mL/m2 [95% CI: 1.01, 1.03] and pooled HR, 1.02 per 1
mL/m2 [95% CI: 1.01, 1.04], respectively), was predictive of
worse outcome. Late gadolinium enhancement was associated with a twofold
increased risk of developing the study end point (pooled HR, 1.86; 95% CI:
1.20, 2.89). T1 mapping and extracellular volume could not be assessed.
Network meta-analysis disclosed that late gadolinium enhancement (P =.884)
and regurgitant fraction (P =.727) were the most important prognostic
factors. Conclusion(s): This network meta-analysis demonstrated the
strong prognostic value of regurgitant fraction and left ventricular
adverse remodeling as assessed with cardiac MRI in risk stratification of
patients with moderate-to-severe AR and no or minimal
symptoms. Copyright © RSNA, 2025.

<8>
Accession Number
2039541360
Title
Representativeness of surgical controls in aortic valve replacement
trials: comparison with routine surgical cohorts.
Source
Heart. (no pagination), 2025. Article Number: heartjnl-2025-326162. Date
of Publication: 2025.
Author
Tomsic A.; Velders B.J.J.; Kawczynski M.J.; Schoones J.W.; Klautz R.J.M.;
Palmen M.; Sardari Nia P.; Owais T.; Girdauskas E.; Heuts S.
Institution
(Tomsic, Owais, Girdauskas) Department of Cardiothoracic Surgery, Augsburg
University Medical Centre, Ausburg, Germany
(Velders, Klautz, Palmen) Department of Cardiothoracic Surgery, Leiden
University Medical Centre, Leiden, Netherlands
(Kawczynski, Sardari Nia, Heuts) Department of Cardiothoracic Surgery,
Maastricht University Medical Centre, Maastricht, Netherlands
(Kawczynski, Sardari Nia, Heuts) Cardiovascular Research Institute
Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
(Schoones) Directorate of Research Policy, Leiden University Medical
Center, Zuid-Holland, Leiden, Netherlands
(Klautz) Department of Cardiothoracic Surgery, Amsterdam University
Medical Centre, Amsterdam, Netherlands
Publisher
BMJ Publishing Group
Abstract
Background: Randomised controlled trials (RCTs) comparing transcatheter
aortic valve implantation (TAVI) and surgical aortic valve replacement
(SAVR) have significantly influenced treatment guidelines for aortic
stenosis, expanding the use of TAVI into lower risk populations. However,
the patients enrolled in the SAVR arms of these trials may differ from
those typically undergoing SAVR in routine clinical practice. This study
aims to critically assess the representativeness of SAVR patients in these
RCTs by comparing their characteristics and outcomes to those of patients
undergoing SAVR in routine clinical practice. Method(s): A systematic
literature review was conducted across PubMed, Embase, Web of Science,
Emcare and the Cochrane Library, focusing on RCTs and large prospective
studies (n>=500 SAVR patients), enrolling low-risk or intermediate-risk
patients since 2010. Patient characteristics, early outcomes and 5-year
survival were compared between RCT SAVR cohorts and those treated in
routine clinical practice settings. Meta-analyses of pooled data and
reconstructed Kaplan-Meier survival analyses were performed, with
stratification by risk category. Result(s): Nineteen studies (9 RCTs
and 10 studies describing routine clinical practice), encompassing 74 797
SAVR patients, were included. SAVR patients in routine clinical practice
demonstrated comparable early mortality to SAVR patients in RCTs but
experienced fewer periprocedural complications, including lower rates of
stroke, pacemaker implantation and myocardial infarction. At 5 years,
overall survival was notably higher in patients treated in routine
clinical practice compared to those in the SAVR arms of RCTs, both for
low-risk (HR 0.64, 95% CI 0.55 to 0.75) and intermediate-risk patients (HR
0.55, 95% CI 0.470.64). Conclusion(s): Compared with typical SAVR
patients treated in routine practice, RCT SAVR patients experienced higher
complication rates and worse long-term survival, despite similar or lower
surgical risk scores. These findings question the external validity of
SAVR versus TAVI trials. Copyright © Author(s) (or their
employer(s)) 2025. No commercial re-use. See rights and permissions.
Published by BMJ Group.

<9>
Accession Number
2035293100
Title
Effect of pulmonary hypertension on the prognosis of patients with severe
aortic stenosis after transcatheter aortic valve replacement: a systematic
review and meta-analysis.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
515. Date of Publication: 01 Dec 2025.
Author
Ruan Y.; Wei X.; Li Q.; Jin Z.
Institution
(Ruan, Wei, Li, Jin) Department of Cardiology, Beijing Tiantan Hospital,
Capital Medical University, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Objective: To systematically evaluate the impact of pulmonary hypertension
(PH) on the prognosis of patients with severe aortic stenosis (AS)
undergoing transcatheter aortic valve replacement (TAVR). Method(s):
We conducted a meta-analysis of cohort studies to evaluate the impact of
PH on the prognosis of patients with severe AS undergoing TAVR. A
comprehensive search was performed in PubMed, Embase, and the Cochrane
Library up to June 2024. Data extraction and quality assessment were
carried out independently by two researchers. Statistical analyses were
conducted using STATA 15.1. Result(s): A total of 7 cohort studies
were included. Meta-analysis results demonstrated that patients with PH
who underwent TAVR had significantly higher rates of all-cause mortality
at 30 days (OR = 2.52, 95% CI: 1.70-3.73, P < 0.001), 1 year (OR = 2.01,
95% CI: 1.52-2.66, P < 0.001) and 1-year cardiovascular mortality (OR =
2.56, 95% CI: 1.84-3.57, P < 0.001), compared to those without PH. There
was no statistical difference between the two groups in major bleeding
events, stroke, myocardial infarction and pacemaker implantation.
 Conclusion(s): PH is associated with higher short- and long-term
mortality in AS patients undergoing TAVR, suggesting it as a crucial
factor in patient prognosis post-procedure. Copyright © The
Author(s) 2025.

<10>
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.

<11>
[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.

<12>
Accession Number
2039450705
Title
Mitral Valve Transcatheter Edge-to-Edge Repair or Medical Therapy in
Systolic Heart Failure: A Meta-Analysis of Randomized Trials.
Source
Journal of the American Heart Association. 14(13) (no pagination), 2025.
Article Number: e039285. Date of Publication: 2025.
Author
Reddy R.K.; Koeckerling D.; Stone G.W.; Howard J.P.; Ahmad Y.
Institution
(Reddy, Howard) National Heart and Lung Institute, Imperial College
London, London, United Kingdom
(Reddy) Nuffield Department of Population Health, University of Oxford,
Oxford, United Kingdom
(Koeckerling) Department of Cardiology, Angiology and Respiratory
Medicine, Heidelberg University Hospital, Heidelberg, Germany
(Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Ahmad) Division of Cardiology, University of California, San Francisco,
CA, United States
Publisher
American Heart Association Inc.

<13>
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.

<14>
Accession Number
2035293216
Title
Enhancing bleeding reporting in acute coronary syndrome clinical trials: a
systematic review of the ABC guidelines adherence.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
512. Date of Publication: 01 Dec 2025.
Author
Garcia-Campa M.; Medrano-Juarez S.; Castillo-Morales P.L.;
Montiel-Labastida J.A.; Vera-Pineda R.; Carrizales-Sepulveda E.F.;
Reyes-Araiza R.; Alvarez-Villalobos N.; Rodriguez-Gutierrez R.;
Azpiri-Lopez J.R.; Flores-Ramirez R.
Institution
(Garcia-Campa, Vera-Pineda, Carrizales-Sepulveda, Reyes-Araiza,
Azpiri-Lopez, Flores-Ramirez) Cardiology Service; "Dr. Jose E. Gonzalez"
University Hospital, Autonomous University of Nuevo Leon, Av. Francisco
Madero s/n, Monterrey, Mexico
(Garcia-Campa, Medrano-Juarez, Castillo-Morales, Montiel-Labastida,
Alvarez-Villalobos, Rodriguez-Gutierrez) Plataforma INVEST UANL-KER Unit
Mayo Clinic, School of Medicine and "Dr. Jose E. Gonzalez" University
Hospital, Autonomous University of Nuevo Leon, Monterrey, Mexico
(Garcia-Campa, Medrano-Juarez, Castillo-Morales, Montiel-Labastida,
Alvarez-Villalobos, Rodriguez-Gutierrez) Advanced Analysis Center of
Scientific Information, School of Medicine and "Dr. Jose E. Gonzalez"
University Hospital, Autonomous University of Nuevo Leon, Monterrey,
Mexico
Publisher
BioMed Central Ltd
Abstract
Background: Bleeding events in acute coronary syndromes (ACS)
significantly affect patient outcomes, yet consistent reporting remains a
challenge for clinicians. Although multiple standardized bleeding
definitions exist, the Academic Bleeding Consensus (ABC) provides the only
dedicated reporting guideline. This systematic review evaluates the
adoption of the ABC guidelines and adherence to bleeding definition
reporting in clinical research. Method(s): We systematically searched
Scopus, Web of Science, MEDLINE, EMBASE, and Cochrane Central for
randomized clinical trials (RCTs) published between 2012 and 2025
involving adult patients with ACS. Result(s): Of the 135 RCTs
included in the quantitative analysis, none fully adhered to the ABC
reporting guidelines. Most trials only partially reported elements in the
red and green domains, with only two RCTs fully reporting the orange
domain. The Bleeding Academic Research Consortium (BARC) definition was
the most frequently used (73.3%), though its reporting was often
incomplete (82.8%). Industry-funded RCTs (OR: 3.66; 95%CI: 1.55-2.90),
those prioritizing patient-important outcomes (OR: 13.22; 95%CI:
1.72-101.27), and trials with bleeding outcome reporting according to
definition (OR: 3.88; 95%CI 10.22) were more likely to fully report
bleeding definitions. Conversely, RCTs using the BARC definition showed
lower rates of complete reporting. Conclusion(s): The lack of
adherence to the ABC guidelines highlights the need for a universally
accepted reporting framework that integrates qualitative and quantitative
bleeding characteristics. Such a guideline would enhance the
interpretability of ACS interventions, supporting better patient-centered
decision-making. Copyright © The Author(s) 2025.

<15>
Accession Number
2035274150
Title
Exploring mitochondrial health and transplantation strategies in DCD heart
transplantation: a systematic review.
Source
Journal of Translational Medicine. 23(1) (no pagination), 2025. Article
Number: 789. Date of Publication: 01 Dec 2025.
Author
Zhang X.; Yang Y.; Wang H.; Yan C.; Feng Y.; Ma X.; Hu M.; Li S.; Cheng C.
Institution
(Zhang, Yang, Yan, Ma, Hu, Li) Department of Cardiothoracic and Vascular
Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of
Science and Technology, 1095# Jiefang Ave, Hubei, Wuhan, China
(Feng, Cheng) Department of Cardiovascular Surgery, The Second Affiliated
Hospital, Zhejiang University School of Medicine, Zhejiang, Hangzhou,
China
(Wang) The Third Affiliated Hospital, Guangzhou Medical University,
Guangdong, Guangzhou, China
Publisher
BioMed Central Ltd
Abstract
This review explores the significant potential of mitochondrial
transplantation (MT) in enhancing outcomes for DCD heart transplantation,
particularly in mitigating ischemia-reperfusion injury (IRI). MT restores
mitochondrial function and ATP production, thereby improving myocardial
contractility and counteracting the energy depletion and oxidative stress
that jeopardize the viability of DCD grafts. Furthermore, the synergistic
application of MT with extracorporeal perfusion significantly enhances
graft viability by reducing metabolic waste accumulation and modulating
the inflammatory response during prolonged preservation. Studies show that
MT decreases reactive oxygen species (ROS) levels, enhances antioxidant
enzyme activity, and regulates immune activation, ultimately improving
graft survival. Notably, MT has shown promising results in maintaining
heart function during extended perfusion, delaying functional loss due to
energy depletion. Despite encouraging preclinical findings, additional
clinical validation is required, particularly in DCD heart
transplantation, to confirm its potential in improving long-term graft
function and expanding the donor pool in high-risk
scenarios. Copyright © The Author(s) 2025.

<16>
Accession Number
2038177617
Title
Transcatheter Aortic Valve Implantation vs Surgical Aortic Valve
Replacement in Patients at Lower Surgical Risk: Meta-analysis of
Randomized Trials.
Source
Canadian Journal of Cardiology. 41(7) (pp 1258-1269), 2025. Date of
Publication: 01 Jul 2025.
Author
Lerman T.T.; Greenberg N.; Kheifets M.; Talmor-Barkan Y.; Codner P.; Perl
L.; Witberg G.; Orvin K.; Eisen A.; Grinberg T.; Skalsky K.; Shapira Y.;
Belkin D.; Jorgensen T.H.; Horsted Thyregod H.G.; De Backer O.; Fishman
B.; Kornowski R.; Levi A.
Institution
(Lerman, Kheifets, Talmor-Barkan, Codner, Perl, Witberg, Orvin, Eisen,
Grinberg, Skalsky, Shapira, Kornowski, Levi) Department of Cardiology,
Rabin Medical Center, Petah Tikva, Israel
(Lerman, Greenberg, Kheifets, Talmor-Barkan, Codner, Perl, Witberg, Orvin,
Eisen, Grinberg, Skalsky, Shapira, Belkin, Fishman, Kornowski, Levi)
Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv,
Israel
(Greenberg) Department of Internal Medicine F-Recanati, Beilinson
Hospital, Rabin Medical Center, Petah Tikva, Israel
(Jorgensen, De Backer) Department of Cardiology, The Heart Centre,
Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
(Horsted Thyregod) Department of Cardiothoracic Surgery, The Heart Centre,
Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
(Fishman) University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
Publisher
Elsevier Inc.
Abstract
Background: The use of transcatheter aortic valve implantation (TAVI) for
severe aortic stenosis is expanding to patients across the entire spectrum
of surgical risk. We performed a meta-analysis and compared TAVI with
surgical aortic valve replacement (SAVR) in trials that enrolled
lower-risk patients. Method(s): We conducted a meta-analysis of
randomized controlled trials and compared safety and efficacy outcomes
between TAVI and SAVR among lower-risk patients (mean and/or median
Society of Thoracic Surgeons [STS] score < 4). Point-estimate
meta-analysis and reconstructed individual patient data survival analysis
were conducted. Primary outcomes included all-cause mortality, stroke, and
a composite of all-cause mortality or disabling stroke (PROSPERO,
CRD42024541837). Result(s): The analysis included 6 randomized
controlled trials, totaling 2668 TAVI and 2573 SAVR patients, with a mean
follow-up time of 3.02 years. TAVI was associated with lower risk of
all-cause mortality (risk ratio, 0.68; 95% confidence interval, 0.52-0.88)
and a composite of all-cause mortality or disabling stroke (risk ratio,
0.69; 95% confidence interval, 0.55-0.86) without a significant difference
in stroke up to 2 years. Longer-term point-estimate analysis showed no
difference. In reconstructed individual patient data, TAVI was associated
with a lower risk of all-cause mortality, driven by an early advantage.
Restricted mean survival time differences for primary outcomes were < 2.5
months and <= 1 month for all-cause mortality. TAVI was associated with a
lower risk of bleeding, kidney injury, and atrial fibrillation, but a
higher risk of pacemaker implantation and moderate to severe aortic
regurgitation. Conclusion(s): In patients at lower surgical risk,
TAVI was associated with improved short-term mortality. More data from
long-term studies are needed. Copyright © 2025 Canadian
Cardiovascular Society

<17>
Accession Number
2039555466
Title
Effectiveness of Pecto-Intercostal Fascia Plane Block in Reducing Total
Postoperative Opioid Consumption in Cardiac Surgery Involving Sternotomy:
A Meta-Analysis.
Source
Annals of Cardiac Anaesthesia. 28(3) (pp 219-227), 2025. Date of
Publication: 01 Jul 2025.
Author
Wardhana A.; Sudono H.; Kurniawaty J.
Institution
(Wardhana, Kurniawaty) Department of Anesthesiology and Intensive Therapy,
School of Medicine, Faculty of Medicine Public Health and Nursing,
Universitas Gadjah Mada, Yogyakarta, Indonesia
(Sudono) Department of Anesthesiology and Intensive Therapy, Blambangan
Public District Hospital, East Java, Indonesia
Publisher
Wolters Kluwer Medknow Publications
Abstract
The pecto-intercostal fascia plane block (PIFB) is gaining recognition for
its potential to reduce postoperative opioid use after cardiac surgery.
This study aimed to evaluate the effectiveness of PIFB compared with
conventional intravenous regimens in reducing total postoperative opioid
consumption in patients undergoing cardiac surgery involving sternotomy. A
meta-analysis of relevant studies, published up to August 13, 2024,
retrieved from the PubMed and CENTRAL databases was performed. The
inclusion criteria were studies involving a superficial parasternal block
or PIFB for patients undergoing cardiac surgery involving sternotomy.
Studies comparing PIFB with other blocks or local anesthetic regimens were
excluded. Data analysis was performed using an inverse variance
random-effects model using RevMan 5.4.1 software, with the effect measure
expressed as standardized mean difference (SMD) to account for the
different opioids used. Of 88 studies retrieved in the literature search,
16 fulfilled the inclusion criteria [ten ultrasound (US)-guided and six
non-US-guided]. PIFB significantly reduced total opioid consumption [SMD
-1.55 (95% CI -2.15 to -0.95); P < 0.001] and time to extubation [SMD
-1.22 (95% CI -2.05 to -0.38); P < 0.001]. A subgroup analysis of
multiple- versus single-shot injections yielded consistent results.
Analyses including only US-guided PIFB revealed consistent reductions in
total opioid consumption [SMD -1.18 (95% CI -1.79 to -0.56); P < 0.001]
and time to extubation [SMD -0.82 (95% CI -1.01 to -0.63); P < 0.001].
PIFB effectively reduced opioid consumption and shortened postoperative
time to extubation in cardiac surgery involving sternotomy. Copyright
© 2025 Annals of Cardiac Anaesthesia.

<18>
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.

<19>
Accession Number
2039464789
Title
Outcomes of Lesions With Discordance Between FFR and Nonhyperemic Pressure
Ratios.
Source
JACC: Cardiovascular Interventions. 18(13) (pp 1631-1642), 2025. Date of
Publication: 14 Jul 2025.
Author
Ha E.T.; Nishi T.; Takahashi T.; Yamazaki T.; Saito Y.; Kuramitsu S.;
Kawase Y.; Parikh M.A.; Waksman R.; Kobayashi Y.
Institution
(Ha, Nishi, Parikh, Kobayashi) NewYork-Presbyterian Brooklyn Methodist
Hospital, Brooklyn, NY, United States
(Takahashi) Smidt Heart Institute, Cedars-Sinai Medical Center, CA, United
States
(Yamazaki, Saito) Department of Cardiovascular Medicine, Chiba University
Graduate School of Medicine, Chiba, Japan
(Kuramitsu) Sapporo Cardiovascular Clinic, Sapporo Heart Center, Sapporo,
Japan
(Kawase) Gifu Heart Center, Gifu, Japan
(Parikh, Kobayashi) Weill Cornell Medical College, New York, NY, United
States
(Waksman) Medstar Washington Hospital Center, Washington, DC, United
States
Publisher
Elsevier Inc.
Abstract
Background: Discordance between fractional flow reserve (FFR) and
nonhyperemic pressure ratios (NHPRs) can occur in about 20% of clinical
cases, creating treatment dilemmas in the cardiac catheterization
laboratory. Objective(s): The authors sought to perform a systematic
review and meta-analyses investigating the long-term outcome of deferral
strategy in patients found to have discordant physiology. Method(s):
The primary comparison tested the long-term prognosis of patients who were
deferred for discordant physiology vs those deferred for concordant
negative results. Various NHPRs were compared with FFR. The primary
endpoint was a composite of death (all-cause or cardiac) and myocardial
infarction/revascularization with several definitions. Secondary endpoint
consisted of death or myocardial infarction. The study is registered with
PROSPERO (CRD42024628393). Result(s): Six eligible trials with 9,854
intermediate lesions deferred for PCI were considered in the analysis.
Compared with concordant-negative physiology
(FFR-/NHPRs-), deferral of PCI for discordant
physiology was associated with an increase in the primary endpoints
(FFR-/NHPRs+: HR: 2.73 [1.95-3.80]; P < 0.00001 and
FFR+/NHPRs-: HR: 3.29[2.33-4.64]; P < 0.00001).
Secondary dichotomous analysis showed that deferral of PCI in both
discordant groups was associated with an increase in the hard endpoints
(death or myocardial infarction) compared with concordant-negative
physiology. Exploratory analysis comparing revascularization vs deferral
groups within discordant physiology demonstrated reduction in the primary
endpoint in the FFR+/NHPRs- group, but not in the
FFR-/NHPRs+ group. Conclusion(s): Deferral of
PCI in discordant-physiology was associated with worse long-term outcomes
compared with the concordant-negative physiology. There may be a benefit
of revascularization in FFR+/NHPRs- lesions, which
requires further investigation. Copyright © 2025 American College
of Cardiology Foundation

<20>
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.

<21>
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.

<22>
[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.

<23>
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.

<24>
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.

<25>
Accession Number
2038641621
Title
Continuation versus Discontinuation of Renin-Angiotensin System Inhibitors
Before Noncardiac Surgery: A Systematic Review and Meta-Analysis of
Randomized Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(8) (pp 2057-2066),
2025. Date of Publication: 01 Aug 2025.
Author
Saad M.; Sohail M.U.; Ansari I.; Aamer H.; Ahmed A.; Arshad M.S.; Mohan
A.; Kumar V.; Alraies M.C.
Institution
(Saad, Sohail, Ansari, Aamer, Ahmed, Arshad) Department of Medicine, Dow
University of Health Sciences, Karachi, Pakistan
(Mohan) Department of Medicine, Mayo Clinic, Rochester, MN, United States
(Kumar) Department of Internal Medicine, Creighton University of Arizona,
Phoenix, AZ, United States
(Alraies) Cardiovascular Institute, Detroit Medical Center, DMC Heart
Hospital, Detroit, MI, United States
Publisher
W.B. Saunders
Abstract
Objectives: The optimal management of renin-angiotensin system inhibitors
(RASIs) before noncardiac surgery remains unclear. Continuing RASIs may
increase intraoperative hypotension, while discontinuation risks
postoperative hypertension and heart failure. Current guidelines suggest
withholding RASI 24 hours prior to surgery, but evidence is limited. This
meta-analysis of randomized controlled trials aimed to clarify the risks
and benefits of continuing versus withholding RASIs in this setting.
 Design(s): A systematic review of randomized clinical trials (RCTs)
and meta-analysis. Setting(s): A comprehensive electronic search
conducted in PubMed, Scopus, and Cochrane from inception to August 2024.
 Participant(s): Nine clinical trials that collectively enrolled 8,906
patients undergoing noncardiac surgery. Intervention(s): A comparison
of continuation versus discontinuation of RASIs preoperatively in patients
undergoing noncardiac surgery. Measurements and Main Results: The
primary outcomes were intraoperative hypotension, major adverse
cardiovascular events (MACE), and all-cause mortality. Secondary outcomes
included acute kidney injury (AKI) and postoperative hypertension.
Patients who discontinued RASIs had a significantly lower incidence of
intraoperative hypotension (risk ratio [RR], 0.66; 95% confidence interval
[CI], 0.52-0.84) compared to those who continued treatment. No significant
differences were observed in all-cause mortality (RR, 0.85; 95% CI,
0.40-1.85), MACE (RR, 1.01; 95% CI, 0.87-1.17), AKI (RR, 0.98; 95% CI,
0.79-1.22), and postoperative hypertension (RR, 1.57; 95% CI, 0.92-2.68).
 Conclusion(s): Continuation of RASIs significantly increased the risk
of intraoperative hypotension compared to discontinuation of treatment.
Overall, no significant differences were observed in all-cause mortality,
MACE, AKI, or postoperative hypertension between patients who continued or
discontinued RASIs preoperatively. Copyright © 2025 Elsevier Inc.

<26>
Accession Number
2036861031
Title
The impact of smoking on lung cancer patients.
Source
European Respiratory Review. 34(176) (no pagination), 2025. Article
Number: 240175. Date of Publication: 01 Apr 2025.
Author
Minervini F.; Lampridis S.; Kestenholz P.; Pardo E.; Crommelinck J.;
Putora P.M.; Schnider M.; Petroncini M.; Mayer N.; Bertoglio P.
Institution
(Minervini, Kestenholz, Schnider, Mayer) Division of Thoracic Surgery,
Cantonal Hospital of Lucerne, Lucerne, Switzerland
(Lampridis) National Heart and Lung Institute, Faculty of Medicine,
Imperial College London, London, United Kingdom
(Lampridis) Department of Thoracic Surgery, 424 General Military Hospital,
Thessaloniki, Greece
(Pardo) Division of Medical Oncology, Cantonal Hospital of Lucerne,
Lucerne, Switzerland
(Crommelinck, Putora) Department of Radiation Oncology, Kantonsspital St.
Gallen, St. Gallen, Switzerland
(Putora) Department of Radiation Oncology, Inselspital, Bern University
Hospital and University of Bern, Bern, Switzerland
(Petroncini, Bertoglio) Division of Thoracic Surgery, IRCSS Azienda
Ospedaliero-Universitaria, Bologna, Italy
Publisher
European Respiratory Society
Abstract
Although smoking prevalence has shown a decreasing trend, the total number
of smokers remains high due to population growth. Smoking causes several
diseases, including lung cancer, COPD, coronary heart disease, stroke and
peripheral vascular disease. Most of the adverse effects of smoking are
reversible and smoking cessation treatments are a cost-effective and
high-impact intervention for reducing the risk of mortality and morbidity
from smoking-related illness. Smoking cessation may have a significant
impact in patients diagnosed with lung cancer, as continued tobacco use
can critically compromise treatment efficacy, increase the risk of
recurrence and reduce overall survival. Moreover, the benefits of smoking
cessation in lung cancer patients can also improve quality of life. The
tremendous health and economic consequences of the smoking epidemic should
make tobacco control a top priority for governments worldwide. This review
aims to highlight the necessity of incorporating smoking cessation as a
standard component of lung cancer treatment protocols to enhance patients'
clinical outcomes and quality of life. At the same time, we identified a
lack of current evidence regarding the optimal timing of smoking cessation
among lung cancer patients, which provides the basis for further
investigation. Copyright ©The authors 2025.

<27>
[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.

<28>
Accession Number
2039477905
Title
Preemptive regional nerve blocks for sternotomy in pediatric cardiac
surgery: a Bayesian network meta-analysis.
Source
Brazilian Journal of Anesthesiology (English Edition). 75(5) (no
pagination), 2025. Article Number: 844652. Date of Publication: 01 Sep
2025.
Author
Wegner B.F.M.; Wegner G.R.M.; Arias J.A.; Nascimento T.S.
Institution
(Wegner) Universidade Federal do Rio Grande do Sul, RS, Porto Alegre,
Brazil
(Wegner) Universidade Federal da Fronteira Sul, RS, Passo Fundo, Brazil
(Arias) Hospital Ana Nery, BA, Salvador, Brazil
(Nascimento) University of Iowa, Iowa City, United States
Publisher
Elsevier Editora Ltda
Abstract
Background: Effective pain management and expedited recovery are critical
in pediatric cardiac surgery. While regional anesthesia techniques provide
targeted pain control and may reduce opioid use and related complications,
comparative evidence among regional nerve blocks in this population is
limited. This study aimed to conduct a systematic review and network
meta-analysis to support clinical decision-making for optimal analgesia.
 Method(s): We conducted a Bayesian Network Meta-Analysis (NMA)
including Randomized Controlled Trials (RCTs) of pediatric patients (0-12
years) undergoing cardiac surgery by sternotomy and receiving preemptive
regional nerve blocks. Primary outcomes included pain scores, opioid
consumption and extubation time. Both direct and indirect evidence were
synthesized to rank interventions probabilistically. This study was
registered on PROSPERO (CRD42024585785) and followed PRISMA Extension
Statement for Reporting of Systematic Reviews Incorporating Network
Meta-analyses of Health Care Interventions. Result(s): The NMA
incorporated 12 RCTs, comprising 969 participants, and evaluated seven
regional nerve blocks. Among the techniques studied, transversus Thoracis
Muscle Plane Block (TTPB) consistently ranked among the most effective for
pain relief and recovery. Other blocks, including thoracic retrolaminar
block and thoracic paravertebral block, also demonstrated notable
performances. Adverse events were infrequent but inconsistently reported,
preventing an adequate analysis. Conclusion(s): This NMA identified
TTPB as a consistently top-performing technique across outcomes. These
findings provide promising support for its inclusion in ERAS protocols,
although further high-quality trials are needed. Registration: PROSPERO
ID: CRD42024585785. Copyright © 2025 Sociedade Brasileira de
Anestesiologia

<29>
[Use Link to view the full text]
Accession Number
2033992011
Title
Effect of in Vivo Administration of Fibrinogen Concentrate Versus
Cryoprecipitate on Ex Vivo Clot Degradation in Neonates Undergoing Cardiac
Surgery.
Source
Anesthesia and Analgesia. 141(2) (pp 240-251), 2025. Date of Publication:
01 Aug 2025.
Author
Downey L.A.; Moiseiwitsch N.; Nellenbach K.; Xiang Y.; Brown A.C.;
Guzzetta N.A.
Institution
(Downey, Guzzetta) Department of Anesthesiology, Emory University School
of Medicine, Atlanta, GA, United States
(Downey, Guzzetta) Department of Anesthesiology, Children's Healthcare of
Atlanta, Atlanta, GA, United States
(Moiseiwitsch, Nellenbach, Brown) Department of Biomedical Engineering,
University of North Carolina-Chapel Hill and North Carolina State
University, Raleigh, NC, United States
(Moiseiwitsch, Nellenbach, Brown) Comparative Medicine Institute, North
Carolina State University, Raleigh, NC, United States
(Xiang) Department of Population and Public Health Sciences, Keck School
of Medicine of University of Southern California, Los Angeles, CA, United
States
(Brown) Department of Material Science and Engineering, North Carolina
State University, Raleigh, NC, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Neonates undergoing cardiac surgery require fibrinogen
replacement to restore hemostasis after cardiopulmonary bypass (CPB).
Cryoprecipitate is often the first-line treatment, but recent studies
demonstrate that fibrinogen concentrate (RiaSTAP; CSL Behring) may be
acceptable in this population. This investigator-initiated, randomized
trial compares cryoprecipitate to fibrinogen concentrate in neonates
undergoing cardiac surgery (ClinicalTrials.gov NCT03932240). The primary
end point was the percent change in ex vivo clot degradation from baseline
at 24 hours after surgery between groups. Secondary outcomes included
intraoperative blood transfusions, coagulation factor levels, and adverse
events. METHOD(S): Neonates were randomized to receive
cryoprecipitate (control group) or fibrinogen concentrate (study group) as
part of a post-CPB transfusion algorithm. Blood samples were drawn at 4
time points: presurgery (T1), after treatment (T2), arrival to the
intensive care unit (ICU) (T3), and 24 hours postsurgery (T4). Using the
mixed-effect models, we analyzed the percent change in ex vivo clot
degradation from a patient's presurgery baseline at each time point.
Intraoperative blood product transfusions, coagulation factor levels,
perioperative laboratory values, and adverse events were collected.
 RESULT(S): Thirty-six neonates were enrolled (intent to treat [ITT]).
Thirteen patients in the control group and seventeen patients in the study
group completed the study per protocol (PP). After normalizing to the
patient's own baseline (T1), no significant differences were observed in
clot degradation at T2 or T3. At T4, patients in the study group had
greater degradation when compared to those in the control group (826.5%,
95% confidence interval [CI], 291.1-1361.9 vs-545.9%, 95% CI,-1081.3
to-10.4; P <.001). Study group patients received significantly less median
post-CPB transfusions than control group patients (ITT, 27.2 mL/kg
[19.0-36.9] vs 41.6 [29.2-52.4]; P =.043; PP 26.7 mL/kg [18.8-32.2] vs
41.2 mL/kg [29.0-51.4]; P <.001). No differences were observed in bleeding
or thrombotic events. CONCLUSION(S): Neonates who received fibrinogen
concentrate, as compared to cryoprecipitate, have similar perioperative ex
vivo clot degradation with faster degradation at 24 hours postsurgery,
less post-CPB blood transfusions, and no increased bleeding or thrombotic
complications. Our findings suggest that fibrinogen concentrate adequately
restores hemostasis and reduces transfusions in neonates after CPB without
increased bleeding or thrombosis risk. Copyright © 2025
International Anesthesia Research Society.

<30>
Accession Number
2039516632
Title
Effects of increased cardiopulmonary bypass pump flow on renal filtration,
perfusion, oxygenation and tubular injury in cardiac surgical patients - a
randomized controlled trial.
Source
Anesthesiology. (no pagination), 2025. Article Number:
10.1097/ALN.0000000000005648. Date of Publication: 2025.
Author
Wijk J.; Cordefeldt-Keiller A.; Bragadottir G.; Redfors B.; Ricksten
S.-E.; Lannemyr L.
Institution
(Wijk, Cordefeldt-Keiller, Bragadottir, Redfors, Ricksten, Lannemyr)
Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska
Academy, University of Gothenburg and Section of Cardiothoracic Anesthesia
and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Cardiac surgery with cardiopulmonary bypass (CPB) is
associated with impaired renal oxygenation and acute kidney injury. We
investigated whether a higher than our standard blood flow during CPB
could improve renal blood flow, oxygen demand/supply relationship,
function and attenuate tubular injury. Method(s): After ethical
approval and informed consent, 36 adult patients undergoing cardiac
surgery received either high-flow (2.9 L/min/m2, n=19) or
standard-flow (2.4 L/min/m2, n=17) during CPB in this
randomized, non-blinded, parallell-arm study. Systemic hemodynamics and
renal variables were measured before and during CPB. Glomerular filtration
rate was measured by infusion clearance of iohexol and renal blood flow by
infusion clearance of para-aminohippuric acid, corrected for renal
extraction of para-aminohippuric acid, using a renal vein catheter. Renal
oxygen demand/supply relationship was estimated from renal oxygen
extraction and tubular injury assessed by urinary
N-acetyl-beta-D-glucosaminidase. Result(s): During CPB, high-flow
lead to a larger increase in systemic oxygen delivery (100
ml/min/m2, 95% CI [60;141], vs 31[1.9;65], between group
p<0.001, effect size Cohens dz 0.59) and target mean arterial pressure was
maintained at a lower norepinephrine dose (0.03 g/kg/min [-0.01;0.06] vs
0.10 [0.02;0.19], p=0.048, Cohens dz=0.62) compared with standard-flow.
There were no differences in renal blood flow or oxygen extraction between
groups. Glomerular filtration rate increased during high-flow CPB (6.4
ml/min/1.73m2 [1.9;10.9]), but not in the standard-flow group
(-2.3 [-10.9;6.2], between group p=0.044, Cohens dz 0.66). The peak
urinary excretion of N-acetyl-beta-D-glucosaminidase was 1.42 units/mol
creatinine [0.87,3.6] vs 3.74 [1.5,7.7] in the high-flow and standard-flow
groups, respectively (p=0.049). No perfusion-related adverse events were
seen in either group. Conclusion(s): A 20% higher than standard CPB
flow during cardiac surgery improved renal function while no change in
renal blood flow or oxygen demand/supply relationship could be detected.
Higher CPB flow was associated with a less pronounced tubular injury
marker release compared with standard flow. Copyright © 2025
Wolters Kluwer Health, Inc.

<31>
Accession Number
2032786953
Title
Recommendations of the Brazilian Society of Surgical Oncology for the
Treatment of Neoplastic Pericardial Effusion.
Source
Journal of Surgical Oncology. 131(8) (pp 1499-1507), 2025. Date of
Publication: 01 Jun 2025.
Author
Carvalho E.D.A.; Oliveira R.E.N.D.N.; Ribeiro J.H.A.; Gross J.L.; Galhardo
C.A.V.; Neto H.F.E.C.; Santos G.D.; Ribeiro R.; Oliveira A.F.; Pinheiro
R.N.
Institution
(Carvalho, Oliveira, Ribeiro, Gross, Neto, Santos, Ribeiro, Oliveira,
Pinheiro) Brazilian Society of Surgical Oncology, Sao Paulo, Brazil
(Carvalho) Thoracic Surgery and Pneumology Service, Hospital das Clinicas
of UFMG, Mario Penna Institute, Minas Gerais, Belo Horizonte, Brazil
(Oliveira) Thoracic Surgery Service, Barretos Cancer Hospital, Sao Paulo,
Sao Paulo, Brazil
(Gross) Thoracic Surgery Service, AC Camargo Cancer Center, Sao Paulo, Sao
Paulo, Brazil
(Galhardo) Thoracic Surgery Service, Alfredo Abrao Cancer Hospital, Mato
Grosso do Sul, Campo Grande, Brazil
(Neto) Surgical Oncology Service, Cancer Institute of Ceara, Ceara,
Firtaleza, Brazil
(Ribeiro) Surgical Oncology Service, Erasto Gaertner Hospital, Parana,
Curitiba, Brazil
(Oliveira) Surgical Oncology Service, Federal University of Juiz de Fora,
Minas Gerais, Juiz de Fora, Brazil
(Pinheiro) Surgical Oncology Department, Hospital de Base of the District
Federal, District Federal, Brasilia, Brazil
Publisher
John Wiley and Sons Inc
Abstract
This document presents guidelines to assist surgeons in the diagnosis and
management of this condition, emphasizing a multidisciplinary approach.
Recommendations described by a group of physicians members of the
Brazilian Society of Oncological Surgery regarding the treatment of
neoplastic pericardial effusion, developed to guide oncological surgeons,
cardiothoracic surgeons and general surgeons in their clinical practice.
Members of the Thoracic Neoplasms Committee carried out a literature
review and discussion among expert peers to create a guideline that would
help in managing this very serious clinical condition in our oncology
practice: Neoplastic pericardial effusion. Copyright © 2024 Wiley
Periodicals LLC.

<32>
Accession Number
2034812960
Title
Optimal Thromboembolism Prevention for Patients With Atrial Fibrillation
on Long-Term Dialysis.
Source
PACE - Pacing and Clinical Electrophysiology. 48(7) (pp 733-753), 2025.
Date of Publication: 01 Jul 2025.
Author
Hashimoto K.; Fujisaki T.; Aikawa T.; Iwagami M.; Miyamoto Y.; Slipczuk
L.; Biase L.D.; Briasoulis A.; Yasuhara J.; Takagi H.; Kuno T.
Institution
(Hashimoto) Westmead Applied Research Centre, University of Sydney,
Sydney, NSW, Australia
(Fujisaki) Department of Cardiovascular Medicine, National Cerebral and
Cardiovascular Center, Osaka, Japan
(Fujisaki) Department of Cardiovascular Medicine, Graduate School of
Medical Sciences, Kumamoto University, Kumamoto, Japan
(Aikawa) Department of Cardiovascular Biology and Medicine, Juntendo
University Graduate School of Medicine, Tokyo, Japan
(Iwagami) Department of Digital Health, Social Medicine Group, Institute
of Medicine, University of Tsukuba, Tsukuba, Japan
(Iwagami) Department of Non-Communicable Disease Epidemiology, London
School of Hygiene and Tropical Medicine, London, United Kingdom
(Miyamoto) Department of Real-world Evidence, The University of Tokyo,
Tokyo, Japan
(Slipczuk, Biase, Kuno) Division of Cardiology, Montefiore Health
System/Albert Einstein College of Medicine, New York, NY, United States
(Briasoulis) Division of Cardiovascular Medicine, University of Iowa, Iowa
City, IA, United States
(Yasuhara) Department of Pediatric Cardiology, Monash Heart and Monash
Children's Hospital, Monash Health, Melbourne, Australia
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno) Division of Cardiology, Jacobi Medical Center, Albert Einstein
College of Medicine, New York, NY, United States
(Kuno) Division of Cardiology, Massachusetts General Hospital, Harvard
Medical School, Boston, MA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Optimal strategies for thromboembolism prevention, including
vitamin K antagonists (VKA), direct oral anticoagulants (DOAC), and left
atrial appendage occlusion (LAAO), for patients with atrial fibrillation
(AF) and on dialysis have not been fully investigated. We aimed to
investigate the efficacy and safety of thromboembolism prevention
strategies in AF patients on dialysis through a network meta-analysis.
 Method(s): Multiple databases were searched through January 2024. The
primary efficacy endpoint was thrombotic events, defined as ischemic
stroke or systemic thromboembolism, whereas the primary safety endpoint
was major bleeding. These strategies were ranked using P-scores.
 Result(s): Our study identified 28 eligible studies (including 3
randomized controlled trials) that enrolled 144,630 AF patients on
dialysis. The risks of thrombotic events in any DOAC and VKA were
comparable to no-anticoagulant, whereas LAAO was associated with a lower
risk of thrombotic events (HR [95% CI]: 0.19 [0.06-0.60]). Compared to
no-anticoagulant, VKA, regular-dose rivaroxaban, and dabigatran were
associated with a higher risk of major bleeding, but rivaroxaban 10 mg
daily, and apixaban 2.5 or 5 mg twice daily were not. LAAO, rivaroxaban 10
mg daily and apixaban 2.5 or 5 mg twice daily were highly ranked in
efficacy and safety outcomes. Conclusion(s): LAAO may possibly be the
reasonable therapeutic option for AF patients on dialysis, but rivaroxaban
10 mg daily and apixaban 2.5 or 5 mg twice daily can also be considered.
Further studies are warranted to confirm these findings. Copyright
© 2025 Wiley Periodicals LLC.

<33>
Accession Number
2034499488
Title
Assessing heart failure after surgical occlusion of the left atrial
appendage. Letter regarding the article 'Heart failure after left atrial
appendage occlusion: Insights from the LAAOS III randomized trial'.
Source
European Journal of Heart Failure. 27(6) (pp 1145), 2025. Date of
Publication: 01 Jun 2025.
Author
Stollberger C.; Finsterer J.; Schneider B.
Institution
(Stollberger) Institut Gesunder Leben, Vienna, Austria
(Finsterer) Neurology & Neurophysiology Center, Vienna, Austria
(Schneider) Sana Kliniken Lubeck, Lubeck, Germany
Publisher
John Wiley and Sons Ltd

<34>
Accession Number
2033382376
Title
Perioperative Mechanical Circulatory Support for Cardiac Assistance in
Thoracic Surgery: A Scoping Review.
Source
Artificial Organs. 49(8) (pp 1249-1264), 2025. Date of Publication: 01 Aug
2025.
Author
Agosta V.T.; D'Andria Ursoleo J.; Bottussi A.; Bugo S.; Monaco F.
Institution
(Agosta, D'Andria Ursoleo, Bottussi, Bugo, Monaco) Department of
Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute,
Milan, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: Patients with pre-existing severe cardiovascular comorbidities
are often deemed ineligible for potentially life-saving thoracic surgeries
and are referred to other conservative therapies. However, this patient
population may theoretically benefit from the timely perioperative
implantation of temporary mechanical circulation support (tMCS) to both
mitigate the surgical stress and stabilize hemodynamics. We performed a
scoping review to summarize the evidence regarding the use of tMCS in
thoracic surgery. Method(s): We conducted a systematic search across
PubMed/MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials,
Web of Science, Scopus, and Google Scholar from their inception, aided by
a search string encompassing a combination of terms for the key research
concepts: i) tMCS devices; ii) thoracic surgery procedures (except lung
transplantation); and iii) the adult population. Result(s): Fifteen
studies pertinent to the research question, which summarized data from 28
patients, were retrieved for inclusion. In 14 patients, tMCS implantation
occurred as a "pre-emptive" strategy, while the remaining patients had
tMCS implanted either intra and/or postoperatively as a "bail-out"
strategy. Specifically, 14 patients required an intra-aortic balloon pump,
10 veno-arterial extracorporeal membrane oxygenation, two required a
multidevice strategy, and one cardiopulmonary bypass. The relative risk
analysis revealed that the mortality rate in the pre-emptive group was
half that of the bail-out group. Additionally, the risk of both infectious
and vascular complications was lower in the pre-emptive group compared to
the bail-out tMCS strategy. Conclusion(s): We found that the timely
implantation of tMCS in thoracic surgery-either to mitigate patients'
heightened cardiovascular risk or as a rescue strategy in the event of
life-threatening surgical complications-may lead to better patient
outcomes, as well as allowing them to undergo curative surgery with an
acceptable safety profile, characterized by overall good survival rates
and a low incidence of device-related complications. Copyright ©
2025 The Author(s). Artificial Organs published by International Center
for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals
LLC.

<35>
[Use Link to view the full text]
Accession Number
2038224586
Title
Review of the Global Activity of Heart Transplant.
Source
Circulation: Heart Failure. 18(7) (no pagination), 2025. Article Number:
e012272. Date of Publication: 01 Jul 2025.
Author
Rafei A.E.; Cogswell R.; Atik F.A.; Zuckermann A.; Allen L.A.
Institution
(Rafei, Allen) Division of Cardiology, Department of Medicine, University
of Colorado School of Medicine, Aurora, United States
(Cogswell) Division of Cardiology, Department of Medicine, University of
Minnesota, Minneapolis, United States
(Atik) Department of Cardiology, University of Brasilia Medical School,
Brazil
(Zuckermann) Department of Cardiac Surgery/Medical, Medical University of
Vienna, Austria
Publisher
Lippincott Williams and Wilkins
Abstract
Heart failure is a global disease with significant morbidity. Heart
transplant (HT) can be a lifesaving therapy for select patients with
end-stage heart failure. In 2020, over 7000 HTs were performed globally;
90% of HTs were performed in the United States and Western Europe, with
only 10% throughout the rest of the world. In this article, we offer an
overview of the global landscape of HT, exploring challenges and prospects
worldwide. We review HT practices, rates and post-HT outcomes,
underscoring the differences between countries within each region. We
review limitations hindering HT expansion, such as sociocultural factors,
as seen in Japan and Israel; health care funding, in countries like India
and South Africa; socioeconomic disparities in access, like the United
States; and shortage in organ supply, as seen in China and Saudi Arabia.
This review underscores the need to address limitations and highlights
opportunities to enhance global HT accessibility, especially in lower- and
middle-income countries. Copyright © 2025 American Heart
Association, Inc.

<36>
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

<37>
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.

<38>
Accession Number
2039381566
Title
Biolimus-Eluting Biomatrix Stent vs a Dual-Therapy Sirolimus-Eluting Stent
in PCI: The SORT OUT XI Randomized Trial.
Source
Journal of the American College of Cardiology. 86(2) (pp 106-115), 2025.
Date of Publication: 15 Jul 2025.
Author
Eftekhari A.; Jensen L.O.; Veien K.; Raungaard B.; Rasmussen J.G.; Maeng
M.; Terkelsen C.J.; Ellert-Gregersen J.; Stottrup N.B.; Lassen J.F.;
Hansen H.S.; Thim T.; Jensen R.V.; Nielsen R.; Jensen S.E.; Kristensen
S.D.; Hougaard M.; Junker A.; Christensen M.K.; Aaroe J.; Froslev T.;
Jakobsen L.; Christiansen E.H.
Institution
(Eftekhari, Raungaard, Rasmussen, Jensen, Aaroe) Department of Cardiology,
Aalborg University Hospital, Aalborg, Denmark
(Jensen, Veien, Ellert-Gregersen, Lassen, Hansen, Hougaard, Junker,
Christensen, Christiansen) Department of Cardiology, Odense University
Hospital, Odense, Denmark
(Jensen, Lassen) University of Southern Denmark, Odense, Denmark
(Maeng, Terkelsen, Stottrup, Thim, Jensen, Nielsen, Kristensen, Jakobsen)
Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus,
Denmark
(Froslev) Department of Clinical Epidemiology, Aarhus University Hospital,
Aarhus, Denmark
Publisher
Elsevier Inc.
Abstract
Background: Percutaneous coronary intervention (PCI) with new-generation
drug-eluting stents (DES) is still associated with risk of target lesion
failure (TLF). The biolimus A9-eluting Biomatrix Alpha stent (BES), with
biodegradable polymer and thin struts, has not been compared head-to-head
with another contemporary DES. Objective(s): This study compared
1-year TLF in BES vs dual therapy sirolimus-eluting Combo stent (DTS) in
an all-comer population undergoing PCI. Method(s): The trial was
conducted in the 3 Western Danish Heart centers (Aalborg, Aarhus, and
Odense). The primary composite endpoint was 1-year TLF defined as a
composite of cardiac death, target lesion myocardial infarction, or target
lesion revascularization. The trial was designed as a noninferiority trial
with a noninferiority margin of 2.1%. Data were analyzed by
intention-to-treat. Result(s): From August 14, 2019, to March 19,
2023, 3,136 patients were randomized 1:1 to BES (n = 1,566; 1,891 lesions)
vs DTS (n = 1,570; 1,878 lesions). In the intention-to-treat analysis, TLF
at 1-year follow-up occurred in 65 patients (4.2%) in the BES group and 82
patients (5.2%) in the DTS group: risk difference: -1.07% (upper limit of
1-sided 90% CI: 0.21%), (P for noninferiority = 0.00002); incidence rate
ratio: 0.79 (95% CI: 0.57-1.09; P = 0.15). Cardiac death occurred in 18
patients (1.1%) in the BES group and 30 (1.9%) in the DTS group: incidence
rate ratio: 0.60 (95% CI: 0.33-1.07; P = 0.08). Target lesion myocardial
infarction occurred in 36 (2.3%) in the BES group and 33 (2.1%) in the DTS
group: incidence rate ratio: 1.09 (95% CI: 0.68-1.75; P = 0.73). Definite
stent thrombosis occurred in 21 patients (1.3%) in the BES group and 9
(0.6%) in the DTS group: incidence rate ratio: 2.33 (95% CI: 1.07-5.11; P
= 0.034). Conclusion(s): BES was noninferior to DTS at 1-year
follow-up regarding the primary endpoint of TLF. However, BES was
associated with significantly increased risk of definite stent thrombosis.
(Combo Stent Versus Biomatrix Alpha Stent [SORT OUT XI]
NCT03952273) Copyright © 2025 American College of Cardiology
Foundation

<39>
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.

<40>
Accession Number
2039606262
Title
Impact of diabetes mellitus type-2 on the outcomes following mitral
transcatheter edge-to-edge repair (TEER): A meta-analysis.
Source
American Heart Journal Plus: Cardiology Research and Practice. 57 (no
pagination), 2025. Article Number: 100574. Date of Publication: 01 Sep
2025.
Author
Chigurupati H.D.; Neppala S.; Chikatimalla R.; Fath A.; Upreti P.; Bolte
J.; Naveed M.A.; Rao A.; Altaee O.; Sattar Y.; Desai R.; DeFronzo R.A.;
Rana J.S.; Paul T.K.
Institution
(Chigurupati) Department of Medicine, New York Medical College at Saint
Michael's Medical Center, Newark, NJ, United States
(Neppala, Fath, Bolte, Altaee) Department of Cardiology, University of
Texas Health Sciences Center, San Antonio, TX, United States
(Chikatimalla) Department of Cardiology, Leonard M. Miller School of
Medicine, University of Miami, Miami, FL, United States
(Upreti) Sands-Constellation Heart Institute, Rochester Regional Health,
Rochester, NY, United States
(Naveed) Department of Medicine, Dow Medical College, Karachi, Pakistan
(Rao) Department of Internal Medicine, Guthrie Robert Packer Hospital,
Sayre, PA, United States
(Sattar) Department of Cardiology, West Virginia University Heart and
Vascular Institute, Morgantown, WV, United States
(Desai) Independent Outcomes Researcher, Atlanta, GA, United States
(DeFronzo) Division of Diabetes, University of Texas Health Sciences
Center, San Antonio, TX, United States
(Rana) Department of Cardiology, The Permanente Medical Group, Oakland,
CA, United States
(Paul) Department of Cardiovascular Sciences, Ascension St. Thomas
Hospital/University of Tennessee Health Sciences Center, Nashville, TN,
United States
Publisher
Elsevier Inc.
Abstract
Background: Diabetes mellitus (DM) has been linked to unfavorable outcomes
in patients undergoing Mitral Transcatheter Edge-to-Edge Repair (TEER).
Nevertheless, the literature contains conflicting data. This meta-analysis
aimed to assess the impact of DM on outcomes following Mitral TEER.
 Method(s): We searched PubMed, Scopus, and Medline for studies
reporting outcomes following mitral TEER in diabetic and non-diabetic
patients. Using a random-effects model, we determined the pooled odds
ratio (OR) for clinical outcomes in patients who underwent Mitral TEER,
regardless of their diabetes status. Result(s): We included four
studies with 2130 patients. DM was present in 31 % of the population, with
a mean age of 73.9 (+/-8.2) years, 50.2 % of males, and 30 % of the
population being obese. Patients with DM were more likely to be obese
compared to patients without DM. In this meta-analysis, individuals with
DM exhibited a higher 30-day MACCE (OR: 1.50, 95 % CI: 1.08-2.09, p =
0.02) and all-cause recurrent hospitalizations (OR: 1.36, 95 % CI:
1.07-1.72, p = 0.01) compared to those without diabetes. However, the
difference in 30-day all-cause mortality (OR: 1.20, 95 % CI: 0.92-1.56, p
= 0.19) and in-hospital all-cause mortality (OR: 0.92, 95 % CI: 0.51-1.67,
p = 0.78) was not statistically significant between the two groups.
 Conclusion(s): DM is associated with an increased risk of 30-day
MACCE and recurrent hospitalizations following Mitral TEER. Consequently,
DM should be regarded as a predictor of adverse outcomes. Future,
well-designed prospective randomized trials are necessary to evaluate the
mid-term impact of DM on MACCE. Copyright © 2025 The Authors

<41>
[Use Link to view the full text]
Accession Number
2038725169
Title
Impact of Natriuretic Peptide and Prior Hospitalization in Patients With
Severe Mitral Regurgitation: COAPT Trial.
Source
Circulation: Cardiovascular Interventions. 18(7) (no pagination), 2025.
Article Number: e015192. Date of Publication: 01 Jul 2025.
Author
Goel S.S.; Guha A.; Lindenfeld J.; Abraham W.T.; Kar S.; Kapadia S.R.;
Little S.H.; Lim D.S.; Reardon M.J.; Kleiman N.S.; Aiyer J.; Kotinkaduwa
L.N.; Mack M.J.; Stone G.W.
Institution
(Goel, Guha, Little, Reardon, Kleiman) Houston Methodist Hospital, TX,
United States
(Lindenfeld) Vanderbilt University Medical Center, Nashville, TN, United
States
(Abraham) The Ohio State University Wexner Medical Center, Columbus,
United States
(Kar) Los Robles Regional Hospital, Thousand Oaks, CA, United States
(Kapadia) Cleveland Clinic, OH, United States
(Lim) University of Virginia School of Medicine, Charlottesville, United
States
(Aiyer) Abbott Laboratories, Santa Clara, CA, United States
(Kotinkaduwa) Cardiovascular Research Foundation, New York, NY, United
States
(Mack) Baylor Scott and White Health, Plano, TX, United States
(Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The clinical significance of elevated baseline natriuretic
peptide level and prior heart failure hospitalization (HFH) within the
prior year in mitral transcatheter edge-to-edge repair outcomes is
unclear. This analysis examined the impact of BNP (B-type natriuretic
peptide) or NT-proBNP (N-terminal pro-B-type natriuretic peptide) and
prior HFH on outcomes in patients with severe secondary mitral
regurgitation. METHOD(S): The COAPT trial (Cardiovascular Outcomes
Assessment of the MitraClip Percutaneous Therapy for Heart Failure
Patients With Functional Mitral Regurgitation) was a randomized controlled
trial of subjects assigned to mitral valve transcatheter edge-to-edge
repair with the MitraClip device versus guideline-directed medical therapy
alone. COAPT patients were grouped by BNP/NT-proBNP levels and prior HFH
within 1 year: (1) Mild heart failure (HF): no prior HFH with
BNP/NT-proBNP<median; (2) Moderate HF: prior HFH with BNP/NT-proBNP<median
or no prior HFH with BNP/NT-proBNP>=median; and (3) Severe HF: prior HFH
and BNP/NT-proBNP>=median. The primary measures were 2-year rates of death
or HFH. RESULT(S): Of 572 patients, mild, moderate, and severe HF
were present in 125 (21.9%), 288 (50.3%), and 159 (27.8%) patients,
respectively. With guideline-directed medical therapy alone, the 2-year
rates of death or HFH in mild, moderate, and severe HF were 56.4%, 60.5%,
and 84.1%, respectively (Ptrend=0.001). These rates were 48.7% and 73.4%
among patients with moderate HF and a prior HFH only versus elevated
BNP/NT-proBNP>=median only (P=0.003). Mitral transcatheter edge-to-edge
repair reduced death/HFH compared with guideline-directed medical therapy
alone regardless of HF severity (Pinteraction=0.50). CONCLUSION(S):
In patients with HF with severe secondary mitral regurgitation enrolled in
the COAPT trial, 2-year rates of death/HFH were increased with an elevated
baseline BNP/NT-proBNP>=median, and more so if HFH within 1 year prior had
occurred. Treatment with mitral transcatheter edge-to-edge repair reduced
all-cause mortality and HFH consistently in mild, moderate, and severe HF.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier:
NCT01626079. Copyright © 2025 American Heart Association, Inc.

<42>
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.

<43>
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

<44>
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.

<45>
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.

<46>
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.

<47>
Accession Number
2039460159
Title
Are systemic and topical tranexamic acid superior to each other in
bleeding control in coronary bypass surgery?.
Source
European Research Journal. 11(4) (pp 714-721), 2025. Date of Publication:
04 Jul 2025.
Author
Gozen F.; Maltepe F.
Institution
(Gozen) Department of Anesthesiology and Reanimation, University of Health
Sciences, BursaYuksek Ihtisas Research and Training Hospital, Bursa,
Turkey
(Maltepe) Department of Anesthesiology and Reanimation, Dokuz Eylul
University, Faculty of Medicine, Izmir, Turkey
Publisher
Association of Health Research and Strategy
Abstract
Objectives: Tranexamic acid significantly reduces postoperative bleeding
and transfusion requirements in cardiac surgery. Intravenous
administration has been associated with thromboembolism and seizures. The
complex protocols and serious side effects associated with this
administration increase interest in intrapericardial administration, and
its preferability is being reviewed. The purpose of this prospective,
randomized, double-blind study was to compare the effects of
intrapericardial tranexamic acid administered following cardiac surgery
with those of intravenous administration on postoperative bleeding and
possible complications. Method(s): The study included 60 patients
over the age of 18 who were undergoing elective coronary artery bypass
grafting for the first time. The patients were randomized into intravenous
and intrapericardial groups. Primary postoperative bleeding and
transfusion requirements, and secondarily complications, reoperation and
discharge times were evaluated. Result(s): The 60 coronary artery
bypass grafting patients included in the study, consisting of 30 patients
in intravenous and intrapericardial groups, were not different from each
other in terms of demographic data and Euroscore parameters. Postoperative
24-hour chest tube drainage was measured as 890+/-551 mL in the
intrapericardial group and 708+/-504 mL in the intravenous group. The
similar drainage amounts detected in the two groups did not create a
statistically significant difference (P=0.190). Transfusion requirements
were similar in both groups. No complications developed in any patient and
no reoperation was required due to bleeding. Conclusion(s): In
conclusion; intrapericardial tranexamic acid application in coronary
artery bypass grafting surgery reduces postoperative bleeding and
transfusion requirement at an equivalent rate to intravenous.
Intrapericardial application, which can provide the same effect without
creating extra risk, may be a simpler and more practical method than
systemic application, which includes complex protocols regarding dose and
timing. Copyright © The Author(s)

<48>
Accession Number
2035196555
Title
Predictors of Post-TAVR Left Bundle Branch Block: A Systematic Review and
Meta-Analysis.
Source
Journal of Cardiovascular Electrophysiology. (no pagination), 2025. Date
of Publication: 2025.
Author
Alzu'bi H.; Rmilah A.A.; Bahmad H.F.; Urina-Jassir D.; Elajami M.K.;
Rogers E.; Elgozair M.; Ghssein G.; Salami A.; Welty F.K.; Escolar E.;
Mihos C.G.; Beohar N.; Elajami T.K.
Institution
(Alzu'bi, Escolar, Elajami) Columbia University Division of Cardiology,
Mount Sinai Heart Institute, Miami Beach, FL, United States
(Rmilah, Elgozair) Department of Cardiology, Mayo Clinic, Rochester, MN,
United States
(Rmilah) Department of Internal Medicine, Magnolia Regional Health Center,
Corinth, MS, United States
(Bahmad) Department of Pathology and Laboratory Medicine, University of
Miami Miller School of Medicine, Miami, FL, United States
(Urina-Jassir) Department of Cardiology, John W. Deming Department of
Medicine, Tulane University School of Medicine, New Orleans, LA, United
States
(Elajami, Rogers) Department of Internal Medicine, Mount Sinai Medical
Center, Miami Beach, FL, United States
(Ghssein) Department of Biology, Faculty of Sciences, Lebanese University,
Nabatieh, Lebanon
(Salami) Department of Mathematics, Faculty of Sciences, Lebanese
University, Nabatieh, Lebanon
(Welty) Division of Cardiology, Beth Israel Deaconess Medical Center,
Boston, MA, United States
(Mihos, Elajami) Echocardiography Laboratory, Columbia University Division
of Cardiology, Mount Sinai Heart Institute, Miami Beach, FL, United States
(Beohar) Cardiac Catheterization Laboratory, Columbia University Division
of Cardiology, Mount Sinai Heart Institute, Miami Beach, FL, United States
Publisher
John Wiley and Sons Inc
Abstract
Left bundle branch block (LBBB) is the most common conduction abnormality
following transcatheter aortic valve replacement (TAVR) and has been
associated with adverse clinical outcomes. While multiple predictors of
post-TAVR LBBB have been proposed, data remain limited. This systematic
review and meta-analysis aims to identify and summarize predictors of
new-onset LBBB post-TAVR. A systematic literature search was performed to
identify studies that reported predictors of new-onset post-TAVR LBBB.
Extracted data included patient factors, electrocardiographic (ECG) and
anatomic parameters, and device-related factors. A random-effects model
was used to calculate crude risk ratios (RRs), mean differences, and 95%
confidence intervals (CI) of the predictors. Of 450 articles screened, 17
studies comprising a total of 6357 patients were included. Among these,
26.4% developed post-TAVR LBBB. Increased risk was associated with
diabetes mellitus (RR: 1.22, p < 0.001), use of 29-mm valve (RR: 1.59, p <
0.001), and use of Medtronic CoreValve (MCV) (RR: 2.25, p = 0.008).
Significant differences were found between patients with and without LBBB
in interventricular septal thickness (IVS; by -0.66 mm), membranous septal
length (MSL; by -0.9 mm), left ventricular outflow tract (LVOT) diameter
(by -0.48 mm), PR interval (by +13.95 ms), and prosthesis implantation
depth (by +2.6 mm). Diabetes Mellitus, use of 29-mm valve or MCV,
decreased IVS thickness, shorter MSL, smaller LVOT diameter, increased
prosthesis implantation depth, and prolonged PR duration were all
associated with an elevated risk of post-TAVR LBBB. Early identification
of these predictors may help reduce the risk of conduction abnormalities
after TAVR. Copyright © 2025 Wiley Periodicals LLC.

<49>
Accession Number
2039453108
Title
Effectiveness of the hypotension prediction index in non-cardiac
surgeries: a systematic review, meta-analysis and trial sequential
analysis.
Source
Brazilian Journal of Anesthesiology (English Edition). 75(5) (no
pagination), 2025. Article Number: 844649. Date of Publication: 01 Sep
2025.
Author
Felippe V.A.; Pinho A.C.; Barbosa L.M.; Queiroz I.; Tavares A.H.; Diaz R.;
Bersot C.D.; Vincent J.-L.
Institution
(Felippe, Pinho) Instituto Nacional de Cancer (INCA), RJ, Rio de Janeiro,
Brazil
(Barbosa) Universidade Federal de Minas Gerais, Departamento de Medicina,
MG, Belo Horizonte, Brazil
(Queiroz) Universidade Catolica de Pernambuco, Departamento de Medicina,
PE, Recife, Brazil
(Tavares) Universidade de Pernambuco, Departamento de Medicina, PE,
Recife, Brazil
(Diaz) Universidade Federal do Rio de Janeiro, Hospital Universitario
Clementino Fraga Filho, RJ, Rio de Janeiro, Brazil
(Bersot) Escola Paulista de Medicina da Universidade Federal de Sao Paulo
(EPM-UNIFESP), Programa de Pos-Graduacao em Medicina Translacional, SP,
Sao Paulo, Brazil
(Vincent) Universite Libre de Bruxelles, Erasme University Hospital,
Brussels, Belgium
Publisher
Elsevier Editora Ltda
Abstract
Background: The efficacy of the Hypotension Prediction Index (HPI) for
reducing Intraoperative Hypotension (IOH) among patients undergoing
non-cardiac surgeries remains unclear. We aimed to perform a systematic
review, meta-analysis, and trial sequential analysis to determine whether
the HPI is effective for adult patients undergoing non-cardiac surgeries.
This study was prospectively registered in the PROSPERO database
(CRD42024571931). Method(s): PubMed, Embase, and Cochrane were
systematically searched for Randomized Controlled Trials (RCTs) comparing
HPI-guided therapy with standard care in non-cardiac surgeries. We
computed Mean Difference (MD) and Risk Ratios (RR) for continuous and
binary outcomes, respectively, with 95 % Confidence Intervals (95 % CI).
Statistical analyses were performed using R Software, version 4.2.3.
 Result(s): We included 11 RCTs, comprising a total of 789 patients,
of whom 395 (50.1 %) received HPI-guided management. HPI significantly
reduced the Time-Weighted Average (TWA) of Mean Arterial Pressure (MAP) <
65 mmHg (MD = -0.23 mmHg.min-1; 95 % CI -0.35 to -0.10; p <
0.01) and the Area Under the Curve (AUC) of MAP < 65 mmHg (MD = -97.2
mmHg.min-1; 95 % CI -143.4 to -50.98; p < 0.01). HPI also
decreased the duration of MAP < 65 mmHg (MD = -16.22 min; 95 % CI -25.87
to -6.57; p < 0.01) and the number of hypotensive episodes per patient (MD
= -3.38; 95 % CI -5.38 to -1.37; p < 0.01). No significant differences
were observed in the number of hypotensive events, phenylephrine use, or
AKI incidence (p > 0.05). Conclusion(s): In adult patients undergoing
non-cardiac surgeries, HPI use was associated with a reduction in the
duration and severity of IOH, with no significant difference for adverse
events. Limitations include significant heterogeneity across studies,
differences in HPI implementation, and lack of long-term outcome
data. Copyright © 2025 Sociedade Brasileira de Anestesiologia

<50>
[Use Link to view the full text]
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.

<51>
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

<52>
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.

<53>
Accession Number
2039408953
Title
Safety and efficacy of stem cell therapy in acute myocardial infarction: a
systematic review and meta-analysis of adverse events, infarct size and LV
ejection fraction assessed by CMRI.
Source
Open Heart. 12(1) (no pagination), 2025. Article Number: e003301. Date of
Publication: 27 Jun 2025.
Author
Moeswir D.; Nurbaeti P.; Hendarto H.; Rahman M.F.A.
Institution
(Moeswir, Nurbaeti, Rahman) Division of Cardiology, Department of Internal
Medicine, UIN Syarif Hidayatullah, Jakarta, Indonesia
(Hendarto) Division of Endocrine-Metabolic-Disease, Department of Internal
Medicine, UIN Syarif Hidayatullah, Jakarta, Indonesia
Publisher
BMJ Publishing Group
Abstract
Introduction The current standard treatment for ST-segment elevation
myocardial infarction is prompt reperfusion through primary percutaneous
coronary intervention. However, myocardial infarction remains the leading
cause of heart failure, contributing to prolonged hospital stay and a 30%
rehospitalisation rate within 6 months. Stem cell therapy has emerged as a
potential approach to repair myocardial damage. Methods This study is a
meta-analysis of randomised clinical trials available online. The
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines were followed, and the study was conducted according to the
Cochrane Handbook for Systematic Reviews of Interventions. Results 21
articles from 15 trials (21 clinical trial interventions) with a total of
1218 participants were included. Stem cell therapy was associated with
fewer adverse events than controls (OR 0.66, 95% CI 0.44 to 0.99, p=0.05),
supporting its short-term to midterm safety. No cardiac-related cancer
cases were reported in any group, but longer follow-up is needed to assess
potential oncogenic risks. Efficacy analyses showed no significant effect
on infarct size (absolute or relative) or left ventricular ejection
fraction (LVEF) in short-term follow-up. In long-term follow-up, relative
infarct size became statistically significant in favour of stem cell
therapy only after exclusion of an outlier study (standardised mean
difference -0.63, 95% CI -0.94 to -0.32, p<0.0001). Long-term LVEF
improvement was also significant (mean difference 2.63%, 95% CI 0.50% to
4.76%, p=0.02), although substantial heterogeneity remained unexplained
despite sensitivity analyses, including the removal of low-correlation
studies. Conclusion Stem cell therapy for acute myocardial infarction
demonstrates a favourable safety profile. While overall efficacy remains
uncertain, long-term benefits may exist, particularly for relative infarct
size and LVEF. However, interpretation is limited by study heterogeneity.
Future trials with standardised protocols and longer follow-up are
warranted. Copyright © Author(s) (or their employer(s)) 2025.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ Group.

<54>
Accession Number
2035072024
Title
Comparing Stenting with Medical Therapy Versus Medical Therapy Alone in
Patients with Intracranial Atherosclerotic Stenosis: A Current Systematic
Review and Meta-Analysis.
Source
Clinics and Practice. 15(6) (no pagination), 2025. Article Number: 113.
Date of Publication: 01 Jun 2025.
Author
Bin Aziz K.; Alhathlol H.; Bin Aziz F.; Alshammari M.; Alhefdhi M.A.;
Alrasheed A.M.; Alfayez N.; Alhowaish T.S.
Institution
(Bin Aziz, Alhathlol, Bin Aziz, Alhefdhi, Alrasheed, Alfayez) College of
Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh,
Saudi Arabia
(Bin Aziz, Alhathlol, Bin Aziz, Alshammari, Alhefdhi, Alrasheed, Alfayez,
Alhowaish) King Abdullah International Medical Research Center, Riyadh,
Saudi Arabia
(Alshammari, Alhowaish) Department of Neurology, King Abdulaziz Medical
City, Ministry of the National Guard Health Affairs (MNGHA), Riyadh, Saudi
Arabia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Intracranial atherosclerotic stenosis (ICAS) is a significant
cause of ischemic stroke worldwide, with high recurrence rates despite
optimal medical therapy. While endovascular stenting has been proposed as
an adjunctive treatment, its clinical benefit remains controversial as a
first line therapy. Objective(s): To evaluate the efficacy and safety
of stenting plus medical therapy (STN+MT) compared to medical therapy
alone (MT) in patients with symptomatic ICAS through a systematic review
and meta-analysis of randomized controlled trials (RCTs). Method(s):
We systematically searched PubMed, Web of Science, the Cochrane Library,
Embase, Scopus, and EBSCO for RCTs comparing STN+MT with MT in adult
patients with symptomatic ICAS. Primary outcomes included transient
ischemic attack (TIA), stroke, intracerebral hemorrhage (ICH), and death
at 30 days and 1 year. Pooled risk ratios with 95% confidence intervals
were calculated using random-effects or fixed-effects models as
appropriate. Meta-regression was conducted to assess effect modification
by study-level characteristics. Result(s): Four trials comprising 990
patients were included. STN+MT was associated with significantly higher
30-day risk of stroke and ICH compared to MT alone. No significant
differences in TIA, stroke, ICH, or death were found at 1 year.
Meta-regression revealed no significant effect modifiers, suggesting
consistent findings across subgroups. Conclusion(s): Our
meta-analysis consolidates the evidence that intracranial stenting as a
first line therapy offers no significant advantage over medical therapy in
preventing stroke in symptomatic ICAS, while it does pose added early
risks. This holds true across different trials, patient demographics, and
clinical scenarios examined. The consistency of this message across
multiple RCTs provides a high level of evidence to guide practice. At
present, aggressive medical therapy alone should be the default management
for most patients. Endovascular intervention should be reserved for
clinical trial settings or carefully selected salvage cases, until and
unless new evidence emerges to change the risk-benefit calculus such as
the promising use of balloon angioplasty in the BASIS trial. Copyright
© 2025 by the authors.

<55>
Accession Number
2035168647
Title
Protamine sulphate for heparin reversal in percutaneous cardiac
interventions: a systematic review and meta-analysis of randomized
controlled trials.
Source
Naunyn-Schmiedeberg's Archives of Pharmacology. (no pagination), 2025.
Date of Publication: 2025.
Author
Balbaa E.; Gadelmawla A.F.; Tawfik A.M.; Naeem A.; Elbataa A.; Bazzazeh
M.; Fatiem A.R.; Ali K.; Altobaishat O.; Abuelazm M.
Institution
(Balbaa, Tawfik, Bazzazeh, Fatiem) Faculty of Medicine, Alexandria
University, Alexandria, Egypt
(Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Naeem) Faculty of Medicine, Al-Azhar University, Asyut, Egypt
(Elbataa) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Ali) Internal Medicine, Rosalind Franklin University of Medicine and
Science, Chicago, United States
(Altobaishat) Faculty of Medicine, Jordan University of Science and
Technology, Irbid, Jordan
(Abuelazm) Faculty of Medicine, Tanta University, Tanta, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Vascular complications after percutaneous cardiac interventions are a
significant cause of morbidity that affects post-procedural prognosis.
Data about the efficacy and safety of routine protamine sulphate to
prevent these complications remain scarce. Hence, we aim to assess the
efficacy and safety of routine protamine sulphate use for heparin reversal
in patients undergoing percutaneous cardiac interventions. We
systematically searched PubMed, Embase, Cochrane, Scopus, and Web of
Science for randomized controlled trials (RCTs) until September 2024. The
RCTs' quality was assessed using the Cochrane tool (RoB 2). Using R, we
pooled dichotomous outcomes using risk ratios (RR) and continuous outcomes
using mean differences (MD), both along the corresponding 95% Confidence
interval (CI). PROSPERO ID: (CRD42024593002). Six RCTs with 1,076 patients
were eligible. Hemostasis success was significantly higher in the
protamine group (RR, 1.06; 95% CI [1.01-1.10]; P = 0.01), and the length
of hospital stay was significantly shorter (MD, -0.46; 95% CI [-0.65,
-0.26]; P < 0.01). There was no significant difference between both groups
in stroke (RR, 0.60; 95% CI [0.18-2.03]; P = 0.41), major bleeding (P =
0.25), minor bleeding (P = 0.11), life-threatening bleeding (P = 0.65),
time to ambulation (P = 0.13), all-cause mortality (P = 0.92),
hematoma/pseudoaneurysm (P = 0.92), and major vascular complications (P =
0.70). While protamine improved hemostasis success, its effect on reducing
bleeding events and time to ambulation was insignificant. Also, reducing
the length of hospital stay in the protamine group highlights its
potential clinical benefit. Copyright © The Author(s) 2025.

<56>
Accession Number
2038800223
Title
Impact of sodium-glucose co-transporter 2 inhibitors on cardiovascular
outcomes in patients with acute myocardial infarction: Systematic review
and meta-analysis.
Source
American Journal of the Medical Sciences. 370(2) (pp 139-147), 2025. Date
of Publication: 01 Aug 2025.
Author
Akkawi M.; Upreti P.; Damlakhy A.; Kidess G.G.; Hamza M.; Rajak K.;
Turkmani M.; Harmouch K.M.; Bahar Y.; Alraies M.C.
Institution
(Akkawi, Damlakhy, Harmouch) Wayne State University School of Medicine,
Detroit Medical Center, Detroit, MI, United States
(Upreti) Internal Medicine, Rochester General Hospital, Rochester, NY,
United States
(Kidess) Wayne State University School of Medicine, Detroit, MI, United
States
(Hamza) Guthrie Medical Group, Cortland, NY, United States
(Rajak) Department of Internal Medicine, University of Pittsburgh Medical
Center, Pittsburgh, PA, United States
(Turkmani) Faculty of Medicine, Michigan State University, East Lansing,
MI, United States
(Turkmani) Department of Internal Medicine, McLaren Health Care, Oakland,
MI, 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: The role of sodium-glucose co-transporter inhibitors (SGLT2i)
in heart failure is well-established. However, evidence supporting their
use in acute myocardial infarction remains limited. Method(s): Two
independent researchers conducted a comprehensive literature review on
PubMed and Embase until April 2024. They identified 14 articles,
consisting of randomized controlled trials and observational studies,
investigating the use of SGLT2i in acute myocardial infarction. The
analysis focused on cardiovascular outcomes, including all-cause
mortality, cardiovascular mortality, major adverse cardiovascular events
(MACE), heart failure exacerbation, strokes, and recurrence of acute
coronary syndrome. Result(s): Our pooled analysis of 19,319
participants revealed a significant reduction in MACE [OR 0.50, 95 % CI
[0.36; 0.70], p-value = 0.0001] and hospitalization due to heart failure
[OR 0.59 (0.43-0.79), P < 0.0004] in the SGLT2i group compared to the
control group. In contrast, there were no statistically significant
differences between the SGLT2i and control groups regarding all-cause
mortality, cardiovascular mortality, recurrence of acute coronary
syndrome, or new-onset arrhythmia. Conclusion(s): Our study
highlights that among patients with acute myocardial infarction, the use
of SGLT2i reduces MACE and hospitalizations due to heart failure. However,
there was no significant reduction in mortality, recurrence of acute
coronary syndrome, or arrhythmia in the SGLT2i group. Copyright ©
2025

<57>
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)

<58>
Accession Number
646544023
Title
Re: Stroke prevention strategies for cardiac surgery: a systematic review
and meta-analysis of randomized controlled trials.
Source
ANZ journal of surgery. 95(6) (pp 1282-1283), 2025. Date of Publication:
01 Jun 2025.
Author
Wang H.; Yang M.; Gao H.; Liu X.
Institution
(Wang, Yang) Operating Room, Rehabilitation University Qingdao Central
Hospital, Qingdao, China
(Gao, Liu) Department of Cardiovascular Surgery, Affiliated Hospital of
Qingdao University, Qingdao, China

<59>
Accession Number
2031323908
Title
Direct-to-catheter ablation versus second line catheter ablation for
persistent atrial fibrillation: Effect on arrhythmia recurrence, AF
burden, early left atrium remodeling and quality of life.
Source
Journal of Interventional Cardiac Electrophysiology. 68(4) (pp 787-793),
2025. Date of Publication: 01 Jun 2025.
Author
Younes H.; Ademi B.; Tsakiris E.; Feng H.; Pandey A.C.; Mekhael M.;
Noujaim C.; Lim C.; Dagher L.; Hajjar A.H.E.; Bidaoui G.; Bsoul M.; Assaf
A.; Rao S.; Mahnkopf C.; Shamaileh G.; Kreidieh O.; Hassan A.; Liu Y.; Jia
Y.; Polo F.T.; Marrouche N.F.; Donnellan E.
Institution
(Younes, Ademi, Tsakiris, Feng, Pandey, Mekhael, Noujaim, Lim, Dagher,
Hajjar, Bidaoui, Bsoul, Assaf, Rao, Shamaileh, Kreidieh, Hassan, Liu, Jia,
Polo, Marrouche, Donnellan) Tulane Research Innovation for Arrhythmia
Discovery (TRIAD), Cardiac Electrophysiology, Tulane University School of
Medicine, New Orleans, LA, United States
(Mahnkopf) Department of Cardiology, Klinikum Coburg, Coburg, Germany
(Mahnkopf) Medical School, University of Split, Split, Croatia
Publisher
Springer
Abstract
Background: Catheter ablation has obtained class 1 indication in ablation
of young, healthy patients with symptomatic paroxysmal atrial fibrillation
(AF). Anti-arrhythmic drugs (AADs) remain first-line therapy before
ablating persistent AF (PersAF). We sought to evaluate the efficacy of a
direct-to-catheter ablation approach against catheter ablation post AADs
in PersAF. Method(s): In this DECAAF II subanalysis, patients were
stratified into two subgroups: 'Direct-to-catheter' group comprising
patients who had not received AADs prior to ablation, and'second-line
ablation' group, comprising patients who had been on any AAD therapy at
any time before ablation. Patients were followed over 18 months. The
primary outcome was AF recurrence. Secondary outcomes included AF burden,
quality of life (QoL) that assessed by the AFSS and SF-36 scores, and
changes in the left atrial volume index (LAVI) assessed by LGE-MRI scans.
 Result(s): The analysis included 815 patients, with 279 classified
as'direct-to-catheter' group and 536 classified as'Second-line ablation'
group. The primary outcome was similar between both groups (44.8% vs
44.4%, p > 0.05), as was AF burden (20% vs 16%, p > 0.05). Early
remodeling, reflected by LAVI reduction, was similar between the groups
(9.1 [1.6-18.0] in the second-line ablation group and 9.5 [2.5-19.7] in
the direct-to-catheter group, p > 0.05). QoL pre/post ablation was also
similar (p > 0.05). On multivariate analysis, history of AAD was not
predictive of AF recurrence(p > 0.05). Conclusion(s): Prior AAD
therapy demonstrated minimal impact on atrial remodeling and QoL
improvement, in addition to limited benefit on AF recurrence and burden
post-ablation in patients with PersAF. Additional studies are warranted to
explore the efficacy of catheter ablation as a first-line therapy in
PersAF. Copyright © The Author(s) 2024.

<60>
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)

<61>
Accession Number
2035075018
Title
Systematic Review of Pharmacogenetics of Immunosuppressants in Heart
Transplantation.
Source
Cardiogenetics. 15(2) (no pagination), 2025. Article Number: 18. Date of
Publication: 01 Jun 2025.
Author
Megias-Vericat J.E.; Palanques-Pastor T.; Fernandez-Sanchez M.;
Guerrero-Hurtado E.; Gil-Candel M.; Solana-Altabella A.; Ballesta-Lopez
O.; Centelles-Oria M.; Garcia-Pellicer J.; Poveda-Andres J.L.
Institution
(Megias-Vericat, Garcia-Pellicer) Pharmacy Department, Hospital
Universitari i Politecnic La Fe, Valencia, Spain
(Palanques-Pastor, Gil-Candel, Ballesta-Lopez, Centelles-Oria) Accredited
Research Group on Pharmacy, Instituto Investigacion Sanitaria La Fe,
Valencia, Spain
(Fernandez-Sanchez) Pharmacy Department, Consorcio Hospitalario Provincial
de Castellon, Castello de la Plana, Spain
(Guerrero-Hurtado) Pharmacy Department, Hospital Universitario Fundacion
Jimenez Diaz, Madrid, Spain
(Solana-Altabella) Accredited Research Group on Hematology, Instituto
Investigacion Sanitaria La Fe, Valencia, Spain
(Poveda-Andres) Management Department, Hospital Universitari i Politecnic
La Fe, Valencia, Spain
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
The standard immunosuppressive treatments in heart transplantation are
calcineurin inhibitors, corticosteroids, and antimetabolite agents or
inhibitors of the mammalian target of rapamycin. Pharmacogenetic studies
show the impact on clinical course of genetic variability in genes that
encode transporters, metabolizers, or molecular targets of
immunosuppressants. The aim of this systematic review is to elucidate the
role that pharmacogenetics of immunosuppressant drugs plays in clinical
outcomes upon heart transplantation. PubMed, EMBASE, the Cochrane Central
Register, and the Database of Abstracts of Reviews of Effects were
searched without restrictions. The 64 studies analyzed followed these
criteria: (1) were based on clinical data on heart transplantation
patients; (2) analyzed the associations between polymorphisms and clinical
response; (3) analyzed the impact of polymorphisms on immunosuppressant
safety. CYP3A4/5 variants were associated with higher doses of tacrolimus,
whereas POR*28 variants with lower doses-ABCB1, ABCC2, SLCO1B1, and
SLC13A1-contribute to interindividual variability in drug absorption,
distribution, and toxicity. An ABCC2 polymorphism (rs717620) was related
to higher risk of graft rejection in pediatrics. Variations in HLA-G,
TNF-alpha and TGF-beta genes influence transplant rejection risk and
immune response. Implementing pharmacogenetic screening of polymorphisms
could enhance therapeutic outcomes by improving drug efficacy, reducing
toxicity, and ultimately increasing heart graft survival rates. Strong
evidence supports genotyping for CYP3A5 and TPMT, but further research is
required for transporter genes and cytokine polymorphisms. Copyright
© 2025 by the authors.

<62>
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.

<63>
Accession Number
2039682872
Title
Opioid-sparing Anesthesia in Cardiac Surgery: A Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Rauseo M.; Mirabella L.; Carrideo A.A.; Padovano F.P.; Cantatore L.P.;
Vetuschi P.; Da Lima S.; Paternoster G.; Cinnella G.
Institution
(Rauseo, Padovano, Cantatore, Vetuschi, Da Lima) Department of Cardiac
Anesthesia, Policlinico di Foggia, Foggia, Italy
(Rauseo, Mirabella, Carrideo, Cinnella) Department of Anesthesia and
Intensive Care Medicine, Policlinico di Foggia, Foggia, Italy
(Rauseo, Mirabella, Cinnella) Department of Medical and Surgical Science,
University of Foggia, Foggia, Italy
(Paternoster) Department of Health Sciences, School of Medicine,
University of Basilicata, Anesthesia and Intensive Care, San Carlo
Hospital, Potenza, Italy
Publisher
W.B. Saunders
Abstract
This systematic review and meta-analysis evaluated the impact of
opioid-sparing versus opioid-based anesthesia in adult patients undergoing
cardiac surgery. A comprehensive literature search was conducted across
major databases from 2015 to 2025. Eligible studies included randomized
controlled trials and observational cohorts reporting at least one of the
following outcomes: opioid consumption (in morphine milligram equivalents
[MME]), intensive care unit (ICU) length of stay, mechanical ventilation
duration, pain scores, and mortality. A total of 27 studies (8 randomized
controlled trials and 19 observational studies), including 58,998
patients, were analyzed. Opioid-sparing protocols, involving multimodal
analgesia and regional anesthesia, were significantly associated with
reduced intraoperative and postoperative opioid consumption. The pooled
mean difference in opioid consumption was -2.48 MME (95% confidence
interval [CI]: -2.60 to -2.35, p < 0.001). Opioid-sparing strategies were
also associated with shorter ICU length of stay (odds ratio [OR]: 1.32,
95% CI: 1.14-1.51), reduced duration of mechanical ventilation (OR: 1.46,
95% CI: 1.24-1.72), and lower postoperative pain scores at 12 hours (OR:
1.18, 95% CI: 1.07-1.30). No significant difference was observed in
postoperative mortality (OR: 0.20; 95% CI: 0.04-1.14). Narrative outcomes
such as persistent opioid use, postoperative nausea, early mobilization,
and patient satisfaction generally favored opioid-sparing anesthesia,
although reporting was inconsistent. Adverse events related to nonopioid
adjuncts were inconsistently reported. The overall risk of bias was low to
moderate, and heterogeneity was moderate across most outcomes. These
findings support opioid-sparing strategies in selected cardiac surgery
patients as part of multimodal, enhanced recovery protocols, but highlight
the need for standardized definitions and prospective trials with rigorous
safety reporting. Copyright © 2025 The Author(s)

<64>
Accession Number
2039666680
Title
Effect of a virtual reality program on patient comfort in the surgical
intensive care unit of a French university hospital: study protocol for a
monocentric, prospective, superiority, randomised controlled trial-ZION
study.
Source
BMJ Open. 15(7) (no pagination), 2025. Article Number: e101243. Date of
Publication: 17 Jul 2025.
Author
Huette P.; Malaquin S.; Lefebvre T.; Devos C.; Ibrahima A.; Daumin C.;
Coupez A.; Josse E.; Besserve P.; Haye G.; Bayart G.; Guilbart M.; Gibert
L.; Beyls C.; Dupont H.; Meynier J.; Diouf M.; Mahjoub Y.; Abou-Arab O.
Institution
(Huette, Malaquin, Lefebvre, Devos, Ibrahima, Daumin, Coupez, Besserve,
Haye, Bayart, Guilbart, Beyls, Dupont, Mahjoub, Abou-Arab) Department of
Anesthesia and Critical Care, University Hospital, Amiens, France
(Josse) Clinical Research Centre, University Hospital, Amiens, France
(Gibert) Department of Medical Intensive Care Unit, University Hospital,
Amiens, France
(Meynier, Diouf) Department of Statistics, University Hospital, Amiens,
France
Publisher
BMJ Publishing Group
Abstract
Introduction Admission to a surgical intensive care unit (ICU) following
major surgery is associated with a number of discomforts, not only related
to the disease itself but also to the care provided or the ICU environment
itself (lights, sounds, pain, sleep deprivation, thirst, etc). This
discomfort is real and can be associated with psychological consequences.
We hypothesised that the use of immersive virtual reality (IVR) with
HypnoVR is feasible and can help reduce discomfort in intensive care.
Methods and analysis The ZION trial is a prospective, monocentric trial
randomising 194 patients admitted to a surgical ICU after a major surgery.
The inclusion criterion is patients admitted to a surgical ICU for at
least 48 hours following major surgery (cardiac, thoracic or major
abdominal surgery). Patients will be allocated to the intervention group
(n=97) or the control group (n=97). In the intervention group, patients
will receive IVR using HypnoVR two times a day during the ICU stay (2-5
days). In the control group, postoperative care will be conducted
according to standard care without IVR. The primary endpoint will be the
18-item IPREA (Inconforts des Patients de REAnimation) questionnaire on
the day of ICU discharge. The secondary endpoints will include intensity
of discomfort symptoms (anxiety, pain, dyspnoea, thirst and sleep
deprivation); the 18-Item IPREA Questionnaire assessed daily from
randomisation to the V1 follow-up visit (ICU discharge); incidence of
delirium; cumulative morphine consumption at ICU discharge; length of ICU
stay and anxiety or depression at 1 month after discharge from intensive
care and patient experience of device use. Ethics and dissemination
Ethical approval was obtained from the institutional review board of the
University Hospital of Amiens (Registration number ID: 2024-A01528-39) in
January 2025. Trial registration number NCT06830369. Copyright ©
Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ Group.

<65>
Accession Number
2039651221
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. 67(7) (no pagination), 2025.
Article Number: ezaf206. Date of Publication: 01 Jul 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 International Cancer
Institute, Osaka, Japan
(Nakagawa) Department of Thoracic Surgery, Tokyo Metropolitan Cancer and
Infectious Diseases Center Komagome Hospital, Tokyo, Japan
Publisher
European Association for Cardio-Thoracic Surgery
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. METHODS This analysis
draws information from JCOG1413, comparing the efficacy of lobe-specific
versus systematic LND with standardized LND protocols. A total of 1685
patients were included in this exploratory analysis (1251 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. RESULTS Among 1685 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 2 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).
CONCLUSIONS 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. Copyright © 2025 The Author(s).

<66>
Accession Number
2039662905
Title
Alternative LDL cholesterol-lowering strategy versus high-intensity statin
strategy in patients with diabetes and ASCVD: An individual patient data
meta-analysis from the racing and lodestar trials.
Source
Atherosclerosis. Conference: EAS 2025. Glasgow United Kingdom.
407(Supplement) (no pagination), 2025. Article Number: 119524. Date of
Publication: 01 Aug 2025.
Author
Hong M.-K.; Lee Y.-J.; Lee S.-J.; Hong S.-J.; Ahn C.-M.; Kim J.-S.; Kim
B.-K.; Ko Y.-G.; Choi D.
Institution
(Hong) Division Of Cardiology, Yonsei University College of Medicine,
Seoul, South Korea
(Lee, Lee, Hong, Ahn, Kim, Kim, Ko, Choi) Yonsei University College of
Medicine, Seoul, South Korea
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims: The effect of the alternative approach to lowering
low-density lipoprotein (LDL) cholesterol levels compared to the
high-intensity statin approach in patients with concomitant diabetes and
atherosclerotic cardiovascular disease (ASCVD), remains unclear. This
study aimed to compare the long-term efficacy and safety of alternative
LDL cholesterol-lowering strategy versus high-intensity statin strategy in
patients with diabetes and ASCVD in randomized clinical trials.
 Method(s): Individual patient data were pooled from randomized
clinical trials that compared alternative LDL cholesterol-lowering
strategy, using statins with or without non-statin agents, versus
high-intensity statin strategy and including >=1000 ASCVD patients who
were followed for at least 1 year. This analysis focused on patients with
diabetes. The primary outcome was a 3-year composite of all-cause death,
myocardial infarction, stroke, or coronary revascularization. The
secondary endpoints comprised clinical efficacy and safety endpoints.
 Result(s): Of 8180 patients randomized in the two trials (RACING and
LODESTAR), 2866 (35.0%) patient had diabetes at baseline. Patients with
diabetes had a higher risk of primary outcome than without diabetes (9.8%
vs. 6.4%; HR=1.56; 95% CI=1.33-1.82; P<0.001). Among patients with
diabetes, the rate of the primary outcome did not differ between the
alternative strategy and high-intensity statin strategy groups (9.4% vs.
10.2%; HR=0.92; 95% CI=0.73-1.17; P=0.491). The mean LDL cholesterol level
during treatment was 60.1 +/- 19.0 mg/dL in the alternative strategy group
and 63.8 +/- 19.9 mg/dL in the high-intensity statin strategy group
(P<0.001). The alternative strategy group had a lower rate
intolerance-related discontinuation or dose reduction of assigned therapy
(4.4% vs. 7.1%; P=0.002). [Formula presented] Conclusion(s): Compared
to high-intensity statin strategy, alternative LDL cholesterol-lowering
strategy showed comparable efficacy regarding 3-year death or
cardiovascular events, while achieving lower LDL cholesterol levels and
reducing intolerance concerns among patients with concomitant diabetes and
ASCVD. Copyright © 2025

<67>
Accession Number
2036871618
Title
Anticoagulation for Stroke Prevention in Patients with Atrial
Fibrillation: A Review of the Literature and Current Guidelines.
Source
Reviews in Cardiovascular Medicine. 26(6) (no pagination), 2025. Article
Number: 39233. Date of Publication: 01 Jun 2025.
Author
Vyas V.; Sharma A.; Kumar P.A.
Institution
(Vyas) Cardiology, ECU Health, Tarboro, NC, United States
(Vyas) Anesthesiogy and Intensive Medicine/Critical Care, Marienhospital,
Stuttgart, Germany
(Sharma) Department of Medicine, University at Buffalo - Catholic Health
System, Buffalo, NY, United States
(Kumar) Hematology-Oncology, George Washington University, Washington, DC,
United States
Publisher
IMR Press Limited
Abstract
Atrial fibrillation (AF) is the most common arrhythmia worldwide,
characterized by uncoordinated atrial activation leading to a loss of
effective atrial contraction and increased risk for atrial thrombi
formation, promoting an increased risk of cardioembolic strokes and
mortality, and associated increased healthcare expenditure. Therefore,
stroke prevention represents a key focus in managing patients with atrial
fibrillation, and strategies to achieve this aim have drastically evolved
over the years. Previously, aspirin and warfarin were the cornerstone of
stroke prophylaxis. However, direct oral anticoagulants have emerged and
are now recognized as a safer and more effective alternative for
non-valvular AF. Meanwhile, newer non-pharmacological methods to prevent
AF related strokes, such as left atrial appendage occlusion devices, have
been approved to ameliorate the need for lifelong anticoagulation in
patients with elevated bleeding risks. This review outlines the current
recommendations and provides an overview of the literature on stroke
prevention in patients with atrial fibrillation, particularly focusing on
using direct-acting oral anticoagulants. Comparisons between these agents
and special considerations for use are also reviewed. Copyright ©
2025 The Author(s).

<68>
Accession Number
2035380535
Title
Impact of aortic angulation on outcomes in transcatheter aortic valve
replacement with balloon-expandable and self-expanding valves: a
systematic review and meta-analysis.
Source
Cardiovascular Intervention and Therapeutics. (no pagination), 2025. Date
of Publication: 2025.
Author
Khalefa B.B.; Gonnah A.R.; Yassin M.N.A.; Fayed H.; Arnaout M.; Elkholy
M.K.A.; Ramadan M.; Elettreby A.M.; Dway A.; Eldeeb H.; Abujabal A.S.;
Roberts D.H.
Institution
(Khalefa, Abujabal) Faculty of Medicine, Ain Shams University, Cairo,
Egypt
(Gonnah) Department of Medicine, Imperial College Healthcare NHS Trust,
London, United Kingdom
(Yassin) Faculty of Medicine, Cairo University, Cairo, Egypt
(Fayed, Eldeeb) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Arnaout) Faculty of Medicine, Aleppo University, Aleppo, Syrian Arab
Republic
(Elkholy) Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
(Ramadan) Faculty of Medicine, Suez University, Suez, Egypt
(Elettreby) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Dway) Faculty of Medicine, Al-Andalus University for Medical Sciences,
Tartus, Syrian Arab Republic
(Roberts) Lancashire Cardiac Centre, Blackpool, United Kingdom
(Roberts) School of Medicine, University of Liverpool, Liverpool, United
Kingdom
Publisher
Springer
Abstract
High aortic angulation (AA) can pose significant challenges during TAVR.
This meta-analysis determines the impact of a horizontal aorta on TAVR
outcomes with balloon-expandable (BEV) and self-expanding valves (SEVs). A
comprehensive search was conducted from inception to June 2024. Thirteen
observational studies assessing the impact of aortic angulation in
patients undergoing TAVR replacement were included. The pooled results
indicated that short-term mortality was significantly lower in patients
with a non-horizontal aorta (RR = 0.76; 95% CI 0.62-0.95, P = 0.01).
Subgroup analysis displayed that BEVs had a lower short-term mortality
with a horizontal aorta than SEVs. The incidence of stroke was not
significantly affected by aortic angulation with either valve type.
However, the overall risk of permanent pacemaker implantation was lower in
patients with a non-horizontal aorta for both valve types. Paravalvular
regurgitation was also reduced in the non-horizontal aorta group, with no
difference between aortic angulations in patients with BEVs. In contrast,
SEVs favored a non-horizontal aorta in reducing paravalvular leak (RR =
0.66; 95% CI 0.46-0.94, P = 0.02). Both BEVs and SEVs show better results
in patients with lower aortic root angulation. The increased incidence of
conduction abnormalities and PPI rates with both valve types in patients
with horizontal aorta is a concern. BEVs could be potentially used
preferentially to SEVs in patients with a horizontal aorta as there was no
difference between horizontal and non-horizontal aorta groups regarding
short-term mortality, moderate-to-severe paravalvular leak, and need for a
second valve. Copyright © The Author(s) 2025.

<69>
Accession Number
647914874
Title
Can Intraoperative Hyperoxia Induce Better Outcomes in Patients Undergoing
Cardiac Surgery? A Systematic Review and Meta - Analysis.
Source
Swiss Medical Weekly. Conference: Swiss Society of Cardiology and Swiss
Society of Cardiac Surgery Annual Meeting 2025. Zurich Switzerland.
155(Supplement 287) (pp 99S), 2025. Date of Publication: 01 May 2025.
Author
Ferrara V.Z.; Downes D.; Menon J.A.; Arrighini G.S.
Institution
(Ferrara) University of Padova, Padova, Italy
(Downes) University of New England, Armidale, Australia
(Menon) Harvard Medical School, Boston, United States
(Arrighini) University of Bologna, Bologna, Italy
Publisher
SMW supporting association
Abstract
Introduction: While the use of high doses of supplementary oxygen during
cardiac surgery is often considered beneficial, its necessity, safety, and
efficacy remain subjects of ongoing debate. Material(s) and
Method(s): A meta-analysis adhering to PRISMA guidelines was conducted,
systematically searching PubMed, Cochrane, and Embase from their inception
to October 30th, 2024. The analysis included studies comparing hyperoxia
and normoxia as interventional strategies in cardiac surgery. Results were
reported using standardized mean differences (SMD), mean differences (MD),
odds ratios (OR), and their respective 95% confidence intervals (95% CI).
 Result(s): A total of 1188 patients from six studies met the
inclusion criteria, with 592 assigned to the hyperoxia group and 596 to
the normoxia group. Preoperative characteristics were comparable between
the groups. Hyperoxia was associated with a significant increase in
intraoperative arterial partial pressure of oxygen (PaO2) and a notable
reduction in acute kidney injury (AKI) (Figure 1). However, no significant
differences were found between the groups in terms of intraoperative
oxygen saturation levels (SpO2%), postoperative delirium, stroke, atrial
fibrillation (AF), surgical site infections (SSI), or hospital and ICU
lengths of stay. Conclusion(s): Although hyperoxia significantly
increased intraoperative PaO2 and reduced postoperative AKI, these
physiological effects did not yield clinical benefits, calling into
question its presumed protective role in cardiac surgery. Larger,
multicenter trials employing standardized methodologies are needed to
clarify the long-term consequences and clinical implications of hyperoxia.
Until then, a patient-centered approach to oxygen therapy remains
essential for optimizing outcomes while minimizing potential risks.

<70>
Accession Number
2039663375
Title
Liver steatosis and liver fibrosis predict major adverse cardiovascular
events in the clear outcomes trial.
Source
Atherosclerosis. Conference: EAS 2025. Glasgow United Kingdom.
407(Supplement) (no pagination), 2025. Article Number: 119672. Date of
Publication: 01 Aug 2025.
Author
De Jong V.; Nissen S.; Sasiela W.; Li N.; Bloedon L.; Lincoff A.; Nicholls
S.; Cabezas M.; Grobee D.
Institution
(De Jong, Grobee) University Medical Center Utrecht, Utrecht, Netherlands
(De Jong, Cabezas, Grobee) Julius Clinical, Zeist, Netherlands
(Nissen, Lincoff) Cleveland Clinic, Cleveland, United States
(Sasiela, Li, Bloedon) Esperion Therapeutics, Ann Arbor, United States
(Nicholls) Victorian Heart Institute, Monash University, Melbourne,
Australia
(Cabezas) Franciscus Gasthuis Vlietland, Schiedam, Netherlands
(Cabezas) Erasmus MC Medical Center, Rotterdam, Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims: Metabolic dysfunction-associated steatotic liver
disease (MASLD), and liver fibrosis (LF), are linked to liver-related and
cardiovascular (CV) complications in middle-aged patients, although data
on CV outcomes are limited. We evaluated whether liver steatosis (LS) or
LF are associated with CV outcomes in a large clinical trial of
statin-intolerant (SI) patients at high CV risk and whether bempedoic acid
(BA) reduces this CV risk. Method(s): CLEAR Outcomes evaluated BA's
efficacy in 13,970 SI patients randomized to BA (180 mg/day) or placebo,
followed for a median of 40.6 months. The primary outcome was 4-component
major adverse cardiovascular event (MACE-4: nonfatal MI, nonfatal stroke,
coronary revascularization, CV death). This post-hoc analysis used
non-invasive algorithms to estimate LS and LF at baseline: Framingham
Steatosis Index (FSI), Fibrosis-4 index (FIB-4) and NAFLD fibrosis score
(NFS). Time-to-event data was analyzed with Cox proportional hazards
model, reporting adjusted hazard ratios (aHR) for each 1-unit score
increase and 95% confidence interval (CI). Result(s): Participants
(mean age: 66+/-9 years, 48% female, mean BMI: 30+/-5 kg/m2)
had balanced characteristics across treatment arms. Baseline scores were:
FSI, 0.2+/-1.5; FIB-4, 1.3+/-0.6; NFS, -0.6+/-1.2. Overall, LS was
associated with higher MACE-4 incidence, with aHR of 1.09 (1.06-1.12) for
each FSI unit increase. LF was also associated with increased MACE-4 risk,
aHR of 1.19 (1.11-1.28) for each FIB-4 unit increase and aHR 1.14
(1.10-1.19) for each NFS unit increase. For LS, each FSI unit increase,
the aHR for MACE-4 was lower in the BA group: 1.04 (0.99-1.09) for BA vs.
1.14 (1.09-1.18) for placebo, interaction p=0.004. LF showed no
significant treatment interaction. Conclusion(s): Both LS and LF are
associated with an increased risk of MACE-4. Overall, bempedoic acid was
associated with lower rates of MACE-4 across LS and LF categories (data
not shown). Bempedoic acid demonstrated lower LS-associated MACE-4 risk,
but LF-associated MACE-4 benefits were less clear. Copyright ©
2025

<71>
Accession Number
2039662104
Title
Effectiveness and safety of early administration of colchicine in patients
with non-ST-segment-elevation myocardial infarction.
Source
Atherosclerosis. Conference: EAS 2025. Glasgow United Kingdom.
407(Supplement) (no pagination), 2025. Article Number: 120134. Date of
Publication: 01 Aug 2025.
Author
Nadaraia K.; Shengelia T.; Rigvava L.
Institution
(Nadaraia) School Of Health Sciences, University of Georgia, TBILISI,
Georgia
(Nadaraia, Shengelia, Rigvava) Clinical And Interventional Cardiology And
Therapy Department, TSU University Clinic Vivamedi, TBILISI, Georgia
(Shengelia) Internal Medicine, Caucasus International University, (+ ), (+
), (+ ), Georgia
(Rigvava) Internal Medicine, Caucasus International University, (+ ),
Georgia
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims: In re-perfused non-ST-segment-elevation myocardial
infarction, inflammation is a major contributor to myocardial damage.
Indeed, colchicine has direct anti-inflammatory and possible
anti-arrhythmic, anti-fibrotic, and anti-atherosclerotic properties, all
of which are very relevant in this population. Colchicine effects in the
context of acute myocardial infarction were investigated in numerous
clinical studies. We hypothesized that early administration of
colchicine's potent anti-inflammatory medication could improve outcomes
with non-ST-segment-elevation myocardial infarction. Our primary goal was
to compare the primary effectiveness and safety endpoints Methods: we
conducted a randomized, double-blind trial with patients enrolled within 1
day to 30 days following a myocardial infarction. One group receives 2 mg
colchicine on the first day of MI before PCI, while the second group
receives colchicine after PCI for 30 days after myocardial infarction. The
primary effectiveness endpoint was myocardial infarction, and stroke,
urgent hospitalization for angina requiring coronary revascularization and
their composites. The components of the primary endpoint and safety,
HS-CRP,6 min walk, EF were also evaluated on a day 0, 1 and 12 month
follow up visits from randomization. Result(s): A total of 172
patients satisfied the inclusion criteria and were randomized. One hundred
patients were assigned to the early treatment group, and 72 to the late
treatment group. Colchicine pre-treatment in NSTMI patients (Group 1)
reduces the risk of primary endpoints ( P < 0.05). The risk of adverse
gastrointestinal events was increased in both groups, there was no
significant difference between them ( P < 0.05). Also, there was no
significant difference between groups in all-cause mortality, or the
incidence of stroke ( P < 0.05). Conclusion(s): Early administration
of Colchicine lowers the risk of cardiovascular death, myocardial
infarction, stroke, or urgent hospitalization for angina requiring
coronary revascularization ( P<0.05). Early administration no influence on
the incidence of stroke, or all-cause death. Copyright © 2025

<72>
Accession Number
2039597338
Title
Valve replacement during pregnancy: literature review including new data
from the Registry Of Pregnancy And Cardiac disease III.
Source
European Journal of Cardio-thoracic Surgery. 67(7) (no pagination), 2025.
Article Number: ezaf180. Date of Publication: 01 Jul 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,
CIBER-CV, 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, KY, 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
Publisher
European Association for Cardio-Thoracic Surgery
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 1 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 1 case, and in 2 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 1st 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.

<73>
Accession Number
647913651
Title
Stellate Ganglion Blockade for Treatment of Ventricular Electrical Storm:
An updated meta-analysis.
Source
Swiss Medical Weekly. Conference: Swiss Society of Cardiology and Swiss
Society of Cardiac Surgery Annual Meeting 2025. Zurich Switzerland.
155(Supplement 287) (pp 118S-119S), 2025. Date of Publication: 01 May
2025.
Author
Zafeiropoulos S.; Doundoulakis I.; Saguner A.; Fudim M.
Institution
(Zafeiropoulos, Saguner) Department of Cardiology, University Hospital of
Zurich, Center of Translational and Experimental Cardiology, Zurich,
Switzerland
(Doundoulakis) Heart Rhythm Management Centre, UZ Brussels, Brussels,
Belgium
(Fudim) Division of Cardiology, Duke University Medical Center, Durham,
United States
Publisher
SMW supporting association
Abstract
Introduction: Ventricular electrical storm (ES) significantly increases
the risk of heart failure hospitalization, heart transplantation and
mortality. Standard treatment options include antiarrhythmic drugs and
catheter ablation. The autonomic nervous system plays a role in
arrhythmogenesis, and autonomic modulation techniques, such as stellate
ganglion blockade (SGB), have shown promise in drug-refractory ES. This
meta-analysis aims to evaluate the efficacy and safety of SGB in patients
with drug-refractory ES. Material(s) and Method(s): We conducted a
systematic search of MEDLINE, CENTRAL, and Scopus databases to identify
trials using SGB in ES patients, following PRISMA guidelines. The primary
outcome was the percentage of patients free from ventricular arrhythmias
(VA) at 24 and 72 hours post-SGB; the secondary outcome was the incidence
rate ratio (IRR) of VA episodes before and after SGB. A random-effects
meta-analysis was performed using R. Result(s): Out of 932 screened
articles, 9 studies with 418 patients met the inclusion criteria. The mean
age was 63.6 +/- 12.3 years, 84.4% were male, with a mean left ventricular
ejection fraction of 27.4 +/- 11.3%, and 56.9% had ischemic
cardiomyopathy. Pharmacological SGB was performed in 8 studies, with one
study using transcutaneous magnetic stimulation. The pooled proportion of
VA-free patients was 75% (95% CI 62%- 84%) at 24 hours and 59% (95% CI
45%-72%) at 72 hours (Figure 1). The incidence of VA episodes decreased
from 15.64 to 0.62 episodes per 24 hours, with an IRR of 0.067, indicating
a 93.7% reduction in the incidence rate of VA episodes postintervention
(Figure 2). No serious adverse events were reported; in-hospital mortality
was 27.3%. Conclusion(s): SGB is an effective and safe intervention
for stabilizing patients with drug-refractory ES, with substantial VA
suppression at 72 hours and a 94% reduction in episodes. This minimally
invasive, accessible technique may be viable for hospitals lacking
catheter ablation resources. Further randomized trials are warranted to
confirm these findings.

<74>
Accession Number
647914355
Title
Elevated stroke risk of underexpanded ACURATE neo and neo2 transcatheter
aortic valves.
Source
Swiss Medical Weekly. Conference: Swiss Society of Cardiology and Swiss
Society of Cardiac Surgery Annual Meeting 2025. Zurich Switzerland.
155(Supplement 287) (pp 38S), 2025. Date of Publication: 01 May 2025.
Author
Toggweiler S.; Stolte T.; Brunner S.; Loretz L.; Moccetti F.; Mahfoud F.;
Wagener M.; Kaiser C.; Wolfrum M.; Nestelberger T.
Institution
(Toggweiler, Brunner, Loretz, Moccetti, Mahfoud, Kaiser, Wolfrum) Luzerner
Kantonsspital, Luzern, Switzerland
(Stolte, Wagener, Nestelberger) University Hospital Basel, Basel,
Switzerland
Publisher
SMW supporting association
Abstract
Introduction: A post-hoc analysis from a large randomized controlled trial
has suggested that underexpansion of the ACURATE neo2 transcatheter aortic
valve may be associated with an increased rate of stroke during follow-up
between 30 days and 1 year. With this study, we aim to validate these
findings, provide insights into long-term outcomes and the efficacy of
postdilatation of underexpanded valves. Material(s) and Method(s):
Patients undergoing transcatheter aortic valve replacement with the
ACURATE neo or neo2 were analyzed. Predilatation was routinely performed,
but postdilatation only in the presence of a residual gradient or relevant
PVL. Valve expansion was reviewed based on the final angiogram.
Underexpansion was defined as at least one of the following: 1)
non-parallel posts of the upper crown, 2) the inflow of the valve taller
than wide or 3) the upper crown less expanded than the lower crown (for
examples, see Figure, A). Result(s): A total of 776 patients (mean
age 82 +/- 6 years, 55% women) were analyzed. Main results are summarized
in the Figure A and B. Underexpansion was initially present in 34%.
Postdilatation corrected underexpansion in most patients, but not all.
During long-term follow-up, strokes occured more often in patients with
underexpanded valves (HR 2.38, 95% CI 1.36 - 4.17, p = 0.002).
 Conclusion(s): Postdilatation after ACURATE TAVR should be performed
not only to correct paravalvular leaks or residual gradients, but also in
the presence of underexpansion of the frame at leaflet insertion level.
More research is needed to investigate the pathophysiology and clinical
relevance of transcatheter heart valve underexpansion across different
platforms.

<75>
Accession Number
647913361
Title
Cardiac Shockwave Therapy Induces Long-term Myocardial Improvement in
Ischemic Heart Failure - Results from a Prospective, Randomized Controlled
Trial.
Source
Swiss Medical Weekly. Conference: Swiss Society of Cardiology and Swiss
Society of Cardiac Surgery Annual Meeting 2025. Zurich Switzerland.
155(Supplement 287) (pp 9S), 2025. Date of Publication: 01 May 2025.
Author
Holfeld J.; Steiner P.; Nagele F.; Polzl L.; Engler C.; Graber M.; Hirsch
J.; Schmidt S.; Mayr A.; Ruttmann-Ulmer E.; Ulmer H.; Bauer A.;
Gollmann-Tepekoylu C.; Grimm M.
Institution
(Holfeld) Department of Cardiovascular Surgery German Heart Center Munich,
School of Medicine, Health Technical University of Munich, Munich, Germany
(Holfeld, Nagele, Polzl, Engler, Graber, Hirsch, Schmidt, Ruttmann-Ulmer,
Gollmann-Tepekoylu, Grimm) University Clinic of Cardiac Surgery, Medical
University of Innsbruck, Innsbruck, Austria
(Steiner) Medical University of Innsbruck, Innsbruck, Austria
(Mayr) Department of Radiology, Medical University of Innsbruck,
Innsbruck, Austria
(Ulmer) Institute of Medical Statistics and Informatics, Medical
University of Innsbruck, Innsbruck, Austria
(Bauer) Department of Internal Medicine III, Medical University of
Innsbruck, Innsbruck, Austria
Publisher
SMW supporting association
Abstract
Introduction: Chronic ischemic heart failure remains a significant
clinical challenge, as revascularization strategies relieve symptoms but
provide limited improvement in left ventricular ejection fraction (LVEF).
The randomized controlled CAST-HF trial previously demonstrated that
cardiac shockwave therapy (SWT) is both safe and effective. The current
work focuses on the long-term follow-up results of the CAST-HF trial.
 Material(s) and Method(s): This single-blind, sham-controlled trial,
randomized patients with LVEF <=40% undergoing surgical revascularization
to receive cardiac SWT or sham treatment alongside coronary bypass
surgery. Patients were then followed up to 4 years after surgery. The
primary endpoint consists of the improvement of LVEF. Secondary endpoints
include the improvement of 6-minute walking distance and quality of life
(Minnesota Living with Heart Failure Questionnaire). Result(s): Of
the initial 63 patients, 41 completed long-term follow- up: 22 in the SWT
group and 19 in the sham group. At the 1-year follow-up, the SWT group
showed a greater improvement in the primary endpoint (DELTA from baseline
to 360 days: SWT 11.3%, SD 8.8; Sham 6.3%, SD 7.4, p = .0146). Comparing
these results with the long-term follow-up, the SWT group showed an even
more significant improvement in LVEF up to 4 years after treatment (DELTA
from baseline: SWT 11.5%, SD 10.1; Sham 2.8%, SD 8.3, p = .0009).
Secondary endpoints also showed persistent improvements in the SWT group
up to 4 years after treatment, including the 6-minute walking distance
(DELTA from baseline: SWT 62.6m, SD 114.9; Sham -1.5m, SD 147.0, p = .031)
and quality of life (score at long-term follow-up: SWT 18.9, SD 17.5; Sham
28.5, SD 19.6, p = .046). Conclusion(s): The long-term follow-up
concludes that cardiac SWT is safe, effective on improvement of LVEF, and
shows a stable long-term benefit.

<76>
Accession Number
2035390572
Title
The effect of administration of Del Nido cardioplegia solution containing
vitamin C on myocardial protection and clinical outcomes in patients
undergoing coronary artery bypass graft surgery.
Source
Egyptian Heart Journal. 77(1) (no pagination), 2025. Article Number: 72.
Date of Publication: 01 Dec 2025.
Author
Jalili Shahandashti F.; Mozayan M.; Abdolkarimi L.; Kargar F.; Ghanbari
A.; Heidarinia S.; Totonchi Ghorbani M.Z.; Nabavi S.S.; Hosseini zargaz
S.E.
Institution
(Jalili Shahandashti, Mozayan, Abdolkarimi, Kargar, Ghanbari, Heidarinia,
Totonchi Ghorbani) Rajaie Cardiovascular Medical and Research Institute,
Shaheed Rajaie Cardiovascular Medical and Research Institute, Tehran,
Iran, Islamic Republic of
(Nabavi) Department of General Surgery, School of Medicine, Imam Khomeini
Hospital, Golestan Hospital, Ahvaz Jundishapur University of Medical
Sciences, Ahvaz, Iran, Islamic Republic of
(Hosseini zargaz) Cardiovascular Diseases Research Center, Birjand
University of Medical Sciences, Birjand, Iran, Islamic Republic of
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: A main concern during cardiac surgery is the protection of the
heart. Myocardial ischemia tends to increase the generation of reactive
oxygen species. Based on its oxidation-reduction potentials, vitamin C is
the most powerful antioxidant to counteract the effects of free radicals.
This reason made the researcher to perform this study with the goal to
determine and evaluate the effect of on perioperative clinical outcomes
and laboratory criteria of coronary artery bypass grafting (CABG) cases.
 Method(s): This randomized clinical trial (RCT) was done in 2022 at
Rajaie Cardiovascular Medical and Research Center. Following obtaining
permission from the ethics committee, 62 CABG patients were randomly
allocated to two groups and were included in the study. The control group
received routine Del Nido cardioplegia solution while vitamin C group
received Del Nido cardioplegia solution containing 3gr of vitamin C. In
this study, demographic information and variants like hemodynamic, blood,
and FFP transfusion were evaluated and compared. Data were analyzed by
two-way repeated measures ANOVA. Result(s): According to the
findings, diastolic blood pressure (DBP) in the vitamin C group was lower,
which was significant across both groups (P < 0.05); however, these
alterations were in the normal range. The groups showed no significant
difference in other parameters like fresh frozen plasma (FFP) transfusion
in the intensive care unit (ICU) and return to baseline heart rate (P >
0.05). Also, the average cardiac arrest time (average time to cardiac
arrest from the time of cardioplegia injection) in the controls was
significantly higher compared to the intervention group (P = 0.028).The
data indicate that for CK-MB, the group effect is not statistically
significant, while the effect of time and the interaction effect of group
and time are significant. For troponin, the group effect and the
interaction effect are not significant, although the effect of time is
significant. Therefore, adding vitamin C to the cardioplegia solution does
not significantly affect troponin. Conclusion(s): One of the factors
that contribute to myocardial protection is the reduction in the time to
achieve cardiac arrest. In the group that received vitamin C, this time
was reduced; therefore, it can be concluded that in this group, the risk
of damage due to lack of blood flow and oxygen to the cardiac tissue is
lower. Clinical trial number: This study is a randomized clinical trial
(RCT).IRCTID: IRCT20220716055477N1. Copyright © The Author(s)
2025.

<77>
Accession Number
647913871
Title
3-Year Outcomes From the Comparison of Amulet and Watchman/FLX Device in
Patients Undergoing Left Atrial Appendage Closure: The SWISS-APERO
Randomized Clinical Trial.
Source
Swiss Medical Weekly. Conference: Swiss Society of Cardiology and Swiss
Society of Cardiac Surgery Annual Meeting 2025. Zurich Switzerland.
155(Supplement 287) (pp 26S), 2025. Date of Publication: 01 May 2025.
Author
Galea R.; De Marco F.; Aminian A.; Meneveau N.; Chalkou K.; Anselme F.;
Grani C.; Franzone A.; Vranckx P.; Fischer U.; Valgimigli M.; Raber L.
Institution
(Galea) Department of Cardiology, Inselspital, University Hospital of
Bern, Hospital of Biel, Bern, Switzerland
(De Marco) Department of Cardiology, Monzino Cardiology Center, Milan,
Italy
(Aminian) Department of Cardiology, Centre Hospitalier Universitaire de
Charleroi, Charleroi, Belgium
(Meneveau) Besancon University Hospital, EA3920, University of Burgundy
Franche-Comte, Besancon, France
(Chalkou) Department of Clinical Research, CTU Bern, University of Bern,
Bern, Switzerland
(Anselme) Department of Cardiology, University Hospital of Rouen, Rouen,
France
(Grani, Raber) Department of Cardiology, Bern University Hospital,
University of Bern, Bern, Switzerland
(Franzone) Department of Advanced Biomedical Sciences, University Federico
II University, Naples, Italy
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Faculty of Medicine and Life Sciences, Hasselt
University, Hasselt, Belgium
(Fischer) Department of Neurology, Bern University Hospital, University of
Bern, Bern, Switzerland
(Valgimigli) Cardiocentro Ticino Institute, Universita della Svizzera
Italiana (USI), Lugano, Switzerland
Publisher
SMW supporting association
Abstract
Introduction: No study has so far compared Amulet with Watchman FLX for
clinical outcomes beyond 1 year after percutaneous left atrial appendage
closure (LAAC). Material(s) and Method(s): In the
investigator-initiated SWISS APERO trial, patients with atrial
fibrillation and high bleeding risk undergoing LAAC were randomly assigned
(1: 1) to receive Amulet or Watchman/FLX across 8 centers. Pre-specified
analyses included the ischemic composite endpoint including cardiovascular
death (CVD), stroke, transient ischemic attack (TIA) or systemic embolism
(SE) at 3 years. Additional endpoints were major bleedings, device related
thrombus (DRT), and peridevice leak (PDL). Analyses were repeated in the
as-treated (AT) populations. Result(s): Of the 221 randomized
patients, 220 completed LAAC and 3 patients randomized to Amulet received
Watchman FLX. Follow-up rate at three years was 96.4% in the Amulet and
97.3% in the Watchman group. The majority of patients were on single
antiplatelet therapy (Amulet 59% vs. Watchman 49%, p = 0.26). The
composite of CVD, stroke, TIA or SE occurred numerically less frequently
in the Amulet as compared to Watchman group (18.2%vs. 31.0%; HR: 0.58;
95%CI: 0.33-1.03; p = 0.06). Major bleedings (16.5%vs.18.0%; HR: 1.03;
95%CI: 0.53-1.97; p = 0.94), DRT (3.6%vs.6.4%; RR: 0.57: 95%CI: 0.17-1.88;
p = 0.35) and PDL (35.1%vs.42.7%; RR: 0.82; 95%CI: 0.59-1.15; p = 0.25)
did not differ between groups. In the AT population, the composite of CVD,
stroke, TIA or SE was significantly lower in the Amulet as compared to
Watchman group (17.0%vs.31.1%; HR: 0.53; 95%CI: 0.30- 0.96 ; p = 0.04).
Major bleedings (16.2% vs.17.5%; HR: 1.03; 95%CI: 0.53-2.00; p = 0.93),
DRT (2.8%vs.7.1%; RR: 0.40; 95%CI: 0.11-1.45; p = 0.15) and PDL
(34.6%vs.43.4%; RR: 0.80; 95%CI: 0.57-1.11; p = 0.18) did not differ
between groups. Conclusion(s): At three years after LAAC, the primary
analysis indicates a trend towards a lower ischemic risk in patients
treated with Amulet as compared to Watchman FLX. This finding is
corroborated by significantly lower occurrence of the ischemic composite
endpoint in the AT analysis. Longer follow- up and more comparative
studies are needed to confirm potential differences in ischemic outcomes
between devices.

<78>
Accession Number
2039663590
Title
Aortic valve replacement (AVR) versus conservative care in patients with
asymptomatic aortic stenosis: A systematic review and meta-analysis of
randomized controlled trials.
Source
Atherosclerosis. Conference: EAS 2025. Glasgow United Kingdom.
407(Supplement) (no pagination), 2025. Article Number: 120169. Date of
Publication: 01 Aug 2025.
Author
Shahid S.; Jain H.; Warsi T.; Dey D.; Shahzad M.; Batool A.; Ahmed R.
Institution
(Shahid) Khawaja Muhammad Safdar Medical College, Sialkot, Pakistan
(Jain) Department Of Cardiology, All India Institute of Medical Sciences
(AIIMS), Jodhpur, India
(Warsi) University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom
(Dey) Medical College Kolkata, Kolkata, India
(Shahzad) Dow University of Health Sciences, Karachi, Pakistan
(Batool) Allama Iqbal Medical College, Lahore, Pakistan
(Ahmed) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims: Aortic valve replacement (AVR) is recommended for
patients with symptomatic severe aortic stenosis (AS). However, evidence
of its role in asymptomatic patients with severe AS remains controversial.
Hence, a systematic review and meta-analysis of randomized controlled
trials (RCTs) comparing AVR to conservative management in patients with
asymptomatic severe AS was conducted. Method(s): A systematic
literature search was performed on electronic databases including MEDLINE
(via PubMed), Embase, and Cochrane CENTRAL Library until November 2024.
For calculating pooled effect estimates, a random effects model was used
to pool individual risk ratios (RRs) with their corresponding 95%
confidence intervals (CIs) using Review Manager Version 5.4.1.
 Result(s): Three RCTs with a total of 1,203 patients (42% females)
were included. On pooled analysis, AVR significantly reduced the risk of
hospitalization for heart failure (RR=0.11, CI: 0.02-0.56, p=0.008)
compared to conservative care. However, there were no significant
differences between the two groups in all-cause mortality (RR=0.63, CI:
0.36-1.11, p=0.11), stroke (RR=0.59, CI: 0.35-1.01, p=0.05), myocardial
infarction (RR=0.43, CI: 0.06-2.92, p=0.38), or thromboembolic events
(RR=0.54, CI: 0.13-2.29, p=0.40). Conclusion(s): In asymptomatic
patients with severe AS, AVR significantly reduces the risk of
hospitalization due to heart failure, with comparable risks in terms of
mortality, myocardial infarction, stroke, and thromboembolic events
compared to conservative management. [Formula presented] Copyright
© 2025

<79>
Accession Number
2039625029
Title
Management of Coronary Artery Disease in the Context of Transcatheter
Aortic Valve Implantation: A Systematic Review and Meta-analysis of
Percutaneous Coronary Intervention Timing and an Algorithmic Approach to
Management.
Source
Interventional Cardiology: Reviews, Research, Resources. 20 (no
pagination), 2025. Article Number: e21. Date of Publication: 2025.
Author
Murray C.; Ryan C.; Cronin M.; Temperley H.; O'Sullivan N.; O'Connor S.;
Maree A.; Hensey M.
Institution
(Murray, Cronin, O'Connor, Maree, Hensey) Cardiology Department, St
James's Hospital, Dublin, Ireland
(Ryan) Cardiology Department, Mater Misericordiae University Hospital,
Dublin, Ireland
(Temperley, O'Sullivan) Radiology Department, St James's Hospital, Dublin,
Ireland
Publisher
Radcliffe Medical Media
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is widely
performed for severe aortic stenosis (AS), often accompanied by coronary
artery disease (CAD). The optimal management of CAD in TAVI patients
remains uncertain. This study reviews the evidence on percutaneous
coronary intervention (PCI) timing in TAVI, and proposes an algorithmic
approach for CAD management. Method(s): A comprehensive search of
PubMed, EMBASE and Cochrane identified studies comparing PCI timing
strategies in TAVI patients. Result(s): Thirteen studies with 15,412
participants were included. Mortality at 30 days (OR 5.70; 95% CI
[1.34-24.36]) and 2 years (OR 4.40; 95% CI [2.60-7.44]) were significantly
higher in the combined pre-TAVI and concomitant PCI group than in the
post-TAVI cohort. Rates of other periprocedural complications, such as
stroke and bleeding, varied across studies. Conclusion(s): There is
no clear consensus on PCI timing in TAVI due to a lack of high-quality
randomised data. An individualised, algorithmic approach is proposed for
managing CAD in patients undergoing TAVI. Copyright © The
Author(s) 2025.

<80>
Accession Number
2035313260
Title
Tissue response and clinical outcomes after cardiovascular use of porcine
small intestinal small intestinal submucosal extracellular matrix: a
systematic review.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1532157. Date of Publication: 2025.
Author
Bruun V.J.; Jensen L.L.; Hasenkam J.M.; Jedrzejczyk J.H.
Institution
(Bruun, Jensen, Hasenkam, Jedrzejczyk) Department of Cardiothoracic and
Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
(Hasenkam, Jedrzejczyk) Department of Clinical Medicine, Aarhus
University, Aarhus, Denmark
Publisher
Frontiers Media SA
Abstract
Background: Porcine small intestinal submucosal extracellular matrix
(PSIS-ECM) is a biomaterial that has gained increasing popularity in
cardiovascular surgery over the past three decades. This popularity is due
to PSIS-ECM demonstrating properties of an ideal biological scaffold; it
is easy to use, lacks immunogenicity, is absorbable, possesses the
potential to promote native tissue growth, and exhibits remodelling
properties. We systematically reviewed the literature on the preclinical
and clinical use of this approach in cardiovascular surgery over the past
decade. Method(s): Utilizing a box-search methodology, an extensive
survey of the literature on PSIS-ECM's application in cardiovascular
surgery from 2013 until September 2023 was conducted within the PubMed and
Embase databases. Initially, 245 publications were identified. Following
title, abstract, and full-text screening, 66 articles were included in the
survey. Result(s): Among nine preclinical studies conducting
histological assessments of explants, eight did not report signs of
inflammation. Tissue remodelling was documented in six preclinical
studies. Histological examination of explants was incorporated into
thirteen clinical cohort studies, all of which demonstrated varying
intensities of inflammation and no or minimal signs of regeneration and
remodeling. The reintervention rates among clinical cohort studies range
from 4.5% to 87.5%. Eleven studies reported a reintervention rate
exceeding 15%, while six reported a reintervention rate below 15%.
 Conclusion(s): Preclinical studies corroborate the notion that
PSIS-ECM exhibits properties of an ideal biological scaffold. However,
these findings lack reproducibility in clinical settings. Combined with
reports from clinical studies showing reintervention rates exceeding 15%,
this has raised concerns about whether clinical application of PSIS-ECM
should be confined to selected cases. Copyright 2025 Bruun, Jensen,
Hasenkam and Jedrzejczyk.

<81>
Accession Number
647914551
Title
Left atrial appendage occlusion using the Amplatzer Amulet device in
high-risk patients with atrial fibrillation undergoing transcatheter
aortic valve replacement: A randomized pilot trial.
Source
Swiss Medical Weekly. Conference: Swiss Society of Cardiology and Swiss
Society of Cardiac Surgery Annual Meeting 2025. Zurich Switzerland.
155(Supplement 287) (pp 43S), 2025. Date of Publication: 01 May 2025.
Author
Gong Y.; Heinz P.; Chen M.; Kasel A.M.; Held U.; Paneni F.; Ruschitzka F.;
Moccetti M.; Pilgrim T.; Stahli B.E.; Nietlispach F.; Jakob P.
Institution
(Gong, Chen, Kasel, Paneni, Ruschitzka, Stahli, Jakob) Department of
Cardiology, University Heart Center, University Hospital Zurich, Zurich,
Switzerland
(Heinz, Held) Department of Biostatistics at Epidemiology, Biostatistics
and Prevention Institute, University of Zurich, Zurich, Switzerland
(Moccetti) Cardiology Department, Cardiocentro Ticino, Lugano, Switzerland
(Pilgrim) Department of Cardiology, Inselspital, University of Bern, Bern,
Switzerland
(Nietlispach) Heart Center im Park, Hirslanden Klinik im Park, Zurich,
Switzerland
Publisher
SMW supporting association
Abstract
Introduction: This investigator-initiated, randomized, multicenter,
non-blinded, all-comers pilot study assessed efficacy and safety of left
atrial appendage occlusion (LAAO) with the Amplatzer Amulet LAA-device
with early cessation of oral anticoagulation (OAC) as compared to standard
medical therapy (SMT) in high-risk patients with atrial fibrillation (AF)
undergoing transcatheter aortic valve replacement (TAVR). Material(s)
and Method(s): Patients with AF undergoing TAVR were randomly assigned to
LAAO (TAVR+LAAO) or SMT (TAVR+SMT). The primary endpoint was a composite
of ischemic and hemorrhagic neurologic events, peripheral embolism,
life-threatening/disabling and major bleeding, and cardiovascular death at
1 year. A sensitivity analyses was performed in the per-protocol
population. Result(s): This study included 81 patients, 40 with
TAVR+LAAO and 41 with TAVR+SMT between May 2016 and May 2018 at 3 sites in
Switzerland. Average age was 82.8 years. Mean STS score was 9.04% (5.42%),
median CHA2DS2-VASc 4.00 [3.00,5.00] and median HAS-BLED 3.00 [2.00,3.00].
At discharge, 92% of TAVR+LAAO were on antiplatelet therapy only and 87%
of TAVR+SMT on OAC. The primary endpoint occurred in 13 out of 40 patients
(33%) in TAVR+LAAO and in 15 out of 41 patients (37%) in TAVR+SMT (OR,
0.83; 95%CI: 0.33-2.09, P = 0.70). Bleeding occurred in five patients
(13%) in TAVR+LAAO and in seven patients (17%) in TAVR+SMT, with absent
non-procedural bleeding in TAVR+LAAO and five gastrointestinal bleedings
in TAVR+SMT. Four patients in the TAVR+LAAO (10%) and one patient (2.4%)
in the TAVR+SMT had neurologic events. In the per-protocol analysis, the
primary endpoint was similar (OR, 0.58; 95%CI, 0.21-1.53; P = 0.28). Two
(5.6%) and one patient (2.4%) had neurologic events in TAVR+LAAO and
TAVR+SMT, respectively. Bleeding rates were numerically lower in TAVR+LAAO
(8.3%) as compared to TAVR+SMT (17%). Conclusion(s): Among high-risk
patients with AF undergoing TAVR, a strategy of a combined procedure with
LAAO is an alternative to SMT with potential lower bleeding but higher
neurological event rates.

<82>
Accession Number
2039663110
Title
Lerodalcibep and adjudicated cardiovascular events in a pre-defined pooled
analysis of three large long term Phase III studies.
Source
Atherosclerosis. Conference: EAS 2025. Glasgow United Kingdom.
407(Supplement) (no pagination), 2025. Article Number: 119493. Date of
Publication: 01 Aug 2025.
Author
Kallend D.; Raal F.; Kereiakes D.; Klug E.; Vest J.; Stein E.
Institution
(Kallend) LIB Therapeutics Inc., Cincinnati, Switzerland
(Raal) Carbohydrate And Lipid Metabolism Research Unit, Faculty Of Health
Sciences, University of the Witwatersrand, Johannesburg, South Africa
(Kereiakes) Lindner Research Center, The Christ Hospital, Cincinnati,
United States
(Klug) University of Witwatersrand, Johannesburg, South Africa
(Vest) Medpace, Cincinnati, United States
(Stein) LIB Therapeutics Inc., Cincinnati, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims: Lerodalcibep, a small binding protein PCSK9 inhibitor
significantly reduced LDL-cholesterol (LDL-C) in Phase III trials. It has
not been established whether lowering LDL-C with lerodalcibep translates
into a lower risk of cardiovascular (CV) events. Method(s): A
patient-level, pre-defined pooled analysis of the pivotal
placebo-controlled Phase III studies (LIB003-004, LIB003-005 and
LIB003-006), included patients with heterozygous familial
hypercholesterolemia, atherosclerotic CV disease (ASCVD), or very-high or
high risk for ASCVD on maximally tolerated statin and oral
lipid-lowering-therapy. Patients were randomized 2:1 to 300mg lerodalcibep
or placebo monthly SC for 24 (LIB003-004) or 52 weeks (LIB003-005,
LIB003-006). All 3 studies were assessed at Week 24 and LIB003-005 and
LIB003-006 at Week 52. A prespecified exploratory endpoint of CV events
included adjudication by a blinded Clinical Events Committee of all
serious CV adverse events, with a selected composite of death,
resuscitated cardiac arrest, acute myocardial infarction, hospitalization
for unstable angina, stroke and coronary revascularization (MACE).
[Formula presented] Results: At week 24, the placebo-corrected percentage
reductions in LDL-C with lerodalcibep was 54.9% (absolute reduction of
1.74 mmol/L) and at Week 52, 52.3% (absolute reduction of 1.67 mmol/L);
all P < 0.0001. In 2318 patients treated over 24 weeks, 24 (1.04%) CV
events were reported, including 13 (1.7%) on placebo and 11 (0.7%) on
lerodalcibep, a significant reduction in CV events with lerodalcibep [OR
(95% CI): 0.418 (0.186-0.936), p<0.01]. In 1841 patients treated over 52
weeks, 52 (2.8%) CV events were reported, including 25 (4.1%) on placebo
and 27 (2.2%) on lerodalcibep, a significant reduction in CV events with
lerodalcibep [OR (95% CI): 0.527 (0.303-0.917), p<0.01].
 Conclusion(s): This pre-specified analysis offers early insights into
the potential CV benefits of lowering LDL-C with lerodalcibep and suggests
meaningful reductions in MACE. These findings await confirmation in a
planned large definitive CV outcomes trial. Copyright © 2025

<83>
Accession Number
2039653656
Title
Response to "Concerns regarding methodology in the Publication
"Flow-Controlled versus PressureControlled Ventilation in Thoracic Surgery
with One-Lung Ventilation - A Randomized Controlled Trial" by Thoma et al.
Source
Journal of Clinical Anesthesia. 106 (no pagination), 2025. Article Number:
111937. Date of Publication: 01 Sep 2025.
Author
Spraider P.; Abram J.; Martini J.
Institution
(Spraider, Abram, Martini) Department of Anesthesia and Intensive Care
Medicine, Medical University of Innsbruck, Anichstrasse 35, Innsbruck,
Austria
Publisher
Elsevier Inc.

<84>
Accession Number
2039607846
Title
Gender disparities in authorship in European cardio-thoracic journals.
Source
European Journal of Cardio-thoracic Surgery. 67(7) (no pagination), 2025.
Article Number: ezaf205. Date of Publication: 01 Jul 2025.
Author
Galeone A.; Cleuziou J.; Perrone F.; Maffei I.; Fiorinelli G.; Di Padua
C.; Duarte P.; Denora M.; Kluin J.; Pompili C.
Institution
(Galeone, Perrone, Maffei, Fiorinelli, Denora) Division of Cardiac
Surgery, Department of Surgery, Dentistry, Pediatrics and Gynecology,
University of Verona, Verona, Italy
(Cleuziou, Di Padua) Department of Congenital and Paediatric Heart
Surgery, German Heart Centre Munich, Technical University of Munich,
Munich, Germany
(Duarte) Division of Thoracic Surgery, Hospital Israelita Albert Einstein,
Sao Paulo, Brazil
(Kluin) Department of Cardiothoracic Surgery, Amsterdam University Medical
Center, Amsterdam, Netherlands
(Pompili) The Institute for Clinical and Applied Health Research (ICAHR),
Thoracic Surgery Unit, University of Hull, Hull, United Kingdom
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES The goal was to evaluate gender authorship in 2 cardio-thoracic
surgical journals. METHODS 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 authors were 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. RESULTS A total of 5243 articles were included in the analysis.
Women represented 18% of first authors, 7% of senior authors and 13% of
corresponding authors; 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 professors (17% vs 5%) and
associate professors (16% vs 8%), and male senior authors were more
frequently full professors (48% vs 31%) and associate professors (16% vs
8%) compared to female senior authors. CONCLUSIONS 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 © 2025 The Author(s).
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 information please contact journals.permissions@oup.com.

<85>
Accession Number
2039637087
Title
Centrifugation versus filtration-based cell salvage: Impact on
perioperative bleeding in cardiac surgery - The COLTRANE randomised
clinical trial - Study protocol.
Source
BMJ Open. 15(7) (no pagination), 2025. Article Number: e099423. Date of
Publication: 16 Jul 2025.
Author
Beurton A.; Mansour A.; Benard A.; Pernot M.; Brett V.-E.; Batsale C.;
Aitgougam A.; Cordon A.; Mouton C.; Fresselinat A.; Robert G.; Imbault J.;
Nesseler N.; Ouattara A.
Institution
(Beurton, Batsale, Imbault, Ouattara) Department of Cardiovascular
Anesthesia and Critical Care, CHU Bordeaux, Haut-Leveque Hospital,
Bordeaux, France
(Beurton, Imbault, Ouattara) INSERM, U1034, Biologie des Maladies
Cardiovasculaires, Univ. Bordeaux, Pessac, France
(Mansour, Nesseler) Department of Anesthesia and Critical Care
Pontchaillou, Rennes University Hospital, Rennes, France
(Benard, Cordon) Service d'Information Medicale, Clinical Epidemiology
Unit (USMR), CHU Bordeaux, Pole de Sante Publique, Bordeaux, France
(Pernot) Department of Cardiology and Cardio-Vascular Surgery, CHU
Bordeaux, Haut-Leveque Hospital, Bordeaux, France
(Brett, Mouton) Hematology Laboratory, Reference Center for Inherited
Platelet Disorders, CHU Bordeaux, Bordeaux, France
(Aitgougam, Fresselinat) Clinical Pharmacy of Medical Devices, CHU
Bordeaux, Bordeaux, France
(Robert) Clinical Research Manager, Internal Promotion, Clinical Research
and Innovation Department, CHU Bordeaux, Bordeaux, France
Publisher
BMJ Publishing Group
Abstract
Introduction Cardiac surgery remains a high-risk procedure for bleeding
despite advances in patient blood management. Conventional
centrifugation-based autotransfusion devices primarily recover red blood
cells, losing platelets and coagulation factors. The SAME autotransfusion
device (i-SEP, Nantes, France) introduces an innovative filtration-based
approach, recovering erythrocytes, leucocytes and platelets to enhance
perioperative haemostasis. The main objective is to determine whether the
filtration-based SAME device reduces significant perioperative bleeding
compared with the centrifugation-based system in high-risk cardiac surgery
patients. Methods and analysis The Centrifugation-based vs
filtration-based intraOperative cell saLvage on qualiTy of peRioperAtive
haemostasis iN cardiac surgEry (COLTRANE) trial is a multicentre,
parallel-group, single-blinded, superiority-randomised clinical trial.
Conducted over 19 months in 10 French hospitals, the study will target
patients at high risk of bleeding undergoing on-pump cardiac surgery via
sternotomy. A total of 570 patients (285 per group) are required to
achieve 80% statistical power for detecting clinically significant
differences. Eligible patients will be randomised to either a
centrifugation-based or filtration-based autotransfusion group. Both
groups will follow standardised perioperative and cardiopulmonary bypass
management, with the devices used only intraoperatively. The primary
outcome is the proportion of patients with clinically significant
perioperative bleeding defined as classes 2 to 4 of the Universal
Definition of Perioperative Bleeding. The secondary outcomes include
device efficiency and safety, perioperative haemostasis, lengths of
intensive care unit and hospital stays, early postoperative morbidity and
30-day all-cause mortality. Ancillary studies will be performed to
evaluate cell recovery and washing performance, the viscoelastic
properties of retransfused blood (Quantra Qplus; Stago,
Asnieres-sur-Seine, France), and the effect of salvaged leucocytes on
postoperative inflammation and immune function. Ethics and dissemination
This trial has received a favourable opinion from the Committee for the
Protection of Persons and authorisation from the French authorities
(Comite de protection des personnes Nord Ouest, IDRCB: 2023-A02566-39).
Protocol V.1.1 was approved on 22 January 2024. The trial is registered on
ClinicalTrials.gov (NCT06425614). The findings will be disseminated
through oral communications at national and international scientific
meetings and peer-reviewed journal publications. Individual participant
data will be made available on reasonable request to qualified
researchers, following review and approval by the study sponsor and ethics
committee. Copyright © 2025 Author(s) (or their employer(s)).

<86>
Accession Number
2039607847
Title
Permanent pacemaker implantation following mitral valve surgery.
State-of-the-art scoping review.
Source
European Journal of Cardio-thoracic Surgery. 67(7) (no pagination), 2025.
Article Number: ezaf210. Date of Publication: 01 Jul 2025.
Author
Finke J.; Pasierski M.; Dabrowski E.J.; Kurasz A.; Braczkowski J.;
Drzazdzynska A.; Benny A.; Kozlowski L.; Pawelczak K.; Stec S.; Kuzma L.;
Urbanowicz T.; Lorusso R.; Suwalski P.; Kowalewski M.; De Piero M.E.;
Mariani S.; Makhoul M.; Massimi G.; Litwinowicz R.; Ronco D.; Wanha W.;
Perazzo A.; Jiritano F.; Chiarini G.; Malvindi P.G.; Matteucci M.; Raffa
G.M.; Pilato M.; Maesen B.; La Meir M.; De Asmundis C.; Meani P.
Institution
(Finke, Pasierski, Braczkowski, Stec, Kuzma, Suwalski, Kowalewski)
Department of Cardiac Surgery and Transplantology, National Medical
Institute, Ministry of Interior and Administration, Warsaw, Poland
(Finke, Pasierski, Braczkowski, Drzazdzynska, Benny, Kozlowski, Pawelczak,
Kuzma, Urbanowicz, Kowalewski) Thoracic Research Centre, Collegium Medicum
Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz,
Poland
(Dabrowski, Kurasz, Kuzma) Department of Invasive Cardiology, Medical
University of Bialystok, Bialystok, Poland
(Stec) Institute for Cardiovascular Science, CardioMedicum Medical Centre,
Cracow, Poland
(Urbanowicz) Cardiac Surgery and Transplantology Department, Poznan
University of Medical Sciences, Poznan, Poland
(Lorusso, Kowalewski, De Piero, Mariani, Maesen) Cardio-Thoracic Surgery
Department, Heart and Vascular Centre, Maastricht University Medical
Centre (MUMC), Cardiovascular Research Centre Maastricht (CARIM),
Maastricht, Netherlands
(Makhoul) Department of Cardiac Surgery, Harefield Hospital, London,
United Kingdom
(Massimi) Cardiac Surgery Unit, Santa Maria della Misericordia Hospital,
Perugia, Italy
(Litwinowicz) Department of Cardiac Surgery, Regional Specialist Hospital,
Grudziadz, Poland
(Ronco, Matteucci) Department of Cardiac Surgery, Circolo Hospital,
University of Insubria, Varese, Italy
(Wanha) Department of Cardiology and Structural Heart Diseases, Medical
University of Silesia, Katowice, Poland
(Perazzo) Department of Cardiac Surgery, Pronto-Socorro Cardiologico de
Pernambuco (PROCAPE), Universidade de Pernambuco, Pernambuco, Recife,
Brazil
(Jiritano) Department of Experimental and Clinical Medicine, Magna Graecia
University, Catanzaro, Italy
(Chiarini) Division of Anaesthesiology, Intensive Care and Emergency
Medicine, Spedali Civili University, Affiliated Hospital of Brescia,
Brescia, Italy
(La Meir) Cardiac Surgery Unit, Lancisi Cardiovascular Center, Ospedali
Riuniti Delle Marche, Polytechnic University of Marche, Ancona, Italy
(Malvindi) Cardiac Surgery Unit, Department of Precision Medicine in
Medical Surgical and Critical Area (Me.Pre.C.C.), University of Palermo,
Palermo, Italy
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
(Pilato) Cardiac Surgery Department, Vrije Universiteit Brussel,
Universitair Ziekenhuis Brussel, Brussels, Belgium
(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
(Meani) Department of Cardiothoracic and Vascular Anesthesia, Intensive
Care Unit, IRCCS Policlinico, San Donato Milanese, Milan, Italy
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES This scoping review investigates the prevalence, indications,
risk factors, timing and outcomes related to permanent pacemaker
implantation following mitral valve surgery. METHODS A comprehensive
search of PubMed, Embase and Cochrane databases was conducted to identify
studies on permanent pacemaker implantation after mitral valve surgery.
Relevant articles discussing prevalence, indications, risk factors,
optimal timing, device choice and long-term dependency were included,
prioritizing clinical studies and reviews published in the last 2 decades.
RESULTS The incidence of permanent pacemaker implantation after isolated
mitral valve surgeries varies from 1% to 10%, with observation periods
ranging from 2 to 12 days across centres. Atrioventricular block is the
most common indication. Risk factors include older age, atrial
fibrillation, reduced left ventricular function and prior cardiac surgery.
Patients undergoing mitral valve replacement face a higher risk compared
to those having mitral valve repair, while minimally invasive surgery and
left atriotomy approach are linked to a lower permanent pacemaker rate.
Long-term pacemaker dependency ranges between 20% and 60%, with increased
rates observed in patients with atrioventricular block or those operated
in the setting of infective endocarditis. CONCLUSIONS This review
highlights the complex interplay of factors influencing permanent
pacemaker implantation after mitral valve surgery. Future research should
focus on strategies to reduce postoperative conduction abnormalities and
better identify patients who may require permanent pacemaker during
long-term follow-up. Copyright © 2025 The Author(s).

<87>
Accession Number
2039662921
Title
Multimodal prehabilitation as a strategy to reduce postoperative
complications in cardiac surgery: A randomised controlled trial.
Source
European Journal of Anaesthesiology. (no pagination), 2025. Article
Number: 2236. Date of Publication: 2025.
Author
Lopez-Hernandez A.; Gimeno-Santos E.; Navarro-Ripoll R.; Arguis M.J.;
Lopez-Baamonde M.; Sanz-De La Garza M.; Sandoval E.; Castella M.;
Martinez-Palli G.
Institution
(Lopez-Hernandez) Universitat de Barcelona, Hospital Clinic de Barcelona,
Barcelona, Spain
(Lopez-Hernandez, Navarro-Ripoll, Arguis, Lopez-Baamonde, Martinez-Palli)
Anaesthesiology Department, Hospital Clinic de Barcelona, Barcelona, Spain
(Lopez-Hernandez, Gimeno-Santos, Navarro-Ripoll, Lopez-Baamonde)
Prehabilitation Unit, Hospital Clinic de Barcelona, Barcelona, Spain
(Gimeno-Santos, Arguis, Sanz-De La Garza, Sandoval, Castella,
Martinez-Palli) Fundacio de Recerca Clinic Barcelona-Institut
d'Investigacions Biomediques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona,
Spain
(Sanz-De La Garza) Cardiovascular Institute, Hospital Clinic de Barcelona,
Barcelona, Spain
(Sandoval, Castella) Cardiovascular Surgery Department, Hospital Clinic de
Barcelona, Barcelona, Spain
(Martinez-Palli) Centro de Investigacion Biomedica en Red Enfermedades
Respiratorias (CIBERES), Madrid, Spain
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND Prehabilitation has shown efficacy in improving postoperative
outcomes in abdominal surgery. Data on cardiac surgery are controversial.
OBJECTIVE To determine if a multimodal prehabilitation programme reduces
the rate of postoperative complications after elective cardiac surgery.
DESIGN Randomised controlled trial. SETTING Single-centre study in a
tertiary hospital with inclusion period spanned from March 2018 to June
2021. PATIENTS One hundred and fifty-one patients, with an expected
waiting time before surgery of 6 weeks or more, completed the study.
Excluded were those with functional, anatomical or cognitive impairment;
cardiac instability; dynamic left ventricle outflow tract obstruction or
proven exercise-induced arrhythmias. INTERVENTION Four to six weeks of a
multimodal prehabilitation programme, including exercise training,
psychological and nutritional support. MAIN OUTCOME Incidence of
postoperative complications. RESULTS No differences were found in the rate
of postoperative complications (80% in both groups, P = 0.968), most of
which were mild, with a Comprehensive Complication Index of 21 and more
than 70% with Clavien-Dindo grade I or II. Prehabilitated patients showed
a significant improvement in endurance time assessed by a constant-work
rate cycling exercise test: preintervention vs. postintervention (301 +/-
109 vs. 578 +/- 257 s, P = 0.001), and in 6-min walk test (6MWT) (487 +/-
77 vs. 504 +/- 74 min, P = 0.001). No patients experienced adverse events
attributable to the intervention. A sub-analysis restricted to
prehabilitated patients who showed a meaningful response to exercise
assessed by the 6MWT (increase >= 30 m) showed a reduction in the number
and severity of postoperative complications, compared to nonresponders
(1.1 +/- 0.9 vs. 2 +/- 2 complications per patient, P = 0.038); and the
Comprehensive Complication Index (16 +/- 15 vs. 25 +/- 19, P = 0.044).
CONCLUSION A multimodal prehabilitation programme before elective cardiac
surgery did not reduce the incidence of postoperative complications.
Nevertheless, when analysis was restricted to meaningful responders to
intervention, a significant reduction in postoperative complications and
their severity was observed. TRIAL REGISTRATION ClinicalTrials.gov
(NCT03466606). Copyright © 2025 European Society of
Anaesthesiology and Intensive Care.

<88>
Accession Number
2039641610
Title
Global Research Trends and Hotspots in Anesthesia for Coronary Artery
Bypass Graft Surgery: A Bibliometric Analysis from 2004 to 2024.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Liu Y.; Li C.
Institution
(Liu, Li) Department of Anesthesiology, Second Hospital, Hebei Medical
University, Shijiazhuang, China
Publisher
W.B. Saunders
Abstract
Objectives: This study aimed to analyze global research trends and
hotspots in anesthesia for coronary artery bypass grafting (CABG) surgery
through a comprehensive bibliometric analysis. Design(s):
Observational bibliometric analysis. Setting(s): Data was collected
from the Web of Science Core Collection database, which encompasses a
broad array of international research publications. Participant(s):
There were 740 publications related to anesthesia for CABG surgery
published between 2004 and 2024. Intervention(s): No direct
interventions were performed. The study involved the collection and
analysis of published research data. Measurements and Main Results:
Key findings revealed that the United States, Turkey, and China are
leading in anesthesia for CABG surgery research output, with an average
international collaboration rate of 12.57%. The Cleveland Clinic
Foundation was the top contributor with 48 publications. The Journal of
Cardiothoracic and Vascular Anesthesia was noted for its high impact
(H-index of 33). Influential authors identified include Landoni Giovanni
and Zangrillo Alberto. Keyword analysis showed a shift in research focus
from ischemia and morphine to myocardial protection, complications, and
cardiac anesthesia from 2019 to 2024. Conclusion(s): This
bibliometric study provides a comprehensive overview of the evolving
research landscape in anesthesia for CABG surgery, highlighting trends,
collaborative efforts, and emerging research areas that may guide future
investigations and clinical practices in cardiac anesthesia
management. Copyright © 2025 Elsevier Inc.

<89>
Accession Number
2039596536
Title
Response to: Correspondence on "incidence of chronic postsurgical pain
after cardiac surgery and the effect of bilateral erector spinae plane
block: A randomized controlled trial" by Zhao et al.
Source
Regional Anesthesia and Pain Medicine. (no pagination), 2025. Article
Number: rapm-2025-106901. Date of Publication: 2025.
Author
Dost B.; Kaya C.; Turunc E.; De Cassai A.
Institution
(Dost, Kaya, Turunc) Department of Anesthesiology and Reanimation, Ondokuz
Mayis University, Samsun, Turkey
(De Cassai) Institute of Anesthesia and Intensive Care, University
Hospital of Padua, Padua, Italy
(De Cassai) Department of Medicine, University of Padua, Padua, Italy
Publisher
BMJ Publishing Group

<90>
Accession Number
647894433
Title
CURRENT STRATEGIES FOR MANAGING HYPERTENSION IN PARAGANGLIOMA: A
SYSTEMATIC REVIEW.
Source
Journal of Hypertension. Conference: 19th International Society of
Hypertension Scientific Annual Meeting, InaSH 2025. Jakarta Indonesia.
43(Supplement 2) (pp e4-e5), 2025. Date of Publication: 01 May 2025.
Author
Rohman M.H.N.; Salabila A.S.; Zhulmi F.; Wijaya J.H.
Institution
(Rohman, Salabila, Zhulmi, Wijaya) Prembun General Hospital, Central Java,
Kebumen, Indonesia
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Paragangliomas are rare neuroendocrine tumors that may secrete
catecholamines, leading to secondary hypertension. Hypertension in
paraganglioma can be persistent, paroxysmal, or refractory, posing
challenges in diagnosis and management. Effective blood pressure (BP)
control is crucial to minimize cardiovascular complications and surgical
risks. Objective(s): This systematic review aims to evaluate the
current strategies for managing hypertension in patients with
paraganglioma, focusing on pharmacological therapies and preoperative
optimization. Method(s): A comprehensive literature search was
performed using PubMed, EMBASE, and Scopus databases up to 8 January 2025.
Eligible studies included randomized controlled trials, observational
studies, and case series discussing antihypertensive treatments,
preoperative management, and outcomes in patients with paraganglioma. Data
were synthesized narratively and quantitatively where appropriate. Risk of
bias of included studies were assessed using the Newcastle Ottawa Scale
(NOS). Result(s): Sixteen studies (n = 3,647 patients) highlighted
alpha-blockers as the primary BP control strategy, effective in 87% of
cases. Beta-blockers were frequently employed as supplementary agents
following alpha blockade to address tachycardia. Calcium channel blockers
and angiotensin receptor blockers provided additional control.
Preoperative BP optimization reduced hypertensive crises by 15%. Minimally
invasive surgery shortened recovery and stabilized BP. Following NOS
assessment, eligible studies had low bias. Conclusion(s):
Hypertension management in paraganglioma relies on alpha-adrenergic
blockade as first-line therapy, supplemented by beta-blockers and other
antihypertensives as needed. Preoperative optimization is critical for
reducing perioperative risks. Further research is needed to refine
pharmacological regimens and improve long-term outcomes.

<91>
Accession Number
647895110
Title
The Effect of Levesimendan on Postoperative Results in Cardiac Surgery
Patients: A Systematic Review.
Source
British Journal of Surgery. Conference: 49th ASiT Annual Surgical
Conference. Belfast United Kingdom. 112(Supplement 10) (pp x90), 2025.
Date of Publication: 01 Jun 2025.
Author
Nagy N.; Afifi F.
Institution
(Nagy, Afifi) Nahda University in Beni Sweif, Beni Sweif, Egypt
Publisher
Oxford University Press
Abstract
Aim: The rise in cardiac surgeries, especially in older patients with
comorbidities, has increased the risk of postoperative complications like
low cardiac output syndrome (LCOS) and Acute right ventricular failure
which are serious conditions linked to high morbidity and mortality.
Levosimendan, a calcium sensitizing inotrope, has been investigated in
previous clinical trials and suggested improving hemodynamic and
laboratory findings after cardiac surgery. In this review we assess the
effect of levosimendan on cardiac surgery patients compared to placebo and
other iontropes like dobutamine and milrinone. Method(s): 6 studies
fully met the inclusion criteria. Data used in other studies cannot be
pooled due to heterogeneity of patient sample categories and conditions.
 Result(s): We have 4 comparisons in contrast to Levosimendan:
Dobutamine, beta blockers, milirinone and placebo, in which Levosimendan
has shown more sustained direct effects on hemodynamics and laboratory
biomarkers compared to the control. However no significant differences in
cardiac functions are shown postoperatively after the use of levosimendan
compared to control. Levosimendan had a significant positive effect in
improvement of renal function in patients with post operative cardiac
comorbidities. Conclusion(s): Levosimendan can prevent complications
and remarkably Improve clinical biomarkers and functions of patient
undergoing cardiac surgery, and it shows significant improvement in renal
functions of cardiac surgery patients, However, due to limited data, a
definitive conclusion cannot be made regarding the efficacy of
levosimendan in comparison to other controls in terms of post operative
cardiac functions. The current evidence highlights a pressing need for
large-scale, rigorously designed randomized trials. Future research should
focus on identifying patient subgroups and surgical contexts that may
benefit most from levosimendan, as well as determining the optimal dosing
and administration protocols.

<92>
Accession Number
2039663371
Title
Impact of adjunctive lipid-modifying therapy in clear outcomes trial.
Source
Atherosclerosis. Conference: EAS 2025. Glasgow United Kingdom.
407(Supplement) (no pagination), 2025. Article Number: 119638. Date of
Publication: 01 Aug 2025.
Author
Menon V.; Bloedon L.; Li N.; Lincoff A.; Nicholls S.; Powell H.; Nissen S.
Institution
(Menon, Lincoff, Nissen) Cleveland Clinic, Cleveland, United States
(Bloedon, Li, Powell) Esperion Therapeutics, Ann Arbor, United States
(Nicholls) Victorian Heart Institute, Monash University, Melbourne,
Australia
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims: Randomization of statin-intolerant patients to
bempedoic acid (BA) resulted in a 13% reduction in the risk of MACE4 (CV
death, nonfatal myocardial infarction, nonfatal stroke or coronary
revascularization) compared to placebo (PBO) in the Clear Outcomes trial
(n= 13,970). During the median 40.6 month follow-up, add-in
lipid-modifying therapy (LMT) was observed in 1,749 (12.5%) patients. As
part of a prespecified sensitivity analysis, we evaluated the impact of
LMT on the overall trial results. Method(s): MACE4 in the BA and PBO
groups was evaluated by censoring patient data at the time of starting the
first cross-in LMT therapy plus 30 days. Concomitant medications were
recorded through the end of study visit. Result(s): A first MACE4
event occurred in 819 (11.7%) and 927 (13.3%) patients randomized to BA
and PBO, respectively. Cross-in LMT was observed in 660 (9.4%) BA and
1,089 (15.6%) PBO patients. The majority of first MACE4 (92.9% and 90.9%
of events in the BA and PBO groups, respectively) occurred before any
cross-in LMT. Statins were used most often, with all cross-in LMT usage
higher in PBO. When LMT cross-in patient data was censored, BA reduced
MACE4 similar to the full analysis set (Table 1). [Formula presented]
 Conclusion(s): A minority of patients in Clear Outcomes (PBO > BA)
were treated with LMT during the trial. The timing of LMT initiation in
more than 90% of subjects occurred after the observed first MACE event.
Consequently, censored data at LMT initiation shows negligible impact of
LMT cross-in on the overall primary endpoint. Copyright © 2025

<93>
Accession Number
647896004
Title
Use of Endobronchial Valves for the Management of Bronchopleural Fistulas
and Concomitant Empyema: Updated Insights to Clinical Outcomes, Efficacy,
and Concerns.
Source
British Journal of Surgery. Conference: 49th ASiT Annual Surgical
Conference. Belfast United Kingdom. 112(Supplement 10) (pp x89), 2025.
Date of Publication: 01 Jun 2025.
Author
Rojanathagoon T.; Chitty A.Z.; Nainwal T.; He C.; Boon Chun K.L.
Institution
(Rojanathagoon, Chitty, Nainwal) School of Medicine, University of
Nottingham, Nottingham, United Kingdom
(Rojanathagoon) Faculty of Medicine, Srinakharinwirot University, Bangkok,
Thailand
(He) Faculty of Natural and Applied Sciences, Trinity Western University,
Langley, BC, Canada
(Boon Chun) St. Hilda's College, University of Oxford, Oxford, United
Kingdom
Publisher
Oxford University Press
Abstract
Aim: Bronchopleural fistulas (BPF), although rare, are fatal complications
associated with a significant risk of mortality and morbidity.
Endobronchial valves (EBVs) have emerged as a minimally invasive
therapeutic option for BPFs, offering a means to seal air leaks and
promote healing. Empyema, characterized by infected pleural fluid, has
seen the use of EBVs to isolate infected areas and facilitate drainage.
This narrative review aims to assess and synthesize the clinical outcomes,
efficacy, and challenges of EBVs in managing BPFs and concomitant empyema,
highlighting current evidence, pitfalls, and future directions.
 Method(s): A narrative review was performed; PubMed, Ovid Medline,
and Embase were systematically searched from inception till 2024 for
peer-reviewed articles focusing on the use of EBVs for the management of
BPFs and concomitant empyema. Relevant articles were screened, data
extracted and summarized. Result(s): EBVs have shown effectiveness in
managing BPFs and persistent air leaks (PAL), with some studies reporting
success rates exceeding 70%. Studies have reported immediate air leak
cessation following EBV placement, particularly in critically ill,
mechanically ventilated patients, with recovery times of 5 to 13 days. The
most successful outcomes were seen in patients with fistulas <=8mm. EBVs
also proved useful in combination with minimally invasive surgical
debridement for treating parapneumonic empyema with peripheral BPFs.
Complications were minimal, including valve secretion adhesion and mild
granulation tissue hyperplasia. Conclusion(s): EBVs offer a promising
treatment for BPFs and PALs, particularly in patients unfit for major
thoracic surgery. Larger studies are needed to confirm the efficacy of
EBVs in this population.

<94>
Accession Number
2035312877
Title
Evaluating long-term outcomes and the impact of small aortic annulus on
valve replacement-a novel systematic review and meta-analysis comparing
surgery vs. transcatheter interventions.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1555853. Date of Publication: 2025.
Author
Amin A.; Mohammed C.; Kajitani S.; AlMashari K.; Kumar R.; Sabir A.;
Briz-Echeverria P.; Mokhtassi S.; Kallikere Lakshmana S.K.; Bokhari A.;
Ehsan M.; Ahmad H.; Ahmed R.; Bahrami T.
Institution
(Amin, Mokhtassi) Department of Cardiothoracic Surgery, Harefield
Hospital, Guy's and St Thomas NHS Foundation Trust, London, United Kingdom
(Mohammed) Department of Orthopaedic Surgery, Sangre Grande Hospital,
Sangre Grande, Trinidad and Tobago
(Kajitani) School of Medicine, University College Cork, Cork, Ireland
(AlMashari) College of Medicine, Imam Abdulrahman Bin Faisal University,
Dammam, Saudi Arabia
(Kumar) Department of CTVS, Jay Prabha Medanta Super Speciality Hospital,
Patna, India
(Sabir) Department of Cardiac Surgery, Rawalpindi Institute of Cardiology,
Rawalpindi, Pakistan
(Briz-Echeverria) Department of Cardiac Surgery, Hospital Universitario de
Toledo, Toledo, Spain
(Kallikere Lakshmana) Cardiothoracic Surgery, Royal Brompton Hospital,
London, United Kingdom
(Bokhari) Department of Cardiothoracic Surgery, Jazan University, Jazan,
Saudi Arabia
(Ehsan) Department of Medicine, King Edward Medical University, Lahore,
Pakistan
(Ahmad, Ahmed) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Bahrami) Department of Cardiac Surgery, Royal Brompton and Harefield
Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, United
Kingdom
Publisher
Frontiers Media SA
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is often
compared to surgical aortic valve replacement (SAVR) for aortic stenosis
treatment. This meta-analysis evaluates the long-term efficacy and safety
of TAVI vs. SAVR in aortic stenosis patients, as well as their respective
impact on patients with small aortic annulus (SAA). Method(s):
MEDLINE, Embase, Cochrane Library, and ClinicalTrials.gov were searched
for randomized controlled trials (RCTs) and comparative observational
studies on TAVI vs. SAVR with long-term follow-up (3-5 years) or SAA. Risk
of bias was assessed using the Cochrane Risk of Bias tool (RoB 2.0) and
the Newcastle Ottawa Scale. Meta-analyses were conducted with RevMan 5.4
using a random-effects model, with risk ratio (RR) and mean difference
(MD) as effect measures. Result(s): A total of 17 studies were
included in our review. In the long-term analysis, all-cause mortality was
significantly higher in the TAVI group [RR 1.10; 95% CI: 1.01-1.19], but
the incidence of major bleeding [RR 0.79; 95% CI: 0.68-0.90] and atrial
fibrillation was significantly lower [RR 0.37; 95% CI: 0.29-0.48] in the
TAVI group. No significant difference was found between the two groups
regarding other long-term outcomes. For SAA outcomes, there was no
significant difference in terms of all-cause mortality [RR 0.92; 95% CI:
0.63-1.35], although cardiovascular mortality was significantly increased
in the TAVI group [RR 2.08; 95% CI: 1.09-3.98]. TAVI significantly
increased the rate of major vascular complications [RR 3.58; 95% CI:
1.10-11.61], aortic regurgitation/PVL [RR 6.91; 95% CI: 2.66-17.97], and
pacemaker implantation (RR 2.87; 95% CI: 1.74-4.75]. TAVI significantly
improved the incidence of prosthesis patient mismatch [RR 0.70; 95% CI:
0.54-0.89], effective orifice valve area (EOA) [MD 0.10; 95% CI:
0.01-0.19], and length of stay in hospital [MD -4.88; 95% CI: -5.52 to
-4.23]. There were no significant differences in other clinical or
echocardiographic outcomes. Conclusion(s): TAVI was associated with
higher long-term all-cause mortality compared to SAVR in the overall
population. Among patients with small aortic annulus, no survival benefit
was observed with TAVI, and cardiovascular mortality was significantly
increased. Future RCTs should explore SAA-related outcomes with
standardized diagnostic criteria. Systematic Review Registration:
https://www.crd.york.ac.uk, PROSPERO CRD42024541862. Copyright 2025
Amin, Mohammed, Kajitani, AlMashari, Kumar, Sabir, Briz-Echeverria,
Mokhtassi, Kallikere Lakshmana, Bokhari, Ehsan, Ahmad, Ahmed and Bahrami.

<95>
Accession Number
647903564
Title
On-Pump Beating-Heart Coronary Bypass Surgery: An Effective Alternative to
Off-Pump Surgery.
Source
The Thoracic and cardiovascular surgeon. (no pagination), 2025. Date of
Publication: 08 Jul 2025.
Author
Guven H.; Cetintas D.
Institution
(Guven) Cardiovascular Surgery, Bursa Medical Park Hospital, Bursa, Turkey
(Cetintas) TC Saglik Bakanligi Bursa Sehir Hastanesi, Turkey
Abstract
OBJECTIVE: This study aimed to compare the early postoperative outcomes of
cardiopulmonary bypass-supported beating-heart coronary artery bypass
grafting (CPB-BH CABG) and off-pump coronary artery bypass (OPCAB)
surgery. METHOD(S): A total of 589 patients who underwent
beating-heart CABG between October 2021 and January 2025 were
retrospectively analyzed. Patients were categorized into two groups based
on CPB usage: CPB-BH CABG (n=177) and OPCAB (n=412). Primary outcomes
included mortality and major complications, while secondary outcomes
encompassed complete revascularization rates, number of distal
anastomoses, hospital stay, and transfusion requirements. RESULT(S):
No significant differences were observed between the groups regarding
preoperative characteristics. The CPB-BH group had longer operative times
(268.7 vs. 223.6 minutes, p<0.001) and prolonged hospital stays (7 vs. 5
days, p<0.001). The rates of complete revascularization and number of
bypass grafts were slightly higher in the CPB-BH group but did not reach
statistical significance. The CPB-BH group required more blood
transfusions (p<0.001) and had a higher incidence of new-onset atrial
fibrillation (33.9% vs. 24.0%, p=0.016). No significant differences were
found for other major complications. CONCLUSION(S): CPB-BH CABG is a
viable alternative to OPCAB, offering comparable revascularization
outcomes while allowing the flexibility of cardiopulmonary bypass support
when needed. Surgeons should not hesitate to utilize CPB when necessary to
optimize surgical outcomes. Future prospective, randomized controlled
trials are warranted to assess the long-term outcomes of both surgical
techniques and their effectiveness in specific patient
subgroups. Copyright Thieme. All rights reserved.

<96>
Accession Number
647891839
Title
The influence of prosthetic heart valves on the patient's quality of life.
Source
Archives of the Balkan Medical Union. Conference: 38th Balkan Medical
Week. Bucharest Romania. 60(Supplement 1) (pp S18), 2025. Date of
Publication: 01 Jun 2025.
Author
Chiriloae R.A.; Mazur-Nicorici L.
Institution
(Chiriloae) University of Medicine and Pharmacy 'Nicolae Testemitanu',
Chisinau, Moldova
(Mazur-Nicorici) Department of Internal Medicine, Discipline of
Cardiology, University of Medicine and Pharmacy 'Nicolae Testemitanu',
Chisinau, Moldova
Publisher
Balkan Medical Union
Abstract
Introduction: Heart valve diseases represent a significant public health
concern, often necessitating surgical valve replacement. Biological
prostheses are favored due to their advantage of eliminating the need for
long-term anticoagulation. Assessing their impact on patients' quality of
life remains a critical aspect of clinical evaluation. The objective of
the study was to evaluate the influence of prosthetic heart valves on the
quality of patients' life. Material(s) and Method(s): There were
analyzed 109 clinical trials and meta-analyses published between
2020-2025, using Google Academic, ScienceDirect and PubMed. The keywords
used were: aortic valve stenosis, prosthetic valves, quality of life,
intraoperative and postoperative complications. Result(s): The
studies demonstrate a notable enhancement in the functional capacity of
patients following prosthetic valve implantation, accompanied by a
reduction in heart failure symptoms. Individuals with biological valves
experience a superior quality of life in the short term and a diminished
risk of anticoagulation-related complications. Advances in implantation
techniques have effectively minimized several postoperative risks.
 Conclusion(s): The selection of a biological prosthesis should be
tailored to the patient's individual needs and clinical profile. While the
risk of valvular degeneration remains a concern, studies indicate a
significant improvement in quality of life following the procedure.

<97>
Accession Number
647892479
Title
A comparison of antiplatelet and oral anticoagulation strategies to
prevent cerebral microembolism after transcatheter aortic valve
implantation: the AUREA trial.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
21(13) (pp e737-e748), 2025. Date of Publication: 07 Jul 2025.
Author
Jimenez Diaz V.A.; Juan-Salvadores P.; Bellas Lamas P.; Arias Gonzalez M.;
Santos Armentia E.; Vila Nieto O.; Gonzalez Mao C.; Torrado Chedas T.;
Munoz Garcia A.J.; Blazquez I.G.; Bastos Fernandez G.; De Miguel Castro
A.; Fernandez Barbeira S.; Ortiz Saez A.; Baz Alonso J.A.; Ocampo Miguez
J.; Rioboo Leston L.; Pazos Lopez P.; Calvo Iglesias F.; Salgado Barreira
A.; Diaz Lopez C.M.; Figueiras A.; Veiga Garcia C.; Iniguez Romo A.
Institution
(Jimenez Diaz, Bastos Fernandez, De Miguel Castro, Fernandez Barbeira,
Ortiz Saez, Baz Alonso, Ocampo Miguez, Rioboo Leston, Pazos Lopez, Calvo
Iglesias, Iniguez Romo) Cardiology Department, Hospital Alvaro Cunqueiro,
University Hospital of Vigo, Vigo, Spain
(Jimenez Diaz, Juan-Salvadores, Bellas Lamas, Bastos Fernandez, De Miguel
Castro, Fernandez Barbeira, Ortiz Saez, Baz Alonso, Ocampo Miguez, Rioboo
Leston, Pazos Lopez, Calvo Iglesias, Diaz Lopez, Veiga Garcia, Iniguez
Romo) Cardiovascular Research Group, Galicia Sur Health Research Institute
(IIS Galicia Sur), Vigo, Spain
(Bellas Lamas) Neurology Department, Hospital Alvaro Cunqueiro, University
Hospital of Vigo, Vigo, Spain
(Arias Gonzalez) Diagnostic Imaging Unit, Galaria, Public Sanitary
Services Company, Vigo, Spain
(Santos Armentia) Radiology Department, Hospital Ribera Povisa, Vigo,
Spain
(Vila Nieto) Diagnostic Imaging Department, Hospital Alvaro Cunqueiro,
University Hospital of Vigo, Vigo, Spain
(Gonzalez Mao) Clinical Diagnostic Unit, Hospital Alvaro Cunqueiro,
University Hospital of Vigo, Vigo, Spain
(Torrado Chedas) Hematology Department, Hospital Alvaro Cunqueiro,
University Hospital of Vigo, Vigo, Spain
(Munoz Garcia) Cardiology Department, Hospital Universitario Virgen de la
Victoria, Malaga, Spain
(Munoz Garcia, Baz Alonso, Iniguez Romo) Center for Biomedical Research in
Cardiovascular Diseases Network (CIBERCV), Madrid, Spain
(Blazquez) Cardiology Department, Hospital Universitario 12 de Octubre,
Madrid, Spain
(Salgado Barreira, Figueiras) Preventive Medicine and Public Health,
University of Santiago de Compostela, Santiago de Compostela, Spain
(Salgado Barreira, Figueiras) Health Research Institute of Santiago de
Compostela (IDIS), University of Santiago de Compostela, Santiago de
Compostela, Spain
(Salgado Barreira, Figueiras) Consortium for Biomedical Research in
Epidemiology and Public Health (CIBER Epidemiology and Public Health -
CIBERESP), Madrid, Spain
Abstract
BACKGROUND: The effectiveness of oral anticoagulation (OAC) or dual
antiplatelet therapy (DAPT) in reducing subclinical brain infarcts after
transcatheter aortic valve implantation (TAVI) remains unclear. AIMS: We
aimed to compare the efficacy of DAPT versus OAC in preventing cerebral
microembolism during the first 3 months post-TAVI, assessed by
diffusion-weighted magnetic resonance imaging (DW-MRI). METHOD(S):
Patients with aortic stenosis and no indication for OAC were randomly
assigned to receive either OAC (acenocoumarol) or DAPT
(aspirin+clopidogrel) for 3 months post-TAVI. Brain DW-MRI was performed
at baseline (0-3 days pre-TAVI) and at 6 and 90 days post-TAVI. The
primary objective was the proportion of patients with new cerebral emboli
on DW-MRI at 6 and 90 days. RESULT(S): Of the 123 patients included
in the study, 3.3% had new cerebral emboli on the baseline MRI prior to
TAVI. At 6 days post-TAVI, new cerebral emboli were observed in 81.4% of
OAC patients versus 69.8% of DAPT patients (p=0.209), and at 90 days, in
8.0% versus 8.2%, respectively (p=0.879). However, DAPT patients had a
lower mean total emboli volume at 6 days (265.9 mmA3 vs 303.4 mmA3;
p=0.019) and cumulatively at 6+90 days (266.45 mmA3 vs 331.10 mmA3;
p=0.008). CONCLUSION(S): In patients without an indication for OAC,
an OAC strategy for 3 months post-TAVI did not show any benefit over an
antiplatelet strategy in preventing cerebral microembolism. Patients
treated with DAPT showed a lower mean volume of brain damage on DW-MRI
during the 90 days following TAVI compared to those treated with
acenocoumarol.

<98>
Accession Number
2035296451
Title
Arrhythmogenic mitral valve prolapse-a systematic review of ventricular
arrhythmia and sudden cardiac death outcomes before and after mitral valve
surgery.
Source
Journal of Arrhythmia. 41(4) (no pagination), 2025. Article Number:
e70108. Date of Publication: 01 Aug 2025.
Author
Cameron J.N.; Sutherland N.; Chow C.L.; Han H.-C.; Yudi M.; Mahajan R.;
Ganesan A.; Sabbag A.; Haugaa K.H.; Raman J.; Sanders P.; Farouque O.; Lim
H.S.
Institution
(Cameron, Yudi, Farouque, Lim) Department of Cardiology, Austin Health,
Melbourne, VIC, Australia
(Cameron, Chow, Yudi, Farouque, Lim) Faculty of Medicine, Dentistry and
Health Sciences, University of Melbourne, Melbourne, VIC, Australia
(Sutherland, Chow) Department of Cardiology, Northern Health, Melbourne,
VIC, Australia
(Han) Victorian Heart Institute, Monash University, Clayton, VIC,
Australia
(Mahajan) Adelaide Medical School, University of Adelaide, Adelaide, SA,
Australia
(Mahajan) Lyell McEwin Hospital, Northern Adelaide Health Local Health
Network, Elizabeth Vale, SA, Australia
(Ganesan) Department of Cardiovascular Medicine, Flinders Medical Centre,
Adelaide, SA, Australia
(Sabbag) The Davidai Center for Rhythm Disturbances and Pacing, Chaim
Sheba Medical Center, Tel Hashomer, Israel
(Haugaa) ProCardio Center for Cardiological Innovation, Department of
Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
(Haugaa) University of Oslo, Oslo, Norway
(Raman) Department of Cardiac Surgery, Austin Health, Melbourne, VIC,
Australia
(Sanders) Centre for Heart Rhythm Disorders, South Australian Health and
Medical Research Institute, University of Adelaide and Royal Adelaide
Hospital, Adelaide, SA, Australia
Publisher
John Wiley and Sons Inc
Abstract
Background: Several autopsy and observational studies have investigated
the link between mitral valve prolapse (MVP) and sudden cardiac death
(SCD) given the well accepted yet rare occurrence of ventricular
arrhythmias (VA). Whether surgical intervention for arrhythmogenic MVP
(aMVP) reduces VA and SCD risk remains unknown. Method(s): A
systematic literature review was conducted using the PubMed database in
December 2024. Studies documented in English were included if patients had
undergone mitral valve (MV) surgery (MVS; repair or replacement) for MVP
with documented rates of VA or SCD pre- and postintervention.
 Result(s): Sixteen identified studies (8 cohort and 8 case studies)
comprised 1233 patients (receiving medical or surgical treatment) with a
pooled mean age of 61.5 years and 41.9% being female. A total of 657 MVP
patients underwent MVS. Seven cohort studies reported rates of VA pre- and
postintervention, with six of these and all case studies reporting a
significant reduction. The remaining cohort study reported a reduction in
SCD. Conclusion(s): This systematic review indicates a reduction in
VA following current guideline-directed MVS for MVP. However, a residual
risk of VA and SCD may remain postintervention. Copyright © 2025
The Author(s). Journal of Arrhythmia published by John Wiley & Sons
Australia, Ltd on behalf of Japanese Heart Rhythm Society.

<99>
Accession Number
647895510
Title
673 The Effectiveness of Tranexamic Acid in Reducing Post-Tonsillectomy
Haemorrhage.
Source
British Journal of Surgery. Conference: 49th ASiT Annual Surgical
Conference. Belfast United Kingdom. 112(Supplement 10) (pp x21), 2025.
Date of Publication: 01 Jun 2025.
Author
Sivakumar S.; Vallamkondu V.; Samanth R.; Pujary K.
Institution
(Sivakumar, Vallamkondu) University of Aberdeen, Aberdeen, United Kingdom
(Samanth, Pujary) Kasturba Medical College Manipal, Manipal, India
Publisher
Oxford University Press
Abstract
Aim: Post-tonsillectomy haemorrhage (PTH) is a serious and
life-threatening complication of tonsillectomy. Various haemostatic
techniques have been used to counteract PTH and presently there are no
standardised guidelines for the management of PTH. Tranexamic acid (TXA)
has played a role in controlling bleeding in the settings of acute trauma,
cardiothoracic surgery and postpartum haemorrhage. However, its role in
PTH remains elusive. This review aims to shed light on the efficacy of TXA
in reducing PTH by evaluating its effect in reducing the need for surgical
intervention and blood loss in patients with PTH. Method(s): Data was
gathered by performing a literature search across six databases: OVID
Medliner, EMBASE, PUBMED, Cochrane, Google Scholar, and Scopus. Search
terms and Boolean operators were applied to the search. The search yielded
102 papers, which were filtered down to 19 papers that fulfilled the
inclusion and exclusion criteria. Result(s): Five retrospective
cohort studies and five case reports showed that TXA, especially in
nebulised form, reduced the need for operative intervention. In the four
randomised case-control trials, preoperative administration of TXA
decreased blood loss. No significant adverse effects from TXA were
reported across all studies. Conclusion(s): TXA has the potential to
reduce the need for surgical intervention, and blood loss and provide a
safe method of managing PTH. However, inconsistent study results and the
absence of optimal dosage criteria and protocols underlie the need for
more research. Clear guidelines on optimal dose, timing and route of
administration should be established to enhance the management of PTH.

<100>
Accession Number
647895484
Title
Systematic Review: Vascular Tissue Engineering Current Status and Future
Clinical Applications in Libya.
Source
British Journal of Surgery. Conference: 49th ASiT Annual Surgical
Conference. Belfast United Kingdom. 112(Supplement 10) (pp x120), 2025.
Date of Publication: 01 Jun 2025.
Author
Elabani M.J.; Zidan A.M.; Kushan A.; El-Naas N.
Institution
(Elabani, Zidan, Kushan, El-Naas) Libyan International Medical University,
Benghazi, Libyan Arab Jamahiriya
(Kushan) University of Bristol, Bristol, United Kingdom
Publisher
Oxford University Press
Abstract
Aim: To investigate recent advancements in Tissue-Engineered Vascular
Grafts (TEVGs), focusing on the use of various cell types and assessing
the current awareness and barriers to adoption in Libya. Method(s): A
systematic review of 173 studies identified through PubMed was conducted,
narrowing to 23 articles that met strict inclusion criteria, focusing on
endothelial cells (ECs), induced pluripotent stem cells (iPSCs),
mesenchymal stem cells (MSCs), smooth muscle cells (SMCs), and pericytes.
Additionally, a survey of 22 Libyan cardiovascular surgeons was
administered to evaluate their awareness and perspectives on TEVG
integration in Libya. Result(s): Each cell type showed unique
benefits: ECs offered a non-thrombogenic surface; iPSCs enabled
personalized grafts; MSCs contributed immunomodulation; SMCs enhanced
structural stability; and pericytes supported tissue remodelling. Barriers
to TEVG adoption included limited infrastructure and high costs, with 55%
of surgeons citing insufficient training as a primary obstacle. Despite
this, 41% of participants believed TEVG integration was feasible with
proper investment and education. Conclusion(s): TEVGs present a
transformative potential in cardiovascular surgery, leveraging diverse
cell types to improve graft function and patient outcomes. While Libya
faces significant challenges, targeted investments in healthcare
infrastructure and training could enable TEVG adoption, advancing
cardiovascular treatment and tissue engineering in the region.

<101>
Accession Number
647895465
Title
Comparing Cardioplegia Solutions to Mitigate Ischemic Reperfusion Injury
in Cardiac Surgeries: A Systematic Review and Libyan Survey.
Source
British Journal of Surgery. Conference: 49th ASiT Annual Surgical
Conference. Belfast United Kingdom. 112(Supplement 10) (pp x119-x120),
2025. Date of Publication: 01 Jun 2025.
Author
Omar Z.; Manghoush A.; Elkawafi M.; El-naas N.A.; Kushan A.
Institution
(Omar, Manghoush, Elkawafi, El-naas) Libyan International Medical
University, Benghazi, Libyan Arab Jamahiriya
(Kushan) University of bristol, Bristol, United Kingdom
Publisher
Oxford University Press
Abstract
Aim: This study aimed to determine optimal techniques for reducing
ischemic reperfusion injury (IRI) associated with cardiopulmonary bypass
(CPB) in Libyan hospitals, providing insights to improve patient outcomes
during cardiac surgeries. Method(s): A systematic review of clinical
trials from PubMed (2010-2024) was conducted, comparing five main types of
cardioplegia: Del Nido cardioplegia (DNC), cold blood cardioplegia (CBC),
warm blood cardioplegia (WBC), St. Thomas' (STC), and Bretschneider /
histidine-tryptophan-ketoglutarate (HTK) / Custodial cardioplegia.
Additionally, a survey was administered to 30 experienced cardiac surgeons
in Libyan hospitals to assess their preferences and practices regarding
cardioplegia use. Result(s): The systematic review analysed 22
clinical trials involving 7,693 patients: 1,174 received DNC, 774 received
CBC, 302 received WBC, 5,246 received STC, and 197 received HTK. DNC was
studied in 12 trials, CBC in 10, WBC in 4, STC in 4, and HTK in 6. DNC
effectively reduced CPB time, cardioplegia volume, and postoperative
complications. Survey results indicated a preference for DNC, with
hypothermic and antegrade delivery commonly used. Although most surgeons
perceived a low risk of IRI, some cases of IRI were reported, emphasizing
the need for standardized protocols. Conclusion(s): DNC demonstrates
strong potential as an optimal myocardial protective solution in Libyan
hospitals. The adoption of standardized practices shows progress toward
better outcomes, though further research and protocol refinements are
essential to minimize IRI.

<102>
Accession Number
647895911
Title
AI and Robotics in Cardiothoracic Surgery: Transforming Precision, Safety,
and Global Adoption.
Source
British Journal of Surgery. Conference: 49th ASiT Annual Surgical
Conference. Belfast United Kingdom. 112(Supplement 10) (pp x87-x88), 2025.
Date of Publication: 01 Jun 2025.
Author
Khan T.
Institution
(Khan) United Lincolnshire Hospitals Trust, Lincoln, United Kingdom
Publisher
Oxford University Press
Abstract
Background: Cardiothoracic surgery demands precision and innovation.
Advancements in artificial intelligence (AI) and robotic technologies have
transformed this field by reducing complication rates, enhancing surgical
accuracy, and improving patient recovery. These technologies have
optimized outcomes in the UK, minimizing human error (Etienne et al.,
2020). This review examines the impact of AI and robotics in
cardiothoracic surgery, focusing on clinical benefits in the UK and
adoption challenges, particularly in low- and middle-income countries
(LMICs). Method(s): A systematic literature review from 2018 to 2023
was conducted using PubMed, MedLine, and The Lancet. Search terms included
"AI in surgery" and "robotic cardiothoracic surgery." Studies were
selected based on relevance to AI, robotics, patient safety,
cost-effectiveness, and adoption barriers. Result(s):
Robotic-assisted surgery has enhanced precision in procedures like mitral
valve repair and CABG, with the da Vinci Surgical System reducing
operative times by 25%. St Bartholomew's Hospital reported a 30% reduction
in complication rates (Chitwood Jr., 2022). AI algorithms in NHS hospitals
reduced readmissions by 20-30%, improving outcomes and cost efficiency
(Bellini et al., 2021). Adoption in LMICs remains limited due to high
costs, underscoring the need for scalable solutions (Gumbs et al., 2021).
 Conclusion(s): AI and robotics have revolutionized precision and
safety in cardiothoracic surgery, especially in the UK. However, LMICs
face adoption barriers requiring cost-effective strategies and
partnerships. Ethical concerns like data privacy and algorithmic bias must
be addressed to ensure equitable outcomes. Collaboration among surgeons,
engineers, and data scientists is crucial to advance these technologies
globally.

<103>
Accession Number
647896785
Title
Sucrosomial iron for health-care improvement in elective cardiac surgery.
Source
Blood Transfusion. Conference: 9th International Multidisciplinary Course
on Iron Deficiency. Palermo Italy. 23(Supplement 3) (pp S444), 2025. Date
of Publication: 01 Jun 2025.
Author
Weltert L.P.
Institution
(Weltert) Department of Heart Surgery, European Hospital, Rome, Italy
Publisher
Edizioni SIMTI
Abstract
Background. The fact that anemia, blood loss and RBC transfusion (RBCT) is
a problem in cardiac surgery (CS) is not matter of discussion nowadays1.
The use of tranexamic acid and lower transfusion thresholds have greatly
reduced RBCT rates. However, the prevalence of low preoperative hemoglobin
(Hb) and impaired iron homeostasis is high among CS patients 2,3. A
post-hoc analysis of a large RCT of adult elective CS patients
(No.=1,000)4 receiving 60 mg/day of Sucrosomial iron (SI), for 30 days
before surgery, versus no iron (No.=594), revealed that SI increased
preoperative Hb in both anemic (Hb <13 g/dL) and non-anemic patients.
However, women still have higher RBCT rate (%) and index (units/patient)
than men, despite the SI therapy5. Methods. To get further insight of
which patients benefit the most from this quality improvement strategy, we
reanalyzed data on RBCT rate according to six baseline Hb strata. Results.
As depicted in Table I, preoperative oral SI resulted in reduced RBCT
rates for all baseline Hb strata >11 g/dL, though with differences
according to Hb strata, and possible future actions are suggested (e.g.,
increase SI dose, addition of epoetin). Conclusions. Preoperative SI
administration confirms to be a safe, well tolerated and cost-effective
strategy to increase preoperative Hb and decrease RBCT rates in elective
CS. As such, 2024 EACT/EACTAIC guidelines for Patient Blood Management
recommends preoperative SI administration in anemic adults patients
undergoing CS (Class IIa, Level of Evidence B)6. For those with
moderate-to-severe preoperative anemia, erythropoietin supplementation in
addition to iron is recommended (Class IIa, Level of Evidence A)6. The
positive effects of SI supplementation in non-anemic patients (Hb >13
g/dL) could be attributed to the high prevalence of absolute or functional
iron deficiency among this patient subgroup3. (Table Presented).

<104>
Accession Number
647894411
Title
PROGNOSTIC VALUE OF BLOOD PRESSURE VARIABILITY IN PATIENTS WITH HEART
FAILURE: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of Hypertension. Conference: 19th International Society of
Hypertension Scientific Annual Meeting, InaSH 2025. Jakarta Indonesia.
43(Supplement 2) (pp e15), 2025. Date of Publication: 01 May 2025.
Author
Nurhafizah A.; Huang W.; Khairunnisa A.R.; Frederich A.; Atmojo S.
Institution
(Nurhafizah, Huang, Khairunnisa, Frederich) Faculty of Medicine,
University of Padjadjaran, Bandung, Indonesia
(Atmojo) National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Studies have associated high blood pressure variability (BPV)
with an increased risk of morbidity and mortality in various
cardiovascular (CV) diseases. However, the prognostic importance of BPV in
heart failure (HF) remains unknown. Objective(s): This review aims to
explore the potential prognostic value of BPV in HF population.
 Method(s): We conducted a search on 3 medical databases and
subsequently performed a meta-analysis of studies that described the
association between BPV and composite outcomes in HF population. Composite
endpoint (including all-cause mortality, CV mortality, CV hospitalization,
nonfatal stroke, nonfatal myocardial infarction, and heart
transplantation), all-cause mortality, CV mortality, and HF
rehospitalization were calculated as pooled hazard ratios using a generic
inverse variance and random effect model. Result(s): A total of 12
cohort studies (1 prospective and 11 retrospective) with no significant
risk of bias that comprises 28,636 patients with an average age of 62
years old were included. After performing the sensitivity analysis, the
results showed that higher visit-to-visit BPV associated significantly
with an increased risk of the composite endpoint (HR 1.31, CI 1.22-1.40,
I2 0%), all-cause mortality (HR 1.20, CI 1.10-1.30, I2 0%), CV mortality
(HR 1.12, CI 1.00-1.25, I2 0%), and HF rehospitalization (HR 1.42, CI
1.31-1.55, I2 0%). Additionally, U-shaped association between
visit-to-visit BPV and the risk of the composite endpoint and
cardiovascular mortality was demonstrated. Conclusion(s): Higher BPV,
measured as visit-to-visit variability, is significantly associated with
composite endpoint, all-cause mortality, CV mortality, and HF
rehospitalization in patients with heart failure.

<105>
Accession Number
2035310142
Title
Resveratrol improves lipid profile and recovers heart function in
postoperative CABG patients.
Source
Molecular and Cellular Biochemistry. (no pagination), 2025. Date of
Publication: 2025.
Author
Ahmadi P.; Akbarzadeh S.; Alizadeh M.; Mohammadi N.; Mahmoodi M.; Amini
A.; Netticadan T.; Rezaei M.; Movahed A.
Institution
(Ahmadi, Mohammadi) Bushehr University of Medical Sciences, Bushehr, Iran,
Islamic Republic of
(Akbarzadeh, Alizadeh, Movahed) Department of Clinical Biochemistry,
Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr,
Iran, Islamic Republic of
(Mahmoodi) Department of Biostatistics and Epidemiology, Addiction and
Lifestyle Research Center, Bushehr University of Medical Sciences,
Bushehr, Iran, Islamic Republic of
(Amini) Department of Internal Medicine, Faculty of Medicine, Bushehr
University of Medical Sciences, Bushehr, Iran, Islamic Republic of
(Netticadan) Canadian Centre for Agri-Food Research in Health and
Medicine, Winnipeg, Canada
(Rezaei) Department of Cardiovascular Surgery, Faculty of Medicine,
Bushehr University of Medical Sciences, Bushehr, Iran, Islamic Republic of
Publisher
Springer
Abstract
Cardiovascular diseases (CVD), especially coronary artery disease (CAD),
are among the most important causes of mortality in the world. Coronary
artery bypass grafting (CABG) is a standard treatment for this disease,
but it may be associated with complications in the postoperative period.
This study investigated the effect of resveratrol (RES), a potent
antioxidant and anti-inflammatory molecule, on cardiovascular indices and
oxidative stress in patients after CABG surgery. This randomized,
double-blind, placebo-controlled trial was carried out at the Bushehr
Heart Center in Bushehr, Iran. A total of 60 patients undergoing CABG were
randomly assigned in equal numbers to either the intervention group or the
control group. The intervention group received RES capsules for 60 days,
and the control group received a placebo for the same duration.
Cardiovascular function and biochemical parameters, including lipid
profile, cardiac enzymes, and markers of oxidative stress and
inflammation, were measured at the beginning and end of the intervention.
Compared to the control group, RES intake significantly reduced systolic
blood pressure (SBP), triglyceride (TG), total cholesterol (TC),
low-density lipoprotein (LDL), and improved ejection fraction (EF).
Although decreases in cardiac enzymes, including creatine phosphokinase
(CPK) and lactate dehydrogenase (LDH), were observed in the RES group,
these changes were not statistically significant. Also, the two groups
showed no significant differences in diastolic blood pressure (DBP), HDL,
or oxidative stress markers. RES supplementation protects patients after
CABG by improving cardiovascular function and lipid profiles. Trial
registration: IRCT20111119008129N12, first trial registration date:
2022-06-18. Copyright © The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2025.

<106>
Accession Number
647895971
Title
Short-Term Outcomes of Self-Expanding TAVR Valve Systems (ACURATE and
EVOLUT): A Meta-Analysis.
Source
British Journal of Surgery. Conference: 49th ASiT Annual Surgical
Conference. Belfast United Kingdom. 112(Supplement 10) (pp x88), 2025.
Date of Publication: 01 Jun 2025.
Author
AbdalJawwad T.; Musa A.; Al-Tawil M.; Elhayek M.M.; Alqeeq B.F.
Institution
(AbdalJawwad, Al-Tawil, Elhayek) Faculty of Medicine, AlQuds University,
East Jerusalem, Abu Dis, Palestine
(Musa) Universities of Morecambe, Bay Hospitals Trust, Lancaster, United
Kingdom
(Alqeeq) Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
Publisher
Oxford University Press
Abstract
Aim: Transcatheter aortic valve replacement (TAVR) is the gold standard
treatment for severe aortic stenosis. ACURATE Neo/Neo2 is a newly approved
valve for TAVR; other options include Evolut PRO/PRO+. Our study aims to
provide the latest evidence regarding the short-term outcomes of ACURATE
Neo/Neo2 versus Evolut PRO/PRO+ in TAVR. Method(s): In compliance
with the PRISMA 2020 statement, we systematically retrieved articles from
Pubmed, Scopus, and Embase. Of the identified studies, we included
observational cohort studies and randomized controlled trials that
compared ACURATE versus Evolut devices for TAVR. Outcomes were compared
according to the Valve Academic Research Consortium 3 (VARC-3) clinical
endpoints and standardized definitions. Result(s): Nine articles met
the inclusion criteria and were included for analysis. There was no
difference in technical success, incidence of stroke, or paravalvular
leakage (PVL) between the valves. Moreover, the need for permanent
pacemaker (PPM) implantation was significantly lower in the ACURATE group.
The ACURATE valve was linked to significantly higher rates of major
vascular complications (RR 1.50; 95% CI 1.01-2.23; p=0.04) and bleeding
(RR 1.69; 95% CI 1.24-2.32; p=0.001) when compared to the Evolut group.
 Conclusion(s): Our findings suggest ACURATE Neo/Neo2 as a promising
option in TAVR, especially in reducing the need for PPM. However, the
differences in regurgitation and vascular complications highlight the need
for further randomized controlled trials to better define the most
suitable patient populations for each valve type.

<107>
Accession Number
2035312883
Title
Cardiac Contractility Modulation as bridge to recovery in a patient with
advanced heart failure evaluated for left ventricular assist devices: a
case report and review of literature.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1516574. Date of Publication: 2025.
Author
Menichetti F.; Solari M.; Salvetti E.; Guarnaccia V.; Girasole T.; Venturi
F.; Del Rosso A.
Institution
(Menichetti, Solari, Salvetti, Guarnaccia, Girasole, Venturi, Del Rosso)
Cardiology Unit, Department of Internal Medicine, San Giuseppe Hospital,
Empoli, Italy
Publisher
Frontiers Media SA
Abstract
This case report illustrates the effects of CCM as a bridge to recovery in
a patient who has been a candidate for LVAD. After CCM the patient hase
become stable in NYHA class II, with no further acute HF episodes and a
significant clinical and functional improvements. Consequently, the
patient was no longer an LVAD candidate, as CCM had acted as a bridge to
recovery, making the advanced HF designation no longer applicable. The
ease of implantation, uneventful procedural recovery, extraordinary device
longevity, and favorable risk profile all position CCM as an important
tool in the treatment of advanced HFrEF patients candidate to LVAD
therapy, serving as a bridge to recovery.Further large-scale randomized
controlled trials are needed to confirm the long-term benefits of CCM
therapy in this particular population subgroup, helping a better patient
selection. Copyright 2025 Menichetti, Solari, Salvetti, Guarnaccia,
Girasole, Venturi and Del Rosso.

<108>
Accession Number
647896800
Title
Superficial parasternal intercostal plane block and full sternotomy; a
randomized trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2025.
Date of Publication: 08 Jul 2025.
Author
Kalli A.; Vistback J.; Moilane E.; Jarvela K.; Mennander A.
Institution
(Kalli, Jarvela, Mennander) Faculty of Medicine and Health Technology,
Tampere University, Tampere, Finland
(Kalli, Jarvela, Mennander) Tampere University Hospital, Heart Hospital,
Tampere, Finland
(Vistback, Moilane) Immunopharmacology Research Group, Faculty of Medicine
and Health Technology, Tampere University and Tampere University Hospital,
Tampere, Finland
Abstract
OBJECTIVES: Cardiac surgery via full sternotomy impacts postoperative lung
function. We studied whether Ultrasound-guided superficial parasternal
intercostal plane block (SPIP) before surgical aortic valve replacement
via full sternotomy would ameliorate postoperative lung function and
filtration capacity. METHOD(S): A total of 74 consecutive patients
undergoing surgical aortic valve replacement were randomized to receive
either or not additional SPIP. Pre- and postoperative lung function tests
were compared among the patients. Venous and arterial blood samples were
collected to calculate lung filtration (venous/arterial) of the
inflammatory factors chemerin, chitinase-3-like protein 1 (YKL-40),
resistin and interleukin-6 (IL6) immediately before (T1), 1 h after
releasing aortic cross-clamp (T2), and on the following morning (T3) after
surgery in 30 age- and sex-adjusted patients. RESULT(S): Patients
with SPIP were older as compared to those without (66.7 [10.7] vs 60.2
[13.4], years, respectively, p < 0.04). Neither other patient
characteristics nor preoperative lung functions differed between the
patient groups. Forced expiratory volume (FEV), forced volume capacity
(FVC), and relative FVC changes decreased less in patients treated with
wound analgesia as compared to those without (P = 0.024, P = 0.042 and P =
0.042). Total oxycodone consumption (P = 0.634), YKL-40 and resistin did
not differ between the groups. Arterial chemerin decreased and
venous/arterial IL6 ratio increased in patients with SPIP as compared to
those without (P = 0.024 versus P = 0.332, respectfully).
 CONCLUSION(S): SPIP before aortic valve surgery via full sternotomy
impacts postoperative respiratory function and venous/arterial IL6 ratio.
CLINICAL REGISTRATION NUMBER: The study was approved by the institutional
review board (Ethical Committee of the Tampere University Hospital,
Tampere, Finland, registration number R18011M) on March 8th, 2018, and the
study conforms to the ethical guidelines of the Declaration of Helsinki.
The trial was registered as ClinicalTrials.gov ID NCT03704753 (EudraCT=
2017-004744-38). Copyright © The Author(s) 2025. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<109>
Accession Number
647899006
Title
Network meta-analysis of cardioplegic methods, in elective isolated
coronary artery bypass grafting.
Source
Perfusion. (pp 2676591251359901), 2025. Date of Publication: 08 Jul 2025.
Author
Kalogerakos P.D.; Kokkinakis S.; Akoumianakis E.; Karagkounis T.; Gavalaki
A.; Kiparakis M.; Akoumianakis I.; Lazopoulos L.; Gaitanaki T.; Andreou
A.; Lasithiotakis K.; Kontopodis N.; Lazopoulos G.
Institution
(Kalogerakos, Karagkounis, Gavalaki, Kiparakis, Lazopoulos, Lazopoulos)
Department of Cardiac Surgery, General University Hospital of Heraklion,
Crete, Greece
(Kokkinakis) Department of General, Visceral, Tumor, Transplantation
Surgery, University Hospital of Cologne, Cologne, Germany
(Akoumianakis) Department of Otorhinolaryngology - Head and Neck Surgery,
General University Hospital of Heraklion, Crete, Greece
(Akoumianakis) Cardiovascular Medicine Division, Radcliffe Department of
Medicine, University of Oxford, Oxford, United Kingdom
(Gaitanaki) Department of Cardiology, General University Hospital of
Heraklion, Crete, Greece
(Andreou, Lasithiotakis) Department of General Surgery, General University
Hospital of Heraklion, Crete, Greece
(Kontopodis) Department of Vascular Surgery, General University Hospital
of Heraklion, Crete, Greece
Abstract
BackgroundCardioplegic arrest can be induced by various methods, fueling a
long-standing controversy about their comparative merit. We aim to compare
cardioplegic methods in coronary artery disease.MethodsPubMed, Embase, and
Cochrane databases were interrogated for randomized trials that compared
various cardioplegic methods in adult patients undergoing elective
isolated coronary artery bypass grafting. Differences in cardioplegic
composition - crystalloid or blood, route of delivery - antegrade or
retrograde, and temperature, were evaluated in a network meta-analysis.
The endpoints were mortality, myocardial infarction, insertion of
intra-aortic balloon pump, low cardiac output syndrome, increased
inotropic support, as well as cardiopulmonary bypass time, aortic
cross-clamp time, intensive care stay, hospital stay, new onset atrial
fibrillation, reperfusion ventricular fibrillation, and neurologic event.
Confidence In Network Meta-Analysis web application was employed.Results75
studies were included, with 6131 patients receiving one of 13 cardioplegic
methods. Warm ante/retrograde blood cardioplegia was associated with fewer
deaths (P-score 0.81), fewer intra-aortic balloon pumps (P-score 0.77),
and shorter intensive care (P-score 0.69) and hospital stay (P-score
0.81). Cross clamp time was shorter with crystalloid cardioplegias, while
reperfusion ventricular fibrillation was less frequent with warm blood
cardioplegias. Cold cardioplegias were associated with lower rates of new
onset atrial fibrillation and stroke. Confidence varied greatly across the
endpoints.ConclusionThe outcomes of this network study indicate presumable
advantages of warm ante/retrograde blood cardioplegia in elective isolated
coronary artery bypass grafting. Under the light of certain biases and
mixed confidence, the results should be cautiously interpreted. More
studies are needed.

<110>
Accession Number
2039602194
Title
Impact of olive oil consumption on surgical outcomes in patients
undergoing open heart surgery: A randomized clinical trial.
Source
Journal of Complementary and Integrative Medicine. (no pagination), 2025.
Date of Publication: 2025.
Author
Bahrami R.; Ebadi A.; Saeed Y.; Farzam S.S.; Gomrokchian E.; Moayed M.S.
Institution
(Bahrami) Student Research Committee, Faculty of Nursing, Baqiyatallah
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Ebadi, Saeed, Moayed) Nursing Care Research Center, Clinical Sciences
Institute, Faculty of Nursing, Baqiyatallah University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Farzam) Department of Cardiology, School of Medicine Bu Ali Sina,
Teaching Hospital Qazvin University of Medical Sciences, Qazvin, Iran,
Islamic Republic of
(Gomrokchian) Teaching Hospital Qazvin University of Medical Sciences,
Qazvin, Iran, Islamic Republic of
Publisher
Walter de Gruyter GmbH
Abstract
Introduction: The incidence of post-surgery outcomes, such as pain and
constipation, in patients undergoing coronary artery bypass surgery can
impact the healing process and the quality of life of patients. This study
aimed to investigate the effect of olive oil consumption on pain and
constipation in adult coronary bypass surgery patients. Method(s): A
randomized controlled trial in Qazvin, Iran (2022-2023) assigned 110
patients scheduled for coronary artery bypass surgery to two groups using
four-block randomization. In the intervention group, patients received
30cc of extra virgin olive oil daily with food from the day before the
operation to 30 days after. The control group received usual care. Pain
and constipation levels were measured before and after surgery and up to
30 days post-surgery using the visual pain scale (VAS) and Bristol stool
form scale (BSFS). Result(s): With similar background variables
between the two groups, the results indicated that the average pain and
constipation scores in the intervention group decreased more than in the
control group (p-value < 0.05). Conclusion(s): Based on the study's
findings and the positive impact of olive oil consumption on reducing pain
and constipation, incorporating olive oil into the diet of heart surgery
patients is recommended. Copyright © 2025 Walter de Gruyter GmbH,
Berlin/Boston.

<111>
Accession Number
2039547383
Title
Colchicine for secondary prevention of vascular events: a meta-analysis of
trials.
Source
European Heart Journal. 46(26) (pp 2564-2575), 2025. Date of Publication:
07 Jul 2025.
Author
D'Entremont M.-A.; Poorthuis M.H.F.; Fiolet A.T.L.; Amarenco P.; Boczar
K.E.; Buysschaert I.; Chan N.C.; Cornel J.H.; Jannink J.; Jansen S.; Kedev
S.; Keech A.C.; Layland J.; Mewton N.; Montalescot G.; Pascual-Figal D.A.;
Rodriguez A.E.; Shah B.; Teraa M.; Van Zelm A.; Wang Y.; Mosterd A.; Kelly
P.; Eikelboom J.; Jolly S.S.
Institution
(D'Entremont, Amarenco, Eikelboom, Jolly) Population Health Research
Institute, 237 Barton Street East, Hamilton, ON, Canada
(D'Entremont, Jolly) Department of Cardiology, Hamilton General Hospital,
McMaster University, 237 Barton Street East, Hamilton, ON, Canada
(D'Entremont) Departement de Medecine, Centre Hospitalier Universitaire de
Sherbrooke, Sherbrooke, QC, Canada
(Poorthuis) Department of Neurology, University Medical Center Utrecht,
Utrecht, Netherlands
(Fiolet) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Fiolet, Cornel, Mosterd) Dutch Network for Cardiovascular Research (WCN),
Utrecht, Netherlands
(Amarenco) Department of Neurology, Bichat University Hospital, Paris,
France
(Boczar) Department of Cardiology, University of Ottawa, Heart Institute,
Ottawa, ON, Canada
(Buysschaert) Department of Cardiology, Sint-Jan Hospital, Brugge, Belgium
(Chan) Department of Medicine, Division of Haematology and
Thromboembolism, McMaster University, Hamilton, ON, Canada
(Cornel) Department of Cardiology, Northwest Clinics, Alkmaar, Netherlands
(Cornel) Department of Cardiology, Radboud University, Medical Centre,
Nijmegen, Netherlands
(Jannink, Mosterd) Department of Cardiology, Meander Medical Center,
Amersfoort, Netherlands
(Jansen) Heart and Vascular Research Institute, Harry Perkins Institute
for Medical Research, Perth, Australia
(Kedev) Department of Cardiology, University Ss. Cyril and Methodius,
Skopje, North Macedonia
(Keech) NHMRC Clinical Trials Centre, Faculty of Medicine and Health,
University of Sydney, Sydney, Australia
(Keech) Department of Cardiology, Royal Prince Alfred Hospital, Sydney,
Australia
(Layland) Department of Cardiology, Peninsula Health, Peninsula Clinical
School, Central Clinical School, Monash University, Frankston, VIC,
Australia
(Mewton) Department of Cardiology, Institut de Cardiologie des Hospices
Civils de Lyon, Lyon, France
(Montalescot) Sorbonne University, ACTION Study Group, Centre Hospitalier
Universitaire Pitie-Salpetriere, Assistance Publique-Hopitaux de Paris,
Paris, France
(Pascual-Figal) Department of Cardiology, Hospital Virgen de la Arrixaca,
University of Murcia, Murcia, Spain
(Pascual-Figal) Department of Cardiology, Centro Nacional de
Investigaciones Cardiovasculares (CNIC), Madrid, Spain
(Rodriguez) Department of Cardiology, Otamendi Hospital, Buenos Aires,
Argentina
(Shah) Department of Cardiology, VA New York Harbor Healthcare System, New
York, NY, United States
(Shah) Leon H Charney Division of Cardiology, NYU Grossman School of
Medicine, New York, NY, United States
(Teraa, Van Zelm) Department of Vascular Surgery, University Medical
Center Utrecht, Utrecht, Netherlands
(Wang) Department of Neurology, Beijing Tiantan Hospital, Capital Medical
University, Beijing, China
(Kelly) Department of Neurology, Mater Misericordiae University Hospital,
School of Medicine, University College Dublin, Dublin, Ireland
(Kelly) Health Research Board Stroke Clinical Trials Network Dublin
Ireland, Dublin, Ireland
(Eikelboom) Department of Medicine, McMaster University, ON, Hamilton,
Canada
Publisher
Oxford University Press
Abstract
Background and Aims Randomized trials of colchicine in secondary
prevention of atherosclerotic cardiovascular disease have shown mixed
results. Methods A systematic review and study-level meta-analysis of
randomized controlled trials was performed comparing colchicine vs no
colchicine in a secondary-prevention atherosclerotic cardiovascular
disease population. A fixed-effect inverse variance model was applied
using the intention-to-treat population from the included trials. The
primary outcome was the composite of cardiovascular death, myocardial
infarction, or stroke. Results Nine trials, including 30 659 patients
(colchicine 15 255, no colchicine 15 404) with known coronary artery
disease or stroke, were included. Compared with no colchicine, patients
randomized to colchicine had a relative risk (RR) of 0.88 [95% confidence
interval (CI) 0.81-0.95, P =. 002] for the primary composite outcome,
including a RR of 0.94 for cardiovascular death (95% CI 0.78-1.13, P =.
5), a RR of 0.84 for myocardial infarction (95% CI 0.73-0.97, P =. 016),
and a RR of 0.90 for stroke (95% CI 0.80-1.02, P =. 09). Colchicine was
associated with a RR of 1.35 for hospitalization for gastrointestinal
events (95% CI 1.10-1.66, P =. 004) with no increase in hospitalization
for pneumonia, newly diagnosed cancers, or non-cardiovascular death.
Conclusions In patients with prior coronary disease or stroke, colchicine
reduced the composite of cardiovascular death, myocardial infarction, or
stroke by 12%. Copyright © The Author(s) 2025. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved.

<112>
Accession Number
2035273967
Title
Trends in enhanced recovery after surgery (ERAS) in thoracic surgery from
a bibliometric insight.
Source
Hereditas. 162(1) (no pagination), 2025. Article Number: 131. Date of
Publication: 01 Dec 2025.
Author
Liu Y.; Zhang T.; Gao T.; Li G.; Xu G.
Institution
(Liu, Zhang, Gao, Li, Xu) Department of Thoracic Surgery, Second
Affiliated Hospital of Harbin Medical University, Harbin, China
Publisher
BioMed Central Ltd
Abstract
Background: In thoracic surgery, the concept of Enhanced Recovery After
Surgery (ERAS) has been extensively implemented. Although numerous studies
have investigated ERAS in thoracic surgery, bibliometric analyses remain
limited. In this study, the developmental trajectory, current research
status, and prospective trends of ERAS in thoracic surgery were
systematically analyzed through bibliometric and visual analysis
techniques. Method(s): Literature pertaining to ERAS in thoracic
surgery was retrieved from the Web of Science Core Collection (WoSCC).
Microsoft Excel 2019, R software (version 4.1.0), the Bibliometric Online
Analysis Platform, VOSviewer (version 1.6.18), and Citespace (version
6.3.R1) were utilized for statistical analysis, bibliometric evaluation,
and data visualization. Result(s): A total of 617 publications were
retrieved over the past decade. The number of publications has generally
demonstrated an upward trend from 2015 to 2024. China and Sichuan
University ranked as the leading country and institution, respectively, in
terms of publication volume. The Journal of Thoracic Disease was
identified as the leading journal in both publication count and citation
frequency. Henrik Kehlet was recognized as the most prolific and highly
co-cited author. Current research hotspots include "video-assisted
thoracic surgery," "pain management," and "multicenter clinical trials."
 Conclusion(s): ERAS-related research in thoracic surgery has been
increasing steadily, highlighting it as a rapidly evolving and promising
field. The ERAS concept plays a critical role in all perioperative
phases-preoperative, intraoperative, and postoperative-and requires
further in-depth investigation. Many existing ERAS studies in thoracic
surgery lack high-quality evidence, underscoring the urgent need for
rigorously designed research with robust methodological
standards. Copyright © The Author(s) 2025.

<113>
Accession Number
2039638854
Title
Filling the Void: The Past, Present, and Future of Left Atrial Appendage
Occlusion.
Source
American Journal of Cardiology. 254 (pp 13-20), 2025. Date of Publication:
01 Nov 2025.
Author
Malik S.A.; Jhand A.; Shabbir M.A.; Ahmad S.; Goldsweig A.M.
Institution
(Malik, Shabbir, Ahmad, Goldsweig) Division of Cardiovascular Medicine,
University of Nebraska Medical Center, Omaha, NE, United States
(Jhand) Division of Cardiovascular Medicine, Geisinger Medical Center,
Danville, Pennsylvania, United States
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center
and Division of Cardiovascular Medicine, University of
Massachusetts-Baystate, Springfield, Massachusetts, United States
Publisher
Elsevier Inc.
Abstract
Left atrial appendage occlusion (LAAO) has emerged as an alternative
strategy to oral anticoagulation (OAC) to mitigate the risk of
thromboembolic events in patients with atrial fibrillation (AF).
Endovascular LAAO devices were first developed in the early 2000s for
patients with relative and absolute contraindications to OAC. Four
randomized controlled trials have demonstrated the safety and efficacy of
LAAO procedures, and two LAAO devices have been approved and are
commercially available in the United States. Procedural complications,
especially pericardial effusion, as well as subsequent peri-device leak
and device-related thrombosis have decreased over time due to improved
device design and implantation techniques. Many aspects of the LAAO
technology continue to evolve. Intracardiac echocardiography (ICE) is used
increasingly and offers distinct advantages and disadvantages compared to
transesophageal echocardiography (TEE) for procedural guidance. The role
of universal post-procedure surveillance imaging remains unclear.
Post-LAAO antithrombotic therapy has shifted from short-term
anticoagulation to immediate dual antiplatelet therapy, with ongoing
research exploring the feasibility of single antiplatelet therapy. Novel
devices with improved design and technology are currently undergoing
clinical trials. Additionally, the patient population eligible for LAAO
may significantly increase in the coming years, as ongoing trials are
evaluating the effectiveness of LAAO devices in a broader population of
patients with AF. In conclusion, the history, current state, and active
research related to LAAO are summarized in this review
article. Copyright © 2025 Elsevier Inc.

<114>
Accession Number
647866462
Title
Meta-Analysis of Coronary Bypass Graft Patency Assessment with Invasive
versus Computed Tomography Angiography.
Source
The Annals of thoracic surgery. (no pagination), 2025. Date of
Publication: 01 Jul 2025.
Author
Mantaj P.; Hirofuji A.; Aquila M.D.; Demetres M.; Gregg A.; Krieger K.;
Abdalla S.; Kennedy M.; Savic M.; Ahmadi-Hadad A.; Rossi C.S.; Soletti G.;
Nikolikj A.; Rahouma M.; Sandner S.; Gaudino M.
Institution
(Mantaj) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New
York, USA; Department of Cardiac Surgery, Medical University of Graz,
Graz, Austria
(Hirofuji, Demetres, Gregg, Krieger, Abdalla, Rossi, Soletti, Rahouma)
Department of Cardiothoracic Surgery, Weill Cornell Medicine, NY, United
States
(Aquila) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New
York, USA; Department of Cardiothoracic Surgery, Catharina Ziekenhuis,
Eindhoven, Netherlands
(Kennedy) University of Notre Dame, Notre Dame, IN, United States
(Savic) Johannes Kepler University, Linz, Austria
(Ahmadi-Hadad) University of Naples, Federico II, Naples, Italy
(Nikolikj) Department of Cardiac Surgery, Acibadem Sistina Hospital,
Skopje, Macedonia
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
NY, United States
Abstract
BACKGROUND: Computed tomography (CT) coronary angiography has emerged as a
non-invasive alternative for evaluating graft patency after coronary
artery bypass grafting (CABG), but there is ongoing debate regarding its
diagnostic performance compared to invasive coronary angiography,
particularly for arterial and composite grafts. METHOD(S): MEDLINE,
Embase, and Cochrane databases were searched to identify studies comparing
CT coronary angiography to invasive coronary angiography for detection of
graft occlusion in post-CABG patients. Outcomes included sensitivity,
specificity, positive predictive value, negative predictive value, and
diagnostic accuracy. Meta-regression explored key modifiers. Pooled
estimates were calculated using random-effects models, with heterogeneity
measured via I2. RESULT(S): Fifty studies met inclusion criteria,
including 3,449 patients (25% women). CT coronary angiography sensitivity
for graft occlusion was 0.96 (I2 = 48%), specificity was 0.97 (I2 = 46%),
positive predictive value was 0.94 (I2 = 62%), negative predictive value
was 0.98 (I2 = 41%) and overall diagnostic accuracy was 0.97 (I2 = 58%).
The pooled incidence rate of graft occlusion across 7,506 included grafts
was 0.08 per graft-year (PGY) (95% CI: 0.06-0.10) using a random-effects
model, and 0.07 PGY (95% CI: 0.07-0.08). At meta-regression, study year,
sample size, beta-blocker use, number of slices, and time since surgery,
but not type and configuration of CABG grafts, were significantly
associated with CT coronary angiography sensitivity. CONCLUSION(S):
CT coronary angiography detects coronary artery bypass graft occlusion
with a high degree of sensitivity and specificity independently of graft
type and configuration and can be used for imaging of every type of CABG
graft. Copyright © 2025. Published by Elsevier Inc.

<115>
Accession Number
2035274574
Title
Colchicine in patients with aortic stenosis undergoing transcatheter
aortic valve replacement: a double-blind randomized trial.
Source
Nature Communications. 16(1) (no pagination), 2025. Article Number: 6501.
Date of Publication: 01 Dec 2025.
Author
Ryffel C.; Lanz J.; Guntli N.; Samim D.; Furholz M.; Stortecky S.; Tomii
D.; Heg D.; Boscolo Berto M.; Peters A.A.; Reineke D.; Reichlin T.; Grani
C.; Windecker S.; Pilgrim T.
Institution
(Ryffel, Lanz, Guntli, Samim, Furholz, Stortecky, Tomii, Boscolo Berto,
Reichlin, Grani, Windecker, Pilgrim) Department of Cardiology,
Inselspital, Bern University Hospital, University of Bern, Bern,
Switzerland
(Ryffel) Department of Nuclear Medicine, Cardiac Imaging, University
Hospital Zurich, Zurich, Switzerland
(Samim) Clinical Trial Service Unit and Epidemiological Studies Unit
(CTSU), Nuffield Department of Population Health (NDPH), University of
Oxford (UK), Oxford, United Kingdom
(Heg) Department of Clinical Research, University of Bern, Bern,
Switzerland
(Peters) Department of Diagnostic, Interventional and Pediatric Radiology,
Inselspital, Bern University Hospital, Bern, Switzerland
(Reineke) Department of Cardiac Surgery, Inselspital, Bern University
Hospital, University of Bern, Bern, Switzerland
Publisher
Nature Research
Abstract
An inflammatory process may increase the risk of arrhythmias after
transcatheter aortic valve replacement (TAVR). In this single-centre,
double-blind, placebo-controlled, randomized trial we investigated the
efficacy of colchicine to reduce a composite of new-onset atrial
fibrillation or atrioventricular conduction disturbances requiring the
implantation of a permanent pacemaker at 30 days after TAVR. Between
September 21, 2021 and April 25, 2024, 120 patients with aortic stenosis
undergoing TAVR (mean age 80.6 +/- 5 years, 64% male) were randomly
allocated to treatment with colchicine (n = 60) or placebo (n = 60). The
trial was prematurely stopped due to a higher rate of stroke in the
experimental group in a pre-specified interim analysis (5 [8.3%] versus 0
at maximum available follow-up, p = 0.022). In the intention-to-treat
population, the primary endpoint occurred in 6 patients (10%) in the
colchicine group and in 15 patients (25%) in the placebo group
(risk-difference -15.0%, 95% CI -28.3 to -1.7, p = 0.031). The
prespecified imaging endpoint, subclinical leaflet thrombosis, was
detected in 13 of 48 patients (27%) in the colchicine group versus 26 of
48 patients (54%) in the placebo group (risk difference -27.1%. 95% CI
-46.0% to -8.2%, p = 0.007). Here, we show that periprocedural treatment
with colchicine may reduce the incidence of new-onset arrhythmias and
subclinical leaflet thrombosis after TAVR. However, given the premature
termination of the trial due to an unexpected increase in the stroke rate
among patients treated with colchicine, confirmatory trials are warranted
to corroborate the effect of anti-inflammatory treatment on the incidence
of arrhythmias and subclinical leaflet thrombosis after TAVR. The trial
was an investigator-initiated study supported by dedicated grants from the
Bangerter-Rhyner Foundation and the Swiss Life Foundation.
ClinicalTrials.gov Identifier: NCT04870424. Copyright © The
Author(s) 2025.

<116>
Accession Number
2039627646
Title
EFFECT OF A SINGLE DOSE OF DEXMEDETOMIDINE ADMINISTERED BEFORE EXTUBATION
ON EXTUBATION CONDITIONS IN ADULT PATIENTS UNDERGOING GENERAL ANESTHESIA
IN INGUINAL HERNIA SURGERIES.
Source
International Journal of Academic Medicine and Pharmacy. 6(4) (pp
1170-1174), 2024. Date of Publication: 2024.
Author
Arora M.; Gupta A.; Singh P.
Institution
(Arora) Department of Anaesthesia, Rajshree Medical Research Institute
Bareilly., Rajshree Medical Research Institute, U.P., Bareilly, India
(Gupta) Department of Anaesthesia, Rajshree Medical Research Institute
Bareilly., Rajshree Medical Research Institute, U.P., Bareilly, India
(Singh) Department of Surgery, Department of Anaesthesia, Rajshree Medical
Research Institute Bareilly., Rajshree Medical Research Institute, U.P.,
Bareilly, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: To evaluate the effect of a single dose of dexmedetomidine
given prior to extubation on extubation conditions in adult patients
following general anesthesia. Material(s) and Method(s): This
prospective, randomized study involved 80 patients, aged 18 to 85 years,
classified as ASA class I or II. Patients were randomly assigned to either
Group A (dexmedetomidine 0.75 microg/mL, n = 40) or Group B (normal
saline, n = 40). Premedication included midazolam and glycopyrrolate, and
general anesthesia was induced with propofol and maintained with
isoflurane. Dexmedetomidine was administered 30 minutes before extubation
in Group A, while Group B received saline. Hemodynamic parameters, cough
scores, heart rate, postoperative nausea and vomiting (PONV), and sedation
levels were monitored and analyzed. Result(s): Demographic
characteristics, including age, gender, ASA classification, BMI, and
duration of surgery, were similar between groups. Postoperative cough
scores showed no significant difference between Group A (65% Grade 0) and
Group B (60% Grade 0, p = 0.90). Group B exhibited higher mean arterial
pressure (MAP) at several time points, with significant differences noted
3 minutes post-surgery (p = 0.03). Heart rates were consistently higher in
Group B, with significant differences observed at T0 (p = 0.03) and 3
minutes (p = 0.02). The incidence of PONV was significantly lower in Group
A (p = 0.03). Sedation levels were comparable, with no significant
differences between groups (p = 0.18). Conclusion(s): Dexmedetomidine
administration prior to extubation significantly enhances extubation
conditions by stabilizing hemodynamic parameters, reducing PONV, and
minimizing postoperative cough. Although sedation levels were comparable
between groups, careful monitoring for potential complications, such as
bradycardia and hypotension, remains essential. Dexmedetomidine is a
promising adjunct for improving patient outcomes during
extubation. Copyright © 2024 Society for Healthcare and Research
Development. All rights reserved.

<117>
Accession Number
2039626062
Title
COMPARATIVE STUDY OF THE EFFICACY OF POTASSIUM CHLORIDE AND SODIUM
BICARBONATE AS AN ADJUVANT TO BUPIVACAINE IN BRACHIAL PLEXUS BLOCK IN
PATIENTS UNDERGOING UPPER LIMB SURGERIES.
Source
International Journal of Academic Medicine and Pharmacy. 6(4) (pp
510-514), 2024. Date of Publication: 2024.
Author
Aravind Kumar P.; Gobinath L.; Senthil G.; Santhosh Kumar M.
Institution
(Aravind Kumar, Gobinath, Senthil, Santhosh Kumar) Government Medical
College, Tamilnadu, Namakkal, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: Peripheral nerve blocks, such as brachial plexus blocks, offer
effective anaesthesia for upper limb surgeries with prolonged
postoperative pain relief and minimal haemodynamic changes. Sodium
bicarbonate and potassium chloride, as additives to bupivacaine, improved
block quality and enhanced sensory and motor blockade duration and onset
times. This study aimed to compare the efficacy of sodium bicarbonate and
potassium chloride as adjuvants to bupivacaine in supraclavicular brachial
plexus block. Material(s) and Method(s): This prospective,
randomised, double-blind study at the Government Medical College Hospital,
Namakkal included 60 patients. On the day of surgery, standard monitors
were applied, intravenous access was established, and patients were
positioned appropriately for supraclavicular brachial plexus block. Using
landmarks, a 22G needle was used for local anaesthetic injection upon
paraesthesia confirmation. The block characteristics were closely
monitored, with vital signs and potential complications observed
postoperatively for 24 h. Result(s): Group S (sodium bicarbonate)
experienced significantly longer sensory and motor block durations, faster
onset times, and extended analgesia than Group K (potassium chloride)
(P=0.0001). Both groups showed no significant differences (P > 0.05) in
demographic variables, surgery duration, heart rate, blood pressure, or
SPO2 levels, indicating haemodynamic stability. Conclusion(s): The
comparison of potassium chloride and sodium bicarbonate as adjuvants to
bupivacaine for brachial plexus block showed that potassium chloride
provided shorter onset times for sensory and motor blocks, whereas sodium
bicarbonate extended the duration of these blocks and analgesia. Both
adjuvants enhanced the block quality and were safe for use. Copyright
© 2024 Society for Healthcare and Research Development. All rights
reserved.

<118>
Accession Number
2035241685
Title
A novel dura splitting technique for surgical resection of anterior spinal
meningioma: a case series and systematic review of the literature.
Source
European Spine Journal. (no pagination), 2025. Date of Publication: 2025.
Author
Elashaal A.; Ibdah A.; Hulliel A.; Almomani A.
Institution
(Elashaal) Windsor Regional Hospital, Windsor, Canada
(Ibdah) Hashemite University, Zarqa, Jordan
(Hulliel, Almomani) Jordan University of Science and Technology, Irbid,
Jordan
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Introduction: Recent research indicates that the extent of tumor resection
impacts the recurrence rate of spinal meningiomas, with Simpson grade II
resection potentially being inadequate. Simpson grade I resection, which
involves full-thickness dura resection, carries a high risk of
cerebrospinal fluid (CSF) leak and neurological complications. To mitigate
these issues, Saito et al. introduced the dura split (DS) technique in
2001. This method separates the dura into inner and outer layers, allowing
the tumor to be removed with the inner layer while preserving the outer
layer for primary closure. This approach reduces the risk of CSF leaks and
avoids the need for dural graft reconstruction. The DS technique's safety
and efficacy have been validated by subsequent studies. Method(s): We
retrospectively reviewed medical records for six patients with spinal
meningiomas who underwent dura-splitting technique surgeries between 2018
and 2022. A systematic literature review was conducted following the
Preferred Reporting Items for Systematic Reviews and Meta-Analysis
guidelines. Result(s): The case series included six patients treated
between 2018 and 2022 for ventral or ventrolateral spinal meningiomas,
predominantly in the thoracic region (4 thoracic, 2 cervical). Surgical
approaches included posterior laminectomy in five cases and anterior
cervical corpectomy (C4-5) in one. No perioperative complications were
reported. The systematic review encompassed nine studies involving 69
patients, with a mean age of 63 years (range: 36-82) and 80.4% female
predominance. Most tumors were thoracic (75-82.5%), followed by cervical
(15-17.5%) and lumbar (2.5%). The dural splitting technique was the most
common surgical approach, minimizing complications and preserving dura
integrity. CSF leakage occurred in 1.4% of cases, while tumor recurrence
was reported in 5.8%. Neurological recovery was observed in multiple
studies, with follow-up durations ranging from 4 months to 19 years.
 Conclusion(s): Our study confirms the dura-splitting technique as an
effective alternative to Simpson grade I and II resections, providing a
safer method for radical resection with reduced CSF leak
risk. Copyright © The Author(s), under exclusive licence to
Springer-Verlag GmbH Germany, part of Springer Nature 2025.

<119>
Accession Number
2035249136
Title
Importance of extracorporeal membrane oxygenation (ECMO) in congenital
heart diseases: a systematic review.
Source
Egyptian Heart Journal. 77(1) (no pagination), 2025. Article Number: 70.
Date of Publication: 01 Dec 2025.
Author
Faheem M.S.B.; Khan A.A.; Cheema S.; Akhtar M.; Ashraf D.A.
Institution
(Faheem) Karachi Institute of Medical Sciences, KIMS, Karachi, Pakistan
(Khan, Ashraf) Foundation University Medical College, Islamabad, Pakistan
(Cheema) King Edward Medical University, Lahore, Pakistan
(Akhtar) Gujranwala Medical College, Gujranwala, Pakistan
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Congenital heart diseases (CHDs) represent a significant
healthcare challenge with incidence rates of 17.9 per 1000 live births.
Extracorporeal membrane oxygenation (ECMO) has become an invaluable
therapeutic option providing essential aid to support both cardiac as well
as pulmonary failure. Method(s): A systematic search was performed
using PubMed, Embase, and Scopus from 2000 till date. Observational
studies involving pediatric patients with CHD undergoing cardiac surgery
using ECMO were included. The main outcomes were to determine short-term
mortality, weaning off ECMO, complications, hospital and ICU length of
stay, and indications for ECMO. Assessment of the risk of bias of included
studies was done by Newcastle-Ottawa scale. Result(s): 24
retrospective observational studies, encompassing 1,658 patients, were
ultimately included in our review. The overall incidence of mortality
across these studies was 45.2%. Successful weaning from ECMO was achieved
in 73.9% of patients. The most frequently reported complications included
bleeding, which affected 42.9% of patients, renal failure in 42.5%, and
sepsis in 27.5%. The mean duration of hospital stay was 47.8 +/- 41.1
days, while the mean length of stay in the ICU was 33.4 +/- 32.6 days.
 Conclusion(s): ECMO benefits pediatric heart patients but comes with
risks like bleeding and high mortality. Percutaneous techniques can reduce
complications; more research on minimally invasive approaches is
needed. Copyright © The Author(s) 2025.

<120>
Accession Number
2035237876
Title
Management of analgesia in cardiac surgery.
Source
Pain Management. (no pagination), 2025. Date of Publication: 2025.
Author
Strumia A.; Lusini M.; Costa F.; Stefani E.; Cipollone E.; Cusimano L.;
Libri F.; Ricci M.; Ruggiero A.; Sarubbi D.; Mattei A.; Schiavoni L.;
Barbato R.; Mastroianni C.; Jawabra M.; Agro F.E.; Chello M.; Cataldo R.;
Carassiti M.; Pascarella G.
Institution
(Strumia, Costa, Sarubbi, Mattei, Schiavoni, Agro, Cataldo, Carassiti,
Pascarella) Operative Research Unit of Anesthesia and Intensive Care,
Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
(Lusini, Jawabra, Chello) Research Unit of Cardiac Surgery, Department of
Cardiovascular Surgery, University Campus Bio-Medico di Roma, Roma, Italy
(Lusini, Barbato, Mastroianni, Chello) Operative Research Unit of Cardiac
Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Roma,
Italy
(Stefani, Cipollone, Cusimano, Libri, Ricci, Ruggiero, Agro, Cataldo,
Carassiti) Research Unit of Anaesthesia and Intensive Care, Department of
Medicine, University Campus Bio-Medico di Roma, Roma, Italy
Publisher
Taylor and Francis Ltd.
Abstract
Background: Pain management in cardiac surgery remains a critical
component of perioperative care, influencing recovery, patient
satisfaction, and outcomes. Traditional opioid-based analgesia is
associated with significant adverse effects, prompting the exploration of
multimodal strategies, including regional anesthesia (RA), non-opioid
analgesics, and enhanced recovery after surgery (ERAS) protocols. This
review evaluates the evolution of cardiac surgery pain management, from
conventional opioid-based regimens to multimodal approaches with regional
anesthesia. Method(s): A comprehensive analysis of existing
literature was conducted, assessing the efficacy, safety, and integration
of different pain management strategies in cardiac surgery on PubMed,
Google Scholar, MEDLINE, UpToDate, Embase and Web of Science until 1
November 2024. Studies on opioids, adjunct analgesics (e.g. NSAIDs,
acetaminophen, ketamine, dexmedetomidine), RA techniques, and ERAS
frameworks were reviewed to provide a comparative perspective.
 Result(s): Multimodal analgesia significantly reduces opioid
consumption, enhances pain control, and minimizes complications such as
respiratory depression and postoperative nausea. RA techniques, including
fascial plane blocks, offer promising opioid-sparing benefits. ERAS
protocols further optimize recovery, yet challenges remain in
standardizing approaches across institutions. Conclusion(s): The
future of cardiac surgery pain management lies in individualized,
multimodal strategies following ERAS principles. Standardized guidelines
and further research are needed to refine these protocols for widespread
adoption. Copyright © 2025 Informa UK Limited, trading as Taylor
& Francis Group.

<121>
Accession Number
647866450
Title
Safety of Oral Intake Prior to Cardiac Catheterization with Minimal to
Moderate Sedation: A Systematic Review and Meta-Analysis of Randomized
Controlled Trials.
Source
American heart journal. (no pagination), 2025. Date of Publication: 01
Jul 2025.
Author
Pir M.S.; Mitchell B.K.; Saqib N.U.; Saleem M.S.; Gertz Z.M.
Institution
(Pir) Christus Heart and Vascular Institute, Christus St. Frances Cabrini
Hospital, Alexandria, Louisiana
(Mitchell) Sentara Health, Norfolk, VA, United States
(Saqib) Tidal Health, Seaford, DE, United States
(Saleem) Wright Center for Graduate Medical Education, Scranton, PA,
United States
(Gertz) Virginia Commonwealth University, Richmond, VA, United States
Abstract
Fasting prior to percutaneous cardiac procedures is common, despite a lack
of high-quality evidence. We conducted a systematic review and
meta-analysis to assess the safety of a non-fasting strategy. Online
databases Medline, Cochrane CENTRAL, and Google Scholar were searched.
Quantitative analysis was performed using R software (Version 4.1.2) with
meta package. Analyzed outcomes included nausea, vomiting, aspiration,
intubation, hypoglycemia, hypotension, acute kidney injury, patient
satisfaction score, and length of hospital stay. Eight randomized
controlled trials were included with 3,382 patients. There was no
significant difference between fasting and non-fasting for nausea/vomiting
odds ratio (OR) 0.99 (95% CI: 0.68 to 1.45), hypoglycemia OR 1.28 (95% CI:
0.75 to 2.18), aspiration OR 0.72 (95% CI: 0.36 to 1.43), acute kidney
injury OR 0.69 (95% CI: 0.38 to 1.23), and hypotension OR 1.57 (95% CI:
0.47 to 5.30). No patient in either group underwent endotracheal
intubation. Additionally, there was no difference in patient satisfaction
score and length of hospital stay with a standardized mean difference
(SMD) of 0.23 (95% CI: -0.62 to 1.07) and 0.0 (95% CI: -0.6 to 0.7)
respectively. Sub-group analysis, however, showed increased odds of
nausea/vomiting in the fasting group compared to non-fasting OR 1.20 (95%
CI: 1.04 to 1.39) and decreased odds of acute kidney injury in fasting
compared to non-fasting group OR 0.50 (95% CI: 0.28 to 0.89). In
conclusion, this analysis shows no significant difference in most safety
outcomes between a fasting and a non-fasting strategy with potential
increase in nausea/vomiting and decrease in acute kidney injury with
fasting. More studies are needed to better understand these
differences. Copyright © 2025. Published by Elsevier Inc.

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