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<1>
Accession Number
2032687865
Title
Identifying Paediatric Populations with Increased Risk for Oropharyngeal
Dysphagia in Acute and Critical Care Settings: A Scoping Review.
Source
Dysphagia. 40(4) (pp 973-986), 2025. Date of Publication: 01 Aug 2025.
Author
Grunke C.; Marshall J.; Miles A.; Carrigg B.; Ward E.C.
Institution
(Grunke, Marshall, Ward) School of Health and Rehabilitation Sciences, The
University of Queensland, Brisbane, Australia
(Marshall) Queensland Children's Hospital, Children's Health Queensland
Hospital and Health Service, Brisbane, Australia
(Miles) Speech Science, School of Psychology, The University of Auckland,
Auckland, New Zealand
(Carrigg) The Royal Children's Hospital, Melbourne, Australia
(Ward) Centre for Functioning and Health Research (CFAHR), Metro South
Hospital and Health Service, Brisbane, Australia
Publisher
Springer
Abstract
Dysphagia is common in hospitalised children. Clarity regarding its
prevalence is required to direct service needs. This review reports
oropharyngeal dysphagia prevalence in children admitted to acute and/or
critical care, following acute illness, medical or surgical intervention.
It also explores patient characteristics significantly associated with
oropharyngeal dysphagia in these settings. Five electronic databases
(EMBASE, CINAHL, Cochrane, PubMed, Scopus) were searched. Studies
identified for inclusion involved children (0-16 years), in acute or
critical care settings, where prevalence data for new-onset or worsening
oropharyngeal dysphagia was reported. Peer reviewed journal articles,
including systematic reviews were included. Data was extracted and
synthesised using a purpose designed extraction tool. A total of 7,522
studies were screened and 67 studies met criteria. The most researched
populations included congenital heart disease surgeries, posterior fossa
tumour resections, stroke and post-extubation dysphagia. Populations with
the highest documented dysphagia prevalence were children after posterior
fossa tumour resection with a new tracheostomy, children using nasal
continuous positive airway pressure, and children following ischemic
stroke. Characteristics significantly associated with oropharyngeal
dysphagia were younger age, lower weight, longer intubation, upper/middle
airway dysfunction (e.g., vocal paresis), and presence of additional
comorbidities. This review presents synthesised prevalence data for
children in acute and critical care settings with new-onset or worsening
oropharyngeal dysphagia. It highlights the broad nature of oropharyngeal
dysphagia in hospitalised children and the need for more rigorous research
into characteristics associated with increased risk to better support
screening and early identification of oropharyngeal dysphagia in these
settings. Copyright © The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2024.

<2>
Accession Number
2039816210
Title
Superficial vs. deep serratus anterior plane block for analgesia in
patients undergoing single-port video-assisted thoracoscopic surgery: A
randomized prospective trial.
Source
Journal of Clinical Anesthesia. 106 (no pagination), 2025. Article Number:
111950. Date of Publication: 01 Sep 2025.
Author
Meng G.; Chen W.; Shi D.; Mei B.; Liu X.
Institution
(Meng, Chen, Shi, Mei, Liu) Department of Anesthesiology, The First
Affiliated Hospital of Anhui Medical University, Hefei, China
Publisher
Elsevier Inc.
Abstract
Study objective: Postoperative pain following thoracic surgery is often
severe, and serratus anterior plane block (SAPB) is widely used for
perioperative analgesia in such patients. Local anesthetics injected on
the surface of the serratus anterior muscle are called superficial SAPB
(SSAPB), while those injected on the deep surface are called deep SAPB
(DSAPB). We observed the differences in analgesic effects of two variants
of SAPB (superficial and deep) on patients receiving single-port
video-assisted thoracoscopic surgery (VATS). Design(s): A randomized
prospective trial. Setting(s): Single university teaching hospital.
 Patient(s): Eighty patients who underwent single-port VATS under
general anesthesia. Intervention(s): Eighty patients who received
single-port VATS were randomly assigned to Group S (patients who received
SSAPB) and Group D (patients who received DSAPB). Measurements: The
primary outcome was opioid consumption within 24 h after surgery.
Secondary outcomes were pain scores at rest and on coughing before
surgery, immediately after surgery, 6, 12, and 24 h after surgery.
 Main Result(s): Within 24 h after surgery, the total opioid
consumption of patients in Group S was lower than that of patients in
Group D (P = 0.001). The pain scores of patients in Group S were lower
than those in Group D at rest or coughing 6 h after surgery (P = 0.000, P
= 0.000). The pain score on coughing in Group S was lower than that in
Group D at 12 h after surgery (P = 0.000), and there was no difference in
postoperative pain scores between the two groups at other time points.
 Conclusion(s): For patients undergoing single-port VATS lobectomy,
SSAPB was associated with reduced opioid consumption and lower pain scores
compared to DSAPB. Copyright © 2025

<3>
Accession Number
2039818925
Title
Comparison of Two Activated Clotting Time Targets During Cardiac Surgery
With Cardiopulmonary Bypass: A Prospective Multicenter Randomized
Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Gorter K.A.M.; Stehouwer M.C.; de Vroege R.; Zuthof D.; Meesters M.I.;
Noordzij P.G.; Niesten E.D.; Suyker W.J.L.
Institution
(Gorter) Department of Perfusion, University Medical Center, Utrecht,
Netherlands
(Stehouwer) Department of Perfusion, Sint Antonius Hospital, Nieuwegein,
Netherlands
(de Vroege) Department of Perfusion, Haga Hospital, Den Haag, Netherlands
(Zuthof) Department of Perfusion, Medisch Spectrum Twente, Enschede,
Netherlands
(Meesters) Department of Anesthesiology, Catharina Hospital, Eindhoven,
Netherlands
(Noordzij) Department of Anesthesiology, Intensive Care and Pain
Management, Sint Antonius Hospital, Nieuwegein, Netherlands
(Noordzij) Department of Intensive Care, University Medical Center,
Utrecht, Netherlands
(Niesten) Department of Anesthesiology, Medisch Spectrum Twente, Enschede,
Netherlands
(Suyker) Department of Cardiothoracic Surgery, University Medical Center,
Utrecht, Netherlands
Publisher
W.B. Saunders
Abstract
Objectives: The present study was designed to investigate the equivalence
of two target activated clotting time (ACT) values with regard to packed
red blood cell (PRBC) transfusion in patients undergoing cardiac surgery
with cardiopulmonary bypass (CPB). Secondary endpoints include
postoperative blood loss, transfusion of other blood products, and
postoperative laboratory parameters, including renal function, intensive
care unit length of stay, postoperative thrombotic events, and other
adverse events. Design(s): Multicenter, randomized, single-blind,
controlled equivalence trial. Patients were randomized to a lower target
ACT of >=400 seconds or a higher target ACT of >=480 seconds.
 Setting(s): Three tertiary and one university medical center in the
Netherlands. Participant(s): 1,021 patients >=18 years of age
scheduled for first-time elective cardiac surgery with CPB between
November 2019 and December 2023. Measurements and Main Results: PRBC
transfusion was equivalent in both ACT groups (19.1% v 17.2% risk
difference -0.029; 0.066). In the low ACT group, blood loss at 6 and 24
hours postoperative was significantly lower (median [interquartile range],
260 [245] v 300 [250] mL, p = 0.003 and 480 [363] v 550 [410] mL, p =
0.007) and the hemoglobin level at 6 hours and 1 day after surgery
significantly higher (mean [95% confidence interval], 11.8 [11.6-11.9] v
11.6 [11.3-11.8] g/dL, p = 0.017 and 11.4 [11.1-11.6] v 11.1 [11.0-11.4]
g/dL, p = 0.045) compared with the high ACT group, but lacking clinical
relevance. The frequency of thromboembolic events was similar in both
groups. Conclusion(s): This study showed that a target ACT of >=400
seconds is equivalent to a target ACT of >=480 seconds in terms of
intraoperative and postoperative PRBC transfusion rates in the modern
cardiac surgery setting. This target range is considered comparable
regarding the outcomes of patients undergoing cardiac surgery with
CPB. Copyright © 2025 The Author(s)

<4>
Accession Number
2039880892
Title
Postoperative outcomes of perioperative cognitive training: a systematic
review and meta-analysis.
Source
Minerva Anestesiologica. 91(6) (pp 555-563), 2025. Date of Publication: 01
Jun 2025.
Author
Tang R.-R.; Lu Y.-N.; Chen S.-S.; Zhang X.-J.; Lu Z.-R.
Institution
(Tang, Lu, Chen, Zhang, Lu) Yancheng No. 1 People's Hospital, Operating
Room Jiangsu, China
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: It remains unclear whether surgical patients can really
benefit from cognitive training. This meta-analysis was performed to
assess the efficacy of cognitive training in this population. EVIDENCE
ACQUISITION: A literature search was performed in four databases: PubMed
(Medline), Web of Science and Cochrane database, from inception to
September 2024, on topics related to cognitive training in surgical
persons. EVIDENCE SYNTHESIS: Eighteen studies were eventually included.
compared to the control group, cognitive training group significantly
reduced the incidence of postoperative delirium (RR: 0.72; 95% CI: 0.55,
0.94) and postoperative cognitive dysfunction (RR: 0.72; 95% CI: 0.54,
0.95). There was improvement of anxiety (SMD: -1.87; 95% CI: -3.40,
-0.35), depression (SMD: -1.17; 95% CI: -2.00, -0.34), and quality of life
(SMD: 0.78; 95% CI: 0.22, 1.34). However, there was no statistical
significance in cognitive function scores (SMD: 0.65; 95% CI: -0.97,
2.28), and memory scores (SMD: 1.09; 95% CI: -0.11, 2.29).
 CONCLUSION(S): Cognitive training had a positive impact on
postoperative delirium, postoperative cognitive dysfunction, anxiety,
depression, and quality of life among surgical patients. The application
of cognitive training should be expanded to perioperative
patients. Copyright © 2025 EDIZIONI MINERVA MEDICA.

<5>
Accession Number
2039818173
Title
Letter to Editor: Critical Appraisal of Continued Versus Interrupted Oral
Anticoagulation During Transcatheter Aortic Valve Replacement in Patients
With Atrial Fibrillation: A Meta-Analysis.
Source
American Journal of Therapeutics. (no pagination), 2025. Date of
Publication: 2025.
Author
Qasim S.
Institution
(Qasim) Ameer-ud-Din Medical College PGMI, Lahore, Pakistan
Publisher
Lippincott Williams and Wilkins

<6>
Accession Number
645720476
Title
Impact of intravenous infusion of lidocaine on intrapulmonary shunt and
postoperative cognitive function in patients undergoing one-lung
ventilation.
Source
Advances in clinical and experimental medicine : official organ Wroclaw
Medical University. 34(7) (pp 1139-1144), 2025. Date of Publication: 01
Jul 2025.
Author
Yang D.; Yang Q.; Wang Y.; Liu F.; Xing Z.; Li S.; Zhang J.
Institution
(Yang, Yang, Wang, Liu, Xing, Zhang) Department of Anesthesiology,
Affiliated Hospital of Yangzhou University, China
(Li) Department of Anesthesiology, First People's Hospital Affiliated to
Shanghai Jiaotong University, China
Abstract
BACKGROUND: Intravenous infusion of lidocaine as an anesthesia adjuvant
can improve patient outcomes, but its impact on intrapulmonary shunt
during one-lung ventilation (OLV) has not been clarified.
 OBJECTIVE(S): To determine the effect of intravenous lidocaine
infusion on intrapulmonary shunt during OLV and postoperative cognitive
function in video-assisted thoracoscopic surgery (VATS). MATERIAL AND
METHODS: Sixty patients who underwent OLV for thoracic surgery were
randomized to receive intravenous infusion of lidocaine (lidocaine group,
n = 30) or normal saline (control group, n = 30) for anesthesia induction.
Arterial and venous blood gases were measured during two-lung ventilation
and at 15 and 30 min after OLV (OLV + 15 and OLV + 30). The Mini-Mental
State Examination was administered before the surgery and at postoperative
12 months to assess patient cognitive function. RESULT(S): No
significant difference was found in intrapulmonary shunt fraction (Qs/Qt)
between the lidocaine group and the control group at OLV + 15 (p = 0.493)
and OLV + 30 (p = 0.754). The lidocaine group used significantly lower
doses of propofol and remifentanil compared to the control group (both p <
0.001). Furthermore, no significant difference was observed in the
incidence of postoperative cognitive dysfunction between the lidocaine
group and the control group at 1 year post-operation (3.3% vs 6.7%, p =
0.554). CONCLUSION(S): Intravenous lidocaine administered in VATS had
no significant impact on intrapulmonary shunt during OLV or postoperative
cognitive function. However, it significantly reduced the doses of
anesthetics used during the surgery.

<7>
Accession Number
2039784431
Title
Development of an evidence-based protocol for the prevention of
perioperative pressure injuries in pediatric cardiac surgery: A Delphi
study.
Source
Journal of Tissue Viability. 34(4) (no pagination), 2025. Article Number:
100948. Date of Publication: 01 Nov 2025.
Author
Ma X.; Fan J.; Wang J.; Lin H.
Institution
(Ma) Health Management Center, The Second Affiliated Hospital and Yuying
Children's Hospital of Wenzhou Medical University, Zhejiang Province,
Wenzhou, China
(Fan, Wang, Lin) Department of Operating Room, The Second Affiliated
Hospital and Yuying Children's Hospital of Wenzhou Medical University,
Zhejiang Province, Wenzhou, China
Publisher
Tissue Viability Society
Abstract
Aim: Pediatric patients undergoing cardiac surgery are at high risk for
perioperative pressure injuries (PPIs). This study aimed to develop an
evidence-based protocol for the prevention of PPIs in pediatric cardiac
surgery. Method(s): A literature review was conducted to identify and
summarize the existing evidence on PPI prevention in pediatric cardiac
surgery to construct an initial protocol. Two rounds of Delphi surveys
were then performed to refine the protocol. The expert panel consisted of
20 multidisciplinary professionals from five tertiary hospitals, including
nurses, surgeons, and anesthesiologists, 85 % of whom possess more than 20
years of clinical experience. The mean values of importance and
feasibility of each indicator were calculated. Reliability of the Delphi
method assessed by valid response rate, authority coefficient (Cr),
coefficient of variation (CV) and Kendall' W coefficient (Kendall' W).
 Result(s): Consensus was reached on 4 first-level items, 15 s-level
items, and 27 third-level items for the PPI prevention protocol. The valid
response rates for the two Delphi rounds were 83.3 % and 100 %,
respectively, with Cr of 0.905 and 0.901, CV of less than 0.25, and
Kendall' W of 0.172 and 0.142 (P < 0.001). Conclusion(s): The
developed PPI prevention protocol for pediatric cardiac surgery is both
scientific and feasible, providing a reference for perioperative nurses to
implement systematic and standardized PPI prevention care. Copyright
© 2025 The Authors

<8>
Accession Number
2035453740
Title
Impact of Obstructive Sleep Apnea in Surgical Patients: A Systematic
Review.
Source
Journal of Clinical Medicine. 14(14) (no pagination), 2025. Article
Number: 5095. Date of Publication: 01 Jul 2025.
Author
Titu I.-M.; Vulturar D.M.; Chis A.F.; Oprea A.; Manea A.; Todea D.A.
Institution
(Titu, Oprea, Manea) Department of Surgery, Iuliu Hatieganu University of
Medicine and Pharmacy, Cluj-Napoca, Romania
(Titu, Vulturar, Chis, Todea) Department of Pneumology, Iuliu Hatieganu
University of Medicine and Pharmacy, Cluj-Napoca, Romania
(Titu, Todea) Thoracic Surgery Clinic, Leon Daniello Clinical Hospital of
Pneumology, Cluj-Napoca, Romania
(Vulturar, Chis) Pneumology Clinic, Leon Daniello Clinical Hospital of
Pneumology, Cluj-Napoca, Romania
(Oprea, Manea) Cardiovascular Surgery Clinic, Niculae Stancioiu Heart
Institute, Cluj-Napoca, Romania
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Obstructive sleep apnea is a prevalent, yet often
underdiagnosed, condition characterized by recurrent upper airway
obstruction during sleep, leading to significant perioperative risks in
surgical patients. This systematic review aims to evaluate the incidence
and impact of objectively diagnosed obstructive sleep apnea on
postoperative outcomes across various surgical specialties-including
bariatric, orthopedic, cardiac, and otorhinolaryngologic surgeries-and to
assess the effectiveness of preoperative screening and perioperative
management strategies. Method(s): A comprehensive literature search
of PubMed was conducted for studies published between January 2013 and
December 2024, following Preferred Reporting Items for Systematic Reviews
and Meta-Analyses guidelines. Included studies involved adult surgical
patients with OSA confirmed by polysomnography or respiratory polygraphy.
Studies were assessed for methodological quality using the Oxford Centre
for Evidence-Based Medicine Levels of Evidence framework. Result(s):
The findings consistently indicated that obstructive sleep apnea
significantly increases the risk of postoperative complications, such as
respiratory depression, atrial fibrillation, acute kidney injury,
delirium, and prolonged hospital stay. Continuous positive airway pressure
therapy demonstrated a protective effect in bariatric and cardiac
surgeries, though its effectiveness in orthopedic and otorhinolaryngologic
contexts was inconsistent, largely due to adherence variability and
limited implementation. Preoperative screening tools such as the STOP-BANG
questionnaire were widely used, but their utility depended on integration
with confirmatory diagnostics. Conclusion(s): Obstructive sleep apnea
represents a significant, modifiable risk factor in surgical populations.
Preoperative identification and risk-adapted perioperative management,
including CPAP therapy and multimodal analgesia, may substantially reduce
postoperative morbidity. However, further randomized trials and
cost-effectiveness studies are needed to optimize care pathways and ensure
consistent implementation across surgical disciplines. Copyright
© 2025 by the authors.

<9>
Accession Number
2039109621
Title
Benefits of anticoagulation prophylaxis in children undergoing kidney
transplant: systematic review and meta-analysis.
Source
Journal of Thrombosis and Haemostasis. 23(8) (pp 2568-2583), 2025. Date of
Publication: 01 Aug 2025.
Author
Al-Huniti A.H.; Malcolmson C.; Langlois V.; McKay A.M.; Lorenzo A.; Wang
Z.; Williams S.; Teoh C.W.; Brandao L.R.
Institution
(Al-Huniti) Division of Pediatric Hematology/Oncology, Mayo Clinic,
Rochester, MN, United States
(Malcolmson, Williams, Brandao) Division of Pediatric
Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
(Langlois) Division of Pediatric Nephrology, McGill University Health
Centre, Montreal, QC, Canada
(McKay, Teoh) Division of Pediatric Nephrology, The Hospital for Sick
Children, Toronto, ON, Canada
(Lorenzo) Division of Pediatric Urology, The Hospital for Sick Children,
Toronto, ON, Canada
(Wang) Department of Health Care Delivery Research, Robert D. and Patricia
E. Kern Center for the Science of Health Care Delivery, Mayo Clinic,
Rochester, MN, United States
(Brandao) Department of Paediatrics, Dalla Lana School of Public Health,
University of Toronto, Toronto, ON, Canada
Publisher
Elsevier B.V.
Abstract
Background: Graft thrombosis is a preventable cause of early allograft
loss after pediatric kidney transplant, but the role of primary
thromboprophylaxis is uncertain. Objective(s): This study aimed to
determine the effectiveness and safety of thromboprophylaxis in preventing
graft thrombosis among children (0-21 years) undergoing kidney transplant.
 Method(s): We performed a systematic literature review of MEDLINE,
Embase, and Cochrane Libraries from inception until September 2024. The
primary outcome assessed by meta-analysis was graft thrombosis, and the
secondary outcome was major bleeding (per International Society on
Thrombosis and Haemostasis criteria). Result(s): Twenty-five
observational studies (21 retrospective and 4 prospective) describing 2094
patients (1659 cases and 435 controls) met eligibility criteria.
Thromboprophylaxis was used universally (ie, all kidney recipients in the
study) in 64% (1055/1659) or only in high-risk patients (eg, recipient
weight <20 kg and age <5 years) in 36% (604/1659). Compared with no
preventive measures for thrombosis, thromboprophylaxis was associated with
reduced risk of graft thrombosis (odds ratio, 0.31; 95% CI, 0.18-0.53).
Subgroup analyses of heparinoid-only, universal thromboprophylaxis, and
high risk only protocols revealed similar findings. Thromboprophylaxis was
not associated with increased risk of bleeding resulting in surgical
exploration or graft loss. The overall risk of bias was moderate. Studies
showed high clinical and methodologic heterogeneity in study populations
and thromboprophylaxis protocols. Conclusion(s): Primary
thromboprophylaxis appears effective in preventing kidney graft loss from
vascular thrombosis in pediatric recipients. This benefit may be offset by
the risk of bleeding, although clarity on bleeding risk factors is
lacking. We identified knowledge gaps, including uncertainty about optimal
thromboprophylaxis regimens and treatment duration. Copyright ©
2025 The Author(s)

<10>
Accession Number
2035472345
Title
Iatrogenic Pneumopericardium After Pericardiocentesis: A Systematic Review
and Case Report.
Source
Journal of Cardiovascular Development and Disease. 12(7) (no pagination),
2025. Article Number: 246. Date of Publication: 01 Jul 2025.
Author
Merz A.; Ran H.; Chiu C.-Y.; Dreger H.; Morris D.A.; Schneider-Reigbert M.
Institution
(Merz, Chiu, Dreger, Morris, Schneider-Reigbert) Deutsches Herzzentrum der
Charite, Department of Cardiology, Angiology and Intensive Care Medicine,
Berlin, Germany
(Merz, Chiu, Dreger, Morris, Schneider-Reigbert) DZHK (German Center for
Cardiovascular Research), Partner Site Berlin, Berlin, Germany
(Merz, Chiu, Dreger, Morris, Schneider-Reigbert)
Charite-Universitatsmedizin Berlin, Freie Universitat Berlin and
Humboldt-Universitat zu Berlin, Berlin, Germany
(Ran) Department of Echocardiography, Nanjing First Hospital, Nanjing
Medical University, Nanjing, China
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Pneumopericardium is the presence of air within the
pericardial cavity. We report a case of iatrogenic pneumopericardium
following pericardiocentesis in a patient with primary cardiac
angiosarcoma. Additionally, we provide a systematic review of
pericardiocentesis-associated pneumopericardium to offer a comprehensive
overview and evaluate the role of echocardiography in its diagnosis.
 Method(s): The PubMed database was searched from inception until
January 2025 to perform a systematic review following the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
guidelines to evaluate articles on iatrogenic pneumopericardium following
pericardiocentesis published in the English language. The Joanna Briggs
Institute (JBI) Critical Appraisal Checklist for Case Reports was used to
appraise the included case reports. Result(s): Of the 108 search
results obtained, after screening and a backward citation search, 37
articles were selected for inclusion in this review, accounting for a
total of 37 patients. According to the JBI Critical Appraisal Checklist
for Case Reports, 7 case reports were of high quality and 12 of low
quality. The overall evidence of quality of the case reports was moderate,
and 51.6% of patients developed hemodynamic compromise or showed signs of
cardiac tamponade. The main underlying cause for the development of
pneumopericardium was issues relating to the catheter drainage system;
64.9% of cases required decompressive therapy. Conclusion(s):
Pneumopericardium can occur as a complication after pericardiocentesis and
must therefore be considered in symptomatic patients. While detection by
transthoracic echocardiography is difficult and relies on non-validated
signs, chest X-ray and computed tomography can provide a definitive
diagnosis. Copyright © 2025 by the authors.

<11>
Accession Number
2039642525
Title
Effects of a Hypotension-Avoidance Versus a Hypertension-Avoidance
Strategy on Neurocognitive Outcomes After Noncardiac Surgery.
Source
Annals of Internal Medicine. 178(7) (pp 909-920), 2025. Date of
Publication: 01 Jul 2025.
Author
Marcucci M.; Chan M.T.V.; Painter T.W.; Efremov S.; Aguado H.J.; Astrakov
S.V.; Kleinlugtenbelt Y.V.; Patel A.; Cata J.P.; Amir M.; Kirov M.; Leslie
K.; Duceppe E.; Borges F.K.; de Nadal M.; Tandon V.; Landoni G.;
Likhvantsev V.V.; Lomivorotov V.; Sessler D.I.; Martinez-Zapata M.J.;
Xavier D.; Fleischmann E.; Wang C.Y.; Meyhoff C.S.; Wittmann M.; Torres
D.; Highton D.; Jacka M.; Vishwanath B.; Zarnke K.; Sidhu R.S.; Oriani G.;
Ayad S.; Minear S.; Weaver T.E.; Ruetzler K.; Brusasco C.; Parlow J.L.;
Maxwell E.; Miller S.; Mrkobrada M.; Bhatt K.S.C.; Rahate P.; Kowark A.;
De Blasio G.; Ofori S.N.; Conen D.; Srinathan S.; Szczeklik W.; Jayaram
R.; Ellerkmann R.K.; Momeni M.; Copland I.; Vincent J.; Balasubramanian
K.; Li Z.; Wang M.K.; Li D.; McGillion M.H.; Kurz A.; Sharma M.; Short
T.G.; Devereaux P.J.
Institution
(Marcucci, Duceppe, Borges, Ofori, Conen, Copland, Vincent,
Balasubramanian, Li, Wang, McGillion, Sharma, Devereaux) Population Health
Research Institute, Hamilton, ON, Canada
(Marcucci) Clinical Epidemiology and Research Centre, Humanitas
University, IRCCS Humanitas Research Hospital, Milan, Italy
(Marcucci, Borges, Conen, Devereaux) Department of Health Research
Methods, McMaster University, Hamilton, ON, Canada
(Chan) The Chinese University of Hong Kong, Hong Kong
(Painter) Acute Care Medicine, The University of Adelaide, Adelaide, SA,
Australia
(Efremov) Saint Petersburg State University Hospital, Saint Petersburg,
Russian Federation
(Aguado) Trauma & Orthopaedic Surgery Department, Hospital Clinico
Universitario de Valladolid, Valladolid, Spain
(Astrakov) Department of Anesthesiology, Novosibirsk State University,
Novosibirsk, Russian Federation
(Kleinlugtenbelt) Department of Orthopedic and Trauma Surgery, Deventer
Ziekenhuis, Deventer, Netherlands
(Patel, Borges, Tandon, Ofori, Conen, Wang, Li, Sharma) Department of
Medicine, McMaster University, Hamilton, ON, Canada
(Cata) MD Anderson Cancer Center, Houston, TX, United States
(Amir) Department of Surgery, Shifa International Hospital, Shifa
Tameer-eMillat University, Islamabad, Pakistan
(Kirov) Department of Anesthesiology and Intensive Care Medicine, Northern
State Medical University, Arkhangelsk, Russian Federation
(Leslie) Department of Critical Care Medicine, Melbourne Medical School,
University of Melbourne, Melbourne, VIC, Australia
(Duceppe) Department of Medicine, Centre Hospitalier de l'Universite de
Montreal, Montreal, QC, Canada
(de Nadal) Department of Anesthesiology and Intensive Care, Hospital Vall
d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
(Landoni) Department of Anesthesiology and Intensive Care, IRCCS San
Raffaele Scientific Institute, Milan, Italy
(Landoni) Vita-Salute San Raffaele University, Milan, Italy
(Likhvantsev) V. Negovsky Reanimatology Research Institute FRCC RR,
Moscow, Russian Federation
(Lomivorotov) Department of Anesthesiology and Intensive Care, E.
Meshalkin National Medical Research Centre, Novosibirsk, Russian
Federation
(Lomivorotov) Department of Anesthesiology and Perioperative Medicine,
Penn State College of Medicine, Penn State Milton S. Hershey Medical
Center, Hershey, PA, United States
(Sessler) Center for Outcomes Research, Department of Anesthesiology,
UTHealth, Houston, TX, United States
(Martinez-Zapata) Iberoamerican Cochrane Centre, Public Health and
Clinical Epidemiology Service, Institut de Recerca Sant Pau, CIBERESP,
Barcelona, Spain
(Xavier) St. John's Medical College, Bangalore, India
(Fleischmann) Department of Anaesthesia, Intensive Care Medicine and Pain
Medicine, Medical University of Vienna, Vienna, Austria
(Wang) Department of Anesthesiology, Faculty of Medicine, Universiti
Malaya, Kuala Lumpur, Malaysia
(Meyhoff) Department of Anaesthesia and Intensive Care, Copenhagen
University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
(Wittmann, Kowark) Department of Anesthesiology and Intensive Care
Medicine, University Hospital Bonn, Bonn, Germany
(Torres) Departamento de Epidemiologia y Estudios en Salud, Universidad de
Los Andes, Santiago, Chile
(Highton) Princess Alexandra Hospital, Woolloongabba, QLD, Australia
(Jacka) Anesthesiology and Critical Care, University of Alberta, Edmonton,
AB, Canada
(Vishwanath) Nanjappa Hospital, Karnataka, India
(Zarnke) University of Calgary, Calgary, AB, Canada
(Sidhu) Sidhu Hospital Doraha Ludhiana, Ludhiana, India
(Oriani) IRCCS Galeazzi Sant'Ambrogio (OGSA), Site Istituto San Siro,
Milan, Italy
(Ayad, Kurz) Outcome Research Consortium, Department of Anesthesiology,
Cleveland Clinic, Cleveland, OH, United States
(Minear) Cleveland Clinic Florida, Weston, FL, United States
(Weaver) The Ohio State University Wexner Medical Center, Columbus, OH,
United States
(Ruetzler) Department of Anesthesiology and Intensive Care Medicine,
Ordensklinikum Linz, Linz, Austria
(Brusasco) Anaesthesia and Intensive Care Medicine, Galliera Hospital,
Genova, Italy
(Parlow, Short) Department of Anesthesiology and Perioperative Medicine,
Queen's University, Kingston Health Sciences Centre, Kingston, ON, Canada
(Maxwell) Department of Anaesthesia, Auckland City Hospital, Auckland, New
Zealand
(Miller) Wake Forest School of Medicine, Winston Salem, NC, United States
(Mrkobrada) Department of Medicine, Western University, London, ON, Canada
(Bhatt) Surat Institution, Surat, India
(Rahate) Rahate Surgical Hospital, Nagpur, India
(Kowark) University Hospital RWTH Aachen, Aachen, Germany
(De Blasio) IRCCS Galeazzi Orthopedic Institute, Milan, Italy
(Srinathan) Section of Thoracic Surgery, Department of Surgery, University
of Manitoba, Winnipeg, MB, Canada
(Szczeklik) Centre for Intensive Care and Perioperative Medicine,
Jagiellonian University Medical College, Krakow, Poland
(Jayaram) Department of Anaesthetics, Clinical Neurosciences, University
of Oxford, Oxford University Hospitals NHS Trust, Oxford, United Kingdom
(Ellerkmann) Department of Anesthesiology, Klinikum Dortmund, University
Witten-Herdecke, Dortmund, Germany
(Momeni) Cliniques Universitaires Saint-Luc, Brussels, Belgium
(McGillion) School of Nursing, McMaster University, Hamilton, ON, Canada
(Kurz) Department of General Anesthesiology, Emergency and Intensive Care
Medicine, Medical University of Graz, Graz, Austria
Publisher
American College of Physicians
Abstract
Background: Perioperative hemodynamic abnormalities have been associated
with neurocognitive outcomes after noncardiac surgery. Objective(s):
To compare the effects of perioperative hypotension-avoidance versus
hypertension-avoidance strategies on delirium and 1-year cognitive decline
after noncardiac surgery. Design(s): Randomized controlled trial.
(ClinicalTrials. gov: NCT03505723) Setting: 54 centers, 19 countries.
 Participant(s): 2603 high-vascular-risk patients undergoing
noncardiac surgery, receiving 1 or more chronic antihypertensive
medications (mean age, 70 years). Intervention(s): In the
hypotension-avoidance strategy, the intraoperative mean arterial pressure
(MAP) target was 80 mm Hg or greater; before and for 2 days after surgery,
renin-angiotensin-aldosterone system inhibitors were withheld, and other
chronic antihypertensive medications were administered for systolic blood
pressures of 130 mm Hg or greater following an algorithm. In the
hypertension-avoidance strategy, the intraoperative MAP target was 60 mm
Hg or greater; all chronic antihypertensive medications were continued
perioperatively. Measurements: Delirium on postoperative day 1 to 3
(primary outcome); decline of 2 points or more at the Montreal Cognitive
Assessment (MoCA) 1 year after surgery compared with baseline (secondary
outcome). Result(s): 95 of 1310 patients (7.3%) in the
hypotension-avoidance and 90 of 1293 patients (7.0%) in the
hypertension-avoidance group had delirium (relative risk [RR], 1.04 [95%
CI, 0.79 to 1.38]). Among 701 patients who completed 1-year MoCA (full or
telephone version), 129 of 347 (37.2%) in the hypotension-avoidance and
117 of 354 (33.1%) in the hypertension-avoidance group had a decline of 2
or more points (RR, 1.13 [CI, 0.92 to 1.38]). Nineteen percent in the
hypotension-avoidance and 27% in the hypertension-avoidance strategy had
hypotension requiring an intervention (RR, 0.63 [CI, 0.52 to 0.76]),
mostly intraoperatively; only 5%, in both groups, had hypotension
postoperatively. Limitation(s): The COVID-19 pandemic challenged site
participation in the substudy; although large, the sample size was lower
than expected. Conclusion(s): There was no evidence of a difference
in neurocognitive outcomes between the hypotension-avoidance and
hypertension-avoidance strategies. Copyright © 2025 American
College of Physicians. All rights reserved.

<12>
Accession Number
2030746677
Title
Ultrasound-Guided Versus Palpation-Guided Techniques to Achieve Vascular
Access in Children Undergoing Cardiac Surgery: A Systematic Review and
Meta-analysis of Randomized Controlled Trials.
Source
Pediatric Cardiology. 46(6) (pp 1426-1447), 2025. Date of Publication: 01
Aug 2025.
Author
Ibrahim A.A.; Allam A.R.; Amin A.M.; Rakab M.S.; Alhadeethi A.; Hageen
A.W.; Mahmoud A.; Abuelazm M.; Abdelazeem B.
Institution
(Ibrahim, Allam) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Amin, Rakab) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Alhadeethi) Department of General Medicine, Al-Salam Teaching Hospital,
Ninevah, Iraq
(Hageen, Abuelazm) Faculty of Medicine, Tanta University, Tanta, Egypt
(Mahmoud) Faculty of Medicine, Minia University, Minia, Egypt
(Abdelazeem) Department of Cardiology, West Virginia University,
Morgantown, WV, United States
Publisher
Springer
Abstract
Pediatric heart surgery is a vital therapeutic option for congenital heart
disease, which is one of the most prevalent causes of death in children.
Arterial cannulation (AC) and central venous catheter (CVC) are required
in pediatric cardiac surgery for continuous monitoring of the central
venous pressure (CVP), replacement of fluid or blood products, close
hemodynamic monitoring, and frequent sampling for arterial blood gases
(ABG). A systematic review and meta-analysis synthesizing evidence from
randomized controlled trials (RCTs) retrieved from PubMed, Embase
Cochrane, Scopus, and WOS until February 2024. Risk ratio (RR) was used to
report dichotomous outcomes, and mean difference (MD) was used to report
continuous outcomes, both with a 95% confidence interval (CI) using the
random-effects model. Thirteen RCTs with 1060 children were included.
Regarding arterial cannulation, the ultrasound-guided technique (US) was
associated with a statistically significant increase in successful
cannulation [RR: 1.31 with 95% CI (1.10, 1.56), P < 0.0001], and
first-attempt success [RR: 1.88 with 95% CI (1.35, 2.63), P < 0.0001].
However, US was not associated with any statistically significant
difference in venous cannulation in both outcomes with [RR: 1.13 with 95%
CI (0.98, 1.30), P = 0.10], [RR: 1.53 with 95% CI (0.86, 2.71), P = 0.15]
respectively. Moreover, US was associated with a statistically significant
decrease in the number of attempts either in arterial cannulation with
[MD: - 0.73 with 95% CI (- 1.00, - 0.46), P < 0.0001] or in venous
cannulation with [MD: - 1.34 with 95% CI (- 2.55, - 0.12), P = 0.03], and
the time of attempted cannulation also either in arterial cannulation with
[MD: - 2.27 with 95% CI (- 3.38, - 1.16), P < 0.0001] or in venous
cannulation with [MD: - 4.13 with 95% CI (- 7.06, - 1.19), P < 0.0001]. US
guidance improves successful cannulation rates and first-attempt success
in arterial access and reduces the number of attempts and procedural time
for arterial and venous access. It was also associated with a lower
incidence of complications and procedure failure, particularly in arterial
access. However, it was associated with a higher incidence of venous
puncture. Copyright © The Author(s) 2024.

<13>
Accession Number
2036934949
Title
Cardiac function and mortality of stem cell therapy in patients with
coronary artery disease who underwent coronary artery bypass graft without
heart failure: A meta-analysis.
Source
Biomedical Reports. 23(3) (no pagination), 2025. Article Number: 147. Date
of Publication: 01 Sep 2025.
Author
Jansirirat T.; Khamsai S.; Sawanyawisuth K.
Institution
(Jansirirat, Khamsai, Sawanyawisuth) Department of Medicine, Faculty of
Medicine, Khon Kaen University, Khon Kaen, Thailand
Publisher
Spandidos Publications
Abstract
Coronary artery disease (CAD) is a common disease and can be treated with
coronary artery bypass grafting (CABG) in specific cases. Stem cell
therapy has been shown to be effective in patients with CAD who underwent
CABG in several settings but limited to those without heart failure. The
aim of the present study was to evaluate whether stem cell therapy is
effective in patients with CAD who underwent CABG and had no heart
failure. The present systematic review investigated wether there was any
improvement in cardiac function or reduction of mortality in patients with
CAD who received CABG and did not have heart failure. The types of studies
included in this systematic review were randomized controlled trials. In
total, four databases were used for a systematic search: PubMed, CENTRAL
database, Scopus, and CINAHL Plus. The results were reported as the mean
difference of left ventricular ejection fraction (LVEF) and risk ratio of
mortality rate between stem cell therapy vs. controls. There were 125
studies retrieved from a search in the four aforementioned databases; of
those, seven studies met the study criteria. Regarding the outcome of
cardiac function, the standardized mean difference of LVEF between the
experimental and the control groups was 0.17 (95% CI: -0.09, 0.44). The
risk ratio of mortality was also not statistically significant (1.59; 95%
CI: 0.68, 3.73). Stem cell therapy did not exert significant improvement
of the LVEF or the mortality rate compared with controls, in patients with
CAD who underwent CABG and had no heart failure. Further studies are
required to confirm the results of the present study. Copyright ©
2025 Jansirirat et al.

<14>
Accession Number
2036909391
Title
Methylene blue in the intensive care unit: A comprehensive review article.
Source
Anaesthesia, Pain and Intensive Care. 29(4) (pp 407-417), 2025. Date of
Publication: 01 Jul 2025.
Author
Qutob R.A.
Institution
(Qutob) Department of Internal Medicine, College of Medicine, Imam
Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Methylene blue is a broad and potent therapeutic substance that is
effective in treating various medical conditions in the Intensive Care
Unit (ICU). Methylene blue (MB) has a multitarget mode of action that
involves inhibiting nitric oxide synthase and guanylate cyclase, as well
as serving as a redox agent. This makes it beneficial in treating various
disorders in the intensive care unit, including septic and vasoplegic
shock, methemoglobinemia, and Ifosfamide-induced encephalopathy. This
comprehensive narrative review provides current evidence regarding MB use
in the ICU setting, constituents of the chemical, clinical applications,
its efficacy, safety, dosing, guidelines, actual recommendations for its
usage, and future research directions for use in ICU. MB has demonstrated
enhanced results for people who are critically unwell. However, when using
MB as a supplementary medication, it is important to carefully examine the
dosage and treatment schedule in order to obtain the best possible
clinical outcome. This includes closely monitoring and making necessary
adjustments, especially for patients with conditions such as renal or
hepatic impairment, as well as Glucose-6-Phosphate Dehydrogenase (G6PD)
deficiency. Further research and clinical trials are essential for
expanding the understanding and application of MB in critical
care. Copyright © 2025, Faculty of Anaesthesia, Pain and
Intensive Care, AFMS. All rights reserved.

<15>
Accession Number
2034582372
Title
Prophylactic corticosteroids in neonatal cardiac surgeries using
cardiopulmonary bypass: a systematic review and meta-analysis.
Source
Journal of Anesthesia. 39(4) (pp 577-589), 2025. Date of Publication: 01
Aug 2025.
Author
Kataoka K.; Cheng S.; Sumie M.; Adam R.-I.; Niimi N.; Cunningham J.; Yang
A.; Ng W.C.K.; Hayes J.; Maynes J.T.; Aoyama K.
Institution
(Kataoka, Sumie, Niimi, Ng, Hayes, Maynes, Aoyama) Department of
Anesthesia and Pain Medicine, The Hospital for Sick Children, 555
University Ave, #2211, Toronto, ON, Canada
(Kataoka, Cheng, Sumie, Niimi, Cunningham, Hayes, Maynes, Aoyama) Temerty
Faculty of Medicine, University of Toronto, Toronto, ON, Canada
(Sumie, Yang, Aoyama) Program in Child Health Evaluative Sciences,
SickKids Research Institute, Toronto, ON, Canada
(Sumie) Department of Anesthesiology, St. Mary's Hospital, Fukuoka, Japan
(Sumie) Department of Anesthesiology and Critical Care Medicine, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan
(Adam) Department of Psychology, Queen's University, Kingston, ON, Canada
(Cunningham) The Hospital for Sick Children, Health Sciences Library, 555
University Avenue, Toronto, ON, Canada
(Ng) Department of Anesthesia and Perioperative Care, University of
California, San Francisco, CA, United States
(Maynes) Program in Molecular Medicine, SickKids Research Institute,
Toronto, ON, Canada
Publisher
Springer
Abstract
Purpose: Neonates undergoing cardiopulmonary bypass (CPB) are at a high
risk of a systemic inflammatory response leading to cardiac, respiratory,
and renal dysfunction due to their small body size and insufficient
adrenal stress response. We hypothesized that corticosteroids reduce
systemic inflammatory response and improve clinical outcomes in neonates
undergoing cardiac surgery with CPB. Method(s): A systematic search
was conducted on six databases including MEDLINE from their inceptions to
August 20, 2024. Inclusion criteria were randomized controlled trials
(RCTs) comparing corticosteroids and placebo in neonates undergoing
cardiac surgery with CPB. The primary outcomes were IL-6 and IL-10 serum
levels. The secondary outcomes were postoperative clinical outcomes such
as length of intensive care unit (ICU) stay, mortality, and incidence of
acute kidney injury. Pooled risk ratios or mean differences (MDs) and 95%
confidence intervals (CIs) were calculated using random-effects
meta-analysis. Certainty of evidence were assessed following GRADE. This
study was registered in PROSPERO (CRD42024548217). Result(s): Seven
RCTs met all inclusion criteria, consisting of 316 patients.
Administration of corticosteroids significantly decreased plasma IL-6 on
POD1 (MD -64.21 pg/mL, 95% CI -118.26 to -10.16) and plasma IL-10 on POD1
(MD - 4.60 pg/mL, 95% CI - 8.07 to - 1.12). We confirmed corticosteroids
administration did not improve clinical outcomes. Conclusion(s):
Corticosteroids significantly reduced inflammatory cytokines on POD1.
Routine prophylactic use of corticosteroids is not recommended even in
neonatal cardiac surgery, however, because of high incidence of adrenal
insufficiency in neonates after cardiac surgery with CPB, neonates with
clinically suspected adrenal insufficiency could benefit from
perioperative corticosteroids administration. Copyright © The
Author(s) under exclusive licence to Japanese Society of Anesthesiologists
2025.

<16>
Accession Number
2039664643
Title
Cost-effectiveness of an intraoperative antibacterial envelope in
preventing cardiac implantable device-associated infections: a systematic
review.
Source
Europace. 27(7) (no pagination), 2025. Article Number: euaf121. Date of
Publication: 01 Jul 2025.
Author
Mudigonda S.; Hagarty E.; Lei L.; Rennert-May E.; Joza J.; Exner D.V.;
Andrade J.; Raj S.R.; Chew D.S.
Institution
(Mudigonda, Hagarty, Exner, Raj, Chew) Department of Cardiac Sciences,
Libin Cardiovascular Institute, University of Calgary, 3280 Hospital Dr
NW, Calgary, AB, Canada
(Lei, Andrade) Department of Medicine, University of British Columbia,
Vancouver, BC, Canada
(Rennert-May, Chew) Department of Community Health Sciences, University of
Calgary, 3280 Hospital Dr NW, Calgary, AB, Canada
(Rennert-May, Chew) Department of Medicine, University of Calgary, 3280
Hospital Dr NW, Calgary, AB, Canada
(Rennert-May, Chew) O'Brien Institute for Public Health, University of
Calgary, 3280 Hospital Dr NW, Calgary, AB, Canada
(Rennert-May) Department of Microbiology, Immunology and Infectious
Diseases, University of Calgary, Calgary, AB, Canada
(Joza) Department of Medicine, McGill University, Montreal, QC, Canada
Publisher
Oxford University Press
Abstract
Aims Intraoperative use of an antibacterial envelope during surgery for
cardiac implantable electronic device (CIED) surgery reduces infection
risk at increased procedural costs. The objective of this systematic
review was to synthesize the published economic literature on the
cost-effectiveness of the antibacterial envelope. . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . Methods A systematic
review of the published literature was conducted to identify economic
evaluations (i.e. cost-utility, cost-effectiveness, and results
and cost-benefit studies) comparing the antibacterial envelope compared
with standard of care in preventing post-operative CIED infection.
Systematic review best practices were followed, and study quality was
assessed. Of 142 unique citations, 7 studies met the inclusion criteria
for qualitative synthesis. All cost-effectiveness studies were conducted
from the healthcare payer perspective of high-income countries. The base
case analysis of most economic studies (5/7) reported a cost per
quality-adjusted life year gained that exceeded country-specific societal
thresholds for good value in healthcare. Cost-effectiveness was highly
dependent on the baseline infection risk. That is, at current pricing, the
antibacterial envelope may be cost-effective at base infection rates of
greater than 3%, and cost-savings at infection rates that exceed 6%. . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Conclusion Routine use of an antibacterial envelope in patients
undergoing CIED procedures (implantation or revision) is unlikely to be
cost-effective except among those at high risk for post-operative
infection. Individualized risk assessment may help guide efficient and
value-based use of this technology. Copyright © The Author(s)
2025. Published by Oxford University Press on behalf of the European
Society of Cardiology.

<17>
Accession Number
2035538348
Title
Efficacy and Safety of Transcatheter Therapy for Patients With Tricuspid
Regurgitation: A Systematic Review and Meta-Analysis of Randomized
Controlled Trials.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Mojica J.C.; Dandamudi M.; Rehman T.; Faizan M.A.; Giorgi J.
Institution
(Mojica) University of the East Ramon Magsaysay Medical Center, Quezon
City, Philippines
(Dandamudi) Montefiore Medical Center, Moses Campus, Bronx, NY, United
States
(Rehman, Faizan) Gomal Medical College, Dera Ismail Khan, Pakistan
(Rehman, Faizan) Khyber Medical University, Khyber, Pakistan
(Giorgi) Hospital Sirio Libanes, Sao Paulo, Brazil
(Giorgi) Hospital Albert Einstein, Sao Paulo, Brazil
Publisher
John Wiley and Sons Inc
Abstract
Severe tricuspid regurgitation (TR) is a prevalent valvular disorder
associated with significant morbidity, impaired quality of life, and
increased mortality. This meta-analysis evaluates the safety and efficacy
of transcatheter therapies (TCT) that have emerged as promising
alternatives to surgical intervention, especially in the high-risk
population. This study aimed to assess the safety and clinical outcomes of
TCT compared with optimal medical therapy (OMT) for severe TR. Multiple
databases, including MEDLINE, Embase, Scopus, and ClinicalTrials.gov were
searched from inception to March 2025. We assessed the clinical outcomes
of TCT compared with OMT using mean difference (MD) and risk ratio (RR)
with 95% confidence intervals (CI) and I2 for heterogeneity.
Outcomes included all-cause mortality (ACM), cardiovascular death (CV
death), heart failure hospitalizations (HFH), cardiac remodeling,
functional capacity, and quality of life score. We included four RCTs of
TCT on severe TR versus OMT, involving 1292 patients, of whom 710 (55%)
underwent TCT. In the pooled analysis, ACM was not affected by the
intervention therapy compared to OMT (RR = 1.12; 95% CI 0.65-1.93; p =
0.54), nor were CV death (RR = 0.87; 95% CI 0.50-1.51; p = 0.49), stroke
(RR = 1.54; 95% CI 0.27-8.76; p = 0.39), and HFH (RR = 0.86; 95% CI
0.61-1.22; p = 0.21). However, secondary outcomes were robustly affected
in the TCT group, as demonstrated by the six-minute walk distance test
(6MWD) (MD = 33.55 m; 95% CI 17.04-50.07; p < 0.01) and the Kansas City
cardiomyopathy questionnaire (KCCQ) (MD = 14.46; 95% CI 11.42-17.49; p <
0.01). In high-risk patients with severe TR, TCT effectively improves
functional status and enhances quality of life compared with OMT, while
survival benefits remain unproven. Copyright © 2025 Wiley
Periodicals LLC.

<18>
Accession Number
2035455446
Title
Evaluating the Efficacy and Impact of Home-Based Cardiac
Telerehabilitation on Health-Related Quality of Life (HRQOL) in Patients
Undergoing Percutaneous Coronary Intervention (PCI): A Systematic Review.
Source
Journal of Clinical Medicine. 14(14) (no pagination), 2025. Article
Number: 4971. Date of Publication: 01 Jul 2025.
Author
Limonti F.; Gigliotti A.; Cecere L.; Varvaro A.; Bosco V.; Mazzotta R.;
Gravante F.; Ramacciati N.
Institution
(Limonti, Bosco, Mazzotta) Department of Biomedicine and Prevention,
University of Rome Tor Vergata, Rome, Italy
(Gigliotti) Department of Health and Exercise Science, The University of
Oklahoma, Norman, OK, United States
(Cecere) Department of Anesthesia and Resuscitation, A.O.R.N. Antonio
Cardarelli, Naples, Italy
(Varvaro) Department of Medicine and Cardiology, Provincial Healt
Authority of Trapani, Trapani, Italy
(Gravante) Department of Anesthesia, Local Health Authority of Caserta,
Caserta, Italy
(Ramacciati) Department of Pharmacy, Health and Nutritional Sciences
(DFSSN), University of Calabria, Rende, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Introduction: Home-based cardiac telerehabilitation (HBCTR) is a
multidisciplinary intervention aimed at optimizing functional,
psychological, and social recovery in patients undergoing percutaneous
coronary intervention (PCI). This rehabilitation model serves as an
effective alternative to traditional center-based rehabilitation,
providing a cost-effective and clinically advantageous approach.
 Method(s): Following PRISMA guidelines, we conducted a systematic
literature search across multiple databases (PubMed, CINAHL, Cochrane,
Scopus, Web of Science). We included randomized controlled trials (RCTs),
cohort, and observational studies assessing telerehabilitation in post-PCI
patients. Primary outcomes focused on health-related quality of life
(HRQoL) and adherence, while secondary outcomes included functional
capacity (6 min walk test, VO<inf>2</inf>max), cardiovascular risk factor
control, and psychological well-being. Risk of bias was assessed using the
Cochrane RoB 2.0 and ROBINS-I tools. Result(s): A total of 3575
articles were identified after removing duplicates, of which 877 were
selected based on title and abstract, and 17 met the inclusion criteria,
with strong RCT representation ensuring robust evidence synthesis. HBCTR
was associated with significant improvements in exercise capacity, with
increases in VO<inf>2</inf>max ranging from +1.6 to +3.5 mL/kg/min and in
6 min walk distance from +34.7 to +116.6 m. HRQoL scores improved
significantly, with physical and mental component scores increasing by
+6.75 to +14.18 and +4.27 to +11.39 points, respectively. Adherence to
telerehabilitation programs was consistently high, often exceeding 80%,
and some studies reported reductions in hospital readmissions of up to
40%. Wearable devices and smartphone applications facilitated
self-monitoring, enhancing adherence and reducing readmissions. Several
studies also highlighted improvements in anxiety and depression scores
ranging from 10% to 35%. Conclusion(s): HBCTR is a promising strategy
for rehabilitation and quality-of-life improvement after PCI. It offers a
patient-centered solution that leverages technology to enhance long-term
outcomes. By integrating structured telerehabilitation programs,
healthcare systems can expand accessibility, promote adherence, and
improve equity in cardiovascular care. Copyright © 2025 by the
authors.

<19>
Accession Number
2035548834
Title
Parvovirus B19-associated myocarditis in children: A systematic review of
clinical features, management and outcomes.
Source
European Journal of Clinical Investigation. (no pagination), 2025. Date
of Publication: 2025.
Author
Veronese G.; Colombo G.; Garascia A.; Adorisio R.; Bonanomi E.; Ammirati
E.
Institution
(Veronese, Bonanomi) Pediatric Intensive Care Unit, ASST Papa Giovanni
XXIII, Bergamo, Italy
(Veronese) Department of Cardiothoracic Surgery, Heart and Vascular
Centre, Maastricht University Medical Centre, Maastricht, Netherlands
(Colombo, Garascia, Ammirati) De Gasperis Cardio Center, Niguarda
Hospital, Milan, Italy
(Adorisio) Heart Failure, Transplant and Mechanical Assist Device Unit,
IRCCS Bambino Gesu Children's Hospital, Rome, Italy
(Ammirati) University of Milan-Bicocca, School of Medicine and Surgery,
Monza, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: Parvovirus B19 (PVB19) has emerged as a relevant etiologic
agent of paediatric myocarditis, particularly during recent
epidemiological surges in Europe and the United States. Despite increasing
recognition, current knowledge remains fragmented, and standardised
diagnostic and therapeutic strategies are lacking. Method(s): We
conducted a systematic review of the literature up to May 2025, including
40 studies encompassing 53 individual case reports, 107 patients from
registry-based cohorts, and 4 tissue-based investigations. Result(s):
Clinical presentation was frequently fulminant, with cardiogenic shock,
severe left ventricular dysfunction, and need for mechanical circulatory
support in up to 47% of cases. Mortality rates ranged from 10% to 30%,
with heart transplantation rates varying between 5% and 42% across
cohorts. Diagnosis relied primarily on blood polymerase chain reaction
(PCR), while serology showed limited diagnostic utility. Histological
confirmation via endomyocardial biopsy (EMB) was variably applied across
studies, and myocardial viral load quantification was reported in only one
study. Case series and cohort studies confirmed early age of onset (median
16-24 months), respiratory or gastrointestinal prodromes, and poor
outcomes in fulminant presentations. Tissue-based studies revealed high
myocardial PVB19 loads in acute myocarditis, particularly in infants, but
also demonstrated viral persistence in asymptomatic individuals,
complicating causal inference. Immunomodulatory therapy was administered
in up to 58% of cases, although its clinical impact remains uncertain due
to heterogeneity in treatment protocols. No antiviral treatments have been
evaluated to date. Conclusion(s): These findings highlight the need
for standardised diagnostic criteria incorporating PCR, serology, imaging,
and, where appropriate, EMB and viral load assessment. Given recent
epidemiologic surges and high morbidity, prospective multicentre studies
and surveillance efforts are urgently required to refine clinical
algorithms and improve outcomes in paediatric PVB19
myocarditis. Copyright © 2025 The Author(s). European Journal of
Clinical Investigation published by John Wiley & Sons Ltd on behalf of
Stichting European Society for Clinical Investigation Journal Foundation.

<20>
Accession Number
368260163
Title
Shah et al. Induction chemoradiation is not superior to induction
chemotherapy alone in stage IIIA lung cancer. Annals of Thoracic Surgery
2012. (9).
Source
International Journal of Radiation Oncology Biology Physics. 85(3) (pp
572-574), 2013. Date of Publication: 01 Mar 2013.
Author
Machtay M.; Schipper M.; Kong F.-M.
Institution
(Machtay, Schipper) Department of Radiation Oncology and Biostatistics,
University of Michigan, United States
Publisher
Elsevier Inc.

<21>
Accession Number
2038133250
Title
Cardiac Surgery 2024 Reviewed.
Source
Thoracic and Cardiovascular Surgeon. 73(5) (pp 332-345), 2025. Date of
Publication: 27 Mar 2025.
Author
Kirov H.; Caldonazo T.; Mukharyamov M.; Toshmatov S.; Fleckenstein P.;
Kyashif T.; Siemeni T.; Doenst T.
Institution
(Kirov, Caldonazo, Mukharyamov, Toshmatov, Fleckenstein, Kyashif, Siemeni,
Doenst) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University of Jena, University Hospital Jena, Jena,
Germany
Publisher
Georg Thieme Verlag
Abstract
For the 11th consecutive time, we systematically reviewed the
cardio-surgical literature for the past year (2024), using the PRISMA
approach for a results-oriented summary. In 2024, the discussion on the
value of randomized and registry evidence increased, triggered by
consistent findings in the field of coronary artery disease (CAD) and
discrepant results in structural heart disease. The literature in 2024
again confirmed the excellent long-term outcomes of CABG compared with PCI
in different scenarios, generating further validation for the CABG
advantage reported in randomized studies. This has been reflected in the
new guidelines for chronic CAD in 2024. Two studies indicate novel
perspectives for CABG, showing that cardiac shockwave therapy in CABG
improves myocardial function in ischemic hearts and that CABG guided by
computed tomography is safe and feasible. For aortic stenosis, an early
advantage for transcatheter (TAVI) compared with surgical (SAVR) treatment
has found more support; however, long-term TAVI results keep being
challenged, this year by new FDA and registry data in favor of SAVR. For
failed aortic valves, redo-SAVR showed superior results compared with
valve-in-valve TAVI. In the mitral field, studies showed short-term
noninferiority for transcatheter treatment compared with surgery for
secondary mitral regurgitation (MR), and significant long-term survival
benefit in registries with surgery for primary MR. Finally, surgery was
associated with better survival compared with medical therapy for acute
type A aortic intramural hematoma. This article summarizes publications
perceived as important by us. It cannot be complete nor free of individual
interpretation but provides up-to-date information for patient-specific
decision-making. Copyright © 2025 Georg Thieme Verlag. All rights
reserved.

<22>
Accession Number
2035453732
Title
Total Arch Replacement with Ascyrus Medical Dissection Stent Versus Frozen
Elephant Trunk in Acute Type A Aortic Dissection: A Meta-Analysis.
Source
Journal of Clinical Medicine. 14(14) (no pagination), 2025. Article
Number: 5170. Date of Publication: 01 Jul 2025.
Author
Baudo M.; Rosati F.; D'Alonzo M.; Fiore A.; Muneretto C.; Benussi S.; Di
Bacco L.
Institution
(Baudo) Department of Cardiac Surgery Research, Lankenau Institute for
Medical Research, Main Line Health, Wynnewood, PA, United States
(Rosati, Muneretto, Benussi, Di Bacco) Department of Cardiac Surgery,
Spedali Civili di Brescia, University of Brescia, Brescia, Italy
(D'Alonzo) Department of Cardiac Surgery, Poliambulanza Hospital Brescia,
Brescia, Italy
(Fiore) Department of Cardiac Surgery, Hopitaux Universitaires Henri
Mondor, Assistance Publique-Hopitaux de Paris, Creteil, France
(Fiore) CEpiA Team, IMRB U955, Inserm, Universite Paris Est Creteil,
Creteil, France
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Acute Stanford Type A aortic dissection (ATAAD) often requires
total arch replacement (TAR) with frozen elephant trunk (FET) to address
entry tears and support aortic remodeling. In select cases, AMDS may
provide a simpler option. The present meta-analysis aims to compare
surgical outcomes between these two approaches. Method(s): A
comprehensive search in the Pubmed, ScienceDirect, SciELO, DOAJ, and
Cochrane library databases was performed until February 2025. We included
studies that reported the outcomes of patients with ATAAD undergoing TAR
with AMDS or FET. To enable a meaningful comparison, we only included FET
studies where patients met the same inclusion criteria as those with the
AMDS. Result(s): Thirty-eight articles met our inclusion criteria,
with a total of 319 patients in the AMDS group and 4129 in the FET group.
Patients undergoing an AMDS procedure experienced significantly higher
bleeding requiring surgery (21.2% vs. 6.4%, p < 0.001) and a higher
hospital mortality (14.5% vs. 10.0%, p = 0.037) compared to FET. The
individual patient data of 1411 patients were constructed. Overall
survival at 1 and 3 years was 81.9% +/- 3.3% vs. 88.8% +/- 0.9% and 81.9%
+/- 3.3% vs. 85.2% +/- 1.0% between AMDS and FET, respectively. A flexible
parametric survival model demonstrated a significant mortality drawback
for AMDS compared to FET up to 31 days, beyond which the difference was no
longer evident. Conclusion(s): The comparison between AMDS and FET
for ATAAD treatment remains debated, with FET favored for its lower
mortality and stronger long-term evidence. AMDS, as a newer technique,
shows promise but lacks sufficient data to confirm its safety and
efficacy. Copyright © 2025 by the authors.

<23>
Accession Number
2039774247
Title
The Cusp Overlap Technique Reduces Pacemaker Implantation in TAVR: A
Systematic Review and Meta-analysis.
Source
American Journal of Cardiology. 254 (pp 75-84), 2025. Date of Publication:
01 Nov 2025.
Author
Hazique M.; Jafar Z.; Lohana S.; Reyaz I.; Burhan M.; Narayan R.; Alraies
M.C.
Institution
(Hazique, Lohana) Department of Internal Medicine, Nuvance Health/Vassar
Brothers Medical Center, Poughkeepsie, NY, United States
(Jafar, Narayan) Department of Cardiology, Nuvance Health/Vassar Brothers
Medical Center, Poughkeepsie, NY, United States
(Reyaz) Department of Internal Medicine, Christian Medical College,
Ludhiana, India
(Burhan) Department of Internal Medicine, Rawalpindi Medical University,
Rawalpindi, Pakistan
(Alraies) Department of Cardiology, Detroit Medical Center, Michigan,
United States
Publisher
Elsevier Inc.
Abstract
Transcatheter aortic valve replacement (TAVR) has become the preferred
treatment for symptomatic aortic stenosis, yet conduction disturbances
leading to permanent pacemaker implantation (PPI) remain a significant
complication, particularly with self-expanding valves (SEVs). The cusp
overlap view (COV) technique has been introduced to achieve a higher, more
controlled valve implantation compared to the conventional coplanar view
(CPV). We performed a systematic review and meta-analysis (14 studies;
5,266 TAVR patients) comparing the COV to the CPV. Data were pooled using
the DerSimonian-Laird random-effects model with I2 for heterogeneity. The
analysis demonstrated that the COV technique was associated with
significantly lower PPI rates (11.2% vs 17.7%; OR = 0.63; p <0.0001).
Additionally, patients in the COV group experienced a significantly
shorter hospital stay (SMD = -0.56; p = 0.016) and a modestly lower mean
transvalvular gradient (SMD = -0.10; p = 0.049). Although the depth
measured from the non-coronary cusp did not differ significantly between
groups, the arithmetic mean distance from the non-coronary and left
coronary cusps was significantly lower in the COV group (SMD = -0.21; p
<0.001), indicating a higher valve position. Our meta-analysis suggests
that the cusp overlap technique significantly reduces PPI rates and
improves procedural outcomes in TAVR with SEVs. In conclusion, these
findings suggest that COV not only enhances patient outcomes by reducing
conduction disturbances and shortening hospital stays but also optimizes
healthcare resource utilization. Future randomized controlled trials are
needed to confirm these benefits and further standardize TAVR protocols in
clinical practice. Copyright © 2025 Elsevier Inc.

<24>
Accession Number
2031154413
Title
Comparative Efficacy of Colchicine and Intensive Low-density Lipoprotein
Cholesterol Lowering in Patients with Atherosclerotic Diseases receiving
Statins: A Network Meta-analysis of Randomized Controlled Trials.
Source
Cardiovascular Drugs and Therapy. 39(4) (pp 811-822), 2025. Date of
Publication: 01 Aug 2025.
Author
Ou Z.; Wang F.; Chen Y.; Liu X.; Ran B.; Yin Y.; Cui K.
Institution
(Ou, Wang, Ran, Cui) Department of Cardiology, Chongqing General Hospital
of Chongqing University, Chongqing, China
(Ou, Wang, Ran, Cui) Department of Cardiology, Chongqing General Hospital,
No. 118 Xingguang Avenue, Liangjiang New Area, Chongqing, China
(Chen, Yin) Department of Cardiology, The Second Affiliated Hospital of
Chongqing Medical University, Chongqing, China
(Liu) Department of Cardiology, Graduate School of Medicine, Keio
University, Tokyo, Japan
Publisher
Springer
Abstract
Aims: Adding intensive low-density lipoprotein cholesterol
(LDL-C)-lowering agents or colchicine to statin has been shown to result
in additional cardiovascular benefits for patients with atherosclerotic
cardiovascular diseases (ASCVD). We aimed to compare the efficacy and
safety of these supplementary agents in patients with ASCVD receiving
statin. Method(s): We performed a systematic review and frequentist
network meta-analysis of randomized controlled trials. The primary
efficacy endpoint was the main adverse cardiovascular event (MACE), and
the secondary efficacy endpoints were myocardial infarct, stroke, coronary
revascularization, cardiovascular death, and all-cause mortality,
respectively. The safety endpoints were treatment discontinuation and
non-cardiovascular death. We obtained estimates for efficacy outcomes and
safety endpoints and presented these estimates as risk ratio (RR) with 95%
confidence intervals. We ranked the comparative efficacy and safety of all
drugs with P-scores. Result(s): Seventeen trials totaling 85,823
participants treated with colchicine (5926 participants), intensive LDL-C
lowering (37,854 participants) via proprotein convertase subtilisin/kexin
type 9 (PCSK9) inhibitor, Niemann-Pick C1-like 1 protein (NPC1L1)
inhibitor or ATP citrate lyase (ACL) inhibitor, or statin alone (42,043
participants) were included. Colchicine was associated with a greater
reduction in the risk of MACE (RR 0.72, 0.69-0.91), stroke (RR 0.55,
0.33-0.92), and coronary revascularization (RR 0.73, 0.60-0.90) compared
with NPC1L1 inhibitor, and it provided a larger reduction in the risk of
MACE (RR 0.79, 0.69-0.91) compared to PCSK9 inhibitor. However, colchicine
was associated with increased risk of non-cardiovascular death compared
with NPC1L1 inhibitor (RR 1.48, 1.04-2.10) and PCSK9 inhibitor (RR 1.57,
1.08-2.27). Although no regimen prolonged survival, colchicine had worse
performance on non-cardiovascular death and all-cause mortality.
 Conclusion(s): In patients with ASCVD receiving statin, colchicine
seems to be more effective than intensive LDL-C-lowering therapy with
PCSK9 inhibitor or NPC1L1 inhibitor for cardiovascular prevention.
However, using colchicine as an alternative to intensive LDL-C-lowering
therapy may need to be weighed against the cardiovascular benefits and the
potential harms of higher non-cardiovascular death. Trial Registration:
PROSPERO Identifier: CRD42023441385 Copyright © The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2024.

<25>
Accession Number
2039065684
Title
Continuous Erector Spinae Plane Block Reduces Hospital Length of Stay
After Minimally Invasive Cardiac Surgery: Preliminary Meta-Analytic
Insights.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(9) (pp 2546-2549),
2025. Date of Publication: 01 Sep 2025.
Author
Dost B.; Karapinar Y.E.; Ozkal Yalin M.S.; De Cassai A.
Institution
(Dost) Department of Anesthesiology and Reanimation, Ondokuz Mayis
University Faculty of Medicine, Samsun, Turkey
(Karapinar, Ozkal Yalin) Department of Anesthesiology and Reanimation,
Ataturk University School of Medicine, Erzurum, Turkey
(De Cassai) Department of Medicine (DIMED), University of Padua, Padua,
Italy
(De Cassai) Institute of Anesthesia and Intensive Care Unit, University
Hospital of Padua, Padua, Italy
Publisher
W.B. Saunders

<26>
Accession Number
2039799763
Title
The association between diabetes mellitus and postoperative cognitive
dysfunction: a systematic review and meta-analysis.
Source
International Journal of Surgery. 111(3) (pp 2633-2650), 2025. Date of
Publication: 01 Mar 2025.
Author
Liu H.; Chen J.; Ling J.; Wu Y.; Yang P.; Liu X.; Liu J.; Zhang D.; Yin
X.; Yu P.; Zhang J.
Institution
(Liu) Jiujiang Clinical Precision Medicine Research Center, Jiujiang,
China
(Liu) The First Clinical Medical College, Jiangxi Medical College,
Nanchang University, Nanchang, Jiangxi, China
(Chen) School of Stomatology, Jiangxi Medical College, Nanchang
University, Nanchang, Jiangxi, China
(Ling, Wu, Yang, Liu, Yu) Department of Endocrinology and Metabolism, The
Second Affiliated Hospital, Jiangxi Medical College, Nanchang University,
Nanchang, Jiangxi, China
(Liu) Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen
University, Guangzhou, China
(Zhang) Food and Nutritional Sciences, School of Biological Sciences, The
University of Hong Kong, Hong Kong
(Zhang, Yin) Department of Neurology, Clinical Medical School of Jiujiang
University, Jiangxi, Jiujiang, China
(Zhang, Yin, Zhang) Jiujiang Clinical Precision Medicine Research Center,
Jiangxi, Jiujiang, China
(Zhang) Department of Anesthesiology, The Second Affiliated Hospital,
Jiangxi Medical College, Nanchang University, Jiangxi, Nanchang, China
Publisher
Wolters Kluwer Health Inc
Abstract
Background: Postoperative cognitive dysfunction (POCD) is a typical
consequence following surgery, particularly in cardiac surgeries. Despite
its high incidence, the underlying etiology remains unclear. While
diabetes mellitus (DM) has been associated with cognitive impairment, its
specific function in POCD development remains unidentified. This study
aims to evaluate the connection between DM and the risk of POCD.
 Method(s): We conducted a comprehensive search of PubMed, Embase, Web
of Science, and the Cochrane Library databases for studies of DM and risk
with POCD, collecting data up to 14 September 2023. We assessed
publication bias, heterogeneity, and study quality, adhering to PRISMA and
AMSTAR guidelines. Result(s): Our study comprised 38 trials involving
8748 individuals, with 7734 patients undergoing follow-up. The pooled
results showed that individuals with DM had an increased incidence of POCD
compared to nondiabetic individuals (RR: 1.44, 95% CI: 1.26-1.65). The
incidence of POCD was significantly higher in the group of patients with
an average age older than 65 years (RR: 1.69, 95% CI: 1.30-2.20) compared
with diabetic patients with an average age younger than 65 years (RR:
1.29, 95% CI: 1.09-1.64). Compared with diabetic patients undergoing
cardiac surgery (RR: 1.33, 95% CI: 1.15-1.53), patients receiving
non-cardiac surgery showed a greater incidence of POCD (RR: 2.01, 95% CI:
1.43-2.84). Conclusion(s): Current evidence underscores that diabetic
patients face a significantly higher risk of POCD compared to their
nondiabetic counterparts. Further research is warranted to clarify the
precise mechanisms of this relationship and explore potential preventive
strategies for diabetic patients. Copyright © 2025 The Author(s)

<27>
Accession Number
2035453788
Title
Surgical Management Strategies for Pericardial Effusion-A Systematic
Review.
Source
Journal of Clinical Medicine. 14(14) (no pagination), 2025. Article
Number: 4985. Date of Publication: 01 Jul 2025.
Author
Qasba R.K.; Cangut B.; Alhazmi A.; Naseer J.; Mubasher A.; Talapaneni S.;
Fatima M.; Nasir A.; Shafqat S.; Avilala S.; Hameed I.
Institution
(Qasba, Alhazmi, Naseer, Mubasher, Talapaneni, Fatima, Nasir, Shafqat,
Avilala, Hameed) Division of Cardiac Surgery, Department of Surgery, Yale
University School of Medicine, New Haven, CT, United States
(Cangut) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Objectives: Pericardial effusion is the accumulation of excess fluid in
the pericardial sac. The etiology is multi-factorial and different
techniques are used for management, including subxiphoid approaches,
anterior and lateral thoracotomies, video-assisted thoracic surgery
(VATS), and percutaneous pericardiocentesis. We evaluate the surgical
management strategies for pericardial effusion and their outcomes in this
systematic review. Method(s): A systematic literature review was
performed to identify studies on the surgical management of pericardial
effusion from inception to February 2024 using PubMed, Cochrane, and
Scopus. Articles were independently assessed by two reviewers, with
discrepancies resolved by the senior author. Articles were considered for
inclusion if they described different pericardial effusion surgical
management techniques. Baseline patient characteristics and procedural and
outcome variables were extracted. Result(s): A total of 27 studies
comprising 2773 patients were evaluated. The median age was 56.2 years
(interquartile range 47-62.2). The most common etiologies of pericardial
effusion were malignancy (31.0%), post-cardiac surgery (18.7%), and
idiopathic (15.4%). Other causes included uremia (9.6%), infection (9.6%),
and autoimmune disease (4.2%). The subxiphoid pericardial window was the
most common approach (82.6%), followed by anterior and lateral thoracotomy
(12.0%), and median sternotomy (0.6%). At median follow-up of 24 months,
the most frequent post-procedural complications were recurrence of
effusion (10.5%), arrhythmias (2.7%), and pneumonia (0.7%).
 Conclusion(s): Subxiphoid pericardial window is the most common
approach for draining pericardial effusions. Prognosis depends on both the
underlying etiology and the chosen drainage strategy. Treatment should be
tailored to individual patients, considering patient comorbidities and the
specific etiology. Copyright © 2025 by the authors.

<28>
Accession Number
2035434743
Title
A systematic review and network meta-analysis of cardiovascular safety of
benzbromarone compared to febuxostat and allopurinol in patients with
gout.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1541307. Date of Publication: 2025.
Author
Lin T.-S.; Lin Y.-L.; Hsu C.-H.; Hsieh S.-C.; Shau W.-Y.; Yang W.-S.; Chen
C.-L.
Institution
(Lin, Lin, Hsu, Shau, Yang, Chen) Graduate Institute of Clinical Medicine,
College of Medicine, National Taiwan University, Taipei, Taiwan (Republic
of China)
(Lin) Division of Allergy, Immunology and Rheumatology, Department of
Internal Medicine, National Taiwan University Hospital Bei-Hu Branch,
Taipei, Taiwan (Republic of China)
(Lin) Division of Cardiology, Department of Internal Medicine, National
Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan (Republic of
China)
(Hsu) Division of Neurosurgery, Department of Surgery, National Taiwan
University Hospital, Taipei, Taiwan (Republic of China)
(Hsieh) Division of Allergy, Immunology and Rheumatology, Department of
Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
(Republic of China)
(Yang) Division of Endocrinology and Metabolism, Department of Internal
Medicine, National Taiwan University Hospital, Taipei, Taiwan (Republic of
China)
(Chen) Department of Surgery, National Taiwan University Hospital, Taipei,
Taiwan (Republic of China)
(Chen) Graduate Institute of Epidemiology and Preventive Medicine, College
of Public Health, National Taiwan University, Taipei, Taiwan (Republic of
China)
Publisher
Frontiers Media SA
Abstract
Background: Gout is caused by hyperuricemia and is associated with
cardiovascular diseases. Treatment for hyperuricemia primarily involves
urate-lowering medications. Some trials showed higher cardiovascular
mortality rates with febuxostat compared to allopurinol in gout patients.
However, data on the cardiovascular safety of benzbromarone compared to
allopurinol is limited, and there is no data comparing benzbromarone to
febuxostat. This study aims to assess the cardiovascular safety of
benzbromarone, febuxostat, and allopurinol in gout patients.
 Method(s): A comprehensive search was conducted across PubMed and
EMBASE from their inception to August 2024. Inclusion criteria were
randomized controlled trials (RCTs) and cohort studies including adult
patients with the diagnosis of gout, with urate-lowering medications. The
outcome was the incidence of major adverse cardiovascular events. This
systematic review and network meta-analysis were recorded in INPLASY with
the ID INPLASY202460049. Result(s): A total of 176 studies were
identified through the database search. There were 119 articles identified
in EMBASE and 57 articles identified in PubMed. Following screening and
review, 17 qualified studies (5 RCTs) were included in the network
meta-analysis. The relative cardiovascular event risk (risk ratio, RR) for
benzbromarone compared to febuxostat is 0.82 (95% CI 0.61-1.09), and for
benzbromarone compared to allopurinol, the RR is 0.87 (95% CI 0.75-1.01).
The RR for febuxostat compared to allopurinol is 1.08 (95% CI 0.97-1.20).
 Conclusion(s): Our network meta-analysis suggests a subtle trend
indicating a lower risk of cardiovascular events for benzbromarone
compared to both febuxostat and allopurinol in gout patients, although not
statistically significant. Systematic Review Registration:
https://inplasy.com/inplasy-2024-6-0049/, identifier
INPLASY202460049. Copyright 2025 Lin, Lin, Hsu, Hsieh, Shau, Yang and
Chen.

<29>
Accession Number
2032959619
Title
Mesenchymal stem cells and thermal annular procedures for discogenic pain:
a systematic review with pooled analysis.
Source
Pain Management. 14(2) (pp 101-114), 2024. Date of Publication: 2024.
Author
DesRochers J.; DesRochers R.; Patel D.; Andruszka C.; Manchanda S.;
Ernazarov A.; Mobley A.
Institution
(DesRochers, DesRochers, Patel, Andruszka, Manchanda, Ernazarov)
Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, United States
(Mobley) Rowan Medicine NeuroMusculoskeletal Institute, Stratford, NJ,
United States
Publisher
Taylor and Francis Ltd.
Abstract
Aim: Compare the effectiveness of mesenchymal stem cell injection
therapies (MSC) and thermal annular procedures for the treatment of
discogenic lower back pain. Material(s) and Method(s): A systematic
review was performed following PRISMA 2020 guidelines. Pooled analysis was
performed using patients' pain scores at baseline and at 12 months
post-intervention. Result(s): Effect sizes based on change in pain
score from baseline to 12 month follow-up revealed clinically significant
improvement in pain score across all interventions. Conclusion(s):
Minimally invasive interventions provide meaningful relief in discogenic
back pain, with results suggesting promise for MSC injection therapies as
a treatment model. Copyright © 2024 Expert Publishing Medicine
Ltd trading as Taylor & Francis.

<30>
Accession Number
2038872365
Title
Hemodynamic Impact of Cipepofol vs Propofol During Anesthesia Induction in
Patients With Severe Aortic Stenosis: A Randomized Clinical Trial.
Source
JAMA Surgery. 160(7) (pp 763-770), 2025. Date of Publication: 09 Jul 2025.
Author
Ni T.; Zhou X.; Wu S.; Lv T.; Hu Y.; Gao Q.; Luo G.; Xie C.; Zou J.; Chen
Y.; Zhao L.; Xiao J.; Tao X.; Yi Y.; Xu Z.; Wang T.; Zhou J.; Yao Y.; Yan
M.
Institution
(Ni, Zhou, Wu, Hu, Gao, Luo, Xie, Zou, Chen, Zhao, Xiao, Tao, Yi, Xu,
Wang, Zhou, Yao, Yan) Department of Anesthesiology, The Second Affiliated
Hospital of Zhejiang University, School of Medicine, Hangzhou, China
(Lv) Department of Anesthesiology, The Fourth Affiliated Hospital of
Zhejiang University, School of Medicine, Yiwu City, China
Publisher
American Medical Association
Abstract
Importance: Postinduction hemodynamic instability is a frequent
complication among patients with severe aortic stenosis (AS). Using
cipepofol as the anesthesia agent may reduce the incidence and severity of
hemodynamic instability. Objective(s): To assess whether cipepofol
outperforms propofol in maintaining postinduction hemodynamic stability in
patients with AS. Design, Setting, and Participant(s): This
single-center, randomized clinical trial was conducted from June 29, 2023,
to July 8, 2024, at the Second Affiliated Hospital of Zhejiang University
School of Medicine in China. Patients with AS scheduled for transcatheter
aortic valve replacement (TAVR) were eligible for inclusion.
 Intervention(s): Participants were randomized 1:1 to receive either
cipepofol or propofol as anesthesia induction agents at equipotent doses.
 Main Outcomes and Measures: The primary outcome was the area under
the curve (AUC) of the mean arterial pressure (MAP) difference from
baseline during the initial 15 minutes postinduction. Result(s): A
total of 124 patients with AS scheduled for TAVR were randomized into
either the cipepofol group (n = 62) or the propofol group (n = 62). Of 124
patients randomized, 1 patient from each group was excluded due to
ineligibility for the TAVR procedure, and data were analyzed for 122
patients (61 patients per group) based on the intention-to-treat
principle. Among 122 total patients, mean (SD) age was 72.2 (5.0) years,
and 53 patients (43.4%) were female. The cipepofol group exhibited a
significantly smaller median (IQR) AUC (-8505.0 mm Hg . s [-12402.8 to
-5130.0]) compared with the propofol group (-13189.0 mm Hg . s [-17006.7
to -7593.3]; P <.001). Moreover, compared with the propofol group, the
cipepofol group demonstrated a significantly lower incidence of
postinduction hypotension (70.5% vs 88.5%; P =.01) and required a smaller
median (IQR) dose of norepinephrine during the first 15 minutes
postinduction (6.0 mug [0.0-10.0] vs 10.0 mug [5.0-20.0]; P =.006).
Additionally, the 2 groups' bispectral indices were comparable.
 Conclusions and Relevance: In this randomized clinical trial,
cipepofol provided superior hemodynamic stability as an induction agent
compared to propofol at equipotent doses and similar anesthesia depths for
patients with AS. Therefore, cipepofol could serve as an alternative
induction agent to propofol for patients at high cardiovascular
risk. Copyright © 2025 American Medical Association. All rights
reserved.

<31>
Accession Number
2035472332
Title
Surgical vs. Medical Management of Infective Endocarditis Following TAVR:
A Systematic Review and Meta-Analysis.
Source
Journal of Cardiovascular Development and Disease. 12(7) (no pagination),
2025. Article Number: 263. Date of Publication: 01 Jul 2025.
Author
Magouliotis D.E.; Sicouri S.; Baudo M.; Cabrucci F.; Yamashita Y.; Ramlawi
B.
Institution
(Magouliotis, Sicouri, Baudo, Cabrucci, Yamashita, Ramlawi) Department of
Cardiac Surgery Research, Lankenau Institute for Medical Research, Main
Line Health, Wynnewood, PA, United States
(Baudo, Yamashita, Ramlawi) Department of Cardiac Surgery, Lankenau Heart
Institute, Main Line Health, Wynnewood, PA, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Infective endocarditis after transcatheter aortic valve
replacement (TAVR-IE) is a rare but severe complication associated with
high morbidity and mortality. The optimal treatment strategy-surgical
explantation versus medical therapy-remains uncertain, particularly given
the technical demands of TAVR removal and the advanced age of many
affected patients. Method(s): We conducted a systematic review and
meta-analysis of studies comparing the surgical and medical management of
TAVR-IE. Primary outcomes included 30-day mortality and 1-year survival.
Secondary analyses explored microbiological profiles, patient
demographics, prosthesis type, postoperative complications, and surgical
indications. A qualitative synthesis of surgical explantation techniques
and reconstructive strategies was also performed based on recent consensus
recommendations. Result(s): Three studies comprising 1557 patients
with TAVR-IE were included; 155 (10.0%) underwent surgical treatment.
Thirty-day mortality was comparable between groups (surgical: 9.7%;
medical: 8.4%), while the pooled odds ratio for one-year survival did not
reach statistical significance (OR: 1.91, 95% CI: 0.36-10.22;
I2 = 88%). However, single-center outcomes demonstrated
markedly improved survival with surgery (96% vs. 51%). The most common
surgical indications included severe valvular dysfunction (50.3%), aortic
root abscess (26.5%), and large vegetations (21.3%), in line with current
guideline recommendations. Postoperative complications included acute
renal failure (10%) and longer hospitalizations (19.8 vs. 18 days),
although these were not statistically different. Contemporary explant
strategies-such as the Double Kocher, Tourniquet, and Y-incision aortic
enlargement techniques-were highlighted as critical tools for surgical
success. Conclusion(s): While underutilized, surgical intervention
for TAVR-IE may offer significant survival benefits in select patients,
particularly when guided by established indications and performed at
high-volume centers. Outcomes depend heavily on timing, surgical
expertise, and appropriate patient selection. As TAVR expands to younger
populations, TAVR-IE will become increasingly relevant, necessitating
early multidisciplinary involvement and broader familiarity with advanced
explant techniques among cardiac surgeons. Copyright © 2025 by
the authors.

<32>
Accession Number
2039701119
Title
EFFECTS OF IMPROVED ULTRAFILTRATION ON SERUM LEVEL OF IL-6 AND TNF-alpha,
HCT, AND CARDIOPULMONARY FUNCTION IN PATIENTS WITH EXTRACORPOREAL
CIRCULATION IN VALVE REPLACEMENT.
Source
Journal of Medical Biochemistry. 44(4) (pp 854-862), 2025. Date of
Publication: 2025.
Author
Ning G.; Fu L.; Zhou G.
Institution
(Ning, Fu, Zhou) Department of Anesthesiology, Tangshan Workers Hospital,
Hebei, Tangshan, China
Publisher
Society of Medical Biochemists of Serbia
Abstract
Background: To investigate the effects of modified ultrafiltration in
extracorporeal circulation valve replacement surgery. Method(s): A
total of 62 patients with valvular disease who underwent valve replacement
were included. They were randomly divided into the conventional
ultrafiltration group (CUF group, n=31) and the modified ultrafiltration
group (MUF group, n=31). The hematocrit (Hct) values, volume of pleural
fluid drainage at 24 hours after operation, Intensive Care Unit (ICU) stay
time, postoperative 24-hour blood loss, bank blood usage, postoperative
24-hour urine volume, ventilator support time, cardiac function indexes,
postoperative changes of respiratory function, and levels of inflammatory
factors in both groups were compared. Result(s): After
ultrafiltration, the MUF group showed higher Hct value and reduced volume
of pleural fluid drainage, blood loss, bank blood usage, urine volume and
ventilator support time 24 hours after operation compared with the CUF
group (P<0.05). After surgery, left ventricular ejection fraction (LVEF)
levels were elevated, and those in the MUF group were higher than those in
the CUF group. Left ventricular end-diastolic diameter (LVEDD) and heart
rate (HR) were decreased in both groups after surgery. They were lower in
the MUF group than in the CUF group (P<0.05). After ultrafiltration, the
OI value in the MUF group was higher, and the alveolar-arterial oxygen
partial pressure gradient (P (A-a)O<inf>2</inf>) value was lower than the
CUF group (P<0.05). The plasma concentrations of interleukin 6 (IL-6) and
tumour necrosis factor-alpha (TNF-alpha) were increased after
cardiopulmonary bypass (CPB) in both groups and then decreased after
ultrafiltration, and IL-6 and TNF-alpha levels in MUF group were lower
than those in CUF group (P<0.05). Conclusion(s): MUF attenuates the
postoperative systemic inflammatory response, reduces the lung injury
caused by CPB, and improves the lung function of patients in the early
postoperative period, which benefits patient recovery after surgery and is
valuable in heart valve replacement. Copyright © 2025 Society of
Medical Biochemists of Serbia. All rights reserved.

<33>
Accession Number
2039819409
Title
90degree versus 110degree rotation of left double lumen tube for
endobronchial intubation: a randomized controlled trial.
Source
Journal of Thoracic Disease. 17(7) (pp 4724-4731), 2025. Date of
Publication: 31 Jul 2025.
Author
Zhou H.; Zhao J.; Quan X.
Institution
(Zhou, Zhao, Quan) Department of Anaesthesiology, Peking Union Medical
College Hospital, Chinese Academy of Medical Sciences, Peking Union
Medical College, Beijing, China
Publisher
AME Publishing Company
Abstract
Background: It is conventional that anesthesiologist rotates the left
double lumen tube (DLT) 90degree counterclockwise when the DLT
endobronchial cuff crosses beyond the glottis, with which the success rate
of left endobronchial intubation on first attempt is 75.9%. However, the
true inclination angle of the left main bronchus is 108.4degree, so the
first attempt success rate of left bronchial intubation by 110degree left
DLT rotation would be higher than of 90degree left DLT rotation. This
study aimed to assess whether the first attempt success rate of left
bronchial intubation by 110degree left DLT rotation was higher than of
90degree left DLT rotation. Method(s): We conducted a randomized
controlled study to compare left DLT 90degree versus 110degree
counterclockwise rotation in adult patients intubated left DLT to undergo
elective thoracic surgery. We assessed the first attempt left
endobronchial intubation success rate and evaluated the airway injuries at
30 min after the starting of surgery by fiberoptic bronchoscopy and
intubation complications such as sore throat and hoarseness at the
postoperative 24 h. Result(s): A total of 556 patients (56.4+/-12.3
years of age; 322 women) were included: 275 patients in 90degree group and
281 patients in 110degree group. The first attempt success rate of left
bronchial intubation by left DLT was 87.9% in the 110degree group versus
80.7% in the 90degree group (P=0.02). The 110degree group had lower rate
of postoperative sore throat as well (33.9% versus 45.8%, P=0.005).
However, the two group had no statistical difference in carina mucosal
injury and postoperative hoarseness. Conclusion(s): When the
endobronchial cuff passed beyond the glottis, the left DLT 110degree
rotation increased the success rate of the first left bronchus intubation
and reduced the incidence of sore throat in adult patients during thoracic
surgery using left DLT. Copyright © AME Publishing Company.

<34>
Accession Number
2039776713
Title
A Prospective, Multicentre Randomised Controlled Study of Angiographic and
Clinical Outcomes in Total Arterial Coronary Bypass Grafting: The TA Trial
Protocol.
Source
Heart Lung and Circulation. (no pagination), 2025. Date of Publication:
2025.
Author
Royse A.; Ren J.; Bowyer A.; Reid C.M.; Bellomo R.; Smith J.A.; Bannon P.;
Eccleston D.; Vallely M.; Lui E.; Ludbrook G.; Clarke S.; Tian D.H.; Royse
C.
Institution
(Royse, Ren, Bowyer, Tian, Royse) Department of Surgery, The University of
Melbourne, Melbourne, VIC, Australia
(Royse) Department of Cardiothoracic Surgery, Royal Melbourne Hospital,
Melbourne, VIC, Australia
(Royse) Department of Surgery, Universiti Kebangsaan Malaysia, Kuala
Lumpur, Malaysia
(Bowyer, Royse) Department of Anesthesia and Pain Management, Royal
Melbourne Hospital, Melbourne, VIC, Australia
(Bowyer, Royse) Outcomes Research, University of Texas Heath, Houston, TX,
United States
(Reid) Population Health, Curtin University, Perth, WA, Australia
(Bellomo) Department of Critical Care, The University of Melbourne,
Melbourne, VIC, Australia
(Bellomo) Department of Anaesthesia, Austin Health, Melbourne, VIC,
Australia
(Smith) Department of Surgery (School of Clinical Sciences at Monash
Health), Monash University, Melbourne, VIC, Australia
(Smith) Department of Cardiothoracic Surgery, Monash Health, Melbourne,
VIC, Australia
(Bannon) Department of Cardiothoracic Surgery, Royal Prince Alfred
Hospital, Sydney, NSW, Australia
(Bannon) Faculty of Medicine and Health, Central Clinical School, The
University of Sydney, Sydney, NSW, Australia
(Eccleston) Department of Cardiology, Royal Melbourne Hospital, Melbourne,
VIC, Australia
(Eccleston) Department of Medicine, The University of Melbourne,
Melbourne, VIC, Australia
(Vallely) Department of Cardiothoracic Surgery, St George Hospital,
Sydney, NSW, Australia
(Vallely) Faculty of Medicine, Macquarie University, Sydney, NSW,
Australia
(Lui) Department of Medical Imaging, Royal Melbourne Hospital, Melbourne,
VIC, Australia
(Lui) Department of Radiology, The University of Melbourne, Melbourne,
VIC, Australia
(Ludbrook) Discipline of Acute Care Medicine, The University of Adelaide,
Adelaide, SA, Australia
(Clarke) Statistical Consulting Centre, The University of Melbourne,
Melbourne, VIC, Australia
(Tian) Department of Anesthesia and Perioperative Medicine, Westmead
Hospital, Sydney, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background & Aim: Conventional coronary artery bypass grafting (CABG)
procedures typically utilise the left internal mammary artery and
supplementary saphenous vein grafts (SVGs) to re-establish adequate
coronary blood flow to ischaemic territories. However, extensive
observational studies have consistently demonstrated that SVGs are prone
to accelerated atherosclerosis and progressive failure compared to
arterial conduits. These limitations have heightened interest in total
arterial revascularisation (TAR) as a potentially superior strategy.
 Objective(s): The Total Arterial (TA) Trial, fully funded through the
Medical Research Future Fund Cardiovascular Health Mission, aims to
determine the angiographic and clinical outcomes of TAR compared to
conventional non-TAR operations. Method(s): Design: This study is an
open-label, multicentre, randomised controlled trial including 1,000 CABG
patients from multiple cardiac institutions across Australia, with an
allocation ratio of 1:1. Randomisation occurs at a standardised
perioperative time point via computer-generated sequences with variable
block size The trial does not impose specific procedural requirements
regarding the type of arterial conduit, revascularisation or
reconstruction technique, use of sequential or composite methods, or any
perioperative management. Intervention(s): Total arterial CABG with
no use of SVG. Control: Non-total-arterial CABG with at least one SVG.
Main outcomes: The primary endpoint will be perfect graft patency at 24
months postoperatively. The secondary endpoints include patency, major
adverse cardiac and cerebrovascular events, quality of life, all-cause and
cardiac mortality. Clinical follow-up visits will be scheduled at 6-month
intervals, and angiographic assessments at 3 months and 24 months.
Subgroup analyses by diabetes, sex, age, and conduit types are proposed to
examine the potential interactions with treatment effects.
 Conclusion(s): The TA Trial is one of the largest multicentre trials
in the field of coronary revascularisation research, evaluating the graft
status and clinical endpoints of TAR versus non-TAR procedures. The study
design will provide valuable insights into whether differences in graft
failure of SVG translate into differences in survival and cardiac
outcomes. Early postoperative coronary angiography may improve
understanding of the impact of competitive flow on graft function. The
findings from this study will contribute to an improved understanding and
help inform the optimal approach for coronary revascularisation,
supporting evidence-based improvements in patient care. Ethics: Ethical
approval has been granted by the Melbourne Health Institutional Review
Board (HREC/92839/MH-2023), Australia. Trial registration: The trial has
been registered under the Australian New Zealand Clinical Trial Registry
(registration number: ACTRN12623000864628). Dissemination of results: The
analysed results will be published in a peer-reviewed journal on
completion of the clinical trial. Copyright © 2025

<35>
Accession Number
2039871369
Title
Paclitaxel-Coated Balloon for the Treatment of Multilayer In-Stent
Restenosis: AGENT IDE Subgroup Analysis.
Source
Journal of the American College of Cardiology. 86(7) (pp 502-511), 2025.
Date of Publication: 19 Aug 2025.
Author
Kirtane A.J.; Shlofmitz R.; Moses J.; Bachinsky W.; Dohad S.; Rudick S.;
Stoler R.; Jefferson B.K.; Nicholson W.; Altman J.; Bateman C.;
Krishnaswamy A.; Grantham J.A.; Zidar F.J.; Tremmel J.A.; Grines C.; Ahmed
M.I.; Latib A.; Tehrani B.; Abbott J.D.; Batchelor W.; Cavalcante R.; Yeh
R.W.
Institution
(Kirtane, Moses) Columbia University Irving Medical
Center/NewYork-Presbyterian Hospital and the Cardiovascular Research
Foundation, New York, NY, United States
(Shlofmitz) St Francis Hospital, Roslyn, NY, United States
(Bachinsky) University of Pittsburgh Medical Center (UPMC), Central PA,
Harrisburg, PA, United States
(Dohad) Cedars Sinai Medical Center, Los Angeles, CA, United States
(Rudick) Lindner Center for Research and Education at Christ Hospital,
Cincinnati, OH, United States
(Stoler) Baylor Heart and Vascular Hospital, Dallas, TX, United States
(Jefferson) HCA Tristar Centennial Medical Center, Nashville, TN, United
States
(Nicholson) Emory University Hospital, Atlanta, GA, United States
(Altman) St Anthony Hospital, Denver, CO, United States
(Bateman) South Denver Cardiology, Littleton, CO, United States
(Krishnaswamy) Cleveland Clinic Foundation, Cleveland, OH, United States
(Grantham) St Luke's Hospital of Kansas City, Kansas City, MO, United
States
(Zidar) Austin Heart, Austin, TX, United States
(Tremmel) Stanford University Medical Center, Stanford, CA, United States
(Grines) Northside Hospital Cardiovascular Institute, Atlanta, GA, United
States
(Ahmed) University of Alabama at Birmingham, Birmingham, AL, United States
(Latib) Montefiore Medical Center, Bronx, NY, United States
(Tehrani, Batchelor) Inova Heart and Vascular Institute, Falls Church, VA,
United States
(Abbott) Brown University Health Cardiovascular Institute, Rhode Island
Hospital, Providence, RI, United States
(Cavalcante) Boston Scientific Corporation, Marlborough, MA, United States
(Yeh) Beth Israel Deaconess Medical Center, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Patients with coronary in-stent restenosis (ISR) within
multiple layers of stent pose a specific clinical challenge because of
higher rates of recurrent restenosis as well as a desire to avoid an
additional layer of stent. Drug-coated balloons (DCBs) provide an
alternative antiproliferative therapeutic option for multilayer ISR.
 Objective(s): We evaluated the efficacy and safety of a low-dose
paclitaxel-coated vs uncoated balloon among patients with multilayer or
single-layer ISR in the AGENT IDE (A Clinical Trial to Assess the Agent
Paclitaxel Coated PTCA Balloon Catheter for the Treatment of Subjects With
In-Stent Restenosis) trial. Method(s): AGENT IDE is a prospective,
multicenter trial that randomized patients with ISR (reference vessel
diameter >2.0 mm to <=4.0 mm and lesion length <26 mm) in a 2:1 allocation
to paclitaxel-coated or an uncoated balloon following successful lesion
preparation. Randomization was stratified by multi- vs single-layer ISR as
well as by center. The primary study endpoint was 1-year target lesion
failure (TLF): composite occurrence of ischemia-driven target lesion
revascularization (TLR), target vessel-related myocardial infarction (MI),
or cardiac death. Result(s): Of the 600 patients randomized in the
trial, multilayer ISR was present in 258 (44%) patients. Patients with
multilayer ISR had higher rates of TLF at 1 year compared with those with
single-layer ISR (29.0% vs 15.7%, P < 0.0001). The overall study results
were consistent irrespective of multilayer vs single-layer ISR
(P<inf>interaction</inf> = 0.66). Among patients with multilayer ISR, TLF
was lower with paclitaxel-coated balloon compared with an uncoated balloon
(23.8% vs 40.0%; HR: 0.55; 95% CI: 0.34-0.87; P = 0.01), driven by
reductions in both TLR and target vessel-related MI. Similar findings were
observed among patients with single layer ISR (1-year TLF: 13.5% with
paclitaxel-coated vs 20.2% with uncoated balloon; HR: 0.64; 95% CI:
0.37-1.11; P = 0.11), although absolute event rates were lower.
 Conclusion(s): Patients with ISR of multiple stent layers had higher
rates of adverse stent-related events compared with patients with
single-layer ISR. Treatment with a paclitaxel-coated balloon led to
greater absolute risk reduction in 1-year TLF among patients with
multilayer ISR compared with an uncoated balloon. (A Clinical Trial to
Assess the Agent Paclitaxel Coated PTCA Balloon Catheter for the Treatment
of Subjects With In-Stent Restenosis [ISR] [AGENT IDE];
NCT04647253) Copyright © 2025 American College of Cardiology
Foundation

<36>
Accession Number
2035541290
Title
Evaluating Zero-Contrast Transcatheter Aortic Valve Implantation (TAVI)
for Patients With Renal Impairment: A Pooled Meta-Analysis of 1505
Patients.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Badran A.S.; Gadelmawla A.F.; Khelifa H.; Hasanin E.H.; Gbreel M.I.
Institution
(Badran) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Khelifa) Faculty of Medicine, University of Oran 1, Ahmed Ben Bella,
Oran, Algeria
(Hasanin) Faculty of Medicine, University of Tripoli, Tripoli, Libyan Arab
Jamahiriya
(Gbreel) Faculty of Medicine, October 6 University, Giza, Egypt
(Gbreel) Department of Cardiology, Egyptian Railway Medical Educational
Centre, Cairo, Egypt
Publisher
John Wiley and Sons Inc
Abstract
Transcatheter Aortic Valve Implantation (TAVI) is a well-established
treatment for severe aortic stenosis (AS) but poses risks for chronic
kidney disease (CKD) patients due to contrast-induced nephropathy (CIN).
Zero-contrast TAVI offers a promising alternative, though evidence on its
safety and effectiveness is limited. We aim to evaluate the safety and
effectiveness of zero-contrast TAVI compared to standard TAVI in patients
with AS and CKD. We followed the Cochrane Handbook and PRISMA guidelines,
searching databases until September 2024. We conducted the meta-analysis
using the 'metafor' package with a random-effects model, calculating mean
differences (MDs) and risk ratios (RRs) along with their corresponding 95%
confidence intervals (CIs). We included 1505 patients from six papers. The
single-arm meta-analysis of zero-contrast TAVI showed a significant
implantation success rate (proportion = 0.97; 95% CI: [0.95, 0.99]; p <
0.01). Double-arm analysis revealed no significant difference in
implantation success between both groups (RR = 1.02; 95% CI: [0.97, 1.08];
p = 0.34). The postoperative mean transvalvular gradient was comparable
(MD = 0.19 mmHg; 95% CI: [-0.99, 1.39]; p = 0.75). The initial pooled
analysis found no significant difference in in-hospital AKI (RR = 0.66,
95% CI: 0.20-2.17), though this was confounded by significant
heterogeneity (I2 = 71.26%). Sensitivity analysis resolved this
heterogeneity and revealed a significant reduction in AKI with
Zero-contrast TAVI (RR = 0.47, 95% CI: [0.24, 0.92]; p = 0.03).
Post-procedural permanent pacemaker (PPM) implantation risk was higher in
the zero-contrast group, while Stroke rates were comparable. Zero-contrast
TAVI offers comparable success to contrast-based approaches and potential
renal benefits but carries a higher risk of PPM implantation. Trial
Registration: This meta-analysis was registered on PROSPERO. No.:
CRD42024597951. Copyright © 2025 Wiley Periodicals LLC.

<37>
Accession Number
2038554008
Title
Surgical neuromodulation therapies to prevent postoperative atrial
fibrillation: A meta-analysis, meta-regression, and trial sequential
analysis of randomized controlled trials.
Source
Heart Rhythm. 22(8) (pp e301-e308), 2025. Date of Publication: 01 Aug
2025.
Author
Consoli L.N.; Cetinel E.; Lajczak P.; Koziakas I.G.; Majeed M.W.; Wijaya
P.; Salha I.; Samanidis G.
Institution
(Consoli) Federal University of Bahia, Salvador, Brazil
(Cetinel) San Raffaele University, Milan, Italy
(Lajczak) Medical University of Silesia, Katowice, Poland
(Koziakas, Samanidis) Department of Cardiac Surgery, Onassis Hospital,
Athens, Greece
(Majeed) Government Medical College Srinagar, Jammu and Kashmir, India
(Wijaya) Universitas Indonesia, Depok, Indonesia
(Salha) Trinity Centre for Global Health, Trinity College Dublin, Dublin,
Ireland
Publisher
Elsevier B.V.
Abstract
Background: Postoperative atrial fibrillation (POAF) occurs frequently
after cardiac surgery and is associated with increased mortality.
 Objective(s): Surgical neuromodulation therapies (SNMTs) have been
explored as a preventive strategy, but their efficacy and safety remain
uncertain. Method(s): We searched PubMed, Embase, and the Cochrane
Library for eligible randomized controlled trials. Meta-analysis was
performed for primary (POAF) and secondary (hospital stay, complications,
atrial fibrillation at 1 year, operation time, POAF burden, intensive care
unit stay) end points. Subgroup analysis was conducted for each technique.
We compared end points using risk ratio for binary outcomes and mean
difference for continuous outcomes. We calculated 95% confidence intervals
for all outcomes. We carried out a trial sequential analysis for primary
(POAF) and secondary (hospital stay, complications) end points. We
conducted meta-regression for all covariates with at least 10
observations. Result(s): We included 20 trials (n = 3348): 7 studied
anterior fat pad (AFP) preservation; 5, pulmonary vein isolation (PVI); 2,
ganglionated plexus ablation; 1, partial cardiac denervation (PCD); and 5,
epicardial injections. POAF incidence was lower in the SNMT group (risk
ratio, 0.62 [0.48-0.79]; P < .001), driven by the AFP preservation, PCD,
and PVI subgroups. Epicardial injections were effective only in patients
undergoing coronary surgery. SNMTs also reduced hospital stay (P = .03).
All meta-regression analyses were insignificant. In the trial sequential
analysis, a positive effect for POAF was observed. Conclusion(s):
This meta-analysis found a significant reduction in POAF incidence with
implementation of AFP preservation, PCD, and PVI. Epicardial injections
were effective only for patients undergoing coronary bypass. Copyright
© 2025 Heart Rhythm Society

<38>
Accession Number
2039749445
Title
Impact of Electroencephalography-guided Anesthesia in Cardiothoracic
Surgery: A Systematic Review and Updated Meta-analysis of Randomized
Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Silva B.D.M.; Alves e Gomes A.D.; Marcolin Miranda L.; Albuquerque L.G.;
Defante M.L.R.; Miranda N.D.C.D.; De Lima P.E.C.; Damiao V.P.
Institution
(Silva) Department of Medicine, Santo Amaro University, Sao Paulo, Brazil
(Alves e Gomes) Department of Medicine, Federal University of Ceara,
Ceara, Brazil
(Marcolin Miranda) Department of Medicine and Health Sciences, Pontifical
Catholic University of Parana, Parana, Brazil
(Albuquerque) Department of Medicine, Federal University of Bahia, Bahia,
Brazil
(Defante) Redentor University Center, Department of Medicine, Itaperuna,
Brazil
(Miranda) Department of Medicine, Bahiana's School of Medicine and Public
Health, Bahia, Brazil
(De Lima) Department of Medicine, Federal University of Latin American
Integration, Parana, Brazil
(Damiao) Department of Medicine and Health Sciences, Pontifical Catholic
University of Campinas, Campinas, Brazil
Publisher
W.B. Saunders
Abstract
Objective: To evaluate the impact of electroencephalography (EEG)-guided
anesthesia versus non-EEG-guided anesthesia on postoperative delirium and
adverse outcomes in patients undergoing cardiothoracic surgeries.
 Design(s): A systematic review and meta-analysis were performed using
PubMed, Embase, and Cochrane Library. Setting(s): All randomized
clinical trials (RCTs). Participant(s): Eight RCTs with 2,666
patients: 1,304 received EEG-guided anesthesia and 1,362 received usual
care. Intervention(s): Anesthesia guided by EEG in cardiothoracic
surgery. Measurements and Main Results: Mean differences (MDs) were
used to pool continuous outcomes while risk ratios (RRs) were used for
binary outcomes, using 95% confidence intervals (CIs). A random-effects
model was used to examine the treatment. Statistical analysis was
performed using R Studio. EEG-guided anesthesia was associated with a
trend toward reduced ventilatory support duration (MD: -25.08, 95% CI:
-50.12 to -0.04, p = 0.05, I2 = 0%). No significant differences were found
in postoperative delirium (RR: 0.93, 95% CI: 0.79-1.09, p = 0.35, I2 =
42.6%), hospital length of stay (MD: -0.22, 95% CI: -0.53 to 0.09, p =
0.17, I2 = 4.7%), intensive care unit length of stay (MD: -0.24, 95% CI
-0.59 to 0.12, p = 0.19, I2 = 71.7%), mortality (RR: 0.82, 95% CI:
0.54-1.25, p = 0.36, I2 = 42%), or intraoperative blood transfusion (RR:
0.96, 95% CI: 0.74-1.25, p = 0.79, I2 = 0%). Conclusion(s): The
findings demonstrated that EEG-guided anesthesia was associated with a
shorter duration of respiratory support. However, this study did not
identify any significant comparative advantage over standard practices for
the other outcomes analyzed. Copyright © 2025 Elsevier Inc.

<39>
Accession Number
2038690678
Title
Immediate transcatheter aortic valve replacement versus temporizing
balloon aortic valvuloplasty in severe aortic stenosis: A systematic
review and meta-analysis immediate TAVR vs. temporizing BAV.
Source
Cardiovascular Revascularization Medicine. 77 (pp 112-121), 2025. Date of
Publication: 01 Aug 2025.
Author
Doma M.; Huang W.; Hernandez S.; Fatima S.R.; Lingamsetty S.; Kritya M.;
Hemdanieh M.; Naji Z.; Gewehr D.M.; Martignoni F.V.; Goldsweig A.M.
Institution
(Doma) Alexandria Faculty of Medicine, Egypt
(Huang) University of Padjadjaran, Indonesia
(Hernandez) Universidad Xochicalco Campus Tijuana, Mexico
(Fatima) CMH Lahore Medical College and Institute of Dentistry, Pakistan
(Lingamsetty) Mamata Medical College, India
(Kritya) Armed Forces Medical College, India
(Hemdanieh) American University of Beirut, Lebanon
(Naji) Faculty of Medicine of Tunis, Al-Manar University, Tunisia
(Gewehr) Curitiba Heart Institute, Curitiba, Parana, Brazil
(Martignoni) Minneapolis Heart Institute and Foundation, MN, United States
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center
and Division of Cardiovascular Medicine, University of
Massachusetts-Baystate, Springfield, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is a first-line
therapy for severe aortic stenosis (AS). In patients with
contraindications to immediate TAVR, temporizing balloon aortic
valvuloplasty (BAV) may be performed to stabilize patients prior to TAVR.
The relative efficacy and safety of TAVR with or without temporizing BAV
remains inadequately described. Method(s): We searched PubMed,
Embase, and Cochrane databases for studies comparing TAVR with and without
temporizing BAV in patients with severe AS. Random-effects models were
used to calculate pooled odds, risk ratios (RRs) and mean differences with
95 % confidence intervals (CIs). Result(s): Nine studies (59,205
patients: 95.7 % immediate TAVR, 4.3 % BAV + TAVR) met inclusion criteria.
Mean age was 82.9 +/- 6.6 years old, and 45.9 % were males. Patients in
the TAVR group were a mean difference of 1 year younger with no difference
in gender distribution between groups. Direct TAVR was associated with a
lower risk of 30-day all-cause mortality than BAV + TAVR (RR = 0.62; 95 %
CI 0.41 to 0.93; p = 0.02). There were no significant differences in risks
of post-procedural pacemaker implantation, myocardial infarction, cardiac
tamponade, major vascular complications, ischemic stroke, major bleeding,
2+ or greater aortic regurgitation grade or acute kidney injury.
 Conclusion(s): While immediate TAVR was associated with slightly
lower short-term mortality compared to BAV + TAVR in patients with severe
AS, other binary endpoints were equivalent. This potential mortality
difference should be considered when offering BAV + TAVR in patients with
contraindications to immediate TAVR. Randomized studies are required to
confirm these results. Copyright © 2025 Elsevier Inc.

<40>
Accession Number
2034205093
Title
Treatment of and outcomes from hypotension in the post-anaesthesia care
unit: A single-centre retrospective cohort study.
Source
Anaesthesia and Intensive Care. 53(4) (pp 231-237), 2025. Date of
Publication: 01 Jul 2025.
Author
Douglas N.; Gilbert S.; Ong J.; Kave B.; Leslie K.; Darvall J.N.
Institution
(Douglas, Gilbert, Ong, Kave, Leslie, Darvall) Department of Anaesthesia
and Pain Management, The Royal Melbourne Hospital, Parkville, Australia
(Douglas, Leslie, Darvall) Department of Critical Care, Melbourne Medical
School, University of Melbourne, Parkville, Australia
Publisher
SAGE Publications Inc.
Abstract
Hypotension after non-cardiac surgery is common and associated with harm.
Anaesthetists treat hypotension in the post-anaesthesia care unit (PACU)
with intravenous (IV) fluids and vasopressor medications. Our aim was to
determine the incidence of hypotension after these treatments. We
conducted a single centre retrospective cohort study of all adult patients
who were hypotensive (systolic blood pressure less than 90 mmHg) in the
PACU after non-cardiac, non-obstetric surgery over a one-year period. The
primary outcome was a composite of hypotension or vasopressor infusion in
the 24 h after PACU discharge. During the study 459 patients were
hypotensive in the PACU. No treatment was administered in 232 (51%)
episodes, IV fluid alone was administered in 138 (30%) episodes,
vasopressors alone were administered in 22 (5%) episodes, and both fluid
and vasopressors were administered in 67 (14%) patients. A total of 167
patients (36%) met the primary outcome, of which 118 (25%) were
hypotensive and 49 (11%) required vasopressor infusions. The treatment
group was significantly associated with the primary outcome (P < 0.001),
with 36 (15%) patients who received no treatment becoming hypotensive,
compared with 67 (46%, P < 0.001) patients who received IV fluid alone, 12
(55%, P < 0.001) who received vasopressors alone and 52 (75%, P < 0.001)
who received both IV fluid and vasopressors. Patients who were hypotensive
in the PACU frequently developed later hypotension or required
vasopressors in the 24 h after PACU discharge. Treatments delivered in the
PACU had limited long-term effectiveness. Novel treatments to protect
patients from subsequent hypotension are urgently needed. Copyright
© The Author(s) 2025

<41>
Accession Number
2038352745
Title
Exploring the link between parathyroid dysfunction and early cognitive
decline in cardiac surgery patients.
Source
Asian Journal of Surgery. 48(8) (pp 4959-4960), 2025. Date of Publication:
01 Aug 2025.
Author
Ding W.; Shi L.; Li L.; Du Z.
Institution
(Ding, Shi, Li, Du) Cardiothoracic and Vascular, Thyroid and Breast
Surgery Department, 363 Hospital, Wuhou, Sichuan, Chengdu, China
Publisher
Elsevier (Singapore) Pte Ltd

<42>
[Use Link to view the full text]
Accession Number
646282540
Title
Meta-analysis of longitudinal comparison of transcatheter versus surgical
aortic valve replacement in patients at low to intermediate surgical risk.
Source
International journal of surgery (London, England). 110(12) (pp
8097-8106), 2024. Date of Publication: 01 Dec 2024.
Author
Ahmed M.; Ahsan A.; Shafiq A.; Nadeem Z.A.; Arif F.; Zulfiqar E.; Kazmi
M.H.; Yadav R.; Jain H.; Ahmed R.; Alam M.; Shahid F.
Institution
(Ahmed) Rawalpindi Medical University, Rawalpindi, Pakistan
(Ahsan) Foundation University School of Health Sciences, Islamabad,
Pakistan
(Shafiq, Arif, Zulfiqar) Dow University of Health Sciences, Karachi,
Pakistan
(Nadeem) Allama Iqbal Medical College, Lahore, Pakistan
(Kazmi) Sunderland Royal Hospital, Sunderland, United Kingdom
(Yadav) Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan
University, Kathmandu, Nepal
(Jain) All India Institute of Medical Sciences, Jodhpur, India
(Ahmed) Royal Brompton Hospital, London, United Kingdom
(Ahmed) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Alam) Baylor College of Medicine, Houston, TX, United States
(Shahid) Queen Elizabeth Hospital, London, United Kingdom
Abstract
BACKGROUND: Surgical aortic valve replacement (SAVR) is the commonly used
approach for aortic valve replacement (AVR) in patients with aortic
stenosis at low or intermediate surgical risk. However, transcatheter
aortic valve replacement (TAVR) has emerged as an alternative to SAVR for
AVR. This meta-analysis aims to assess the comparative efficacy and safety
of TAVR versus SAVR in low-to-intermediate surgical risk patients by
analyzing temporal trends in the outcomes of TAVR and SAVR at various
follow-up intervals, providing a more detailed understanding.
 METHOD(S): A thorough literature search was performed across
PubMed/MEDLINE, Embase, and the Cochrane Library from their inception up
to May 2024 to identify eligible randomized controlled trials (RCTs).
Clinical outcomes were evaluated using a random-effects model to pool risk
ratios (RRs) with 95% CIs. RESULT(S): A total of 17 studies reporting
data at different follow-ups for nine trials were included (n=9092). No
statistically significant difference was observed between TAVR and SAVR
for reducing all-cause death at 30 days, 1 year, and 2 years but
significantly increased risk with TAVR at 5 years or longer follow-up
(RR=1.13, 95% CI: 1.03-1.23). However, TAVR was associated with a
significantly decreased risk for cardiac death at 1-year follow-up
(RR=0.79, 95% CI: 0.64-0.96) and comparable risk for cardiac death at 30
days, 2 years, and 5 years or longer follow-up when compared with SAVR. No
statistically significant difference was observed between TAVR and SAVR
for reducing the risk of myocardial infarction (MI) at 30 days, 1 year, 2
years, and 5 years or longer follow-up.TAVR was associated with a
significantly lower risk of major bleeding events at 30 days (RR=0.38, 95%
CI: 0.21-0.67); lower risk of acute kidney injury (AKI) at 30 days
(RR=0.38, 95% CI: 0.26-0.54) and 1 year (RR=0.58, 95% CI: 0.41-0.82) and
lower risk of new onset or worsening atrial fibrillation (AF) at 30 days
(RR=0.25, 95% CI: 0.18-0.34), 1 year (RR=0.26, 95% CI: 0.16-0.41) and 2
years (RR=0.32, 95% CI: 0.20-0.49) when compared with SAVR. However, TAVR
was associated with a significantly increased risk of permanent pacemaker
implantation (PPI) at 30 days (RR: 2.62, 95% CI: 1.40-4.91), at 1 year
(RR: 2.19, 95% CI: 1.24-3.87), at 2 years (RR: 2.74, 95% CI: 1.31-5.71),
and beyond 5 years (RR: 1.95, 95% CI: 1.20-3.15). TAVR was also associated
with a significantly increased risk of prosthetic valve thrombosis at 2
years (RR=2.70, 95% CI: 1.08-6.71), though no significant association was
observed at 30 days, 1 year, or 5 years. Similarly, no significant
differences were observed in aortic-valve reintervention rates at 30 days,
2 years, or 5 years, but TAVR showed a significantly increased risk at 1
year (RR=1.98, 95% CI: 1.21-3.24). TAVR was associated with a
significantly increased risk of major vascular complications at 30 days
(RR=2.37, 95% CI: 1.38-4.04) and a significantly increased risk of TIA at
2 years (RR: 1.43, 95% CI: 1.02-2.00, I2=0%). The risk of hospitalizations
was comparable between the groups. CONCLUSION(S): TAVR and SAVR
demonstrated comparable rates of all-cause death up to 2 years of
follow-up. However, at 5 years or longer follow-up, TAVR was associated
with a higher risk of all-cause death. While TAVR showed certain
procedural advantages, such as a lower risk of major bleeding, AKI, and
new-onset or worsening AF, the choice between TAVR and SAVR in patients
with low or intermediate surgical risk should consider long-term outcomes,
with SAVR potentially being more favorable due to better survival observed
on longer follow-up durations. Copyright © 2024 The Author(s).
Published by Wolters Kluwer Health, Inc.

<43>
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Accession Number
644458128
Title
Re-exploration for bleeding and long-term survival after adult cardiac
surgery: a meta-analysis of reconstructed time-to-event data.
Source
International journal of surgery (London, England). 110(9) (pp 5795-5801),
2024. Date of Publication: 01 Sep 2024.
Author
Jr Soletti G.; Cancelli G.; Dell'Aquila M.; Caldonazo T.; Harik L.; Rossi
C.; Tasoudis P.; Leith J.; An K.R.; Dimagli A.; Demetres M.; Gaudino M.
Institution
(Jr Soletti, Cancelli, Dell'Aquila, Caldonazo, Harik, Rossi, Leith, An,
Dimagli, Gaudino) Department of Cardiothoracic Surgery at New York
Presbyterian, Weill Cornell Medicine, NY, United States
(Caldonazo) Division of Cardiothoracic Surgery, University of North
Carolina, Chapel Hill, United States
(Tasoudis) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, Germany
(Demetres) Samuel J. Wood Library & CV Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY
Abstract
BACKGROUND: Postoperative bleeding requiring re-exploration is a serious
complication that occurs in 2.8-4.6% of patients undergoing cardiac
surgery. Re-exploration has previously been associated with a higher risk
of short-term mortality. However, a comprehensive analysis of long-term
outcomes after re-exploration for bleeding has not been published.
MATERIALS AND METHODS: The authors performed a systematic, three databases
search to identify studies reporting long-term outcomes in patients who
required re-exploration for bleeding after cardiac surgery compared to
patients who did not, with at least 1-year of follow-up. Long-term
survival was the primary outcome. Secondary outcomes were operative
mortality, myocardial infarction, stroke, renal and respiratory
complications, and hospital length of stay. Random-effects models was
used. Individual patient survival data was extracted from available
survival curves and reconstructed using restricted mean survival time.
 RESULT(S): Six studies totaling 135 456 patients were included. The
average follow-up was 5.5 years. In the individual patient data, patients
who required re-exploration had a significantly higher risk of death
compared with patients who did not [hazard ratio (HR): 1.21; 95% CI:
1.14-1.27; P <0.001], which was confirmed by the study-level survival
analysis (HR: 1.32; 95% CI: 1.12-1.56; P <0.01). Re-exploration was also
associated with a higher risk of operative mortality [odds ratio (OR):
5.25, 95% CI: 4.74-5.82, P <0.0001], stroke (OR: 2.05, 95% CI: 1.72-2.43,
P <0.0001), renal (OR: 4.13, 95% CI: 3.43-4.39 P <0.0001) respiratory
complications (OR: 3.91, 95% CI: 2.96-5.17, P <0.0001), longer hospital
length of stay (mean difference: 2.69, 95% CI: 1.68-3.69, P <0.0001), and
myocardial infarction (OR: 1.85, 95% CI: 1.30-2.65, P =0.0007).
 CONCLUSION(S): Postoperative bleeding requiring re-exploration is
associated with lower long-term survival and increased risk of short-term
adverse events including operative mortality, stroke, renal and
respiratory complications, and longer hospital length of stay. To improve
both short-term and long-term outcomes, strategies to prevent the need for
re-exploration are necessary. Copyright © 2024 The Author(s).
Published by Wolters Kluwer Health, Inc.

<44>
Accession Number
2039778904
Title
Cardiac patients' death anxiety: A systematic review and meta-analysis.
Source
Journal of Affective Disorders. 391 (no pagination), 2025. Article Number:
119967. Date of Publication: 15 Dec 2025.
Author
Mollaei A.; Zamanzadeh V.; Ranjbar Noei F.; Kamali M.
Institution
(Mollaei, Ranjbar Noei) Student Research Committee, Golestan University of
Medical Sciences, Gorgan, Iran, Islamic Republic of
(Zamanzadeh) Department of Medical-Surgical Nursing, School of Nursing &
Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Kamali) Student Research Committee, School of Nursing and Midwifery,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
Elsevier B.V.
Abstract
Death anxiety (DA) is a critical psychological concern among patients with
cardiovascular diseases (CVDs), yet its prevalence and associated factors
remain understudied. This systematic review and meta-analysis aimed to
determine the level of DA in cardiac patients and identify contributing
factors. A comprehensive search of PubMed, Scopus, Web of Science, and
Google Scholar yielded 27 cross-sectional studies (5292 participants).
Studies were assessed using the AXIS tool, with most rated as high
quality. Pooled estimates revealed moderate DA levels across studies, with
mean scores of 8.46 (95 % CI: 7.05-9.86) for the Templer Death Anxiety
Scale (TDAS) 0-15 range and 45.07 (95 % CI: 34.59-55.55) for the 15-75
range. Subgroup analyses indicated higher DA in Turkey (vs. Iran) and
among coronary artery bypass graft (CABG) patients. Key factors linked to
elevated DA included female gender, younger age, economic hardship,
unemployment, reduced resilience, and diminished religious beliefs.
Meta-regression found no significant moderation by age, sample size, or
gender. These findings determine the need for targeted psychological
interventions addressing modifiable factors like socioeconomic support and
resilience-building in cardiac care. Limitations include reliance on
cross-sectional data and heterogeneity in measurement tools. Future
research should explore longitudinal and culturally diverse cohorts to
clarify causal relationships and optimize DA management
strategies. Copyright © 2025

<45>
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Accession Number
644023429
Title
Clinical outcomes of on-pump versus off-pump coronary-artery bypass
surgery: a meta-analysis.
Source
International journal of surgery (London, England). 110(8) (pp 5063-5070),
2024. Date of Publication: 01 Aug 2024.
Author
He L.; Tiemuerniyazi X.; Chen L.; Yang Z.; Huang S.; Nan Y.; Song Y.; Feng
W.
Institution
(He) Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese
Academy of Medical Sciences and Peking Union Medical College, Beijing,
China
Abstract
BACKGROUND: The ongoing debate regarding off-pump coronary artery bypass
grafting (CABG) and on-pump CABG has endured for over three decades.
Although numerous randomized controlled trials (RCTs) and meta-analyses
have been reported, new evidence has emerged. Therefore, an updated and
comprehensive meta-analysis to guide clinical practice is essential.
MATERIALS AND METHODS: A comprehensive search for eligible articles
published after 2000, reporting RCTs involving at least 100 patients and
comparing off-pump CABG with on-pump CABG, was performed throughout the
databases including Embase, Ovid Medline, and Web of Science. The primary
interested outcomes included the short-term incidence of stroke and
long-term mortality. The primary analysis utilized fixed-effect model with
the inverse variance method. The Grade of Recommendations Assessment,
Development, and Evaluation (GRADE) was used to evaluate the certainty of
evidence. RESULT(S): After thorough screening, 39 articles were
included, consisting of 28 RCTs and involving a total of 16 090 patients.
Off-pump CABG significantly reduced the incidence of short-term stroke
(1.27 vs. 1.78%, OR: 0.74, P =0.03, high certainty). However, it was
observed to be associated with increased mid-term coronary reintervention
(2.77 vs. 1.85%, RR: 1.49, P <0.01, high certainty) and long-term
mortality (21.8 vs. 21.0%, RR: 1.09, P =0.02, moderate certainty).
 CONCLUSION(S): Off-pump CABG significantly reduces the short-term
incidence of stroke, but it also increases the incidence of mid-term
coronary reintervention. Moreover, it may increase long-term
mortality. Copyright © 2024 The Author(s). Published by Wolters
Kluwer Health, Inc.

<46>
Accession Number
2030405869
Title
Impact of cannabidiol on myocardial recovery in patients with acute
myocarditis: Rationale & design of the ARCHER trial.
Source
ESC Heart Failure. 11(5) (pp 3416-3424), 2024. Date of Publication: 01 Oct
2024.
Author
McNamara D.M.; Cooper L.T.; Arbel Y.; Bhimaraj A.; Bocchi E.; Friedrich
M.G.; Kerneis M.; Liu P.; Parker A.B.; Smith E.R.; Tang W.H.W.;
Torre-Amione G.; Tschope C.
Institution
(McNamara) Center for Heart Failure, University of Pittsburgh Medical
Center, Pittsburgh, PA, United States
(Cooper) Department of Cardiovascular Medicine, Mayo Clinic College of
Medicine and Science, Jacksonville, FL, United States
(Arbel) Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel
(Bhimaraj) Houston Methodist Hospital, Houston, TX, United States
(Bhimaraj) Weill Cornell Medical College, New York, NY, United States
(Bocchi) Instituto do Coracao Hospital das Clinicas HCFMUSP, Faculdade de
Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
(Friedrich) Departments of Medicine and Diagnostic Radiology, Research
Institute of the McGill University Health Centre, McGill University,
Montreal, Canada
(Friedrich) Department of Cardiology, Universitatsklinikum Heidelberg,
Heidelberg, Germany
(Friedrich) Department of Cardiac Sciences and Radiology, University of
Calgary, Calgary, Canada
(Kerneis) Pitie Salpetriere Hospital, Paris, France
(Kerneis) Sorbonne University, Paris, France
(Kerneis) ACTION Study Group, Paris, France
(Liu) University of Ottawa Heart Institute, Ottawa, Canada
(Parker, Smith) Cardiol Therapeutics Inc., Oakville, ON, Canada
(Tang) Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland,
OH, United States
(Torre-Amione) Instituto de Cardiologia, Hospital Zambrano-Hellion,
Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey,
Monterrey, Mexico
(Tschope) Department of Cardiology, Angiology and Intensive Medicine,
Deutsches Herzzentrum der Charite (DHZC), Campus Virchow (CVK), Berlin,
Germany
(Tschope) Berlin Institute of Health (BIH) at Charite - Center for
Regenerative Therapies (BCRT), Berlin, Germany
(Tschope) German Center for Cardiovascular Research (DZHK); Partner Site
Berlin, Charite University, Berlin, Germany
Publisher
John Wiley and Sons Inc
Abstract
Aims: Acute myocarditis, although a rare disease, can be associated with
sudden cardiac death or the need for transplantation in both children and
young adults. To date, there is no definitive evidence to support the
routine use of immunosuppressive therapy or treatment targeting
inflammation in patients with myocarditis. Animal models of cardiovascular
(CV), as well as neurological diseases, have demonstrated that cannabidiol
has significant anti-inflammatory properties and may represent a promising
therapy in acute myocarditis. This efficacy has been shown in a murine
model of autoimmune myocarditis as well as in in vitro and in vivo models
of heart failure (HF). Methods and Results: We present the rationale
and design of the ARCHER Trial, an international multicentre,
double-blind, randomized, placebo-controlled, phase II study examining the
safety and efficacy of a pharmaceutically produced cannabidiol
formulation, in patients with mild to moderate acute myocarditis. Eligible
patients are those with acute myocarditis, randomized within 10 days of
the diagnostic cardiac MRI (CMR), which has met defined diagnostic
criteria for myocarditis. Oral treatment (cannabidiol or placebo) is
titrated from 2.5 mg/kg of body weight up to 10 mg/kg of body weight
b.i.d. (or highest tolerated dose) and taken for 12 weeks in addition to
standard of care therapy for HF. The primary endpoints are defined as
changes in global longitudinal strain (GLS) and extra cellular volume
(ECV), measured by CMR at 12 weeks. Assuming 80% power, a 5% alpha risk
and 25% missing CMR follow-up data at Week 12, 100 patients are required
to demonstrate the desired treatment effect of 18%. The change in left
ventricular ejection fraction (LVEF) from baseline to Week 12 was selected
as the secondary endpoint. Additional exploratory endpoints include
changes in hs-troponin, NT-proBNP, markers of inflammation and endothelial
function during the 12-week treatment period. The trial is ongoing but is
now more than 50% recruited. As enrolment in the trial continues, no
interim data are available for inclusion in this Design paper.
 Conclusion(s): The ongoing ARCHER Trial is an international,
multicentre, double-blind, randomized, placebo-controlled phase II study,
designed to determine the effect of a pharmaceutically produced
cannabidiol formulation on CMR parameters in patients presenting with
acute myocarditis. Enrolment of 100 patients is expected to conclude in Q3
2024. Study results will be available in early 2025. Copyright ©
2024 The Author(s). ESC Heart Failure published by John Wiley & Sons Ltd
on behalf of European Society of Cardiology.

<47>
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Accession Number
642303081
Title
Comparative efficacy on outcomes of C-CABG, OPCAB, and ONBEAT in coronary
heart disease: a systematic review and network meta-analysis of randomized
controlled trials.
Source
International journal of surgery (London, England). 109(12) (pp
4263-4272), 2023. Date of Publication: 01 Dec 2023.
Author
Zhu L.; Li D.; Zhang X.; Wan S.; Liu Y.; Zhang H.; Luo J.; Luo Y.; An P.;
Jiang W.
Institution
(Zhu, Zhang, Wan, Luo, Luo, An) Department of Nutrition and Health,
Beijing Advanced Innovation Center for Food, Nutrition and Human Health,
Key Laboratory of Precision Nutrition and Food, Quality, China
Agricultural University, China
(Li, Liu, Zhang, Jiang) Department of Cardiac Surgery, Beijing Anzhen
Hospital
(Li, Liu, Zhang, Jiang) Beijing Advanced Innovation Center for Big
Data-based Precision Medicine, Capital Medical University
(Li, Liu, Zhang, Jiang) Beijing Lab for Cardiovascular Precision Medicine
(Li, Liu, Zhang, Jiang) Key Laboratory of Medical Engineering for
Cardiovascular Disease, Beijing, China
Abstract
IMPORTANCE: Coronary artery bypass grafting (CABG) remains the gold
standard for the treatment of multivessel and left main coronary heart
disease. However, the current evidence about the optimal surgical
revascularization strategy is inconsistent and is not sufficient to allow
for definite conclusions. Thus, this topic needs to be extensively
discussed. OBJECTIVE(S): The aim of this present study was to compare
the clinical outcomes of off-pump CABG (OPCAB), conventional on-pump CABG
(C-CABG), and on-pump beating heart (ONBEAT) CABG via an updated
systematic review and network meta-analysis of randomized controlled
trials. DATA SOURCES: PubMed, Web of Science, and the Cochrane Central
Registry were searched for relevant randomized controlled trials that were
published in English before 1 December 2021. STUDY SELECTION: Published
trials that included patients who received OPCAB, C-CABG, and ONBEAT CABG
were selected. DATA EXTRACTION AND SYNTHESIS: Two authors independently
screened the search results, assessed the full texts to identify eligible
studies and the risk of bias of the included studies, and extracted data.
All processes followed the Preferred Reporting Items for Systematic Review
and Meta-analysis of Individual Participant Data. MAIN OUTCOMES AND
MEASURES: The primary outcome was postoperative mortality in patients who
underwent C-CABG, OPCAB, or ONBEAT CABG. The secondary outcomes were
postoperative myocardial infarction, stroke, and renal impairment in the
three groups. The time point for analysis of outcomes was all time periods
during the postoperative follow-up. RESULT(S): A total of 39 385
patients (83 496.2 person-years) in 65 studies who fulfilled the
prespecified criteria were included. In the network meta-analysis, OPCAB
was associated with an increase of 12% in the risk of all-cause mortality
when compared with C-CABG [odds ratio (OR): 1.12; 95% CI: 1.04-1.21], a
reduction of 49% in the risk of myocardial infarction when compared with
ONBEAT (OR: 0.51; 95% CI: 0.26-0.99), a reduction of 16% in the risk of
stroke when compared with C-CABG (OR: 0.84; 95% CI: 0.72-0.99) and a
similar risk of renal impairment when compared with C-CABG and ONBEAT.
CONCLUSIONS AND RELEVANCE: OPCAB was associated with higher all-cause
mortality but lower postoperative stroke compared with C-CABG. OPCAB was
associated with a lower postoperative myocardial infarction than that of
ONBEAT. Early mortality was comparable among OPCAB, ONBEAT, and
C-CABG. Copyright © 2023 The Author(s). Published by Wolters
Kluwer Health, Inc.

<48>
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Accession Number
642665183
Title
Metabolic syndrome and surgical complications: a systematic review and
meta-analysis of 13 million individuals.
Source
International journal of surgery (London, England). 110(1) (pp 541-553),
2024. Date of Publication: 01 Jan 2024.
Author
Norris P.; Gow J.; Arthur T.; Conway A.; Fleming F.J.; Ralph N.
Institution
(Norris) School of Nursing and Midwifery, University of Southern
Queensland, Australia
(Gow) School of Commerce, University of Southern Queensland, Toowoomba,
Australia
(Gow) Senior Research Associate, School of Accounting, Economics and
Finance, University of KwaZulu- Natal, Durban, South Africa
(Arthur) Department of Surgery and Adjunct Professor, Toowoomba Hospital,
Centre for Health Research, University of Southern Queensland, Toowoomba,
Australia
(Conway) Peter Munk Cardiac Centre, Lawrence S. Bloomberg Faculty of
Nursing, University of Toronto, University Health Network, Toronto, Canada
(Fleming) University of Rochester Medical Center, United States
(Ralph) University of Sunshine Coast, Moreton Bay, Australia
Abstract
BACKGROUND: Metabolic syndrome (MetS) is characterised by the presence of
at least three of the five following components: insulin resistance,
obesity, chronic hypertension, elevated serum triglycerides, and decreased
high-density lipoprotein cholesterol concentrations. It is estimated to
affect 1 in 3 people around the globe and is reported to affect 46% of
surgical patients. For people with MetS who undergo surgery, an emerging
body of literature points to significantly poorer postoperative outcomes
compared with nonaffected populations. The aim of this study is to review
the current evidence on the risks of surgical complications in patients
with MetS compared to those without MetS. METHOD(S): Systematic
review and meta-analysis using PRISMA and AMSTAR reporting guidelines.
 RESULT(S): The meta-analysis included 63 studies involving 1 919 347
patients with MetS and 11 248 114 patients without MetS. Compared to
individuals without the condition, individuals with MetS were at an
increased risk of mortality (OR 1.75 95% CI: 1.36-2.24; P <0.01); all
surgical site infection types as well as dehiscence (OR 1.64 95% CI:
1.52-1.77; P <0.01); cardiovascular complications (OR 1.56 95% CI:
1.41-1.73; P <0.01) including myocardial infarction, stroke, cardiac
arrest, cardiac arrythmias and deep vein thrombosis; increased length of
hospital stay (MD 0.65 95% CI: 0.39-0.9; P <0.01); and hospital
readmission (OR 1.55 95% CI: 1.41-1.71; P <0.01). CONCLUSION(S): MetS
is associated with a significantly increased risk of surgical
complications including mortality, surgical site infection, cardiovascular
complications, increased length of stay, and hospital readmission. Despite
these risks and the high prevalence of MetS in surgical populations there
is a lack of evidence on interventions for reducing surgical complications
in patients with MetS. The authors suggest prioritising interventions
across the surgical continuum that include (1) preoperative screening for
MetS; (2) surgical prehabilitation; (3) intraoperative monitoring and
management; and (4) postoperative rehabilitation and
follow-up. Copyright © 2023 The Author(s). Published by Wolters
Kluwer Health, Inc.

<49>
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Accession Number
2039762965
Title
Randomized Controlled Trial of New Oral Anticoagulants Versus Warfarin for
Post Cardiac Surgery Atrial Fibrillation: The NEWAF Trial.
Source
Annals of Surgery. (no pagination), 2025. Article Number:
10.1097/SLA.0000000000006853. Date of Publication: 2025.
Author
Moonsamy P.; Zhao Y.; Makarem A.; Paneitz D.C.; Wolfe S.; Turco I.; Colon
K.M.; Ethridge B.R.; Li S.S.; Leya G.; Verma S.; D'Alessandro D.A.; Jassar
A.S.; Langer N.B.; Tolis G.; Villavicencio M.A.; Melnitchouk S.I.; Bloom
J.P.; Michel E.; Kreso A.; Alireza Rabi S.; Akeju O.; Sundt T.M.; Osho
A.A.
Publisher
Wolters Kluwer Health
Abstract
Objective To determine whether anticoagulation for new onset atrial
fibrillation (AF) with rivaroxaban decreases length of stay compared to
warfarin. Summary of Background Data Direct Oral Anticoagulants (DOACs)
have been shown to be noninferior to warfarin for stroke prevention in
nonsurgical patients with atrial fibrillation. There are no published
randomized trials comparing DOACs to warfarin in cardiac surgery patients,
and DOACs are yet to be widely adopted in this population. Methods In a
pragmatic, prospective, clinical trial, 100 patients with new-onset AF
after cardiac surgery were randomized to receive rivaroxaban (n=50) or
warfarin (n=50). Patients were followed for 30 days post-discharge, with
patient-reported outcomes assessed two weeks after discharge using the
Perception of Anticoagulant Treatment Questionnaire and the EuroQol-5D-3L
survey. Results The primary endpoint, length of stay (LOS) from day of
surgery to discharge (days, IQR), was 7 (6-9) for rivaroxaban and 8 (6-9)
for warfarin (p=0.460). LOS from initiation of anticoagulation to
discharge was 2 (1-4) days for rivaroxaban and 2 (1-3) days for warfarin
(p=0.738). The mean INR at discharge in the warfarin group was 1.68 (SD
0.5). No major bleeding events, strokes, or other arterial thromboembolism
events occurred in either group. Minor bleeding events were reported in
3/50 (6%) patients in the rivaroxaban group versus 1/50 (2%) in the
warfarin group (p=0.617), none of which required blood transfusion. One
patient (2%) in the rivaroxaban group developed a pericardial effusion
requiring drainage, compared to none in the warfarin group (p=1.000).
Patients taking rivaroxaban reported significantly higher scores for
convenience (p<0.001) and better overall perception of their
anticoagulation experience (p=0.006), though both groups reported similar
treatment satisfaction (p=0.494). Mobility issues were reported by 42.2%
of patients taking rivaroxaban compared to 18.6% of those taking warfarin
(p=0.021). All outcomes were consistent in both the intention-to-treat and
as-treated populations. Conclusions Treatment with rivaroxaban in
new-onset atrial fibrillation after cardiac surgery did not decrease
length of stay compared to warfarin. However, patients treated with
rivaroxaban reported significantly better convenience and a more favorable
overall perception of their anticoagulation experience compared to
warfarin. Given similar safety profiles, these findings support
incorporating rivaroxaban as an option for shared-decision-making when
selecting anticoagulation therapy for this patient
population. Copyright © 2025 Wolters Kluwer Health. All rights
reserved.

<50>
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Accession Number
643086024
Title
Pulmonary vagus nerve transection for chronic cough after video-assisted
lobectomy: a randomized controlled trial.
Source
International journal of surgery (London, England). 110(3) (pp 1556-1563),
2024. Date of Publication: 01 Mar 2024.
Author
Zhang Q.; Ge Y.; Sun T.; Feng S.; Zhang C.; Hong T.; Liu X.; Han Y.; Cao
J.-L.; Zhang H.
Institution
(Zhang, Cao) Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou
Medical University
(Zhang) Department of Anesthesiology, Yancheng Third People's Hospital,
Yancheng, Jiangsu, China
(Ge, Sun, Feng, Zhang, Hong, Liu, Zhang) Thoracic Surgery Laboratory,
Xuzhou Medical University
(Ge, Sun, Feng, Zhang, Hong, Liu, Zhang) Department of Thoracic Surgery,
Affiliated Hospital of Xuzhou Medical University
(Han) Department of Anesthesiology, Eye & ENT Hospital of Fudan
University, Shanghai, China
(Cao) Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical
University, Jiangsu, China
Abstract
BACKGROUND: Chronic cough is common after lobectomy. Vagus nerves are part
of the cough reflex. Accordingly, transection of the pulmonary branches of
vagus nerve may prevent chronic cough. And there are no clear
recommendations on the management of the pulmonary branches of vagus in
any thoracic surgery guidelines. METHOD(S): This is a single-center,
randomized controlled trial. Adult patients undergoing elective
video-assisted thoracoscopic lobectomy and lymphadenectomy were randomized
at a 1:1 ratio to undergo a sham procedure (control group) or transection
of the pulmonary branches of the vagus nerve that innervate the bronchial
stump plus the caudal-most large pulmonary branch of the vagus nerve. The
primary outcome was the rate of chronic cough, as assessed at 3 months
after surgery in the intent-to-treat population. RESULT(S): Between 1
February 2020 and 1 August 2020, 116 patients (59.6+/-10.1 years of age;
45 men) were randomized (58 in each group). All patients received
designated intervention. The rate of chronic cough at 3 months was 19.0%
(11/58) in the vagotomy group versus 41.4% (24/58) in the control group
(OR=0.332, 95% CI: 0.143-0.767; P =0.009). In the 108 patients with 2-year
assessment, the rate of persistent cough was 12.7% (7/55) in the control
and 1.9% (1/53) in the vagotomy group ( P =0.032). The two groups did not
differ in postoperative complications and key measures of pulmonary
function, for example, maximal voluntary ventilation, diffusing capacity
of the lungs for carbon monoxide, and forced expiratory volume.
 CONCLUSION(S): Transecting the pulmonary branches of vagus nerve that
innervate the bronchial stump plus the caudal-most large pulmonary branch
decreased the rate of chronic cough without affecting pulmonary function
in patients undergoing video-assisted lobectomy and
lymphadenectomy. Copyright © 2023 The Author(s). Published by
Wolters Kluwer Health, Inc.

<51>
Accession Number
2039749533
Title
Is Prior Cardiac Surgery a Risk Factor for Patients in Aortic Surgery: A
Systematic Review and Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Lang Q.; Zhang J.; Li J.; Xiao Z.; Meng W.; Qin C.
Institution
(Lang, Zhang, Xiao, Meng, Qin) Department of Cardiovascular Surgery and
Cardiovascular Surgery Research Laboratory, West China Hospital, Sichuan
University, Sichuan, Chengdu, China
(Li) Department of Thoracic Surgery, West China Hospital, Sichuan
University, Sichuan, Chengdu, China
Publisher
W.B. Saunders
Abstract
Background: The rising global incidence of aortic surgical interventions
has increased demand for complex reoperations. However, surgical outcomes
between primary aortic surgery (PAS) and repeat sternotomy aortic surgery
(RAS) remain poorly characterized. This study was designed to evaluate
whether prior cardiac surgery constitutes a risk factor for patients
undergoing aortic surgery. Method(s): A systematic search of PubMed,
Embase, and Web of Science was conducted to identify studies comparing
surgical outcomes between PAS and RAS. The primary outcome was in-hospital
mortality. Secondary outcomes included the incidence of re-exploration for
bleeding, renal failure, deep sternal wound infection, neurologic events,
cardiopulmonary bypass time, and long-term survival rates at 2-year,
4-year, 8-year, and 10-year follow-ups. Result(s): A total of 19
studies involving 31,631 participants were included in this meta-analysis.
Patients undergoing PAS demonstrated significantly lower rates of
in-hospital mortality (9.3% v 16.0%, odds ratio [OR] 0.55, 95% confidence
interval [CI] 0.50-0.60; I2 = 0.0%, p < 0.001) compared with
the RAS cohort. PAS was also associated with a lower incidence of
re-exploration for bleeding (7.2% v 9.4%, OR 0.76, 95% CI 0.68-0.84, p <
0.001), renal failure (13.3% v 15.8%, OR 0.73, 95% CI 0.65-0.81, p <
0.001), and deep sternal wound infection (0.7% v 2.8%, OR 0.47, 95% CI
0.37-0.60, p < 0.001). In anatomical subgroup analyses, patients
undergoing primary aortic root surgery demonstrated significantly lower
mortality odds compared with repeat sternotomy root procedures (5.0% v
8.4%, OR 0.55, 95% CI 0.50-0.61, p < 0.001); while primary aortic arch
surgery demonstrated a mortality benefit compared with repeat sternotomy
for arch interventions, this advantage was less pronounced than that
observed in root procedures (8.4% v 11.9%, OR 0.60, 95% CI 0.39-0.94, p =
0.026). While short-term survival favored the PAS group (62.6% v 55.2%,
2-year OR 0.74, 95% CI 0.58-0.93, p = 0.01), long-term survival converged
between groups (14.8% v 12.7%, 10-year OR 0.82, 95% CI 0.60-1.13, p =
0.23), particularly after propensity score matching. Conclusion(s):
This study shows that RAS is associated with significantly elevated
in-hospital mortality and increased perioperative risks, particularly
pronounced in repeat sternotomy root replacement procedures. However,
prior cardiac surgery did not diminish the long-term benefits of aortic
surgery. Copyright © 2025 Elsevier Inc.

<52>
Accession Number
2039711760
Title
Impact of early high flow nasal oxygen on diaphragmatic function and
pulmonary complications after thoracic surgery: A randomized clinical
trial.
Source
Journal of Clinical Anesthesia. 106 (no pagination), 2025. Article Number:
111945. Date of Publication: 01 Sep 2025.
Author
Fogagnolo A.; Grasso S.; Dres M.; Azzolina D.; Dalla Corte F.; Dolci G.;
Tamburini N.I.; De Paoli G.; Murgolo F.; Pedarzani E.; Andalo A.; Volta
C.A.; Savino S.
Institution
(Fogagnolo, Volta, Savino) Emergency Department, Section of Anaesthesia
and Intensive Care, Azienda Ospedaliera-Universitaria Sant' Anna, Ferrara,
Italy
(Grasso, Murgolo) Department of Precision-Regenerative Medicine and Jonic
Area (DiMePRe-J), Section of Anesthesiology and Intensive Care Medicine,
University of Bari "Aldo Moro", Bari, Italy
(Dres) Service de Medecine Intensive - Reanimation-SRPR, APHP, Hopital
Pitie-Salpetriere, Sorbonne Universite, Paris, France
(Azzolina, Pedarzani) Department of Environmental and preventive science,
University of Ferrara, Italy
(Azzolina, Pedarzani) Research and Innovation Unit, Biostatistics and
Clinical Trial Area, University Hospital of Ferrara, Ferrara, Italy
(Dalla Corte) Department of Anaesthesia and intensive care medicine, IRCSS
Humanitas research Hospital, Rozzano, Milan, Italy
(Dolci, Tamburini) Department of Thoracic surgery, Azienda
Ospedaliera-Universitaria Sant'Anna, Ferrara, Italy
(De Paoli, Andalo, Volta, Savino) Department of translational medicine,
University of Ferrara. Ferrara, Italy
Publisher
Elsevier Inc.
Abstract
Background: Postoperative pulmonary complications (PPCs) are common after
thoracic surgery, particularly in patients that develop postoperative
diaphragmatic dysfunction. High-flow nasal cannula (HFNC) oxygen therapy
decreases postoperative work of breathing and provides a positive
end-expiratory pressure (PEEP) effect. As a result, it may decrease the
occurrence of diaphragmatic dysfunction and PPCs after thoracic surgery.
 Method(s): Single-centre, open-label, randomized controlled trial.
Patients undergoing video-assisted thoracoscopic lobectomy were randomized
to receive conventional oxygen therapy (COT) or high flow nasal cannula
oxygen therapy. In both groups, inspiratory oxygen fraction was titrated
to reach a peripheral oxygen saturation of >94 %. Diaphragmatic
displacement (DD) and diaphragmatic thickening fraction (TF%) were
measured 2 and 24 h after surgery. Diaphragmatic dysfunction was
identified by DD <10 mm. PPCs occurring within 7 days after study
enrollment were recorded. Result(s): We analyzed 116 patients in the
study. Postoperative diaphragmatic dysfunction occurred in 17/58 patients
(29 %) in the HFNC group compared to 21/58 (36 %) in the COT group (p =
0.55). The rate of PPCs was similar between the two groups: 32/58 (55 %)
in the HFNC group and 37/58 (64 %) in the COT group (p = 0.449). Patients
who developed postoperative diaphragmatic dysfunction experienced fewer
PPCs when treated with HFNC (20/37; 54 %) compared to COT (17/21; 81 %) (p
= 0.037). A post hoc mixed-model analysis confirmed that HFNC reduced the
risk of PPCs in patients with diaphragmatic dysfunction (OR 0.16, 95 % CI
0.02-0.83). Conclusion(s): Early HFNC support does not decrease the
rate of postoperative diaphragmatic dysfunction rate or respiratory
complications. In patients who develop postoperative diaphragmatic
dysfunction, HFNC may play a role in mitigating the risk of PPCs. Clinical
trial registration: NCT05532033 Copyright © 2025 The Authors

<53>
Accession Number
2035442335
Title
The effect of repetitive transcranial magnetic stimulation (rTMS) on
perioperative neurocognitive disorders in patients after cardiac surgery:
study protocol for a randomized controlled trial.
Source
Trials. 26(1) (no pagination), 2025. Article Number: 253. Date of
Publication: 01 Dec 2025.
Author
Wang J.; Wang X.; Li S.; Yang J.; Yan X.; Gao J.; Jia X.; Zuo L.; Wu A.;
Wei C.
Institution
(Wang, Wang, Li, Yang, Yan, Wu, Wei) Department of Anesthesiology, Beijing
Chao-Yang Hospital, Capital Medical University, No.8 Gongti Nanlu,
Chao-Yang District, Beijing, China
(Gao) Department of Cardiac Surgery, Beijing Chao-Yang Hospital, Capital
Medical University, No.8 Gongti Nanlu, Chao-Yang District, Beijing, China
(Jia, Zuo) Department of Radiology, Beijing Chao-Yang Hospital, Capital
Medical University, No.8 Gongti Nanlu, Chao-Yang District, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Introduction: Perioperative neurocognitive disorders (PND) is one of the
most common postoperative complications among elderly patients (above 65
years old) undergoing cardiac surgery. However, thus far, there have not
been any effective therapies for managing PND. Recent research has shown
that repetitive transcranial magnetic stimulation (rTMS) alters brain
plasticity and improves cognitive function in several neurodegenerative
disorders and psychiatric disorders. However, the potential benefits of
rTMS in reducing PND in patients undergoing cardiac surgery have not been
investigated. Therefore, the current protocol is designed to determine
whether rTMS can reduce the incidence of PND in patients undergoing
cardiac surgery. Methods and analysis: The study will be a single-blinded,
randomized controlled trial. Participants undergoing elective cardiac
surgery will be randomized to receive either rTMS or sham stimulation with
focal figure-of-eight coils over the right dorsolateral prefrontal cortex.
A series of neuropsychological tests will be completed to evaluate
cognitive function in surgery patients before, on day 7, and on day 30
after cardiac surgery. The primary outcome is the prevalence of PND in
cardiac surgery patients. The secondary outcomes will be the incidence of
postoperative delirium, pain, sleep quality, depressive symptoms,
activities of daily living, length of hospital stay and ICU length of
stay, and rate of complication and mortality during the hospital stay.
Ethics and dissemination: Beijing Chaoyang Hospital Ethics Committee
approved this study and has the number 2022-ke-487. It is registered with
Clinical Trials (trial number NCT 05668559). Informed consent must be
provided by all participants. The study result will be published in a
peer-reviewed journal. Trial registration: NCT05668559. Registered on June
6, 2022. Copyright © The Author(s) 2025.

<54>
Accession Number
2034803978
Title
Acetylsalicylic acid alone or in combination with either enoxaparin or
unfractionated heparin for postoperative thromboprophylaxis in coronary
artery bypass surgery patients. A randomised clinical trial assessing
surrogate outcomes.
Source
Cardiovascular Revascularization Medicine. 77 (pp 66-74), 2025. Date of
Publication: 01 Aug 2025.
Author
Lorenzen U.S.; Arendrup H.; Johansson P.I.; Jakobsen J.C.
Institution
(Lorenzen) Department of Vascular Surgery, Rigshospitalet, Copenhagen,
Denmark
(Arendrup) Department of Thoracic Surgery, Rigshospitalet, Copenhagen,
Denmark
(Johansson) CAG Center for Endotheliomics, Rigshospitalet, Copenhagen,
Denmark
(Jakobsen) Copenhagen Trial Unit, Capitol Region, Copenhagen, Denmark
(Jakobsen) Department of Regional Health Research, The Faculty of Heath
Sciences, University of Southern Denmark, Denmark
(Johansson) Department of Clinical Medicine, University of Copenhagen,
Copenhagen, Denmark
Publisher
Elsevier Inc.
Abstract
Introduction: Coronary artery bypass graft surgery has considerable
effects on patient haemostasis. Heparins as thromboprophylaxis may be
beneficial but may also increase the risk of bleeding complications.
 Objective(s): To assess the effects of heparins on haemostasis in
post-coronary artery bypass graft patients. Method(s): Across one
year, we randomised 60 participants scheduled for an elective coronary
artery bypass graft-procedure with or without aortic valve replacement.
The trial was a prospective, open-label (though blinded for the
laboratory), randomised, single-centre trial with three intervention
groups (n = 20 in each): group 1 received acetylsalicylic acid, group 2
received subcutaneous low molecular weight heparin and acetylsalicylic
acid, and group 3 received intravenous unfractionated heparin and
acetylsalicylic acid. Primary outcomes were platelet activation
(Multiplate ASPI-test) and time to clot initiation (TEG R-time). We
secondly assessed several additional Multiplate and TEG parameters.
 Result(s): Group 3 (intravenous unfractionated heparin) compared with
group 1 (acetylsalicylic acid alone) showed evidence of 1) increased clot
initiation time (R-time + 0.9 min; 95 % CI: +0.4 to +1.4 min; P = 0.009),
and 2) decreased 30-min lysis (-1.3 %; 95 % CI: -2.1 to -0.5 %; P = 0.02).
The remaining analyses of primary and secondary outcomes showed no
evidence of a difference between the three groups. Discussion(s):
Intravenous unfractionated heparins may increase the clot initiation time
post-operatively after coronary artery bypass graft surgery and reduce
lysis. Otherwise, there seems to be no effect of low molecular weight or
unfractionated heparin on haemostatic parameters after coronary artery
bypass surgery patients. Copyright © 2024 The Authors

<55>
Accession Number
2034789425
Title
Tranexamic acid-induced anaphylaxis: a systematic review.
Source
European Journal of Clinical Pharmacology. 81(8) (pp 1119-1127), 2025.
Date of Publication: 01 Aug 2025.
Author
Lin P.-S.; Yao Y.-T.; Turan A.; Sessler D.I.
Institution
(Lin) Department of Cardiovascular Surgery, Fujian Medical University
Affiliated First Quanzhou Hospital, Fujian, China
(Lin, Yao) Evidence in Cardiovascular Anesthesia (EICA) Group, Beijing,
China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College and Chinese Academy
of Medical Sciences, No. 167, Beilishi Road, Xicheng District, Beijing,
China
(Yao, Turan, Sessler) Center of Outcomes Research, Department of
Anesthesiology, Critical Care and Pain Medicine, University of Texas,
Houston, TX, United States
(Yao, Turan, Sessler) Outcomes Research Consortium, Houston, TX, United
States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Tranexamic acid (TXA) is a synthetic antifibrinolytic agent
widely used in a diverse range of hemorrhagic scenarios. Despite
documented superior safety profile, increasing reports have emerged
describing anaphylactic reactions to TXA. We reviewed reported cases of
anaphylactic reactions to TXA and summarize their clinical
characteristics, diagnosis and treatment protocols. Method(s):
PubMed, Embase, Web of Science were searched with the terms "tranexamic
acid", "antifibrinoly*", "anaphylaxis", "anaphylactic", "anaphylactoid",
"allergy" and "hypersensitivity" to identify relevant case reports. Data
were extracted and analyzed. Result(s): Our review identified 15
cases of TXA-induced anaphylaxis. Patients were 2 to 80 years old, with
60.0% adults. The most common symptoms were hypotension, hypoxia and rash
in an equal 66.7%, followed by tachycardia in 60.0%. TXA was confirmed as
the culprit allergen in 73.3% of cases through allergological workup.
Major treatments consisted of corticosteroids (80.0%), epinephrine (73.3%)
and antihistamine (60.0%). While most patients recovered, 1 patient
experienced recurrent anaphylaxis and 1 patient died. Conclusion(s):
Anaphylaxis to TXA is a rare drug adverse reaction with varying
manifestations. Prompt recognition and appropriate treatment are critical
in facilitating optimal outcomes. Copyright © The Author(s),
under exclusive licence to Springer-Verlag GmbH Germany, part of Springer
Nature 2025.

<56>
Accession Number
2035392930
Title
Immunosuppressant Use in Infective Endocarditis-Associated
Glomerulonephritis: A Systematic Review.
Source
Clinical Drug Investigation. 45(8) (pp 443-529), 2025. Date of
Publication: 01 Aug 2025.
Author
Sayad R.; Elsaeidy A.S.; Mokresh M.E.; Shawqi M.M.; Mohammed Y.A.; Hawash
E.A.; Ali A.M.; Kumar D.; Aly M.G.
Institution
(Sayad, Mohammed, Ali) Department of Histology, Faculty of Medicine,
Assiut University, Assiut, Egypt
(Elsaeidy, Hawash) Faculty of Medicine, Benha University, Benha, Egypt
(Mokresh) Hamidiye International School of Medicine, University of Health
Sciences, Istanbul, Turkey
(Shawqi) Emergency Medicine Department, Faculty of Medicine, Benha
University, Benha, Egypt
(Kumar) Dow Medical College, Dow University of Health Sciences, Karachi,
Pakistan
(Aly) Nephrology Unit, Internal Medicine Department, Assiut University,
Assiut, Egypt
(Aly) Nephrology Unit, Sana-Klinikum Hof, Hof, Germany
Publisher
Adis
Abstract
Background: Patients with infective endocarditis can develop various renal
diseases, including infective endocarditis-associated glomerulonephritis.
Antibiotics are essential for eradicating the infection. However, the
prognosis for renal function remains poor. This systematic review examines
the role of immunosuppressants in managing infective
endocarditis-associated glomerulonephritis (GN). Method(s): A
comprehensive search was performed across four databases: PubMed, Scopus,
MedLine, and Web of Science up to April 2024. We included studies that
investigated patients with any type of GN due to infective endocarditis
(IE) who were treated with immunosuppressants. Data extraction was
conducted using a standardized sheet, and study quality was assessed using
the Joanna Briggs Institute (JBI) critical appraisal tool. Result(s):
The review incorporated 55 studies encompassing 84 cases, 65 of whom were
male. The median age was 46.5 years. A total of 30 cases required kidney
replacement therapy. Following immunosuppressive therapy, clinical
improvement of IE was observed in 54 cases, while 9 patients experienced
worsening conditions, 3 patients had no clinical change, and data were
unavailable in 18 cases. Renal outcomes showed improvement in 67 patients,
with 9 cases showing worsening conditions, 3 patients showing no change, 3
experiencing partial or residual impairment, and renal outcome was
unavailable in 2 cases. A total of ten patients died, primarily owing to
sepsis or infection-related complications (five cases), congestive or
global heart failure (three cases), and renal failure with associated
metabolic complications (two cases). Additional treatments included plasma
exchange, with nine cases receiving plasmapheresis/plasma exchange. Of
these, eight patients showed marked renal function improvement, and one
patient showed partial improvement. Three patients also received
intravenous immunoglobulin. Conclusion(s): Immunosuppressive therapy
led to renal function improvement in the majority of cases, suggesting its
potential benefit in managing infective endocarditis-associated
glomerulonephritis. However, variability in response and significant
mortality highlight the need for individualized treatment strategies and
further research to optimize management. Copyright © The
Author(s) 2025.

<57>
Accession Number
2039727152
Title
Nefopam for Analgesia Following Cardiac Surgery: A Randomized
Placebo-Controlled Double-Blind Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Vacharaksa K.; Kongkanond T.; Taechawattananan N.; Weinberg L.; Lertkovit
S.; Subtaweesin T.; Saraphang S.; Kitisin N.; Raykateeraroj N.
Institution
(Vacharaksa, Kongkanond, Taechawattananan, Lertkovit, Kitisin,
Raykateeraroj) Department of Anesthesiology, Faculty of Medicine, Siriraj
Hospital, Mahidol University, Bangkok, Thailand
(Kongkanond) Department of Anesthesiology, Charoenkrung Pracharak
Hospital, Bangkok, Thailand
(Weinberg) Department of Anaesthesia, Austin Health, Heidelberg, Australia
(Weinberg) Department of Critical Care, The University of Melbourne,
Parkville, VIC, Australia
(Subtaweesin) Department of Cardiothoracic Surgery, Faculty of Medicine,
Siriraj Hospital, Mahidol University, Bangkok, Thailand
(Saraphang) Division of Nursing, Faculty of Medicine, Siriraj Hospital,
Mahidol University, Bangkok, Thailand
Publisher
W.B. Saunders
Abstract
Objective: To evaluate the analgesic efficacy, opioid-sparing effects, and
safety profile of nefopam compared with placebo following elective cardiac
surgery. Design(s): Randomized, double-blind, placebo-controlled
trial at a tertiary care center. Setting(s): Perioperative care.
 Participant(s): A total of 103 adults (mean age, 57.9 +/- 11.3 years)
undergoing elective cardiac surgery via median sternotomy were randomized
to receive nefopam (n = 50) or placebo (n = 53). Intervention(s):
Patients were randomized to receive nefopam (20 mg intravenous [IV] bolus,
followed by an 80 mg continuous infusion over 24 hours) or placebo, with
both groups receiving standardized IV fentanyl via patient-controlled
analgesia. Measurements and Main Results: The primary outcome was
cumulative fentanyl consumption over 48 hours. Secondary outcomes included
pain scores (NRS 0-10), intubation duration, intensive care unit
(ICU)/hospital length of stay, and adverse events. Both fentanyl
consumption and pain scores were assessed at 3, 6, 12, 24, and 48 hours
postoperatively. The nefopam group consumed 25% less fentanyl over 48
hours (mean, 16.3 +/- 1.6 microg/kg vs 21.9 +/- 1.6 microg/kg; p = 0.014),
with significant reductions from 6 hours to 48 hours. Pain scores were
lower in the nefopam group at rest at 48 hours (p = 0.03) and during
movement at 24 and 48 hours (p = 0.04 and 0.01), although overall pain
remained mild. Adverse events (eg, sinus tachycardia, agitation/delirium)
were comparable in the 2 groups. Duration of intubation and ICU/hospital
length of stay did not differ between the 2 groups. Conclusion(s):
Nefopam was well tolerated and associated with statistically significant
but clinically modest reductions in fentanyl use and pain scores after
cardiac surgery, supporting its role as a safe adjunct in multimodal
analgesia. Copyright © 2025 Elsevier Inc.

<58>
[Use Link to view the full text]
Accession Number
2037109444
Title
Long-term outcomes of second-generation drug-eluting stents versus
coronary artery bypass graft: a systematic review and meta-analysis of
randomized trials and multivariable adjusted data.
Source
Coronary Artery Disease. 36(6) (pp 518-524), 2025. Date of Publication: 01
Sep 2025.
Author
Carvalho Ferreira A.L.; Benitez M.E.; Lima A.E.; Alamino Lacalle A.; Saad
G.; Guida C.M.
Institution
(Carvalho Ferreira) Department of Medicine, Pontifical Catholic University
of Parana, Curitiba, Brazil
(Benitez) Department of Medicine, Advocate Illinois Masonic Medical
Center, Chicago, IL, United States
(Lima) Department of Medicine, Bahiana School of Medicine and Public
Health, Salvador, Brazil
(Alamino Lacalle) Division of Cardiology, University of Sao Paulo,
Ribeirao Preto, Brazil
(Saad, Guida) Division of Cardiology, Dante Pazzanese Institute of
Cardiology, Sao Paulo, Brazil
Publisher
Lippincott Williams and Wilkins
Abstract
Long-term data are limited comparing percutaneous coronary intervention
(PCI) with second-generation drug-eluting stents (S-DES) vs coronary
artery bypass grafting (CABG) in patients with complex coronary artery
disease (CAD). We aimed to conduct a systematic review and meta-analysis
comparing these interventions in patients with left main or multivessel
CAD. We systematically reviewed PubMed, Embase, and Cochrane for studies
that compared PCI with S-DES and CABG in patients with left main or
multivessel CAD with a minimum mean follow-up period of 3 years. Outcomes
of interest were all-cause mortality, myocardial infarction (MI), stroke,
and major adverse cardiovascular events (MACE). We extracted data from
observational studies as multivariable-adjusted or propensity
score-matched hazard ratio to minimize confounding and pooled hazard
ratios with 95% confidence intervals (CIs) using a random effects model in
Review Manager 5.4.1. We included 10 studies, 3 of which were randomized
controlled trials, comprising a total of 26964 patients, of whom 14928
underwent PCI. As compared with CABG, S-DES had a significantly higher
risk of all-cause mortality (hazard ratio 1.35; 95% CI 1.22-1.49; P <
0.001; I2 = 0%), MACE (hazard ratio 1.27; 95% CI 1.08-1.50; P =
0.005; I2 = 67%), and MI (hazard ratio 2.43; 95% CI 1.80-3.28;
P < 0.01; I2 = 0%). There was no significant difference between
groups in incidence of stroke. In this meta-analysis of patients with
complex CAD, PCI with S-DES was associated with an increased risk of
mortality, MI, and MACE compared with CABG. Copyright © 2025
Wolters Kluwer Health, Inc. All rights reserved.

<59>
Accession Number
2039808917
Title
Comparative Study of 20 ml of Injection Levobupivacaine 0.25% vs 20 ml of
Injection Bupivacaine 0.25% both with Fentanyl for Pecto-Intercostal
Fascial Block for Acute Pain Management in Cardiac Surgery Patients - A
Prospective Randomized Double-Blind Study.
Source
European Journal of Cardiovascular Medicine. 15(7) (pp 690-696), 2025.
Date of Publication: 01 Jul 2025.
Author
Mohod V.; Gautam S.; Arathi C.V.; Devasree D.L.
Institution
(Mohod) Dept - Anesthesiology and Critical Care, Grant Government Medical
College, Sir JJ group of Hospitals, Mumbai, India
(Gautam) Dept - Anesthesiology and Critical Care, Vardhman Mahavir Medical
College, Delhi, India
(Arathi) Dept - Anesthesiology and Critical Care, Lokmanya Tilak Municipal
Medical College and General Hospital, Sion, Mumbai, India
(Devasree) Dept - Anesthesiology and Critical Care, Grant Government
Medical College, Sir JJ Group of Hospitals, Mumbai, India
Publisher
Healthcare Bulletin
Abstract
Background: Effective postoperative analgesia in cardiac surgery is
essential for recovery. Pecto-intercostal fascial block (PIFB) offers an
opioid-sparing regional technique. This study compared levobupivacaine and
bupivacaine (both with fentanyl) for PIFB in cardiac surgery patients.
 Method(s): In this prospective, randomized, double-blind study, 110
adult patients undergoing elective cardiac surgery via median sternotomy
were randomized to receive bilateral ultrasound-guided PIFB using either
0.25% levobupivacaine + fentanyl (n = 56) or 0.25% bupivacaine + fentanyl
(n = 54). The block was administered twice: once after induction
(preoperative) and again at the end of surgery before shifting patients to
ICU. VAS pain scores, fentanyl requirements, extubation time, ICU stay,
and complications were recorded. Result(s): No statistically
significant difference was found between the groups in postoperative VAS
scores (both <= 3 till 16 hrs), total fentanyl consumption
(Levobupivacaine: 161.6 +/- 21.3 mcg; Bupivacaine: 165.74 +/- 27.17 mcg; P
= 0.376), extubation time (P = 0.227), or ICU stay (P = 0.479). No
block-related complications were observed. Conclusion(s): Both
levobupivacaine and bupivacaine are equally effective and safe when used
twice for PIFB during cardiac surgery. The technique provides reliable
analgesia and supports fast-tracking without complications. Copyright
© 2025 Healthcare Bulletin. All rights reserved.

<60>
[Use Link to view the full text]
Accession Number
641547913
Title
Tricuspid valve repair concomitant with mitral valve surgery: a systematic
review and meta-analysis.
Source
International journal of surgery (London, England). 109(7) (pp 2082-2095),
2023. Date of Publication: 01 Jul 2023.
Author
Yi K.; Xu J.; Zhang X.; Wang W.; Liu C.; Li X.; You T.
Institution
(Yi, You) Department of Cardiovascular Surgery, Gansu Provincial Hospital
(Yi, Xu, Zhang, Wang, You) Gansu International Scientific and
Technological Cooperation Base of Diagnosis and Treatment of Congenital
Heart Disease, Gansu Province, Lanzhou, China
(Wang) Department of Cardiac Surgery, First Hospital of China Medical
University, Shenyang, Liaoning, China
(Xu) Evidence-Based Medicine Center, School of Basic Medical Sciences,
Lanzhou University
(Zhang, Wang) First School of Clinical Medicine of Gansu University of
Chinese Medicine, China
(Liu, Li) First Clinical Medical College of Lanzhou University, Lanzhou,
China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Uncertainties persist about whether to aggressively and
effectively treat tricuspid regurgitation (TR) during mitral valve (MV)
surgery. REVIEW METHODS: Systematic literature searches were performed in
five databases to collect all relevant studies published before May 2022
on whether the tricuspid valve was treated during MV surgery. Separate
meta-analyses were performed on data from unmatched studies and randomized
controlled trials (RCT)/adjusted studies. MAIN RESULTS: A total of 44
publications were included, of which eight were RCT studies and the rest
were retrospective studies. There was no difference in 30-day mortality
[odds ratio (OR): 1.00, 95% CI: 0.71-1.42, OR: 0.66, 95% CI: 0.30-1.41)]
or overall survival [hazard ratio (HR): 1.01, 95% CI: 0.85-1.19, HR: 0.77,
95% CI: 0.52-1.14] in unmatched studies and RCT/adjusted studies. Late
mortality (OR: 0.37, 95% CI: 0.21-0.64) and cardiac-related mortality (OR:
0.36, 95% CI: 0.21-0.62) were lower in the tricuspid valve repair (TVR)
group in the RCT/adjusted studies. In the unmatched studies, overall
cardiac mortality (OR: 0.48, 95% CI: 0.26-0.88) was lower in the TVR
group. In the late TR progression analysis, the late TR progression was
lower among patients in the concomitantly intervened tricuspid group, and
patients in the untreated tricuspid group were prone to TR progression in
both studies (HR: 0.30, 95% CI: 0.22-0.41, HR: 0.37, 95% CI: 0.23-0.58).
 CONCLUSION(S): TVR concomitant with MV surgery is most effective in
patients with significant TR and dilated tricuspid annulus, especially
those with a significantly reduced risk of distant TR
progression. Copyright © 2023 The Author(s). Published by Wolters
Kluwer Health, Inc.

<61>
[Use Link to view the full text]
Accession Number
646121324
Title
Transcatheter tricuspid valve intervention versus medical therapy for
symptomatic tricuspid regurgitation: a meta-analysis of reconstructed
time-to-event data.
Source
International journal of surgery (London, England). 110(10) (pp
6800-6809), 2024. Date of Publication: 01 Oct 2024.
Author
Fu G.; Zhu J.; Song W.; Bagaber G.; Wang C.; Chen J.; Wei L.
Institution
(Fu, Song, Wang, Chen, Wei) Department of Cardiovascular Surgery,
Zhongshan Hospital, Fudan University, Shanghai, China
(Zhu) Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital,
Fudan University, Shanghai, China
(Bagaber) Shanghai Medical College, Fudan University, Shanghai, China
(Wang, Chen, Wei) Department of Cardiovascular Surgery, Shanghai Geriatric
Medical Center, Shanghai, China
Abstract
BACKGROUND: Transcatheter tricuspid valve intervention (TTVI) has
demonstrated safety and efficacy in treating high-risk patients with
tricuspid regurgitation (TR). The authors aimed to perform a meta-analysis
based on reconstructed time-to-event data to compare the clinical benefit
of TTVI with medical therapy (MED). METHOD(S): A systematic
literature search was conducted in major databases, including PubMed,
Embase, and the Cochrane Library, until 20 October 2023. All studies
comparing the outcomes between TTVI and MED were included. The primary
outcome was all-cause mortality. The secondary outcomes included heart
failure (HF) hospitalization and the composite outcome of all-cause
mortality and HF hospitalization. RESULT(S): Five studies covering
3826 patients (1146 received TTVI and 2680 received MED) were identified.
At 1-year follow-up, TTVI significantly reduced the risk of all-cause
mortality compared with MED [hazard ratio (HR) 0.54, 95% CI: 0.39-0.74,
P=0.0001]. There was a trend in favor of TTVI in HF hospitalization,
although without significant difference (HR 0.70, 95% CI: 0.42-1.18,
P=0.18). TTVI was also associated with a decreased risk of composite
outcome (HR 0.57, 95% CI: 0.38-0.86, P=0.007). Reconstructed Kaplan-Meier
curves illustrated a 1-year overall survival rate of 83.1% in the TTVI
group and 68.8% in the MED group. The subgroup analysis of device types
yielded consistent results. CONCLUSION(S): Compared with MED, TTVI
was associated with greater 1-year benefits for patients with symptomatic
moderate or greater TR from the aspects of all-cause mortality and HF
hospitalization. Copyright © 2024 The Author(s). Published by
Wolters Kluwer Health, Inc.

<62>
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Accession Number
643680148
Title
A commentary on 'Efficacy and safety of vitamin C for atrial fibrillation
after cardiac surgery: a meta-analysis with trial sequential analysis of
randomized controlled trials'.
Source
International journal of surgery (London, England). 110(7) (pp 4416-4417),
2024. Date of Publication: 01 Jul 2024.
Author
Wang C.; Sun Z.; Zhou W.
Institution
(Wang) Graduate School of Tianjin University of Traditional Chinese
Medicine, China
(Sun) School of Chinese Materia Medica, Beijing University of Chinese
Medicine, Beijing, China
(Zhou) Second Affiliated Hospital of Tianjin University of Traditional
Chinese Medicine, Tianjin, China

<63>
Accession Number
2036789235
Title
Intravenous Amino-acid Infusion to Prevent Acute Kidney Injury after
Cardiac Surgery: A Review of the Evidence.
Source
Annals of Thoracic Surgery. 120(2) (pp 256-266), 2025. Date of
Publication: 01 Aug 2025.
Author
Losiggio R.; Redaelli M.B.; Landoni G.; Bellomo R.
Institution
(Losiggio, Redaelli, Landoni) Department of Anesthesia and Intensive Care,
IRCCS San Raffaele Scientific Institute, Milan, Italy
(Landoni) School of Medicine, Vita-Salute San Raffaele University, Milan,
Italy
(Bellomo) Department of Critical Care, The University of Melbourne,
Melbourne, Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, Australia
(Bellomo) Data Analytics Research and Evaluation Centre, Austin Hospital,
Melbourne, Australia
(Bellomo) Department of Intensive Care, Austin Hospital, Melbourne,
Australia
(Bellomo) Centre for Clinical Informatics, Royal Melbourne Hospital,
Melbourne, Australia
(Bellomo) Department of Intensive Care, Royal Melbourne Hospital,
Melbourne, Australia
Publisher
Elsevier Inc.
Abstract
Background: Acute kidney injury (AKI) is a frequent and important
complication of cardiac surgery. Decreased perfusion is a key mechanism.
This decreased perfusion may be attenuated by intravenous amino acids
(AAs) through recruitment of renal functional reserve. Method(s): The
study investigators performed a PubMed search of all articles published
from 1980 to August 30, 2024, with combined search criteria of "renal
functional reserve," "amino acids," "cardiac surgery," and
"cardiopulmonary bypass" by using MEDLINE (PubMed), Embase, and the
Cochrane Central Register of Clinical Trials. Included were studies
describing the effect of AAs on renal functional reserve and studies of
adult cardiac surgery patients with information on renal function. A
narrative review was developed. Result(s): Multiple experimental and
human studies over >40 years have recurrently and consistently shown that
the administration of an oral protein load or intravenous AAs increase
renal blood flow and glomerular filtration rate by >30%. Moreover, several
pilot investigations in cardiac surgery with cardiopulmonary bypass
consistently showed renal benefits with intravenous AAs. Finally, a
pivotal trial of 3511 cardiac surgery patients (the PROTECTION trial)
recently confirmed such beneficial effects in a double-blind multicenter
international setting. Conclusion(s): Intravenous AAs consistently
recruit renal functional reserve and improve kidney function in cardiac
surgery patients. These findings have been confirmed by the PROTECTION
(Intravenous Amino Acid Therapy for Kidney Protection in Cardiac Surgery)
trial. Intravenous AA therapy is the only proven treatment to prevent
and/or attenuate the severity of cardiac surgery-associated
AKI. Copyright © 2025 The Society of Thoracic Surgeons

<64>
Accession Number
2038260189
Title
FFR-Guided Percutaneous Coronary Intervention vs Coronary Artery Bypass
Grafting in Patients with Diabetes.
Source
JAMA Cardiology. 10(6) (pp 603-608), 2025. Date of Publication: 11 Jun
2025.
Author
Takahashi K.; Otsuki H.; Zimmermann F.M.; Ding V.Y.; Engstrom T.; Horsted
Thyregod H.G.; Beleslin B.; Putnik S.; Tapp L.; Barker T.; Redwood S.;
Young C.; Bech G.J.-W.; Hoohenkerk G.J.F.; De Bruyne B.; Pijls N.H.J.;
Fearon W.F.
Institution
(Takahashi, Otsuki, Ding, Fearon) Stanford University School of Medicine,
Stanford University, Stanford, CA, United States
(Takahashi, Otsuki, Ding, Fearon) Stanford Cardiovascular Institute,
Stanford University, Stanford, CA, United States
(Zimmermann) St Antonius Hospital, Nieuwegein, Netherlands
(Zimmermann, Pijls) Catharina Hospital, Eindhoven, Netherlands
(Engstrom, Horsted Thyregod) Rigshospitalet, University of Copenhagen,
Copenhagen, Denmark
(Beleslin, Putnik) Medical Faculty, University Clinical Center of Serbia,
University of Belgrade, Belgrade, Serbia
(Tapp, Barker) University Hospitals Coventry and Warwickshire, Coventry,
United Kingdom
(Redwood, Young) St Thomas' Hospital, London, United Kingdom
(Bech, Hoohenkerk) Hagaziekenhuis, The Hague, Netherlands
(De Bruyne) Cardiovascular Center Aalst, Aalst, Belgium
(Fearon) VA Palo Alto Medical Systems, Palo Alto, CA, United States
Publisher
American Medical Association
Abstract
Importance: Outcomes in patients with diabetes after fractional flow
reserve (FFR)-guided percutaneous coronary intervention (PCI) using
current-generation drug-eluting stents (DES) compared with coronary artery
bypass grafting (CABG) are unknown. Objective(s): To investigate the
relative treatment effect of PCI vs CABG according to diabetes status with
respect to major adverse cardiac and cerebrovascular events (MACCE) at 3
years and to evaluate the impact of the SYNTAX score. Design,
Setting, and Participant(s): This is a prespecified subgroup analysis of
the FAME (Fractional Flow Reserve vs Angiography for Multivessel
Evaluation) 3 trial, an investigator-initiated, randomized clinical trial
conducted at 48 centers worldwide. The FAME 3 trial enrolled patients with
3-vessel coronary artery disease not involving the left main undergoing
coronary revascularization between August 2014 and December 2019. Data
analysis was conducted in August 2023. Clinical follow-up was performed at
hospital discharge and at 1 month, 6 months, 1 year, 2 years, and 3 years
after randomization. Intervention(s): Either FFR-guided PCI with
current-generation DES or CABG. Main Outcomes and Measures: The
primary end point was MACCE, defined as the composite of all-cause death,
myocardial infarction, stroke, or repeat revascularization at 3 years.
 Result(s): Of 1500 total patients enrolled, mean (SD) patient age was
65.1 (8.4) years, and 265 patients (17.7%) were female. The FAME 3 trial
included 428 patients with diabetes (28.5%). Patients with diabetes,
especially those receiving insulin, had a higher risk of MACCE at 3 years
compared with those without diabetes. Regarding relative treatment effect,
the risk of MACCE was higher after FFR-guided PCI compared with CABG in
both patients with diabetes (hazard ratio [HR], 1.44; 95% CI, 0.91-2.28; P
=.12) and those without diabetes (HR, 1.50; 95% CI, 1.08-2.07; P =.02),
with no significant interaction (P for interaction =.94). In patients with
a low SYNTAX score (<23), there was no significant difference in MACCE
between PCI and CABG, while in patients with an intermediate to high
SYNTAX score (>=23), PCI had a higher risk of MACCE than CABG, regardless
of diabetes status. Conclusions and Relevance: In this subgroup
analysis of the FAME 3 randomized clinical trial, the relative benefit of
CABG compared with FFR-guided PCI was similar among patients with and
without diabetes. Trial Registration: ClinicalTrials.gov Identifier:
NCT02100722. Copyright © 2025 American Medical Association. All
rights reserved.

<65>
[Use Link to view the full text]
Accession Number
644162168
Title
A comment on 'Efficacy of mitral valve repair in combination with coronary
revascularization for moderate ischaemic mitral regurgitation: a
systematic review and meta-analysis of randomized controlled trials'.
Source
International journal of surgery (London, England). 110(8) (pp 5222-5223),
2024. Date of Publication: 01 Aug 2024.
Author
Zheng J.; Chen Z.
Institution
(Zheng) First Clinical Medical School, Guangzhou Medical University
(Chen) Second Clinical Medical School, Guangzhou Medical University,
Guangzhou, Guangdong, China

<66>
[Use Link to view the full text]
Accession Number
2039745787
Title
Bilateral External Oblique Intercostal Plane Block Versus Intravenous
Morphine for Rescue Pain Relief in Patients with Epidurals Following Upper
Abdominal Surgeries: A Randomized Controlled Trial.
Source
A and A Practice. 19(7) (pp e02019), 2025. Date of Publication: 01 Jul
2025.
Author
Srinivasaraghavan N.; Seshadri R.A.; Ramasamy Y.; Raj P.; Chockalingam P.;
Sankar P R P.; Modh V.; Ramakrishnan B.
Institution
(Srinivasaraghavan, Ramasamy, Raj, Chockalingam, Sankar P R, Modh)
Department of Anesthesia and Critical Care, Cancer Institute (WIA), Tamil
Nadu, Chennai, India
(Seshadri) Integrated Cancer Care Group, Tamil Nadu, Chennai, India
(Ramakrishnan) Department of Clinical Trials Services Unit, Clinical
Trials Services Unit, Cancer Institute (WIA), Tamil Nadu, Chennai, India
Publisher
Wolters Kluwer Health
Abstract
BACKGROUND: The management of postoperative pain after upper abdominal
surgery is challenging. Thoracic epidural analgesia, though effective, has
limitations, while intravenous (IV) morphine is associated with side
effects. Ultrasound-guided external oblique intercostal block (EOIB) is an
emerging regional technique for upper abdominal pain relief. We
hypothesized that EOIB would provide superior pain relief to IV morphine
in patients undergoing upper abdominal surgery. The main objective of the
study was to compare pain relief from EOIB versus IV morphine as rescue
analgesia in patients with moderate to severe pain despite an epidural
after upper abdominal surgeries. METHOD(S): This double-blinded,
randomized controlled trial was conducted at a tertiary cancer hospital
from January to November 2024. Patients aged >=18 years undergoing upper
abdominal surgery with pain on the numerical rating scale >=4 despite
epidural and IV paracetamol were randomized (1:1) to IV morphine (0.05
mg/kg, Arm A) or bilateral EOIB (0.1% bupivacaine 1 mL/kg and 4 mg
dexamethasone, Arm B). The primary outcome was the total 24-hour morphine
rescue requirement. Secondary outcomes included pain intensity difference
(PID) at 0.5, 1, 4, 8, 12, 16, 20, and 24 hours, summated pain intensity
difference at 8 and 24 hours (SPID), percentage PID in the first four
hours, pain-free hours (PFH), and adverse events. Participants and outcome
assessor nurses were blinded in the trial. RESULT(S): Of 101 screened
patients, 66 were randomized with 33 in each group. The EOIB arm had
significantly lower 24-hour morphine requirements compared to the morphine
arm median (interquartile range) 0 mg (0-1.5) vs 2.5 mg (1-6.1),
respectively; median difference (95% confidence interval [CI], 1.5
[0.00-3.40]; P =.006). Repeated measures analysis of variance with
Greenhouse-Geisser correction determined that the mean PID did not differ
among the two groups across different time points over 24 hours; F (7,434)
= 1.08, P =.37. SPID at 8 and 24 hours favored EOIB (P =.038 and P =.048,
respectively). The percentage PID in the first four hours was higher in
the EOIB arm than morphine arm, 66.6% [58.5%-100%] vs 50% [34.9%-74%]; P
=.002. PFH was significantly higher in the EOIB arm than morphine arm 4.00
[0.00-8.00] hours vs 0.00[0.00-0.37] hours; P =.015, with two patients
achieving complete pain relief (NRS = 0) for 24 hours, compared to none in
the IV morphine group. No significant adverse events were observed.
 CONCLUSION(S): EOIB provided superior and prolonged analgesia
compared to IV morphine as a supplement to epidural analgesia, reducing
opioid consumption and increasing the pain-free period in patients
undergoing upper abdominal surgery. Copyright © 2025
International Anesthesia Research Society. Unauthorized reproduction of
this article is prohibited.

<67>
Accession Number
2033416258
Title
PENELOPE 1-year follow-up: legacy effect of a short protocol-led
LDL-C-lowering strategy in patients after myocardial infarction.
Source
Netherlands Heart Journal. 33(4) (pp 120-129), 2025. Date of Publication:
01 Apr 2025.
Author
van der Brug S.; van Trier T.; Omar Khader A.; Liem A.-H.; Schut A.;
Martens F.; Alings M.
Institution
(van der Brug, Omar Khader, Alings) Department of Cardiology, Amphia
Ziekenhuis, Breda, Netherlands
(van Trier, Martens) Department of Cardiology, Amsterdam University
Medical Centres, Amsterdam, Netherlands
(Omar Khader) Department of Cardiology, Erasmus Medical Centre, Rotterdam,
Netherlands
(Liem, Schut, Martens, Alings) Workgroup Cardiology, Centres Netherlands,
Utrecht, Netherlands
(Liem) Department of Cardiology, Franciscus Gasthuis, Rotterdam,
Netherlands
(Martens) Department of Cardiology, Deventer Ziekenhuis, Deventer,
Netherlands
Publisher
Bohn Stafleu van Loghum
Abstract
Objective: Lowering low-density lipoprotein cholesterol (LDL-C) reduces
the risk of developing atherosclerotic cardiovascular disease (ASCVD). In
the PENELOPE study, a guideline-based, protocol-led LDL-C-lowering
strategy was applied in patients after myocardial infarction and resulted
in 87% reaching target LDL-C levels of <=1.8mmol/l within a median of 45
days. This study evaluated PENELOPE's legacy effect on LDL-C levels after
1 year. Method(s): In the PENELOPE study, 999 patients with a
myocardial infarction and a history of ASCVD and/or diabetes mellitus were
included. If LDL-C> 1.8mmol/l, lipid-lowering therapy was intensified in
three consecutive steps: (1) high-intensity statin (HIST) monotherapy, (2)
HIST+ ezetimibe, and (3) HIST+ ezetimibe+ proprotein convertase
subtilisin/kexin type 9 inhibitor (PCSK9i). LDL-C levels were monitored
4-6 weeks after each step. The primary objective of this study was to
assess the prevalence of the LDL-C target level of <=1.8mmol/l being
maintained after 1 year. Result(s): Data of 738 patients (74%) were
available for 1-year follow-up. The target LDL-C level was met in 471
patients (64%). Median LDL-C levels changed from 1.5 (1.2-1.7) mmol/l
immediately after implementation of the protocol-led strategy to 1.6
(1.3-2.0) mmol/l after 1 year. Major treatment regimens were statin (58%),
statin+ ezetimibe (30%) and PCSK9i+ ezetimibe (+statin) (7%).
 Conclusion(s): After a myocardial infarction, implementation of a
protocol-led LDL-C-lowering strategy resulted in 87% of patients attaining
the LDL-C target level of <=1.8mmol/l within a median of 45 (32-77) days.
At 1-year follow-up, 64% maintained this target level and the median LDL-C
increased by 0.1mmol/l. Copyright © The Author(s) 2025.

<68>
[Use Link to view the full text]
Accession Number
647004339
Title
Impact of pecto-intercostal fascial block on postoperative fatigue in
elderly patients undergoing off-pump coronary artery bypass grafting: a
randomized clinical trial.
Source
International journal of surgery (London, England). 111(5) (pp 3323-3330),
2025. Date of Publication: 01 May 2025.
Author
Wang X.; Zhou M.; Liu Q.; Shen F.; Zhang Z.; Qi Y.; Sun J.; Wang L.
Institution
(Wang, Wang) Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu
Province Key Laboratory of Anesthesia and Analgesia Application
Technology, NMPA Key Laboratory for Research and Evaluation of Narcotic
and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
(Zhou, Liu, Zhang, Wang, Qi, Sun, Wang) Department of Anesthesiology,
Xuzhou Central Hospital, Xuzhou, China
(Zhou, Liu, Zhang, Wang, Qi, Sun, Wang) Xuzhou Clinical College of Xuzhou
Medical University, Xuzhou, China
(Shen) Department of Anesthesiology & Key Laboratory of Clinical Science
and Research, Zhongda Hospital, Southeast University, Nanjing, China
Abstract
BACKGROUND: Postoperative fatigue syndrome (POFS) is a common yet often
under-recognized consequence of surgical interventions, particularly in
cardiac surgery. POFS is associated with prolonged recovery times,
extended hospital stays, and increased healthcare costs. Current
strategies for preventing POFS have demonstrated limited success. This
study aims to evaluate the impact of pecto-intercostal fascial block
(PIFB) on the incidence of POFS in elderly patients undergoing off-pump
coronary artery bypass graft (CABG) surgery. METHOD(S): In this
randomized controlled trial, 110 elderly patients scheduled for off-pump
CABG surgery were randomly assigned to either the PIFB group ( n = 55;
0.4% ropivacaine) or the control group ( n = 55; normal saline). The
primary outcome was the incidence of POFS, which was assessed using the
ICFS-10 scale. Secondary outcomes included postoperative pain scores,
opioid consumption, extubation time, duration of ICU and hospital stay,
and Quality of Recovery (QoR-15) scores. RESULT(S): The incidence of
POFS was significantly lower in the PIFB group compared to the control
group on postoperative days 1 (69.0% vs. 92.7%, P = 0.004), 3 (63.6% vs.
83.6%, P = 0.030), and 5 (52.7% vs. 72.7%, P = 0.048), with no significant
differences observed by day 7 and 8 weeks. Pain scores were also markedly
lower in the PIFB group at three time points: immediately after
extubation, 12 hours post-surgery, and 24 hours post-surgery ( P < 0.001,
P < 0.001, and P = 0.002, respectively). Furthermore, opioid consumption
was reduced by an average of 11.1 mg ( P < 0.001). Patients in the PIFB
group experienced significantly shorter extubation times (5.5 +/- 1.8
hours vs. 8.6 +/- 2.1 hours, P < 0.001), ICU stays (31.8 +/- 7.3 hours vs.
39.4 +/- 7.5 hours, P < 0.001), and hospital stays (8.2 +/- 1.1 days vs.
8.8 +/- 1.2 days, P = 0.007). QoR-15 scores were significantly higher in
the PIFB group on postoperative days 1, 3, and 5 ( P < 0.001, P = 0.003,
and P = 0.037, respectively). Notably, no PIFB-related adverse events were
reported in either group. CONCLUSION(S): PIFB significantly
alleviated early POFS, enhanced pain management, reduced opioid
consumption, and accelerated recovery, thereby improving the overall
quality of recovery in elderly patients undergoing off-pump
CABG. Copyright © 2025 The Author(s). Published by Wolters Kluwer
Health, Inc.

<69>
[Use Link to view the full text]
Accession Number
640577255
Title
A commentary on 'A comparison of regional anesthesia techniques in
patients undergoing video-assisted thoracic surgery: A network
meta-analysis'.
Source
International journal of surgery (London, England). 109(3) (pp 498-499),
2023. Date of Publication: 01 Mar 2023.
Author
Zhao Y.; Cheng C.; Jiao X.; Guo L.
Institution
(Zhao, Guo) Department of Anesthesiology
(Cheng, Jiao) Intensive Care Unit, Shanxi Province Cancer Hospital, Shanxi
Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical
Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Shanxi
Province, Taiyuan, China
Publisher
NLM (Medline)

<70>
[Use Link to view the full text]
Accession Number
641747021
Title
Relative efficacy and safety of several regional analgesic techniques
following thoracic surgery: a network meta-analysis of randomized
controlled trials.
Source
International journal of surgery (London, England). 109(8) (pp 2404-2413),
2023. Date of Publication: 01 Aug 2023.
Author
Li J.; Sun Q.; Zong L.; Li D.; Jin X.; Zhang L.
Institution
(Li) Department of Thoracic Surgery, Xinjiang Medical University, First
Affiliated Hospital, Urumqi, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: This network meta-analysis was performed to assess the
relative efficacy and safety of various regional analgesic techniques used
in thoracic surgery. MATERIALSAND METHODS: Randomized controlled trials
evaluating different regional analgesic methods were retrieved from
databases, including PubMed, Embase, Web of Science, and the Cochrane
Library, from inception to March 2021. The surface under the cumulative
ranking curve) was estimated to rank the therapies based on the Bayesian
theorem. Moreover, sensitivity and subgroup analyses were performed on the
primary outcomes to obtain more reliable conclusions. RESULT(S):
Fifty-four trials (3360 patients) containing six different methods were
included. Thoracic paravertebral block and erector spinae plane block
(ESPB) were ranked the highest in reducing postoperative pain. As for
total adverse reactions and postoperative nausea and vomiting,
postoperative complications, and duration of hospitalization, ESPB was
found to be superior to other methods. It should be noted that there were
few differences between various methods for all outcomes.
 CONCLUSION(S): Available evidence suggests that ESPB might be the
most effective and safest method for relieving pain after thoracic
surgery, shortening the length of hospital stay and reducing the incidence
of postoperative complications. Copyright © 2023 The Author(s).
Published by Wolters Kluwer Health, Inc.

<71>
[Use Link to view the full text]
Accession Number
646518214
Title
Exercise-based cardiac rehabilitation for patients undergoing coronary
artery operation: a systematic review and meta-analysis based on current
randomized controlled trials.
Source
International journal of surgery (London, England). 111(3) (pp 2708-2721),
2025. Date of Publication: 01 Mar 2025.
Author
Shi Y.; Xu H.; Dong J.
Institution
(Shi, Dong) Rehabilitation Treatment Center of Wangjing Hospital, Chinese
Academy of Traditional Chinese Medicine, Beijing, China
(Xu) Department of Anesthesiology, Wangjing Hospital, Chinese Academy of
Traditional Chinese Medicine, Beijing, China
Abstract
BACKGROUND: Currently, exercise-based cardiac rehabilitation (CR) has been
receiving increasing interest for its potentially beneficial effects on
the health related quality of life (HRQoL) and outcomes of patients with
coronary heart disease (CHD). The aim of this study was to evaluate the
effect of exercise-based CR on patients after coronary artery bypass graft
(CABG) and percutaneous coronary interventions (PCI). METHOD(S): We
searched PubMed, Embase, Cochrane Library, and Web of Science from
inception to 1 December 2023 for relevant studies that evaluated the
effect of exercise-based CR on patients after CABG and PCI. Our primary
outcomes included mortality, complications, hospital admissions, and HRQoL
between patients receiving exercise-based CR and usual care. All
statistical analyses were performed using the standard statistical
procedures provided in Review Manager 5.2 and Stata 12.0. RESULT(S):
We finally indicated and included 25 randomized controlled trials (RCTs)
with 4106 participants for the present analysis. Our pooled results
indicated that, compared to usual care, exercise-based CR did not increase
the all-cause (relative risk, RR: 0.84; 95% confidence interval, CI:
0.54-1.31) and cardiovascular (RR: 0.98; 95% CI: 0.38-2.54) mortality for
patients after coronary artery operation. Similarly, exercise-based CR had
an equal effect on coronary artery complications for patients after
coronary artery surgery, including CABG (RR: 0.60; 95% CI: 0.32 - 1.15)
and PCI (RR: 0.92; 95% CI: 0.55-1.54). It was indicated that
exercise-based CR significantly reduced the incidence of myocardial
infarction (MI) by half with an RR of 0.50 (95% CI: 0.28-0.90). In
addition, exercise-based CR also significantly reduced all-cause hospital
admissions with an RR of 0.74 (95% CI: 0.62-0.88). Compared to usual care,
exercise-based CR obviously improved HRQoL of patients after coronary
artery operation evaluated with SF-36 summary scores (standardized mean
difference, SMD: 0.24; 95% CI: 0.11-0.38) and SF-36 8 domains (SMD: 0.35;
95% CI: 0.24-0.46). CONCLUSION(S): Our analysis indicated that
exercise-based CR had a significant effect on the improvement of HRQoL in
patients after coronary artery surgeries without increasing mortality or
the incidence of re-intervention with operations. Copyright ©
2025 The Author(s). Published by Wolters Kluwer Health, Inc.

<72>
Accession Number
2036893688
Title
Pulmonary function prediction in lung cancer resection candidates: the
latest insights.
Source
Breathe. 21(3) (no pagination), 2025. Article Number: 250041. Date of
Publication: 01 Jul 2025.
Author
Orlandi R.; Degiovanni S.; Uslenghi C.; Anghinelli A.; Besana P.;
Palleschi A.
Institution
(Orlandi, Degiovanni, Uslenghi, Anghinelli, Besana, Palleschi) Department
of Thoracic Surgery, University of Milan, Milan, Italy
(Palleschi) Thoracic Surgery and Lung Transplantation Unit, Fondazione
IRCCS Ca' Granda-Ospedale Maggiore Policlinico of Milan, Milan, Italy
Publisher
European Respiratory Society
Abstract
Surgical resection remains the most effective curative option for
early-stage nonsmall cell lung cancer (NSCLC) in fit patients. However,
many individuals with NSCLC have comorbidities that elevate surgical risks
and complicate postoperative recovery. These challenges necessitate
thorough preoperative assessments to evaluate patient suitability and
predict postoperative lung function. Pulmonary function tests (PFTs) and
imaging modalities, including computed tomography (CT),
ventilation-perfusion scintigraphy and ultrasound, are integral to these
evaluations. Advances in technology, such as ventilation and perfusion
single-photon emission computed tomography (SPECT)/CT, quantitative CT and
magnetic resonance imaging (MRI) techniques, have enhanced the accuracy of
postoperative predictions, offering valuable insights into respiratory
mechanics and regional lung function. Despite these advancements, no
comprehensive evaluation exists to establish the reliability of various
prediction methods. This review explores the role of traditional and
emerging preoperative tools in assessing lung resection candidates,
emphasising their contributions to clinical decision-making. By improving
the precision of postoperative lung function predictions, these tools not
only optimise surgical outcomes but also support shared decision-making,
balancing risks and patient preferences. Further refinement and
integration of these methods promises to enhance the management of
high-risk patients and advance the standard of care in thoracic
surgery. Copyright © ERS 2025.

<73>
[Use Link to view the full text]
Accession Number
643441981
Title
Vascular complications and outcomes following transcatheter aortic valve
replacement in patients on chronic steroid therapy: a meta-analysis.
Source
International journal of surgery (London, England). 110(4) (pp 2421-2429),
2024. Date of Publication: 01 Apr 2024.
Author
Ang S.P.; Chia J.E.; Jaiswal V.; Hanif M.; Vadhera A.; Gautam S.; Raut A.;
Rafaqat S.; Borra V.R.; Khandait H.; Shrestha A.B.; Iglesias J.
Institution
(Ang) Department of Internal Medicine, Rutgers Health/Community Medical
Center, NJ, United States
(Chia) Department of Medicine, International Medical University, Malaysia
(Jaiswal) JCCR Cardiology Research, Varanasi, India
(Hanif) Department of Internal Medicine, SUNY Upstate Medical University,
Syracuse, NY, United States
(Vadhera) Department of Medicine, Maulana Azad Medical College, New Delhi,
India
(Gautam) Department of Internal Medicine, Maimonides Medical Center,
United States
(Raut) Department of Internal Medicine, Nepal Medical College, Nepal
(Rafaqat) Department of Zoology (Molecular Physiology), Lahore College for
Women University, Lahore, Pakistan
(Borra) Department of Internal Medicine, University of Texas Rio Grande
Valley, Edinburg, TX, United States
(Khandait) Department of Internal Medicine, Trinitas Regional Medical
Center/RWJ Barnabas Health, Elizabeth, NJ, United States
(Shrestha) Department of Internal Medicine, Abdur Rahim Medical College,
Dinajpur, Bangladesh
(Iglesias) Department of Critical Care, Rutgers Health/Community Medical
Center, NJ, United States
Abstract
BACKGROUND: Chronic steroid (CS) therapy was reportedly linked to
increased vascular complications following percutaneous coronary
intervention. However, its association with vascular complications after
transcatheter aortic valve replacement (TAVR) remained uncertain, with
conflicting results being reported. OBJECTIVE(S): The authors aimed
to compare the rate of vascular complications and outcomes between
patients with and without CS use after TAVR. METHOD(S): The authors
conducted a comprehensive literature search in PubMed, Embase, and
Cochrane databases from their inception until 18th April 2022 for relevant
studies. Endpoints were described according to Valve Academic Research
Consortium-2 definitions. Effect sizes were pooled using DerSimonian and
Laird random-effects model as risk ratio (RR) with 95% CI. RESULT(S):
Five studies with 6136 patients undergoing TAVR were included in the
analysis. The included studies were published between 2015 and 2022. The
mean ages of patients in both study groups were similar, with the CS group
averaging 80 years and the nonsteroid group averaging 82 years. Notably, a
higher proportion of patients in the CS group were female (56%) compared
to the nonsteroid group (54%). CS use was associated with a significantly
higher risk of major vascular complications (12.5 vs. 6.7%, RR 2.32, 95%
CI: 1.73-3.11, P <0.001), major bleeding (16.8 vs. 13.1%, RR 1.61, 95% CI:
1.27-2.05, P <0.001), and aortic annulus rupture (2.3 vs. 0.6%, RR 4.66,
95% CI: 1.67-13.01, P <0.001). There was no significant difference in
terms of minor vascular complications (RR 1.43, 95% CI: 1.00-2.04, P
=0.05), in-hospital mortality (2.3 vs. 1.4%, RR 1.86, 95% CI: 0.74-4.70, P
=0.19), and 30-day mortality (2.9 vs. 3.1%, RR 1.14, 95% CI: 0.53-2.46, P
=0.74) between both groups. CONCLUSION(S): Our study showed that CS
therapy is associated with increased major vascular complications, major
bleeding, and annulus rupture following TAVR. Further large multicenter
studies or randomized controlled trials are warranted to validate these
findings. Copyright © 2024 The Author(s). Published by Wolters
Kluwer Health, Inc.

<74>
Accession Number
2039522867
Title
Postoperative Infectious Pneumonia in Cardiothoracic Surgery: A Systematic
Review and Meta-Analysis.
Source
F1000Research. 14 (no pagination), 2025. Article Number: 588. Date of
Publication: 2025.
Author
Khallikane S.; Seddiki R.; Serghini I.
Institution
(Khallikane) Cardiothoracic Anesthesia-Cardiovascular ICU,
Anesthesiology-ICU-Emergency Department, Avicenna Military Hospital,
Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech,
Morocco
(Khallikane) Marrakech-Safi, Marrakeck, Morocco
(Seddiki) Hassan II Military Hospital, Anesthesiology-Critical Care,
Avicenna Military Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad
University, Marrakech, Morocco
(Seddiki) Layun, Layun-Sakia Hamra, Morocco
(Serghini) Intensivist-Anesthesiologist Head of Emergency Department,
Avicenna Military Hospital, Marrakech-Safi, Marrakech, Morocco
Publisher
F1000 Research Ltd
Abstract
Background: Postoperative infectious pneumonia (PIP) is a common and
serious complication following cardiothoracic surgery, including coronary
artery bypass grafting (CABG), valve interventions, and thoracic oncologic
procedures. It is associated with increased morbidity, prolonged intensive
care unit (ICU) stay, and healthcare burden. Method(s): We performed
a systematic review and meta-analysis according to PRISMA 2020 guidelines.
Studies published between January 2021 and December 2023 were identified
from PubMed, Embase, and Scopus. Eligible studies reported the incidence
and/or perioperative risk factors for PIP with odds ratios (ORs) and 95%
confidence intervals (CIs). A random-effects model was used for pooled
estimates. Study quality was assessed using the Newcastle-Ottawa Scale.
The review was prospectively registered in PROSPERO 2025 CRD 420251057914.
Available from https://www.crd.york.ac.uk/PROSPERO/view/CRD420251057914.
 Result(s): Six high-quality cohort studies involving 4,392 patients
were included. The pooled incidence of PIP was 14.8% (95% CI,
10.6%-19.2%). Incidence was highest after thoracic oncologic surgery
(17.2%), followed by valve surgery (15.8%) and CABG (13.5%). Significant
risk factors included prolonged mechanical ventilation >48 hours (OR:
3.46), age >70 years (OR: 2.71), chronic obstructive pulmonary disease
(OR: 2.95), cardiopulmonary bypass time >120 minutes (OR: 2.63), and left
ventricular ejection fraction <40% (OR: 2.38). Heterogeneity was moderate
(I 2 = 46%) with no publication bias. Conclusion(s): PIP
remains a major postoperative concern. Identification of key risk factors
enables targeted preventive strategies-early extubation, pulmonary
optimization, and standardized care pathways-to reduce PIP incidence and
improve outcomes. Copyright: © 2025 Khallikane S et al.

<75>
Accession Number
2036891985
Title
The Effect of High-dose Statin on Cardiac Biomarkers Following Lower Limb
Vascular Surgery: A Randomized Clinical Trial.
Source
Shiraz E Medical Journal. 26(8) (no pagination), 2025. Article Number:
e157631. Date of Publication: 01 Aug 2025.
Author
Janatmakan F.; Javaherforooshzadeh F.; Ganj S.; Nasajian N.; Jorirahmadi
S.; Soltani F.; Moosavi S.M.
Institution
(Janatmakan, Ganj, Nasajian, Jorirahmadi, Soltani) Pain Research Center,
Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, Islamic
Republic of
(Javaherforooshzadeh) Ahvaz Anesthesiology and Pain Research Centre, Ahvaz
Jundishapur University of Medical Sciences, Ahvaz, Iran, Islamic Republic
of
(Moosavi) Department of General Surgery, Ahvaz Jundishapur University of
Medical Sciences, Ahvaz, Iran, Islamic Republic of
Publisher
Brieflands
Abstract
Background: Patients undergoing peripheral vascular surgery frequently
present with comorbid cardiovascular disease, where perioperative
myocardial ischemia and infarction represent leading causes of morbidity
and mortality. Through its plaque-stabilizing properties, atorvastatin may
reduce postoperative cardiac complications. Objective(s): This study
investigated whether preoperative high-dose atorvastatin therapy provides
cardioprotective benefits for patients requiring lower limb vascular
revascularization. Method(s): We conducted a single-center,
double-blind, randomized controlled trial at Golestan Hospital (Ahvaz,
Iran) between April 2019 and March 2021. Eighty eligible patients were
randomly assigned (1:1) via computer-generated allocation concealed in
opaque envelopes to receive either high-dose atorvastatin (n = 40) or a
conventional dose (control, n = 40). The study maintained triple blinding
(participants, surgeons, and assessors). Serial measurements of cardiac
biomarkers [troponin I, creatine kinase-MB (CK-MB), creatine phosphokinase
(CPK)], renal function (creatinine), and ECG monitoring were performed at
6, 24, and 72 hours postoperatively. Result(s): Baseline
characteristics showed no significant intergroup differences. The
atorvastatin group demonstrated significantly lower postoperative levels
of troponin I (P < 0.05), CK-MB (P < 0.05), and creatinine (P < 0.05). A
transient elevation in CPK levels occurred at 6 hours post-surgery in the
treatment group (P < 0.05), which subsequently normalized. These findings
support the potential myocardial and renal protective effects of high-dose
statin therapy in vascular surgery patients. Conclusion(s):
Perioperative administration of high-dose atorvastatin significantly
reduces biochemical markers of cardiac and renal injury following lower
extremity vascular procedures. These results suggest statins may improve
outcomes in this high-risk surgical population. Copyright © 2025,
Janatmakan et al.

<76>
Accession Number
2039714369
Title
Acute Normovolemic Hemodilution Versus Norepinephrine Infusion During
Autologous Blood Donation in Coronary Artery Bypass Graft Surgery: A
Prospective Randomized Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Ozgodek H.B.; Aydin M.E.; Oksuz D.A.; Karapinar Y.E.; Ahiskalioglu E.O.;
Celik E.C.; Yayik A.M.; Ahiskalioglu A.
Institution
(Ozgodek) Department of Anesthesiology and Reanimation, University of
Health Sciences, Erzurum, Turkey
(Aydin, Karapinar, Ahiskalioglu, Celik, Yayik, Ahiskalioglu) Department of
Anesthesiology and Reanimation, Ataturk University School of Medicine,
Erzurum, Turkey
(Oksuz) Clinic for Anesthesiology, Intensive Care, Emergency Medicine,
Pain Therapy and Palliative Medicine, Marienhaus Klinikum Hetzelstift,
Neustadt an der Weinstrasse, Germany
Publisher
W.B. Saunders
Abstract
Objective: This study was designed to compare the hemodynamic effects of
acute normovolemic hemodilution (ANH) and norepinephrine infusion during
autologous blood donation, with a particular focus on cardiac cycle
efficiency (CCE), an energy-based parameter of cardiovascular performance.
 Design(s): A prospective, randomized clinical trial. Setting(s):
Single-center, academic hospital. Participant(s): Forty patients
undergoing coronary artery bypass graft surgery. Intervention(s): In
the ANH group, a crystalloid solution was administered simultaneously to
the contralateral upper extremity. The volume of replacement fluid was
calculated at a 3:1 ratio relative to the volume of blood withdrawn. In
the norepinephrine infusion (NA) group, no fluid was administered during
the donation process. Instead, norepinephrine infusion was administered at
a rate of 0.05 microg/kg/min. Measurements and Main Results:
Hemodynamic parameters were monitored at three time points during the
blood donation process. The primary outcome was the comparison of CCE
changes between groups. Secondary outcomes included other advanced
hemodynamic variables, metabolic indicators, and short-term postoperative
clinical results. Changes in CCE during autologous blood donation were
comparable between groups (ANH: 0.20 +/- 0.51, NA: 0.5 +/- 0.57, p =
0.373). Hemodynamic stability was achieved in both groups, with no
relevant differences in cardiac index, stroke volume index, or metabolic
markers (p > 0.05). Dynamic preload parameters showed expected
physiological patterns in the norepinephrine group, consistent with
volume-sparing circulatory support. None of the patients experienced acute
kidney injury. There was no difference between the groups in terms of
intensive care unit or hospital length of stay. Conclusion(s):
Norepinephrine infusion demonstrated hemodynamic equivalence to ANH in the
setting of autologous blood donation during coronary artery bypass graft
surgery. Its ability to preserve circulatory function without fluid
administration suggests it may serve as a viable alternative to ANH,
particularly in patients requiring careful volume
management. Copyright © 2025 Elsevier Inc.

<77>
Accession Number
2039714281
Title
Robustness of Randomized Controlled Trials Evaluating Acute Normovolemic
Hemodilution as a Blood Conservation Strategy in Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Bugo S.; Bottussi A.; D'Andria Ursoleo J.; Mongardini E.; Carravetta M.;
Agosta V.T.; Piazza E.; Erdoes G.; Monaco F.
Institution
(Bugo, Bottussi, D'Andria Ursoleo, Mongardini, Carravetta, Agosta, Piazza,
Monaco) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Erdoes) Department of Anesthesiology and Pain Medicine, Inselspital, Bern
University Hospital, University of Bern, Bern, Switzerland
Publisher
W.B. Saunders
Abstract
Objective: To evaluate the robustness of randomized controlled trials
(RCTs) investigating acute normovolemic hemodilution (ANH), a blood
conservation strategy designed to reduce transfusion requirements, in
cardiac surgery using the Fragility Index (FI). Although recommended in
clinical guidelines, high-quality evidence supporting ANH remains limited.
 Design(s): A systematic review of RCTs. Setting(s): A search of
PubMed/MEDLINE, the Cochrane Central Register of Controlled Trials, and
EMBASE databases was conducted from their inception. Participant(s):
Adult patients undergoing cardiac surgery. Intervention(s): RCTs
comparing ANH with standard care (without ANH) as a blood conservation
strategy in adult patients undergoing cardiac surgery. The statistical
robustness of RCTs was assessed using the FI, reverse FI, and Continuous
FI (CFI), with higher values indicating stronger evidence.
 Measurements and Main Results: Twenty-eight RCTs were identified. The
median sample size was 75.8 patients. On-pump coronary artery bypass
grafting was the most common procedure (39.3%). The median FI for
perioperative transfusion rates was higher in nonsignificant studies (p >=
0.05) than in significant ones (p < 0.05), suggesting weaker evidence for
reducing transfusions in nonsignificant trials. Conversely, the median CFI
for the number of red blood cell units transfused was higher in
significant studies, supporting ANH's effectiveness in reducing
transfusion requirements. Conclusion(s): RCTs reporting significant
reductions in red blood cell transfusions with ANH exhibited greater
statistical robustness, as indicated by higher FI and CFI values, compared
with nonsignificant studies. The fragility of perioperative transfusion
outcomes highlights the need for larger, methodologically rigorous RCTs to
validate ANH's efficacy in cardiac surgery. Copyright © 2025
Elsevier Inc.

<78>
Accession Number
2039853070
Title
High vasoactive-inotropic score is associated with poor outcomes in
patients undergoing coronary artery bypass grafting: A systematic review
and meta-analysis.
Source
Perfusion (United Kingdom). (no pagination), 2025. Article Number:
02676591251364482. Date of Publication: 2025.
Author
Damarlapally N.; Vempati R.; Vasudevan S.S.; Mathur G.; Banda P.; Mourad
D.; Khan A.; Polamarasetty H.; Desai R.; Nunna K.R.
Institution
(Damarlapally) Health Sciences, Houston Community College - Coleman
Campus, Houston, TX, United States
(Vempati) Internal Medicine, Trinity Health Oakland Hospital, Pontiac, MI,
United States
(Vasudevan) Louisiana State University Health Sciences Center, Shreveport,
LA, United States
(Mathur) Mahatma Gandhi Memorial Medical College, Indore, India
(Banda) Internal Medicine, Gandhi Medical College and Hospital, Telangana,
Secunderabad, India
(Mourad, Khan) Internal Medicine, Central Michigan University, Saginaw,
MI, United States
(Polamarasetty) Biomedical Engineering, University of Houston, Houston,
TX, United States
(Desai) Outcomes Research, Independent Researcher, Atlanta, GA, United
States
(Nunna) Critical Care Medicine, Bon Secours - Southside Medical Center,
Petersburg, VA, United States
Publisher
SAGE Publications Ltd
Abstract
Background: Vasoactive-inotropic score (VIS) has been previously utilized
as one of the predictors in open heart procedures postoperatively, but its
association with poor outcomes in patients who underwent coronary artery
bypass graft (CABG) is still unclear. We aim to find the association in
this population. Method(s): PubMed, Google Scholar, and Scopus were
systematically searched for studies showing an association of poor
cardiovascular (CV) outcomes, including mortality with VIS from inception
to May 2024 following CABG surgery. Pooled effect sizes (aOR, OR, and ROC
AUC) were estimated using CMA version 4 with a fixed-effect model and 95%
confidence intervals (CI). I2-Statistic was used to measure heterogeneity.
Leave-one-out sensitivity analysis and meta-regression analysis were
utilized to measure the robustness of our findings and detect influencing
confounding variables, respectively. Quality assessment of the studies was
done through the Joanna Briggs Institute (JBI) tool. p-value <0.05 was
considered significant. Result(s): Six studies with a total sample
size of 6504 patients following CABG surgery, with a mean age of 63.6 +/-
3.15 years, containing predominantly males (71.8%) reported poor outcomes
such as CV morbidity, cardiopulmonary resuscitation, mechanical
ventilation, stroke, and mortality. Most studies had hypertension,
diabetes, and chronic kidney disease as comorbidities. VIS greater than 5
is validated by pooled ROC AUC of 80.1% [95% CI: 73.5-85.4]. Our
meta-analysis found a significant association between VIS >5 and poor
outcomes, including mortality in six studies with pooled unadjusted
OR-1.08 [95% CI: 1.06-1.10, p < 0.0001] and in four studies with adjusted
OR-1.07 [95% CI: 1.04-1.09, p < .0001] among those who underwent CABG.
Sensitivity analysis showed no variations among studies and confirmed the
robustness of our findings. Additionally, meta-regression analysis
indicated that mean age was associated with a minimal progression rate of
mortality in patients succeeding CABG with a VIS > 5 (p = .04). High
scores in the JBI tool revealed high quality among the studies selected.
 Conclusion(s): Our study suggests a significant association of VIS >
5 with poor cardiovascular outcomes in patients following CABG surgery.
This association can help in predicting deleterious cardiovascular
outcomes. Copyright © The Author(s) 2025

<79>
Accession Number
2039975343
Title
Effects of Individualized Positive End-Expiratory Pressure on Patients
Undergoing One-Lung Ventilation During Thoracic Surgery: A Systematic
Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Sun X.; Gao Y.; Jin X.; Lin W.
Institution
(Sun, Jin, Lin) Department of Anesthesiology, The First Affiliated
Hospital, Zhejiang University School of Medicine, Zhejiang, China
(Gao) Department of Anesthesiology, The Second Affiliated Hospital,
Zhejiang University School of Medicine, Zhejiang, China
Publisher
W.B. Saunders
Abstract
Objective: To evaluate the impact of individualized positive
end-expiratory pressure (PEEP) versus fixed PEEP on postoperative
pulmonary complications (PPCs), intraoperative oxygenation, and
respiratory mechanics in thoracic surgery. One-lung ventilation (OLV)
poses potential risks of PPCs. PEEP may mitigate lung injury, but the
optimal PEEP level remains uncertain. Method(s): We searched PubMed,
Embase, Web of Science, and Cochrane for randomized controlled trials
(RCTs) comparing individualized PEEP versus fixed PEEP during OLV
published up to December 2024. The primary outcome was the occurrence of
overall PPCs during hospitalization. Secondary outcomes included
postoperative hypoxemia, atelectasis, pneumonia, acute respiratory
distress syndrome (ARDS), intraoperative oxygenation, dynamic compliance,
driving pressure, and hospital length of stay. Risk ratios (RRs) and mean
differences were calculated using the DerSimonian-Laird method. Study
quality was evaluated using the Cochrane Risk of Bias tool version 2 for
RCTs trials. Trial sequential analysis (TSA) was used to assess result
reliability. Result(s): Six RCTs (with a total of 1,844 patients)
were included, with 5 studies (1,814 patients) reporting PPCs.
Individualized PEEP did not significantly reduce overall PPCs (RR, 0.78;
95% confidence interval, 0.59-1.03; p = 0.08), hypoxemia, pneumonia, or
atelectasis; however, it reduced postoperative ARDS and improved
intraoperative oxygenation and lung compliance. TSA revealed that the
current sample size of 1,814 in PPCs was below the required 3,660, and
that the z-curve did not cross the TSA monitoring boundaries.
 Conclusion(s): Individualized PEEP in thoracic surgery may improve
intraoperative oxygenation, pulmonary mechanics, and reduce postoperative
ARDS but does not significantly lower overall PPCs. Overall, the quality
of the evidence is low and inconclusive, and further investigation is
warranted. Copyright © 2025 Elsevier Inc.

<80>
Accession Number
648171704
Title
META-ANALYTIC REVIEW OF PERIOPERATIVE INFARCTION AFTER CARDIAC SURGERY.
Source
European Heart Journal, Supplement. Conference: 56th Congress of the
Italian Association of Hospital Cardiologists, ANMCO. Rimini Italy.
27(Supplement 5) (pp v82), 2025. Date of Publication: 01 May 2025.
Author
Cereda A.; Cimaglia P.; Fabbri G.; Latta F.; Giovannini D.; Galli M.;
Calvi S.; Nerla R.; Castriota F.; Spangaro A.; Toselli M.
Institution
(Cereda, Cimaglia, Fabbri, Latta, Giovannini, Galli, Calvi, Nerla,
Castriota, Spangaro, Toselli) ASST Santi Paolo e Carlo; Azienda
Ospedaliero-Universitaria di Ferrara, Maria Cecilia Hospital, GVM Care
Research, Italy
Publisher
Oxford University Press
Abstract
Introduction: Perioperative infarction (PMI) after cardiac surgery is a
non-rare event requiring complex multidisciplinary management. The Third
Universal Definition of MI defines type 5 MI as an elevation of cardiac
troponin values >10x 99th percentile during the first 48 h following CABG
surgery. PMI often requires coronary angiography after which conservative
medical therapy, PCI or surgical re-do may be proposed. Epidemiology and
clinical outcomes are poorly known and derive from single-centre case
studies. However, it is an event with a high consumption of healthcare
resources, hospitalisation in intensive care and the need for further
myocardial revascularisation. Method(s): We conducted a meta-analysis
of the 9 studies available in the literature on the subject. The review
includes over 100,000 patients undergoing surgery, 1205 of whom underwent
coronary angiography for suspected perioperative infarction.
 Result(s): PMI has a prevalence of 2% among patients undergoing
cardiac surgery and a mortality rate of 18%. For every 10,000 patients
undergoing surgery, 200 have PMI and 40 die due to this complication. High
use of mechanical support (mainly IABP) is reported. In the network
meta-analysis, patients undergoing PCI and surgical re-do had less
favourable outcomes than conservative medical therapy. In the network
meta-analysis, PCI performed better than surgical re-do in terms of
mortality. Result(s): PMI has a prevalence of 2% among patients
undergoing cardiac surgery (mainly myocardial revascularisation, isolated
CABG 80%) and a mortality rate of 18%. Of every 10,000 patients, 200
patients have PMI and 40 have unfavourable outcomes. In the Network
meta-analysis, patients undergoing redo-surgery tended to have more
unfavourable outcomes, suggesting the benefit of conservative therapy/PCI
in the management of this type of infarction. Interestingly, mechanical
support (IABP or ECMO) was required in 30% of patients (Figure 1).
 Conclusion(s): PMI with type 5 myocardial infarction is not an
irrelevant epidemiological entity and has high mortality. Treatment is not
univocal and requires multidisciplinary management. The topic will be the
subject of a dedicated national/international survey to provide further
knowledge on PMI. (Figure Presented).

<81>
[Use Link to view the full text]
Accession Number
648176585
Title
A Randomized Trial of Acute Normovolemic Hemodilution in Cardiac Surgery.
Source
The New England journal of medicine. 393(5) (pp 450-460), 2025. Date of
Publication: 31 Jul 2025.
Author
Monaco F.; Lei C.; Bonizzoni M.A.; Efremov S.; Morselli F.; Guarracino F.;
Giardina G.; Arangino C.; Pontillo D.; Vitiello M.; Belletti A.; Ajello
V.; Licheri M.; Nigro Neto C.; Barucco G.; Bukamal N.A.; Faustini C.;
Mantovani L.F.; Oriani A.; Santonocito C.; Mucchetti M.; Federici F.;
Gerli C.; Porta S.; Scandroglio A.M.; Zhang H.; Pieri M.; Osinsky R.;
Lazzari S.; Leonova E.; Calabro M.G.; Amitrano D.; Turi S.; Prati P.;
Fresilli S.; D'Amico F.; D'Andria Ursoleo J.; Labanca R.; Marmiere M.;
Pruna A.; Scquizzato T.; Kirali K.; Monti G.; Carmona M.J.C.; Tanaka K.;
Likhvantsev V.; Ti L.K.; Bove T.; Paternoster G.; Singh K.; Gurcu M.E.;
Lomivorotov V.; Landoni G.; Bellomo R.; Zangrillo A.
Institution
(Monaco, Bonizzoni, Morselli, Giardina, Pontillo, Belletti, Licheri,
Barucco, Faustini, Oriani, Mucchetti, Gerli, Scandroglio, Pieri, Lazzari,
Calabro, Turi, Fresilli, D'Amico, D'Andria Ursoleo, Labanca, Marmiere,
Pruna, Scquizzato, Monti, Landoni, Zangrillo) Department of Anesthesia and
Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, United
States
(Lei) Department of Anesthesiology and Perioperative Medicine, Anesthesia
Clinical Research Center, Xijing Hospital, Xi'an, China
(Efremov, Leonova) Saint-Petersburg State University Hospital, St.
Petersburg, Russian Federation
(Guarracino, Amitrano) Department of Cardiothoracic and Vascular
Anesthesia and Intensive Care, Azienda Ospedaliero Universitaria Pisana,
Pisa, Italy
(Arangino) Department of Cardiothoracic Anesthesia and Intensive Care,
IRCCS Centro Cardiologico Monzino, Milan, United States
(Vitiello) Cardiovascular Anesthesia and Intensive Care, San Carlo
Hospital, Potenza, Italy
(Ajello, Prati) Department of Cardiac Anesthesia, Tor Vergata University
Hospital, Rome, United States
(Nigro Neto) Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil
(Bukamal) Mohammed Bin Khalifa Specialist Cardiac Center, Bahrain
(Mantovani) Department of Anesthesia and Intensive Care, Maria Cecilia
Hospital, Cotignola, Italy
(Santonocito) Department of Anesthesia and Intensive Care Medicine III,
Centro di Alte Specialita e Trapianti, Azienda Ospedaliero Universitaria
Policlinico G. Rodolico-San Marco, Catania, Italy
(Federici) Unita Operativa Complessa Anestesia e Rianimazione, Rome,
United States
(Porta) S.C. Anestesia e Rianimazione Cardiovascolare, Azienda Ospedaliera
Ordine Mauriziano Umberto I di Torino, Turin, Italy
(Zhang) Department of Anesthesiology and Perioperative Medicine, Xijing
Hospital, Xi'an, China
(Pieri, Monti, Landoni, Zangrillo) School of Medicine, Vita-Salute San
Raffaele University, Milan, United States
(Osinsky, Lomivorotov) Department of Anesthesiology and Intensive Care, E.
Meshalkin National Medical Research Center, Novosibirsk, Russian
Federation
(Kirali) Department of Cardiovascular Surgery, Kosuyolu High
Specialization Education and Research Hospital, Istanbul, Turkey
(Carmona) Instituto do Coracao, InCor, Hospital das Clinicas da Faculdade
de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
(Tanaka) Department of Anesthesiology, University of Oklahoma Health,
Oklahoma City, United States
(Likhvantsev) Federal Clinical and Research Center of Intensive Care and
Rehabilitation, Moscow, Russian Federation
(Likhvantsev) Loginov Moscow Clinical Scientific Center, Moscow, Russian
Federation
(Ti) Department of Anaesthesia, National University Hospital, Singapore
(Bove) Department of Emergency, University Hospital of Udine, Azienda
Sanitaria Universitaria Friuli Centrale Santa Maria della Misericordia,
Udine, Italy
(Bove) Department of Medicine, University of Udine, Udine, Italy
(Paternoster) Department of Health Science, Anesthesia and Intensive Care,
School of Medicine, University of Basilicata San Carlo Hospital, Potenza,
Italy
(Singh) University of Virginia Health, Charlottesville, United States
(Gurcu) Department of Anesthesiology, Kosuyolu High Specialization
Education and Research Hospital, Istanbul, Turkey
(Lomivorotov) Department of Anesthesiology and Perioperative Medicine,
Penn State Milton S. Hershey Medical Center, Hershey, PA, United States
(Bellomo) Department of Critical Care, University of Melbourne, Melbourne,
VIC, Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, VIC, Australia
Abstract
BACKGROUND: Patients undergoing cardiac surgery often receive red-cell
transfusions, along with the associated risks and costs. Early
intraoperative normovolemic hemodilution (i.e., acute normovolemic
hemodilution [ANH]) is a blood-conservation technique that entails
autologous blood collection before initiation of cardiopulmonary bypass
and reinfusion of the collected blood after bypass weaning. More data are
needed on whether ANH reduces the number of patients receiving allogeneic
red-cell transfusion. METHOD(S): In a multinational, single-blind
trial, we randomly assigned adults from 32 centers and 11 countries who
were undergoing cardiac surgery with cardiopulmonary bypass to receive ANH
(withdrawal of >=650 ml of whole blood with crystalloids replacement if
needed) or usual care. The primary outcome was the transfusion of at least
one unit of allogeneic red cells during the hospital stay. Secondary
outcomes were death from any cause within 30 days after surgery or during
the hospitalization for surgery, bleeding complications, ischemic
complications, and acute kidney injury. RESULT(S): A total of 2010
patients underwent randomization; 1010 were assigned to ANH and 1000 to
usual care. Among patients with available data, 274 of 1005 (27.3%) in the
ANH group and 291 of 997 (29.2%) in the usual-care group received at least
one allogeneic red-cell transfusion (relative risk, 0.93; 95% confidence
interval, 0.81 to 1.07; P = 0.34). Surgery for postoperative bleeding was
performed in 38 of 1004 patients (3.8%) in the ANH group and 26 of 995
patients (2.6%) in the usual-care group. Death within 30 days or during
hospitalization occurred in 14 of 1008 patients (1.4%) in the ANH group
and 16 of 997 patients (1.6%) in the usual-care group. Safety outcomes
were similar in the two groups. CONCLUSION(S): Among adults
undergoing cardiac surgery, ANH did not reduce the number of patients
receiving allogeneic red-cell transfusion. (Funded by the Italian Ministry
of Health; ANH ClinicalTrials.gov number, NCT03913481.). Copyright
© 2025 Massachusetts Medical Society.

<82>
Accession Number
648171787
Title
HOW TO MITIGATE INFLAMMATORY MARKERS IN IRON DEFICIENCY ANEMIA AFTER
CARDIAC SURGERY.
Source
European Heart Journal, Supplement. Conference: 56th Congress of the
Italian Association of Hospital Cardiologists, ANMCO. Rimini Italy.
27(Supplement 5) (pp v42-v43), 2025. Date of Publication: 01 May 2025.
Author
Venturini E.; Giallauria F.; Ambrosetti M.
Institution
(Venturini, Giallauria, Ambrosetti) Civic Hospital Cecina, Unit of Cardiac
Rehabilitation, Cecina, Italy ; Federico II University Hospital,
Department of Translational Medical Sciences, Division of Internal
Medicine, Naples, Italy; ASST of Crema, Cardiac Rehabilitation Unit,
Presidio Ospedale Santa Marta, Rivolta D'Adda (CR)
Publisher
Oxford University Press
Abstract
Background: Both carboxymaltose iron (FCM) and sucrosomial iron (SI) are
effective in the treatment of iron deficiency anemia (IDA) after cardiac
surgery (CS). However, intravenous iron, bypassing the reticuloendothelial
system, may increase the risk of oxidative stress for the myocardium. The
aim of this pilot study was to evaluate whether SI on top of FCM increases
its efficacy on IDA, reducing the increase in ferritin (F), induced by
FCM, and of C-reactive protein (CRP). Method(s): 74 consecutive IDA
patients (mean age 70.7 +/- 9.1 years), admitted to Cardiac Rehabilitation
after CS, were all treated with FCM (group A) and a part (group B, n 38)
also with SI. The study design included a single dose of 1000 mg of FCM at
T1 (8-10 days after CS) and in group B a dose of 60 mg of SI daily from T1
to T2 (the day of discharge 10 days later) until T3, 15 days later.
Efficacy measures included changes from baseline in key hematological
parameters (HP) and CRP. Result(s): Data are shown in Table. T HP
increased significantly, with no difference between the two groups.
However, Hb and transferrin saturation (TSAT) levels were lower at T1 in
group B with a greater DELTA increase [for Hb 2.5 and 1.9 (g/dl), for TSAT
11.8 and 10.8 (%) in FCM + SI group vs. FCM group, respectively]. Blood
Iron was also higher in group B, although not significantly, starting from
a lower baseline level. At T3 F levels were much higher in group A, almost
doubling, despite being slightly lower at baseline (972.4+/-611.3 vs.
699.1+/-289 ng/ml; p. 032); Furthermore, DELTAF was significantly higher
(464.3 +/- 566.8 vs. 110.6 +/- 342.8 ng/ml; p.001). CRP decreased more at
T3 in group B (although levels were higher at T1) with a greater DELTACRP
(-5.0+/-4.9 vs. -3.2+/-3.4) approaching statistical significance (p.007)
(Figure 1). Conclusion(s): The high F levels are due to the
inflammatory state induced by CS. The rapid increase in blood iron levels
after intravenous administration, increases F in its turn and can activate
macrophages through the release of cytokines and other inflammatory
mediators. SI would seem to mitigate the increase in F and CRP, using the
reticuloendothelial pathway and reducing oxidative stress and toxicity.
Another positive effect of the combined therapy is the greater increase in
Hb and TSAT which allows to reach the target for IDA more rapidly and to
delay the subsequent administrations of FCM recommended by the Guidelines.
A larger sample size may provide more meaningful results. (Figure
Presented).

<83>
Accession Number
648171520
Title
FOCUS ON DRIVELINE MANAGEMENT TO REDUCE INFECTION RATES IN PATIENTS WITH
VENTRICULAR ASSIST DEVICES (VAD): A NARRATIVE LITERATURE REVIEW.
Source
European Heart Journal, Supplement. Conference: 56th Congress of the
Italian Association of Hospital Cardiologists, ANMCO. Rimini Italy.
27(Supplement 5) (pp v118-v119), 2025. Date of Publication: 01 May 2025.
Author
Fedeli L.
Institution
(Fedeli) RSA Villa Serena, Italy
Publisher
Oxford University Press
Abstract
Background/Introduction: The ventricular assist device (VAD) represents an
essential therapeutic solution for patients with advanced heart failure.
However, among the complications, driveline infections (DLI) are the most
common and severe, with an incidence of up to 85%. The management of the
driveline exit site plays a fundamental role in reducing infections,
improving patients' quality of life, and clinical outcomes. Objective of
the study: This review aims to identify the most effective strategies for
dressing the driveline exit site, with a particular focus on reducing the
incidence of infections in patients with VADs. Study Population: Patients
with ventricular assist devices (VAD). Material(s) and Method(s): The
search was conducted in two databases, PubMed and Web of Science,
analyzing articles published between 2018 and 2024. Six studies were
included: five systematic reviews and one retrospective study, selected
based on the quality of evidence and relevance to the topic.
 Result(s): The results highlight chlorhexidine as the most effective
disinfectant, followed by povidone-iodine used in patients with
intolerance. Silver-based dressings, combined with transparent dressings
and anchoring devices, have shown to reduce infection rates by 62.5%.
Conversely, less advanced dressings, such as Excilon 5x5, increased the
risk of infection by 27.7%. Identified risk factors include pulsatile flow
devices, exposure of the driveline's velour portion, and elevated body
mass index (BMI). While heart transplantation remains the only definitive
solution, conservative techniques and optimal dressing methods are
essential tools in managing DLIs. Conclusion(s): Currently, there is
no standardized protocol for driveline management. However, this review
emphasizes the importance of driveline care, utilizing chlorhexidine,
silver-based dressings, and anchoring devices to significantly reduce the
incidence of DLI. Effective management not only patients' quality of life
but also enhances the longevity and efficacy of the VAD.

<84>
Accession Number
648147331
Title
Reevaluated role of outpatient cardiovascular rehabilitation on clinical
outcomes after acute myocardial infarction: A meta-analysis of European
randomized clinical trials.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology Congress 2025. Milan Italy. 32(Supplement 1) (pp i353-i354),
2025. Date of Publication: 01 May 2025.
Author
Pintaric H.; Pintaric A.; Mornar Jelavic M.; Kranjcec D.
Institution
(Pintaric) Polyclinic AVIVA, Zagreb, Croatia
(Pintaric) University of Zagreb, School of Medicine, Zagreb, Croatia
(Mornar Jelavic) Affidea Croatia - Polyclinic Sveti Rok, Zagreb, Croatia
(Kranjcec) Institute for Cardiovascular Prevention and Rehabilitation,
Zagreb, Croatia
Publisher
Oxford University Press
Abstract
Background: Outpatient cardiovascular rehabilitation (OCVR) is a useful
and widely accepted measure of the secondary prevention, especially at
patients after acute myocardial infarction (AMI). Purpose(s): To
reevalute the role of OCVR on outcomes after AMI by using the available
data of randomized clinical trials (RCTs). Method(s):
PubMed/ScienceDirect databases were systematically searched for European
RCTs with available data on outcomes at patients undegoing OCVR after AMI.
The outcomes of interest are all-cause death, cardiac death,
revascularisation (PCI/CABG), reinfarction, and cardiac rehospitalisation
during long-term follow-up. Result(s): We included 11 studies (RCTs),
with 3,746 participants. The median duration of OCVR was 9.4 months, while
follow-up was 60 months. During that period, patients who underwent OCVR
had significantly lower rates of all-cause death (15.6% vrs 17.7%),
cardiac death (18.8% vrs 25.9%) and reinfarction (6.5% vrs 9.5%) (for all
P<0.05), while there were no significant differences in the rates of PCI
(5.2% vrs 5.3%), CABG (7.0% vrs 7.3%) and cardiac rehospitalisation (27.5%
vrs 31.4%) (for all P>0.05). Additionally, OCVR reduces the relative risk
(RR) of all-cause death (RR=0.87, Confidence interval (CI)=0.76-0.99,
P=0.037), than cardiac death (RR=0.72, CI=0.62-0.85, P=0.000), and
reinfarctions (RR=0.69, CI=0.54-0.90, P=0.005), while there was a
borderline reduction of the risk of cardiac rehospitalisation (OR=0.89,
CI=0.78-1.01, P=0.065). According to the Egger's test, the publication
biases were not present. Conclusion(s): Outpatient cardiovascular
rehabilitation is still useful measure of the secondary prevention and
should be prescribed to all patients after an acute coronary incident.
(Figure Presented).

<85>
Accession Number
648152476
Title
The effect of the ShotBlocker and breastfeeding on pain and comfort level
during heel lance procedure in newborns: randomized controlled trial.
Source
Intensive & critical care nursing. 91 (pp 104164), 2025. Date of
Publication: 26 Jul 2025.
Author
Dinc C.; Gerceker G.O.; Kalkanli O.
Institution
(Dinc) Department of Neonatology, Ministry of Health, Dr. Behcet Uz
Pediatric Diseases and Surgery Training and Research Hospital, Izmir,
Turkey; Dokuz Eylul University, Institute of Health Sciences, Department
of Nursing, Izmir, Turkey
(Gerceker) Pediatric Nursing Department, Dokuz Eylul University Faculty of
Nursing, Izmir, Turkey
(Kalkanli) Department of Neonatology, Ministry of Health, Dr. Behcet Uz
Pediatric Diseases and Surgery Training and Research Hospital, Izmir,
Turkey
Abstract
BACKGROUND: Newborns are subjected to painful attempts in the early days
of their lives due to medical requirements. Breastfeeding and innovative
devices such as ShotBlocker are used to alleviate pain. OBJECTIVE(S):
This study was planned to evaluate the effect of non-pharmacological
methods on newborns' pain and comfort level during the heel lance
procedure in newborns. DESIGN: The study was a single-center, randomized
controlled trial. SETTING: This study was conducted in the first-level
neonatal intensive care unit between August 2021 and September 2022.
 METHOD(S): Ninety-six newborns were included in this study based on
inclusion criteria. The newborns were randomly assigned to four groups:
(a) breastfeeding, (b) ShotBlocker, (c) breastfeeding + ShotBlocker, and
(d) standard care. Pain and comfort levels of newborns were evaluated
according to the Neonatal Infant Pain Scale and the Newborn Comfort
Behavior Scale before, during, and after the heel lance procedure. Crying
time, heart rate, and oxygen saturation were recorded. RESULT(S): The
difference between the groups in terms of average crying time (p = 0.001)
and comfort levels after the procedure (p = 0.001) was statistically
significant. There was no difference in pain during and after the
procedure. As a result of multiple analyses of variance in repeated
measurements, a difference was found in comfort scores in terms of group,
time, and group-time interaction (p < 0.05). CONCLUSION(S): The
breastfeeding + ShotBlocker group had the lowest mean crying time. There
was no difference in procedure-related pain scores between the groups. The
most comfortable groups after heel lance were the breastfeeding and
breastfeeding + ShotBlocker groups. IMPLICATION FOR CLINICAL PRACTICE:
Breastfeeding, currently the gold non-pharmacological standard, increased
comfort levels during the heel lance procedure. The breastfeeding +
ShotBlocker had a significant reduction in crying time and a significantly
greater post-procedural comfort level (Clinical Trials number:
NCT05246787). Copyright © 2025 Elsevier Ltd. All rights reserved.

<86>
Accession Number
2036967364
Title
Magnesium for Prevention of New-onset Postoperative Atrial Fibrillation
Following Cardiac Surgery: A Systematic Review and Meta-analysis of
Randomized Controlled Trials.
Source
Heart International. 19(1) (pp 3-11), 2025. Date of Publication: 2025.
Author
Ghazizadeh S.; Malektojari A.; Javidfar Z.; Lahuti S.; Shokraei R.;
Zeinaee M.; Badele A.; Mirzadeh R.; Ashrafi M.; Afra F.; Ersi M.H.;
Heydari M.; Ziaei A.; Rezvani Z.; Mah J.; Zeraatkar D.; Abbaszadeh S.;
Pitre T.
Institution
(Ghazizadeh, Malektojari, Ashrafi, Ersi) Evidence Based Medicine Center,
Hormozgan University of Medical Sciences, Bandar Abbas, Iran, Islamic
Republic of
(Ghazizadeh, Malektojari, Javidfar, Abbaszadeh) Cardiovascular Research
Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran,
Islamic Republic of
(Lahuti, Shokraei, Zeinaee, Badele, Mirzadeh, Afra, Heydari, Ziaei)
Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar
Abbas, Iran, Islamic Republic of
(Rezvani) Xi'an Jiaotong University Health Science Center, Shaanxi, Xi'an,
China
(Mah) Department of Medicine, Dalhousie University, Halifax, NS, Canada
(Zeraatkar) Department of Bioinformatics, Harvard Medical School, Boston,
MA, United States
(Zeraatkar) Department of Health Research Methods Evidence and Impact,
McMaster University, Hamilton, ON, Canada
(Pitre) Department of Medicine, Division of Respirology, University of
Toronto, Toronto, ON, Canada
Publisher
Touch Medical Media
Abstract
Background: This meta-analysis article aimed to investigate the efficacy
of magnesium in preventing new-onset postoperative atrial fibrillation
(POAF). Method(s): We searched Medline, Embase, Web of Science and
Cochrane Library without any language or publication date restriction up
to August 2023. We included randomized controlled trials (RCTs) that
enrolled adults undergoing cardiac surgery without a history of atrial
fibrillation, exploring the effect of magnesium supplementation in
preventing new-onset POAF. We assessed the risk of bias using the Cochrane
Risk of Bias 2.0 (RoB 2.0) tool. We conducted a random-effects
meta-analysis using R and assessed the certainty of the evidence.
 Result(s): A total of 24 RCTs with 3,373 participants were included.
We found that magnesium may reduce the risk of POAF compared to the
control group (relative risk [RR]: 0.55; 95% confidence interval [CI]:
0.41, 0.74; low certainty). The subgroup analysis for trials with low/some
concerns risk of bias showed that magnesium reduces the risk of new-onset
POAF compared to control (RR: 0.70 [95% CI: 0.58, 0.84]; high certainty).
Magnesium consumption had no significant effect on all-cause mortality
(RR: 1.00 [95% CI: 0.34, 2.90]) or days of hospitalization (mean
difference: -0.34 [95% CI: -0.94, 0.26]). Conclusion(s): The evidence
indicates that magnesium administration reduces the incidence of new-onset
POAF. Copyright © Touch Medical Media.

<87>
Accession Number
2039722360
Title
The protective effect of pulmonary artery infusion with HTK solution on
the lungs during prolonged cardiopulmonary bypass surgery.
Source
Perfusion (United Kingdom). (no pagination), 2025. Article Number:
02676591251351211. Date of Publication: 2025.
Author
Fei J.; Zhao L.; Wu J.; Yang W.
Institution
(Fei, Zhao, Wu, Yang) Department of Cardiovascular Surgery, Ningbo No. 2
Hospital, Ningbo, China
Publisher
SAGE Publications Ltd
Abstract
Background: Studies have proved that artery infusion during CPB operations
can reduce lung injury led by CPB surgery. This study was undertaken to
investigate the effects of HTK solution infusion on pulmonary injury
during prolonged CPB. Method(s): Based on the complexity of the
surgery, 18 of 55 patients were divided into Group A, whose CPB time would
be less than 180 min, The patients whose CPB time was estimiated more than
180 min were randomly divided in Group H and Group C, patients in Group H
recieved pulmonary artery infusion with 4degreeC HTK solution during
aortic cross-clamping while Group C underwent traditional procedures. Lung
function was assessed by comparing postoperative recovery conditions,
respiratory function, inflammatory response and pathological examination.
Blood samples were collected from all patients at the following time
points: before the start of CPB (T0), 1 hour after aortic declamping (T1),
2 hours (T2), 6 hours (T3), 12 hours (T4), and 24 hours (T5). The levels
of tumor necrosis factor alpha (TNF-alpha) and interleukin-6 (IL-6) were
measured in these samples. Result(s): Extubation time, ICU and the
postoperative hospital stay were shorter in the Group A and Group H (p <
.05). There was a significant increase of TNF-alpha from T2 to T4 in Group
C (p < .05). The level of IL-6 in Group C increased significantly from T1
to T5 (p < .05). Compared to Group H, the mean value of TNF-alpha
increased from T1 to T4 while IL-6 increased from T4 to T5 in Group C (p <
.05) Inflammatory response was more severe when the CPB time exceeds 180
minutes, so did the clinic outcomes. Conclusion(s): Pulmonary artery
infusion with HTK solution is a safe procedure in cardiac surgery with
long term CPB time. It can be used to alleviate lung injury in cardiac
surgery especially when the CPB time exceeds 180 minutes. Copyright
© The Author(s) 2025

<88>
Accession Number
2035395968
Title
Rationale and design of the randomized 'early ventricular assist
device'-Trial (VAD-DZHK3).
Source
ESC Heart Failure. (no pagination), 2025. Date of Publication: 2025.
Author
Knosalla C.; Farber G.; Rieth A.J.; Wachter R.; Placzek M.; Albert W.;
Hasenfuss G.; Falk V.; Friede T.
Institution
(Knosalla, Albert, Falk) Department of Cardiothoracic and Vascular
Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany
(Knosalla, Albert, Falk) Charite - Universitatsmedizin Berlin, corporate
member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin,
Berlin, Germany
(Knosalla, Albert, Falk) German Center for Cardiovascular Research (DZHK),
partner site Berlin, Berlin, Germany
(Knosalla) Department of Thoracic and Cardiovascular Surgery Saarland,
University Medical Center and Saarland University, Homburg, Germany
(Farber) Department of Cardiothoracic Surgery, University Hospital Jena,
Friedrich Schiller University of Jena, Jena, Germany
(Rieth) Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad
Nauheim, Germany
(Rieth) German Center for Cardiovascular Research (DZHK), partner site
Rhine-Main, Frankfurt am Main, Germany
(Wachter) Department of Cardiology, University Hospital Leipzig, Leipzig,
Germany
(Wachter, Hasenfus) Clinic for Cardiology and Pneumology, Heart Research
Center, University Medical Center Gottingen, Gottingen, Germany
(Wachter, Hasenfus, Falk) Department of Health Science and Technology, ETH
Zurich, Zurich, Switzerland
(Placzek, Friede) German Center for Cardiovascular Research (DZHK),
partner site Gottingen, Gottingen, Germany
(Placzek, Friede) Department of Medical Statistics, University Medical
Center Gottingen, Gottingen, Germany
Publisher
John Wiley and Sons Inc
Abstract
Aims: Bridge to transplantation (BTT) with durable, continuous-flow left
ventricular assist devices (LVAD) of patients is a well-established
treatment concept in patients awaiting heart transplantation (HTx).
However, the role of elective LVAD implantation in patients with less
advanced HF, but increased risk of decompensation remains uncertain.
 Methods and Results: The VAD-DZHK3 trial is an
investigator-initiated, randomized controlled trial designed to assess
whether an early strategy of elective LVAD implantation improves outcomes
compared with a conventional approach involving optimal medical therapy
and delayed device implantation only after clinical deterioration.
Eligible patients are those with end-stage HF listed for cardiac
transplantation. This is an event-driven study, that is, the study is
completed once 120 events of the primary composite endpoint have been
observed and all patients have at least 1 year of follow-up unless they
died earlier. Patients meeting inclusion criteria who decline
randomization are enrolled in a parallel observational registry reflecting
standard care. The primary efficacy endpoint is survival free from high
urgent cardiac transplantation, disabling stroke and HF hospitalizations
(including emergency room HF visits >6 h). Conclusion(s): The
VAD-DZHK3 trial will provide guidance on the optimal timing and patient
selection for LVAD implantation in heart transplant candidates,
potentially redefining current standards of care. Copyright ©
2025 The Author(s). ESC Heart Failure published by John Wiley & Sons Ltd
on behalf of European Society of Cardiology.

<89>
Accession Number
2035636842
Title
Non-invasive goal-directed fluid therapy with the pleth variability index
(PVI): a systematic review and meta-analysis.
Source
Journal of Clinical Monitoring and Computing. (no pagination), 2025. Date
of Publication: 2025.
Author
Felippe V.A.; Codeceira R.; Irigaray M.; Sckaff M.; Wegner B.; Nascimento
T.; Darcy C.; Dutra L.; Santiago B.; Buchmann J.; Lessa M.A.
Institution
(Felippe) Department of Anesthesiology, Brazilian National Cancer
Institute, Rio de Janeiro, Brazil
(Codeceira) School of Medicine, Federal University of Rio de Janeiro, Rio
de Janeiro, Brazil
(Irigaray) School of Medicine, University of the Region of Joinville
(UNIVILLE), Joinville, Brazil
(Sckaff) School of Medicine, Johns Hopkins University, Baltimore, United
States
(Wegner) School of Medicine, Federal University of Rio Grande do Sul,
Porto Alegre, Brazil
(Nascimento) Department of Anesthesia, University of Iowa, Iowa City,
United States
(Darcy) Translational Medicine, Paulista School of Medicine (EPM-UNIFESP),
Sao Paulo, Brazil
(Dutra) Department of Anesthesiology, Ipanema Federal Hospital, Rio de
Janeiro, Brazil
(Santiago) IDOMED, Institute for Medical Development, Rio de Janeiro,
Brazil
(Buchmann) Department of Surgery, Anesthesia Division, State University of
Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
(Lessa) Department of Anesthesia, Carver College of Medicine, University
of Iowa, 200 Hawkins Dr 6413 JCP, Iowa City, IA, United States
Publisher
Springer Science and Business Media B.V.
Abstract
Optimal intraoperative fluid management is essential to improve surgical
outcomes and reduce complications. The Pleth Variability Index (PVI), a
dynamic and non-invasive indicator of fluid responsiveness, has been
proposed as a tool for goal-directed fluid management. This systematic
review and meta-analysis aimed to evaluate the effectiveness of PVI-guided
fluid therapy compared to conventional fluid management (CFM) in
non-cardiac surgeries. A comprehensive search of PubMed, Embase, and
Cochrane databases up to January 2024 identified eligible studies. Primary
outcomes included total intraoperative fluid volume and crystalloid
administration. Secondary outcomes included hemodynamic parameters, renal
function markers, acid-base balance, and hospital length of stay (LOS).
Random-effects models were applied, and subgroup and sensitivity analyses
were performed. Nine studies comprising 1,105 patients were included.
Compared to conventional fluid management, PVI-guided therapy
significantly reduced total fluid volume (mean difference [MD] - 761.23
mL; 95% CI - 1267.42 to - 255.03) and crystalloid administration (MD -
655.05 mL; 95% CI - 1096.48 to - 213.62), without significant differences
in colloid use, urine output, norepinephrine requirement, arterial
pressure, acid-base balance, or LOS. Subgroup analysis of abdominal
surgeries confirmed the observed reduction in fluid volumes. PVI-guided
fluid management allows for a more restrictive and individualized approach
without compromising hemodynamic or metabolic stability. While the
heterogeneity across studies limits generalizability, these findings
support the clinical value of PVI as a non-invasive tool for perioperative
fluid optimization, especially in settings where invasive monitoring is
not feasible. Further trials are needed to evaluate its impact on
long-term outcomes. Copyright © The Author(s) 2025.

<90>
Accession Number
648153993
Title
Forecasting the fall: the role of machine learning in predicting
intraoperative hypotension, a scoping review.
Source
Minerva anestesiologica. (no pagination), 2025. Date of Publication: 30
Jul 2025.
Author
Koh A.; Baby D.; Martis W.; Capurro D.
Institution
(Koh) Royal Melbourne Hospital, Melbourne, Australia
(Baby, Capurro) Royal Melbourne Hospital, Melbourne, Australia
(Martis) Department of Critical Care, University of Melbourne, Melbourne,
Australia
(Martis) Anesthesia and Pain Department, Peter MacCallum Cancer Center,
Melbourne, Australia
(Martis) Anesthesia and Pain Department, Monash Health, Melbourne,
Australia
(Capurro) Center for Digital Transformation of Health, University of
Melbourne, Melbourne, Australia
(Capurro) School of Computing and Information Systems, University of
Melbourne, Melbourne, Australia
Abstract
INTRODUCTION: Intraoperative hypotension is associated with increased risk
of postoperative mortality, myocardial injury, acute kidney injury and
stroke. Early identification with machine learning models allows
pre-emptive management to reduce incidence and duration of intraoperative
hypotension. This study aims to assess the accuracy of machine learning
models in predicting intraoperative hypotension and its impact on clinical
outcomes. EVIDENCE ACQUISITION: This scoping review looked at databases
Medline, Embase, PubMed and Cochrane from inception to 25 June 2024.
Inclusion criteria were use of machine learning algorithms predicting
intraoperative hypotension in adult surgical patients (>=18 years of age).
Data extracted were the type and accuracy of machine learning models used,
type of surgery, incidence and duration of hypotension, and patient
relevant outcomes including length of stay, end organ dysfunction and
mortality. EVIDENCE SYNTHESIS: Twenty-six studies were included (N.=48,707
patients). About 92.3% of studies were done in non-cardiac surgeries;
65.4% of studies used a proprietary machine learning algorithm known as
the Hypotension Prediction Index (HPI), followed by neural networks
(19.2%) and logistic regression (19.2%). HPI was the most accurate in
predicting intraoperative hypotension up to 15 minutes prior to the event
with the median area under the receiving operator characteristic curve of
0.912 (0.896-0.930). Machine learning resulted in a statistically
significant difference in dose and incidence of vasopressor use in three
studies and a significant increase in volume of fluids in two studies. Two
studies showed a significant reduction in length of stay, postoperative
complications and quantity of blood transfusion products.
 CONCLUSION(S): Despite the ability of machine learning algorithms to
predict intraoperative hypotension to a high degree of accuracy, practical
implications are not yet fully elucidated. Studies on machine learning
predicting intraoperative hypotension are in their early stages with a
larger emphasis on algorithm accuracy rather than clinical outcomes.

<91>
Accession Number
2039910571
Title
Routine Cerebral Embolic Protection During Transcatheter Aortic Valve
Replacement: A Meta-Analysis of Randomized Controlled Trials.
Source
Mayo Clinic Proceedings: Innovations, Quality and Outcomes. 9(5) (no
pagination), 2025. Article Number: 100651. Date of Publication: 01 Oct
2025.
Author
Ismayl M.; Mufarrih M.; Eleid M.F.; Rihal C.S.; Guerrero M.
Institution
(Ismayl, Mufarrih, Eleid, Rihal, Guerrero) Department of Cardiovascular
Medicine, Mayo Clinic, Rochester, MN, United States
Publisher
Elsevier B.V.
Abstract
The risk of periprocedural stroke with TAVR remains a significant concern.
Cerebral embolic protection (CEP) devices have been developed to mitigate
this risk, but their clinical benefit remains uncertain. We aimed to
evaluate the effectiveness and safety of routine CEP use during TAVR
through a meta-analysis of randomized controlled trials (RCTs). A
systematic search of PubMed, EMBASE, and ClinicalTrials.gov was conducted
from inception to May 22, 2025, to identify RCTs comparing CEP versus
standard care during TAVR. The primary outcome was stroke (including
disabling and nondisabling strokes). Secondary outcomes included disabling
stroke, new ischemic lesions on post-TAVR brain magnetic resonance
imaging, all-cause mortality, major vascular complications,
life-threatening bleeding, and acute kidney injury. Risk ratios (RRs) were
pooled using a random-effects model. A total of 9 RCTs encompassing 11,641
patients (5970 with CEP and 5671 without) were included. CEP use did not
significantly reduce the risk of stroke (RR, 0.91; 95% CI, 0.73-1.14;
P=.41), disabling stroke (RR, 0.80; 95% CI, 0.57-1.12; P=.19), or new
ischemic lesions on magnetic resonance imaging (RR, 0.98; 95% CI,
0.91-1.06; P=.64). There were no significant differences in all-cause
mortality or safety outcomes between the CEP and control groups. Subgroup
analyses based on the type of CEP device showed no significant differences
in outcomes between the 2 groups, regardless of device type. In
conclusion, routine CEP use during TAVR was not associated with reductions
in stroke, disabling stroke, or all-cause mortality. Future studies are
warranted to identify subgroups that may benefit from selective CEP
use. Copyright © 2025 The Authors

<92>
[Use Link to view the full text]
Accession Number
2039944632
Title
Aortic Valve Replacement and Repair With or Without Concomitant Ascending
Aorta Replacement: Impact on Outcomes A Systematic Review.
Source
Cardiology in Review. 33(5) (pp 407-418), 2025. Date of Publication: 01
Sep 2025.
Author
Zhang C.; Butt S.; Kashif H.; Rowe C.; Harky A.; Zeinah M.
Institution
(Zhang) Faculty of Medicine and Health, University of New South Wales,
Sydney, Australia
(Butt) Department of Plastic Surgery, Nottingham City Hospital,
Nottingham, United Kingdom
(Kashif) Department of Acute Medicine, King's College Hospital, London,
United Kingdom
(Rowe) Faculty of Medicine, Department of Medicine, Imperial College
London, London, United Kingdom
(Harky, Zeinah) Department of Cardiothoracic Surgery, Liverpool Heart and
Chest Hospital, Liverpool, United Kingdom
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
(Zeinah) Faculty of Medicine, Ain Shams University, Cairo, Egypt
Publisher
Lippincott Williams and Wilkins
Abstract
Aortic valve surgery is a common procedure used to treat significant
aortic valve stenosis or insufficiency. Some of these patients have
coexisting pathology affecting the ascending aorta requiring ascending
aorta replacement (AAR). Although the outcomes of these procedures are
independently positive, it is proposed that concomitant AAR improves
outcomes and minimizes the chances of future ascending aorta replacement.
A comprehensive literature search for relevant studies published since
2010 comparing outcomes of aortic valve repair and replacement with or
without concomitant ascending aorta replacement was undertaken using
electronic databases PubMed, Cochrane Library, Embase Ovid, and SCOPUS.
Major exclusion criteria were (1) conference posters, literature reviews,
editorials; (2) aortic root surgery, aortic arch surgery, or other
surgeries (3) case series with less than 5 participants. A total of 1189
patients from 6 retrospective cohort studies were included in the final
review, from which clinical outcomes such as mortality and complications
were compared. Mortality rates were similar in both intervention groups.
No significant differences were found between the 2 groups in
reexploration rates due to bleeding, stroke, postoperative dialysis, and
atrial fibrillation. Survival rates varied but had no significant
difference between interventions. Both isolated aortic valve surgery and
concomitant AAR procedures offer comparable favourable outcomes in terms
of mortality, survival rates, and complication risks. However, the
evidence is limited by the lack of randomized controlled trials. We
recommend that future studies should standardize reporting on
postoperative recovery, complications, long-term freedom from
reoperations, and long-term changes to aorta dimensions. Copyright
© 2023 Wolters Kluwer Health, Inc. All rights reserved.

<93>
[Use Link to view the full text]
Accession Number
2039879770
Title
Continued Versus Interrupted Oral Anticoagulation During Transcatheter
Aortic Valve Implantation: A Systematic Review and Meta-Analysis.
Source
Cardiology in Review. (no pagination), 2025. Article Number: 01005. Date
of Publication: 2025.
Author
Naeem F.; Tabassum S.; Rakab M.S.; Gadelmawla A.F.; Naeem A.; Paul T.K.
Institution
(Naeem) Department of Cardiology, Massachusetts General Hospital, Boston,
MA, United States
(Tabassum) Department of Internal Medicine, King Edward Medical
University, Lahore, Pakistan
(Rakab) Department of Internal Medicine, Mansoura University, Mansoura,
Egypt
(Gadelmawla) Faculty of Medicine, Menoufia University Menoufia Egypt,
Egypt
(Gadelmawla) Medical Research Group of Egypt (MRGE), Negida Academy,
Arlington, MA, United States
(Naeem) Department of Internal Medicine, The Wright Center for Graduate
Medical Education, Scranton, PA, United States
(Paul) University of Tennessee Health Science Center at Nashville,
Ascension St. Thomas Hospital, Nashville, TN, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Given the lack of evidence and guideline-based recommendations on the best
preoperative oral anticoagulation (OAC) management strategies for
transcatheter aortic valve implantation (TAVI), this study aims to compare
continued oral anticoagulation (cOAC) versus interrupted oral
anticoagulation (iOAC) strategies. We conducted a comprehensive search
across PubMed, Embase, Cochrane Central, and ClinicalTrials.gov from
inception till February 2025 for studies comparing periprocedural cOAC or
iOAC in patients undergoing TAVI. Outcomes were analyzed using a
random-effects model to pool odds ratios (ORs) with 95% confidence
intervals (CIs). Four studies, comprising a total of 3117 patients, were
included in the final analysis. The early (30-day) safety outcome and
composite ischemic events were comparable between the approaches. There
was no significant difference between cOAC and iOAC in terms of any
bleeding, major bleeding, or life-threatening bleeding. However, cOAC was
associated with a slightly higher incidence of minor bleeding events (OR:
1.40, 95% CI: 1.02-1.93, P = 0.04). Additionally, major vascular
complications, all-cause mortality, cardiac-specific mortality, stroke,
transient ischemic attack, myocardial infarction, and length of hospital
stay were comparable between the 2 strategies. Both cOAC and iOAC
approaches demonstrated comparable outcomes, with cOAC being associated
with a slightly higher incidence of minor bleeding events. Copyright
© 2025 Wolters Kluwer Health, Inc. All rights reserved.

<94>
[Use Link to view the full text]
Accession Number
2039920623
Title
Systematic review and meta-Analysis of the impact of sex on outcomes after
aortic valve replacement.
Source
Journal of Cardiovascular Medicine. 25(7) (pp 539-550), 2024. Date of
Publication: 01 Jul 2024.
Author
El-Andari R.; Bozso S.J.; Fialka N.M.; Alaklabi A.M.; Kang J.J.H.;
Nagendran J.
Institution
(El-Andari, Bozso, Fialka, Kang, Nagendran) Division of Cardiac Surgery,
Department of Surgery, University of Alberta, Edmonton, AB, Canada
(Alaklabi) College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
Publisher
Lippincott Williams and Wilkins
Abstract
AimsIn recent years, extensive literature has been produced demonstrating
inferior outcomes for women when compared with men undergoing heart valve
interventions. Herein, we seek to analyze the literature comparing
outcomes between men and women undergoing surgical aortic valve
replacement (SAVR).MethodsA systematic literature search of PubMed,
MEDLINE, and Embase was conducted for articles comparing differences in
outcomes between adult men and women undergoing SAVR. One thousand nine
hundred and ninety titles were screened, of which 75 full texts were
reviewed, and a total of 19 manuscripts met the inclusion criteria and
were included in this review.ResultsPooled estimates of mortality
demonstrated that women tended to have lower rates of survival within the
first 30 days post-SAVR, although mid-Term and long-Term mortality did not
differ significantly up to 10 years postoperatively. Pooled estimates of
postoperative data indicated no difference in the rates of stroke and
postoperative bleeding. Rates of aortic valve reoperation and acute kidney
injury favored women.ConclusionDespite the inferior outcomes for women
post-SAVR that have been reported in recent years, the results of this
meta-Analysis demonstrate comparable results between the sexes with
comparable mid-to long-Term mortality in data pooled from the literature.
Although mortality favored men in the short term, rates of aortic valve
reoperation and acute kidney injury favored women. Future investigation
into this field should focus on identifying discrepancies in diagnosis and
initial surgical management in order to address any potential factors
contributing to discrepant short-Term outcomes.Graphical
abstracthttp://links.lww.com/JCM/A651. 7copy; 2024 Italian Federation of
Cardiology-I.F.C. All rights reserved. Copyright © 2024
Lippincott Williams and Wilkins. All rights reserved.

<95>
Accession Number
2039931367
Title
Comparison of negative pressure wound therapy with conventional wound care
in the treatment of sternal wound infection after cardiac surgery: A
meta-analysis with trial sequential analysis.
Source
PLOS ONE. 20(8 August) (no pagination), 2025. Article Number: e0328771.
Date of Publication: 01 Aug 2025.
Author
He S.; Tang N.; Li S.
Institution
(He, Tang, Li) Hospital Infection Management Department, Changsha
Stomatological Hospital, Stomatological Clinical College of Hunan
University of Chinese Medicine, Changsha, China
Publisher
Public Library of Science
Abstract
Background Negative pressure wound therapy (NPWT) has become a popular
treatment option for sternal wound infection (SWI). However, it remains
uncertain whether the therapeutic benefits of NPWT are superior to
conventional wound care. This study aimed to systematically evaluate the
therapeutic effects of NPWT on SWI compared to conventional wound care
through meta-analysis. Methods A comprehensive search of PubMed, Web of
Science, Embase, and the Cochrane Library databases was conducted from
inception to April 29, 2024 for all potential studies. The pooling of
dichotomous outcome data was achieved using relative risk (RR), with
results presented within a 95% confidence interval (CI). We utilized the
standard mean difference (SMD) and 95% CI for continuous outcomes.
Heterogeneity test, publication bias assessment, sensitivity analysis, and
trial sequential analysis (TSA) were conducted. Publication bias was
detected through the Begg's and Egger's tests. Software R 4.3.1, Stata
12.0, and TSA v0.9.5.10 Beta software were utilized for all analyses.
Results Out of 1832 articles identified, 10 were included in this study.
The overall results revealed that NPWT significantly decreased the sternal
wound reinfection (SWRI) rate (RR [95% CI] = 0.179 [0.099 to 0.323], 95%
prediction interval [PI]: 0.082 to 0.442), in-hospital mortality (RR [95%
CI] = 0.242 [0.149 to 0.394], 95% PI: 0.144 to 0.461), and shortened the
length of intensive care unit (ICU) stay (SMD [95% CI] = -0.601 [-0.820 to
-0.382], 95% PI: -1.317 to 0.128) compared with conventional wound care.
There was no significant difference in length of hospital stay (SMD [95%
CI] = -0.402 [-0.815 to 0.012], 95% PI: -1.801 to 0.998) and treatment
duration (SMD [95% CI] = -0.398 [-1.646 to 0.849], 95% PI: -16.340 to
15.543) between the NPWT group and control group. Further subgroup
analysis demonstrated the benefits of NPWT in shortening hospitalization
length in the European population (p<0.05). Conclusion The present
evidence corroborates that the application of NPWT in the treatment of SWI
after cardiac surgery effectively reduces the SWRI incidence and
in-hospital mortality while shortening the length of ICU
stay. Copyright © 2025 He et al. This is an open access article
distributed under the terms of the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any
medium, provided the original author and source are credited.

<96>
Accession Number
648147189
Title
Comparative efficacy and safety of antithrombotic regimens following left
atrial appendage occlusion therapy in atrial fibrillation patients: A
comprehensive Bayesian network meta-analysis.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology Congress 2025. Milan Italy. 32(Supplement 1) (pp i30-i31),
2025. Date of Publication: 01 May 2025.
Author
Khalil I.; Rafiqul Islam M.; Chiara Lanari V.; Tanvir Ahmed S.; Acharjee
D.; Abrar S.; Shoyeb Rahman Chowdhury G.M.
Institution
(Khalil, Tanvir Ahmed, Acharjee, Abrar, Shoyeb Rahman Chowdhury) Dhaka
Medical College Hospital, Dhaka, Bangladesh
(Rafiqul Islam) Shaheed Suhrawardy Medical College and Hospital, Internal
Medicine, Dhaka, Bangladesh
(Chiara Lanari) University of Milan, Milan, Italy
Publisher
Oxford University Press
Abstract
Background: Left atrial appendage occlusion (LAAO) is a viable alternative
to oral anticoagulation for stroke prevention in patients with atrial
fibrillation (AF), particularly those at high risk of thromboembolism or
bleeding. This study evaluates the comparative efficacy and safety of
various antithrombotic regimens following LAAO. Objective(s): To
compare the efficacy and safety of various antithrombotic regimens,
including aspirin(ASA), direct oral anticoagulants (DOACs), Warfarin, dual
antiplatelet therapy (DAPT), single antiplatelet therapy (SAPT), and other
combination regimens (e.g., DOAC+ASA, NOAC +APT), in preventing stroke or
transient ischemic attack (TIA) while minimizing bleeding and mortality
after LAAO. Method(s): A systematic search was conducted in PubMed,
Embase, Scopus, Cochrane Library, and Web of Science for studies published
up to November 1, 2024. Studies included adult patients who underwent left
atrial appendage occlusion (LAAO) for stroke prevention, typically in the
context of AF. Bayesian network meta-analysis was performed using the
BUGSnet package in RStudio, applying a random-effects model. Outcome
estimates were reported as risk ratios (RR) with 95% credible intervals
(CrI) relative to no therapy. Interventions were ranked based on surface
under the cumulative ranking curve (SUCRA) values and higher SUCRA values
indicate greater efficacy. Result(s): The analysis included 28
studies, comprising 65,229 patients who received different antithrombotic
regimens with post-LAAO status. Study findings indicate that NOAC (RR:
0.13, 95% CrI: 0.01-0.75; SUCRA: 82.61%) demonstrated the highest efficacy
in reducing stroke/TIA incidence compared to no therapy, followed by
NOAC+APT (RR: 0.13, 95% CrI: 0.00-1.37; SUCRA: 75.47%), DOAC+ASA (RR:
0.20, 95% CrI: 0.01-1.20; SUCRA: 69.12%), and DOAC (RR: 0.25, 95% CrI:
0.02-1.29; SUCRA: 58.82%) respectively. For reducing all-cause mortality,
DOAC+ASA ranked highest (RR: 0.27, 95% CrI: 0.02-0.81; SUCRA: 83.16%),
followed by DOAC (RR: 0.28, 95% CrI: 0.04-0.83; SUCRA: 80.39%), DOAC+APT
(RR: 0.36, 95% CrI: 0.03-1.23; SUCRA: 65.27%), Warfarin+ASA (RR: 0.39, 95%
CrI: 0.04-1.26; SUCRA: 60.92%), and NOAC (RR: 0.38, 95% CrI: 0.03-1.95;
SUCRA: 57.07%) respectively. NOAC+APT (RR: 0.02, 95% CrI: 0.00-0.23;
SUCRA: 91.56%) ranked highest for reducing major bleeding events followed
by NOAC (RR: 0.04, 95% CrI: 0.01-0.26; SUCRA: 86.4%), DOAC (RR: 0.05, 95%
CrI: 0.01-0.32; SUCRA: 79.28%), and Warfarin (RR: 0.05, 95% CrI:
0.01-0.34; SUCRA: 73.64%) respectively. Conclusion(s): NOACs
demonstrated the highest efficacy in reducing stroke/TIA among all
antithrombotic regimens in AF patients with post-LAAO status, while
NOAC+APT showed the lowest risk of major bleeding. DOAC+ASA and DOAC also
provided significant benefits in reducing all-cause mortality. These
findings elucidate the potential of NOAC-based regimens for optimizing
outcomes of post-LAAO status in AF patients. (Figure Presented).

<97>
Accession Number
648147493
Title
OsteopaThic, logopedIc and psychological assessment To improve outcome in
pAtieNts undergoIng Cardiac surgery: A randomized clinical trial (TITANIC
trial).
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology Congress 2025. Milan Italy. 32(Supplement 1) (pp i156), 2025.
Date of Publication: 01 May 2025.
Author
Volpato E.; Stilo L.; Tavanelli M.; Bordoni B.; Oreni L.; Toccafondi A.;
Moraschi A.; Morici N.
Institution
(Volpato, Stilo, Tavanelli, Bordoni, Oreni, Toccafondi, Moraschi, Morici)
Don Gnocchi Foundation - IRCCS Centro S. Maria Nascente, Milan, Italy
Publisher
Oxford University Press
Abstract
Background: Postoperative pain and swallowing disorders are complex,
multifactorial phenomenon that frequently occur after cardiac surgery.
Preoperative anxiety and the interaction between sex and other
sociocultural factors may predict greater sensitivity to postoperative
pain. Cardiac rehabilitation (CR) may address all these functional
domains, improving patients' prognosis. Purpose(s): The study aimed
to assess the effectiveness of a comprehensive cardiac rehabilitation (CR)
approach combining osteopathic interventions (OMT), swallowing screening,
individualized treatments, and psychological support, compared to
conventional practices in managing pain and swallowing disorders in
sternotomy patients. Method(s): This monocentric, randomized,
single-blind, parallel-arm study included patients >18 years who underwent
elective cardiac surgery within the past month, had chest pain (NRS >2),
and no pre-discharge swallowing disorders. Exclusion criteria were
inability to consent or known psychological/psychiatric disorders. The
experimental group (n=20) received standard rehabilitation, osteopathic
treatment (OMT), systematic swallowing screening, and psychological
counseling. The control group (n=20) received standard rehabilitation and
psychological counseling. Outcome measures included the Bordoni
Diaphragmatic Test (BDT), Brief Pain Assessment Questionnaire (BQVD),
HADS, EuroQoL-VAS, Brief-Illness Perception Questionnaire (B-IPQ), Italian
Dysphagia Handicap Index (I-DHI), Mealtime Assessment Scale (MAS), SF-12
and Walking Test (WT). Result(s): The study involved 44 patients (26
men, 18 women, mean age 53.75-72 years) and achieved complete retention,
with no dropouts. Both groups demonstrated a significant reduction in
C-reactive protein (CRP) levels (p<0.0001), indicating an overall
improvement in systemic inflammation. Psychological and behavioural
outcomes, including anxiety, illness perception, adherence, and quality of
life, showed no significant changes in response to the intervention (all
p>0.05). Even though systematic swallowing screening detected more
swallowing disorders at admission in the experimental group, there were no
statistically significant differences at discharge. Systematic osteopathic
treatment did not significantly change the pain course during the
inpatient cardiac rehabilitation. Finally, the length of hospital stay was
comparable between the two groups, with no significant differences
detected (p=0.390). Conclusion(s): CR is a multidisciplinary approach
aimed at improving patients' stabilization and patient's empowerment. In
the setting of cardiac surgery, adding systematic osteopathic treatment
(OMT) and systematic swallowing screening to the standard practice did not
significantly change the patient's outcome.

<98>
[Use Link to view the full text]
Accession Number
2039857026
Title
Left Atrial Appendage Closure Versus Oral Anticoagulation for Stroke
Prevention in Atrial Fibrillation: An Updated Systematic Review and
Meta-Analysis.
Source
American Journal of Therapeutics. (no pagination), 2025. Article Number:
10.1097/MJT.0000000000001992. Date of Publication: 2025.
Author
Naeem F.; Qamar U.; Waqas M.; Tabassum S.; Munir M.B.; Asad Z.U.A.
Institution
(Naeem) Department of Cardiology, Massachusetts General Hospital, Harvard
Medical School, Boston, MA, United States
(Qamar) Department of Internal Medicine, Mayo Clinic, Rochester, NY,
United States
(Waqas) Department of Internal Medicine, Wah Medical College, Wahcantt,
Pakistan
(Tabassum) Department of Internal Medicine, King Edward Medical
University, Lahore, Pakistan
(Munir) Division of Cardiovascular Medicine, University of California
Davis, Sacramento, CA, United States
(Asad) Department of Medicine, Cardiovascular Section, University of
Oklahoma Health Sciences Center, Oklahoma City, OK, United States
Publisher
Lippincott Williams and Wilkins

<99>
Accession Number
648134590
Title
Comparative Effectiveness of Vascular Closure Device Strategies in
Transcatheter Aortic Valve Replacement: A Network Meta-Analysis.
Source
Annals of vascular surgery. (no pagination), 2025. Date of Publication:
23 Jul 2025.
Author
Deng Y.; Feng Y.; He S.; Zhou W.; Zhang J.
Institution
(Deng, Feng) Northern Jiangsu People's Hospital, Yangzhou 225001, China;
Medical College of Yangzhou University, Yang zhou 225001, China
(He, Zhang) Northern Jiangsu People's Hospital, Yangzhou, China
(Zhou) Yangzhou University Affiliated Hospital, Yangzhou, China
Abstract
BACKGROUND AND OBJECTIVE: Transcatheter aortic valve replacement (TAVR)
has become the preferred treatment for high-risk patients with severe
aortic stenosis. However, the management of vascular complications
associated with large-bore femoral arterial access sheaths remains
challenging for clinicians. Traditional manual compression exhibits
limited efficacy in homeostasis, while the clinical outcomes of vascular
closure devices (VCDs) remain controversial.To conduct a systematic
evaluation on the differences among various types of VCDs in preventing
vascular complications and achieving device success rates post-TAVR.
 METHOD(S): Systematic searches were conducted in PubMed, Web of
Science, and Cochrane for clinical studies on VCD application post-TAVR.
Two independent researchers performed study selection, data extraction,
and quality assessment. A network meta-analysis was conducted using STATA
16.0, device ranking was assessed via surface under the cumulative ranking
curve (SUCRA). RESULT(S): A total of twenty-eight studies (21,029
patients, 7 types of VCD) were included. Network meta-analysis revealed
FemoSeal-ProGlide was associated with lower risks of major vascular
complications (OR=0.28, 95% CI: 0.09-0.86) and major bleeding events
(OR=0.20, 95% CI: 0.06-0.63).Prostar demonstrated a higher risk of
non-major vascular complications (OR=1.61, 95% CI: 1.14-2.29).
AngioSeal-ProGlide showed the lowest device failure rate (OR=0.21, 95% CI:
0.10-0.48).No significant differences were observed among other closure
methods.SUCRA rankings indicated FemoSeal-ProGlide demonstrated best
efficacy in reducing major vascular complications (89.7%), 30-day
mortality (94.5%), and major bleeding events (75.4%).AngioSeal-ProGlide
demonstrated best efficacy in minimizing non-major vascular complications
(80.8%) and device failure (89.6%). CONCLUSION(S): Based on current
evidence, the combined use of small-bore collagen plug-based and
suture-mediated vascular closure devices may represent the safest and most
effective strategy for TAVR-related vascular closure. However, its
clinical applicability requires further validation through large-scale
randomized controlled trials. Copyright © 2025 Elsevier Inc. All
rights reserved.

<100>
Accession Number
2039891570
Title
Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk
Patients: Updated Meta-Analysis.
Source
American Journal of Cardiology. 255 (pp 64-66), 2025. Date of Publication:
15 Nov 2025.
Author
Shimoda T.M.; Miyamoto Y.; Fukuhara S.; Ueyama H.A.; Sakurai Y.; Yokoyama
Y.; Sa M.P.; Latib A.; Laham R.J.; Hosseini K.; Kaneko T.; Kuno T.
Institution
(Shimoda) United States Naval Hospital Yokosuka, Yokosuka, Japan
(Miyamoto) Department of Real-World Evidence, of Medicine, University of
Tokyo, Tokyo, Japan
(Fukuhara, Yokoyama) Department of Cardiac Surgery, University of
Michigan, Ann Arbor, MI, United States
(Ueyama) Division of Cardiology, Emory University School of Medicine,
Atlanta, GA, United States
(Sakurai) Department of Surgery, Marshall University Joan Edwards School
of Medicine, Huntington, West Virginia, United States
(Sa) Division of Cardiac Surgery, Massachusetts General Hospital, Harvard
Medical School, Boston, Massachusetts, United States
(Latib) Division of Cardiology, Montefiore Medical Center, Albert Einstein
College of Medicine, New York, New York, United States
(Laham, Kuno) Division of Cardiology, Beth Israel Deaconess Medical
Center, Harvard Medical School, Boston, Massachusetts, United States
(Hosseini) Tehran Heart Center, Cardiovascular Diseases Research
Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Kaneko) Division of Cardiothoracic Surgery, Washington University School
of Medicine, St. Louis, Missouri, United States
(Kuno) Cardiology Division, Massachusetts General Hospital, Harvard
Medical School, Boston, Massachusetts, United States
Publisher
Elsevier Inc.
Abstract
Long-term data are essential for selection between transcatheter (TAVR)
and surgical (SAVR) aortic valve replacement in low-risk aortic stenosis
(AS) patients. Given the recent randomized controlled trials (RCTs) and
mid-term outcomes from existing trials, a reappraisal of the current
literature is necessary. We systematically identified RCTs comparing TAVR
and SAVR in low risk AS patients. A meta-analysis was performed using the
reconstructed time-to-event data from published Kaplan-Meier curves. The
outcome of interest was mid-term mortality. A stratified Cox model was
used to calculate hazard ratios (HRs). Proportional hazard assumptions
were tested, with landmark analysis and restricted mean survival time
(RMST) analysis conducted accordingly. 7 RCTs including 5,740 patients
(TAVR: 2,927; SAVR: 2,813) were included. At 5 years, TAVR was associated
with reduced all-cause mortality (HR 0.83; 95% CI 0.70-1.00). Landmark
analysis showed a significant survival benefit in the first year (HR 0.60;
95% CI 0.45-0.80), but not thereafter. The RMST analysis at 5 years
favored TAVR by 1.01 months (p = 0.01). In low risk AS patients, TAVR
demonstrated an early survival advantage. However, it remains uncertain
whether this short-term benefit translates to long-term advantages.
Long-term data are necessary to fully inform clinical
practice. Copyright © 2025 Elsevier Inc.

<101>
Accession Number
2035611895
Title
The Utilization of Superficial Femoral Artery Access for Transcatheter
Aortic Valve Replacement and Peripheral Vascular Interventions: A
Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Dave P.; Alfaifi A.; Traynor B.; Attumalil T.; Bisleri G.; Latter D.; Deva
D.; Wheatcroft M.; Ong G.; Alhazzani W.; Fam N.P.; Alnasser S.M.
Institution
(Dave, Alfaifi, Traynor, Attumalil, Bisleri, Latter, Deva, Ong, Fam,
Alnasser) Structural Heart Program, St. Michael's Hospital, University of
Toronto, Toronto, ON, Canada
(Wheatcroft) Division of Vascular Surgery, St. Michael's Hospital,
University of Toronto, Toronto, ON, Canada
(Alhazzani) Department of Medicine, St. Joseph's Healthcare, McMaster
University, Hamilton, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
The superficial femoral artery (SFA) is a vascular access alternative for
various cardiovascular interventions, especially when the common femoral
artery CFA is deep, calcified or in high bifurcation. SFA use, however,
was associated with pseudoaneurysms in older literature, and its
utilization for large-bore access is not well established. We conducted a
systematic review, including randomized and observational studies that
reported on SFA vascular access for peripheral arterial disease (PAD), and
transcatheter aortic valve replacement (TAVR) from inception until October
2024. The pooled weighted averages of SFA-related vascular complications
were calculated. In addition, the random-effects model was used to
estimate the pooled odds ratio (OR) comparison between SFA and CFA across
the included studies. The primary endpoint was vascular complications. The
search yielded 1269 articles; 27 (22 in PAD, 5 in TAVR) met our
pre-specified inclusion criteria. Among the PAD studies, 19 were
observational, and three were randomized clinical trials. The weighted
averages for vascular complications and pseudoaneurysms were 9.8% (95% CI
6.1%-15.6%) and 2.7% (95% CI 1.5%-4.9%), respectively. The meta-analysis
included six studies (five observational and one randomized) that compared
outcomes of SFA (838 patients) and CFA (604 patients) and showed no
significant difference in the rates of vascular complications (5.4% in the
SFA group and 6.4% in the CFA group, OR 0.71, 95% CI [0.40-1.27]; p =
0.25%). Among the TAVR studies, SFA was used as the primary access in 18
patients, with no significant bleeding, vascular complications, or
unplanned interventions. In this analysis, SFA access was associated with
good safety in selected patients undergoing peripheral arterial procedures
(low to intermediate risk of bias). It was also feasible as the primary
access route for TAVR in a very small, highly selected group with
unfavorable CFA anatomy (high risk of bias) and therefore is
hypothesis-generating, requiring validation in larger
studies. Copyright © 2025 The Author(s). Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<102>
Accession Number
2039904438
Title
SCAI/HRS technical review on transcatheter left atrial appendage
occlusion.
Source
Heart Rhythm. (no pagination), 2025. Date of Publication: 2025.
Author
Cronin E.M.; Filby S.; Field M.E.; Huded C.; Indik J.H.; Sharma A.; Armah
C.; Firestone S.; Fix A.M.; Senerth E.; Morgan R.L.; Falck-Ytter Y.
Institution
(Cronin) Lewis Katz School of Medicine at Temple University, Philadelphia,
Pennsylvania, United States
(Filby) University Hospitals Cleveland Medical Center, Cleveland, Ohio,
United States
(Field) Roper St. Francis Healthcare, Charleston, South Carolina, United
States
(Huded) Saint Luke's Mid America Heart Institute, Kansas City, Missouri,
United States
(Indik) Sarver Heart Center, University of Arizona, Tucson, AZ, United
States
(Sharma) Rutgers New Jersey Medical School, Newark, New Jersey, United
States
(Armah, Firestone) Society for Cardiovascular Angiography & Interventions,
Washington, DC, United States
(Fix) Heart Rhythm Society, Washington, DC, United States
(Senerth, Morgan, Falck-Ytter) Evidence Foundation, Cleveland Heights, OH,
United States
(Morgan) School of Medicine, Case Western Reserve University, Cleveland,
Ohio, United States
(Morgan) Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
(Falck-Ytter) Case Western Reserve University, Cleveland, Ohio, United
States
(Falck-Ytter) Division of Gastroenterology and Hepatology, Veterans
Affairs Northeast Ohio Healthcare System, Cleveland, Ohio, United States
Publisher
Elsevier B.V.
Abstract
Background: Nonvalvular atrial fibrillation (NVAF) is associated with an
increased risk of stroke due to thrombus formation in the left atrial
appendage, where over 90% of thrombi originate. While oral anticoagulation
(OAC) is the standard therapy for stroke prevention, many patients cannot
tolerate long-term OAC due to bleeding risks. Percutaneous left atrial
appendage occlusion (LAAO) has emerged as an alternative strategy. Despite
its rapid adoption, substantial variability exists in clinical practice
regarding patient selection, imaging techniques, procedural guidance, and
postprocedural management. This systematic review aims to collect and
synthesize evidence to inform the development of new Society for
Cardiovascular Angiography & Interventions (SCAI) and the Heart Rhythm
Society (HRS) guidelines on LAAO. Method(s): We searched PubMed,
Embase, and Cochrane Library from inception through January 5, 2024, for
studies of the percutaneous LAAO procedure. Eligible studies were
conducted in adults with NVAF undergoing LAAO, or with peridevice leak or
device-related thrombus after an occlusion procedure. Studies of surgical
LAAO, double device or combined procedures, and devices that are not
currently marketed in the United States were excluded. Data were extracted
from studies in duplicate and summarized using meta-analysis and narrative
synthesis. Risk of bias (RoB) was assessed using the RoB in nonrandomized
studies of interventions tool, and version 2 of the Cochrane RoB tool for
randomized trials (RoB 2.0). Overall certainty of evidence was assessed
using the Grading of Recommendations Assessment, Development, and
Evaluation (GRADE) approach. Result(s): Our search identified 3769
titles and abstracts, of which 27 studies met eligibility criteria and
contributed data to the analysis. Data were abstracted to address outcomes
of LAAO for stroke prevention in patients with NVAF, in comparison to OAC,
no therapy, and across various approaches including preprocedure imaging,
intraprocedure guidance, and postprocedure antithrombotic regimens.
 Conclusion(s): Left atrial appendage occlusion is an effective
alternative to OAC for stroke prevention in NVAF patients with bleeding
risks, but uncertainties remain regarding imaging strategies and
postprocedural management. Copyright © 2025 Society for
Cardiovascular Angiography & Interventions Foundation and Heart Rhythm
Society.

<103>
Accession Number
2039903907
Title
Ultrasound-Guided Stellate Ganglion Block Regulates Inflammatory Cytokines
and Improves Short-Term Outcome after Cardiac Surgery with Cardiopulmonary
Bypass: A Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Lv H.; Lv X.; Ai Z.; Huang Z.; Yu H.; Yu X.
Institution
(Lv, Ai, Huang) College of Medicine, Zhejiang University, Hangzhou, China
(Lv, Yu) Department of Anesthesiology, Sir Run Run Shaw Hospital of
Zhejiang University, Hangzhou, China
(Yu) Department of General Surgery, Sir Run Run Shaw Hospital of Zhejiang
University, Hangzhou, China
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate the effectiveness of left stellate ganglion block
(SGB) for inflammatory cytokines and short-term outcomes in cardiac
surgery with cardiopulmonary bypass (CPB). Design(s): Prospective,
randomized, double-blinded clinical trial. Setting(s): Single
academic center hospital. Participant(s): We included patients aged
18 to 70 scheduled for cardiac surgery with CPB. Intervention(s):
Before anesthesia induction, the patients who were allocated to either the
SGB group or the control group received SGB using either 0.5% ropivacaine
or 0.9% saline. Measurements and Main Results: The primary outcome
was the inflammatory cytokine concentration before (T0) and 6 hours (T1),
24 hours (T2), and 5 days (T3) after the block. Secondary outcomes
included the incidence of SIRS 24 hours after surgery, immune function at
each time point, intraoperative and postoperative complications, 30-day
mortality, intensive care unit and hospital stay, and hospitalization
costs. The analysis included 25 SGB and 25 control patients. Compared with
the control group, the SGB group significantly inhibited elevated
TNF-alpha concentration at 6 hours and 24 hours after the block (p <
0.05). SGB significantly reduced the SIRS 24 hours after surgery,
decreased the neutrophil percentage at 6 hours after the block, and
increased the lymphocyte percentage at 5 days after the block.
Additionally, SGB decreased the incidence of ventricular fibrillation
after reperfusion, postoperative delirium, and the occurrence of
Clavien-Dindo grade III-IV. Conclusion(s): SGB effectively improves
short-term outcomes in patients with cardiac surgery and CPB, possibly
through modulating the neuro-endocrine-immune network to normalize
sympathetic nervous system activity and stabilize perioperative tumor
necrosis factor-alpha concentration. Copyright © 2025

<104>
Accession Number
648134332
Title
Refining the diagnosis of periprocedural myocardial infarction after
cardiac surgery: Time to embrace the EACTS algorithm?.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2025.
Date of Publication: 25 Jul 2025.
Author
Heuts S.; Swinnen B.; Oosterlinck W.; Gollmann-Tepekoylu C.
Institution
(Heuts, Swinnen) Maastricht University Medical Centre (MUMC+), Maastricht,
Netherlands
(Heuts, Swinnen) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht University, Maastricht, Netherlands
(Oosterlinck) University Hospitals Leuven, Leuven, Belgium
(Gollmann-Tepekoylu) Innsbruck Medical University, Innsbruck, Austria

<105>
Accession Number
2039904465
Title
2025 SCAI/HRS clinical practice guidelines on transcatheter left atrial
appendage occlusion.
Source
Heart Rhythm. (no pagination), 2025. Date of Publication: 2025.
Author
Goldsweig A.M.; Glikson M.; Joza J.; Kavinsky C.J.; Khalique O.;
Lakkireddy D.; Mackensen G.B.; Naccarelli G.V.; Nair D.G.; Saw J.; Sharma
R.P.; Sherwood M.; Szerlip M.; Falck-Ytter Y.; Morgan R.L.; Armah C.;
Firestone S.; Fix A.; Senerth E.; Ellis C.R.
Institution
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center
and Division of Cardiovascular Medicine, University of
Massachusetts-Baystate, Springfield, Massachusetts, United States
(Glikson) Jesselson Integrated Heart Center, Shaare Zedek Medical Center
and Hebrew University Faculty of Medicine, Jerusalem, Israel
(Joza) Division of Cardiology, McGill University, Montreal, Quebec, Canada
(Kavinsky) Beth Israel Deaconess Medical Center, Harvard Medical School,
Boston, Massachusetts, United States
(Khalique) Division of Cardiovascular Imaging, St. Francis Hospital and
Heart Center, Roslyn, New York, United States
(Lakkireddy) Kansas City Heart Rhythm Institute and Research Foundation,
Overland Park, KS, United States
(Mackensen) Division of Cardiothoracic Anesthesiology, Department of
Anesthesiology and Pain Medicine, University of Washington, Seattle, WA,
United States
(Naccarelli) Heart and Vascular Institute, Penn State University College
of Medicine, Hershey, Pennsylvania, United States
(Nair) St. Bernard's Heart and Vascular Center, Jonesboro, AR, United
States
(Saw) Division of Cardiology, Vancouver General Hospital, University of
British Columbia, Vancouver, Canada
(Sharma) Stanford University Medical Center, Palo Alto, California, United
States
(Sherwood) Division of Cardiology, Inova Heart and Vascular Institute,
Fairfax, Virginia, United States
(Szerlip) Baylor Scott & White the Heart Hospital - Plano, Plano, Texas,
United States
(Falck-Ytter, Morgan) Case Western Reserve University, Cleveland, Ohio,
United States
(Armah, Firestone) Society for Cardiovascular Angiography & Interventions,
Washington, District of Columbia, United States
(Fix) Heart Rhythm Society, Washington, District of Columbia, United
States
(Morgan, Senerth) Evidence Foundation, Cleveland, Ohio, United States
(Ellis) Division of Cardiovascular Medicine at Vanderbilt University
Medical Center, Nashville, TN, United States
(Morgan) Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
(Falck-Ytter) VA Northeast Ohio Healthcare System, Cleveland, Ohio, United
States
Publisher
Elsevier B.V.
Abstract
Background: Left atrial appendage occlusion (LAAO) devices reduce the risk
of atrial fibrillation-associated stroke relative to no oral
anticoagulation. However, uncertainty and practice variation persist in
the areas of patient selection, periprocedural imaging, adjunctive
antithrombotic therapy, and management of peridevice leak (PDL) and
device-related thrombus. The Society for Cardiovascular Angiography &
Interventions and Heart Rhythm Society developed these evidence-based
guidelines to support clinicians, patients, and other stakeholders in
management decisions regarding LAAO. Method(s): The Society for
Cardiovascular Angiography & Interventions and Heart Rhythm Society
convened a balanced, multidisciplinary guideline panel with <50% of
members reporting significant conflicts of interest with the industry.
Evidence Foundation, a registered 501(c)(3) nonprofit organization,
provided methodological support for guideline development. The guideline
panel formulated and prioritized clinical questions following the Grading
of Recommendations Assessment, Development, and Evaluation approach in a
population, intervention, comparison, outcome format. A technical review
team of clinical and methodological experts conducted systematic reviews
of the published evidence, synthesized data, and graded the certainty of
evidence across outcomes. The guideline panel then developed
recommendations and supporting statements informed by the technical review
and using the Grading of Recommendations Assessment, Development, and
Evaluation evidence-to-decision framework. Result(s): The guideline
panel developed 8 evidence-based recommendations to address variations in
care related to LAAO. The panel also identified 2 knowledge gaps.
 Conclusion(s): Key recommendations address patient selection for
LAAO, periprocedural imaging, adjunctive antithrombotic therapy, and
management of PDL and device-related thrombus. The panel also recommended
necessary future research regarding the use of single antiplatelet therapy
following LAAO and regarding the management of PDL. Copyright ©
2025 Society for Cardiovascular Angiography & Interventions Foundation and
Heart Rhythm Society

<106>
Accession Number
2039907865
Title
A New Perspective in Cardiac Surgery: Single- and Two-level Deep
Parasternal Intercostal Plane Blocks for Median Sternotomy Pain.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Dolgun I.; Cevirme D.; Bayram E.; Zilifli C.; Erdogan M.B.
Institution
(Dolgun) Haseki Training and Research Hospital, Clinic of Anesthesiology
and Reanimation, Istanbul, Turkey
(Cevirme, Erdogan) Istinye University Faculty of Medicine, Department of
Cardiovascular Surgery, Istanbul, Turkey
(Bayram) Department of Anesthesiology and Reanimation, Faculty of
Medicine, Istinye University Medicalpark Gaziosmanpasa Hospital, Istanbul,
Turkey
(Zilifli) Istinye University Faculty of Medicine, Cardiovascular Surgery
Intensive Care Unit, Istanbul, Turkey
Publisher
W.B. Saunders
Abstract
Objectives: To compare the efficacy of single-level and two-level deep
parasternal intercostal plane (DPIP) blocks in managing postoperative pain
in cardiac surgery patients undergoing median sternotomy. Design(s):
A prospective, randomized controlled study. Setting(s): A cardiac
surgery unit in a tertiary hospital, conducted under institutional ethical
approval. Participant(s): Adult patients (>=18 years) undergoing
elective coronary artery bypass grafting (CABG), valve surgery, or
combined CABG + valve procedures. Exclusion criteria included allergies to
local anesthetics, emergency surgeries, reoperations, chronic pain, and
major comorbidities. Intervention(s): Single-level DPIP block: 10 mL
of 0.25% bupivacaine bilaterally at the T4/5 intercostal space. Two-level
DPIP block: 5 mL bilaterally at T2/3 and T5/6 intercostal spaces. All
blocks were administered preoperatively under ultrasound guidance.
 Measurements and Main Results: Both techniques provided effective
analgesia. However, single-level blocks yielded significantly lower pain
scores at 4, 6, and 8 hours, particularly during movement and in patients
undergoing CABG. Differences decreased at 12 hours and disappeared by 24
hours. Pain scores were inversely correlated with age. No block-related
complications were observed. Conclusion(s): Single-level DPIP blocks
demonstrated more consistent early analgesia and were technically simpler
to perform. Given their efficacy, safety, and efficiency, single-level
blocks may serve as a practical alternative for routine use in cardiac
surgery. Further research is warranted to optimize block level, volume,
and concentration based on patient and surgical
characteristics. Copyright © 2025 Elsevier Inc.

<107>
Accession Number
648123510
Title
The Endo-Bentall Procedure in the Treatment of Ascending Aorta
Pathologies: A Scoping Review.
Source
European journal of vascular and endovascular surgery : the official
journal of the European Society for Vascular Surgery. (no pagination),
2025. Date of Publication: 21 Jul 2025.
Author
Shehab M.; Prendes C.F.; Wanhainen A.; Lindblom R.; James S.; Mani K.
Institution
(Shehab) Department of Surgical Sciences, Vascular Surgery, Uppsala
University, Uppsala, Sweden
(Prendes, Mani) Department of Surgical Sciences, Vascular Surgery, Uppsala
University, Uppsala, Sweden
(Wanhainen) Department of Surgical Sciences, Vascular Surgery, Uppsala
University, Uppsala, Sweden; Department of Surgical and Perioperative
Sciences, Surgery, Umea University, Umea, Sweden
(Lindblom) Department of Surgical Sciences, Cardiothoracic Surgery,
Uppsala University, Uppsala, Sweden
(James) Department of Medical Sciences, Cardiology, Uppsala University,
Uppsala, Sweden
Abstract
OBJECTIVE: The ascending aorta remains a challenging area for endovascular
repair, with limited anatomical suitability of current stent grafts due to
proximal landing zone constraints. This scoping review summarises existing
experiences with the Endo-Bentall procedure, evaluates its use across
pathologies, identifies obstacles, and proposes future advancements. DATA
SOURCES: PubMed, Cochrane, and Embase were systematically searched
(English language, up to 30 November 2024) for studies evaluating the
Endo-Bentall procedure in treating ascending aortic pathologies. REVIEW
METHODS: The Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) protocol extension for scoping reviews was
followed, and data were reported as descriptive narratives or tables.
 RESULT(S): Twenty studies were included, comprising case reports,
anatomical feasibility analyses, reviews, expert opinions, and technical
notes. Proof of concept studies in ex vivo (n = 30) and in vivo (n = 20)
models achieved 95 - 100% technical success rates, with sustained coronary
patency. Five cases were reported; indications included aortic dissection
(n = 2), aneurysm (n = 1), and post-surgical complications (n = 2).
Balloon expandable transcatheter aortic valve implantation (TAVI)
platforms were used in three cases (one utilised single stage and two
utilised two stage procedures), while self expanding platforms were used
in two cases (single stage). Technical success was achieved in all cases.
Early follow up showed favourable outcomes in two of three balloon
expandable cases and two of two self expanding cases. One patient died at
5 months (non-aortic cause). Anatomical feasibility studies for aortic
dissection (n = 547) and aortic aneurysm (n = 80) demonstrated a median
suitability rate of 68% (31 - 80%) for various device designs. The Grading
of Recommendations Assessment, Development, and Evaluation (GRADE)
methodology suggested a very low certainty regarding clinical outcomes.
 CONCLUSION(S): The Endo-Bentall procedure is an emerging endovascular
approach for ascending aortic pathologies, particularly for patients at
high surgical risk. Early experience suggests feasibility. However, the
current literature is significantly limited by publication bias and
methodological heterogeneity. Further research is required, with
systematic evaluation to optimise device development, surgical technique,
bailout strategies, and long term outcomes. Copyright © 2025 The
Author(s). Published by Elsevier B.V. All rights reserved.

<108>
Accession Number
2035578772
Title
Comparison of intravascular imaging, physiological assessment and
angiography for coronary revascularization in acute coronary syndrome: a
systematic review and network meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1604050. Date of Publication: 2025.
Author
Liu X.-Y.; Ye B.-H.; Wu X.-D.; Lin Y.; Lin X.; Li Y.-Y.; Sun J.-C.
Institution
(Liu, Ye, Wu, Lin, Lin, Li) Department of General Medicine, The First
People's Hospital of Wenling, Zhejiang, Taizhou, China
(Sun) Department of Cardiology, Taizhou Municipal Hospital, Zhejiang,
Taizhou, China
Publisher
Frontiers Media SA
Abstract
Background: The optimal percutaneous coronary intervention (PCI) technique
to treat acute coronary syndrome (ACS) requires further investigation.
This network meta-analysis evaluated the effects of physiological
assessment and intravascular imaging techniques on the prevalence of
adverse cardiac outcomes following PCIs. Method(s): We reviewed
PubMed, Cochrane, and EMBASE databases for the purpose of identifying all
randomized control trials published up to October 30, 2024, comparing the
impact of intravascular imaging, physiology assessment, or angiography
techniques on outcomes. The primary outcome for this research was major
adverse cardiovascular events (MACE) occurrences. Each PCI strategy was
ranked as per the risk ratio (RR) at the 95% confidence interval (95% CI)
for developing MACE. Result(s): Twenty-eight RCTs with 18,221
patients were identified. Compared with angiography, intravascular
ultrasound (IVUS)- (RR: 0.62; 95%CI: 0.46-0.85) and fractional flow
reserve (FFR)-guided PCI (RR: 0.62; 95%CI: 0.46-0.85) reduced the risk of
MACE. Patients who received quantitative flow ratio (QFR)-guided PCI
experienced lower all-cause mortality (RR: 0.25; 95%CI: 0.07-0.92) vs.
those receiving angiography. Similarly, the RR decreased to 0.64 after
using FFR-guided PCI vs. angiographic procedures (95% CI: 0.44-0.91).
Compared to angiography, the subgroup analysis showed inconsistent results
for IVUS-guided PCI in preventing MACE for both the optimization (RR:
0.60; 95%CI: 0.49-0.74) and decision-making (RR: 0.55; 95%CI: 0.05-6.18).
The likelihood of developing MACE was lower for FFR-guided CR than for
angiography-guide culprit-only PCIs (RR-0.72; 95%CI: 0.53-0.97), as
confirmed by sensitivity assessment results. The research unveiled no
statistically significant differences between FFR-guided culprit-only PCIs
and culprit-only PCIs or angiography-guided CR. Conclusion(s): IVUS-
and FFR-guided PCI lowers the MACE risk in patients with ACS. In addition,
IVUS achieved the best results in ACS patients undergoing PCI. Systematic
Review Registration: INPLASY (inplasy.com),
INPLASY202420092. Copyright 2025 Liu, Ye, Wu, Lin, Lin, Li and Sun.

<109>
Accession Number
2039906353
Title
The Trials of Interpreting Clinical Trials-A Bayesian Perspective on
Colchicine After an Acute Coronary Syndrome.
Source
Canadian Journal of Cardiology. (no pagination), 2025. Date of
Publication: 2025.
Author
Brophy J.M.
Institution
(Brophy) McGill University Health Center Centre for Health Outcomes
Research (CORE), and Department of Medicine, and Department of
Epidemiology, Biostatistics and Occupational Health, McGill University,
Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
Background: A 2022 meta-analysis concluded colchicine reduced the cardiac
risk in secondary prevention. Nevertheless, a large, randomized clinical
trial continued to randomize patients to colchicine or placebo and in 2025
published findings of no benefit. Bayesian sequential analyses and
hierarchical meta-analysis can assist in understanding not only the
interpretation of this latest trial but also the totality of the evidence.
 Method(s): A systematic review and Bayesian meta-analysis including
the recent CLEAR trial results was performed. The primary outcome was
major adverse cardiovascular events (MACE), a composite of death from
cardiovascular causes, recurrent myocardial infarction, stroke, or
unplanned ischemia-driven coronary revascularization. Bayesian sequential
analyses were performed with vague (results dominated by CLEAR), fully
informative (on the basis of all previous studies), and "focused"
(considering only the largest and most similar previous trial) priors and
results compared in a hierarchical meta-analysis. The probabilities of
clinically meaningful results were based on an absolute > 15% MACE
reduction. Result(s): Although the 2022 meta-analysis suggested a
statistically significant MACE decrease with colchicine, the Bayesian
reanalysis showed a 95% relative risk credible interval of 0.26-1.70 for
the next study, justifying CLEAR continuation. The Bayesian sequential
analyses using vague, all-inclusive, and focused priors showed 58%, 100%,
and 92% probabilities, respectively, of MACE decrease with use of
colchicine. Clinically meaningful probability decreases, based on > an
absolute 15% reduction, were smaller, ranging between 2% and 41%.
 Conclusion(s): Bayesian analyses offer advantages in trial design and
interpretation, suggesting some benefit for colchicine in secondary
cardiovascular prevention, but considerably less certainty of its clinical
importance. Copyright © 2025 Canadian Cardiovascular Society

<110>
Accession Number
2036958963
Title
Assessment of Pain Control using Ultrasound-guided Bilateral
Pecto-intercostal Fascial Plane Block in Pediatric Cardiac Surgeries on
Cardiopulmonary Bypass.
Source
Journal of Cardiac Critical Care. 9(3) (pp 164-170), 2025. Date of
Publication: 01 Jul 2025.
Author
Badge M.; Kapoor P.M.; Nagaswetha L.S.; Rajgopalan K.; Choudhury M.
Institution
(Badge, Kapoor, Nagaswetha, Rajgopalan, Choudhury) Department of Cardiac
Anaesthesia and Critical Care, All India Institute of Medical Sciences,
New Delhi, India
Publisher
Scientific Scholar LLC
Abstract
Objectives: Acute post-operative pain can be a cause of significant
morbidity in pediatric cardiac surgical patients. The purpose of this
study was to evaluate the efficacy and safety of ultrasound-guided
bilateral pecto-intercostal fascial plane block (PIFB) in pediatric
cardiac surgical patients. Material(s) and Method(s): It was a
randomized, prospective, single-blinded, comparative study in a tertiary
care cardiac center. The study comprised 90 patients with acyanotic and
cyanotic congenital heart disease undergoing cardiac surgery through
midline sternotomy on cardiopulmonary bypass (CPB), randomized into two
groups - Group P (PIFB) and Group C (control). Following surgical skin
closure, Group P was administered bilateral PIFB using 3 mg/kg of 0.2%
ropivacaine. Fentanyl was provided before extubation, while tramadol was
employed post-extubation as rescue analgesia. Paracetamol was administered
to both groups as part of a multimodal analgesia protocol. Result(s):
Resting modified objective pain score (MOPS) at 1, 2, 4, 6, 8, 10, 12, 24,
and 36 h was measured post-extubation. After exclusions, 83 patients were
evaluated. MOPS at all-time intervals for 36 h was comparatively less in
the PIFB group (P < 0.01). Time to extubate (P < 0.001), post-operative
fentanyl pre-extubation (P < 0.001), time to first rescue analgesia (P <
0.001), tramadol post-extubation (P < 0.001), paracetamol requirement (P <
0.001), intensive care unit length of stay (P = 0.008), and the hospital
length of stay (P = 0.007) were significantly less in Group P. No adverse
events attributable to PIFB were observed. Conclusion(s):
Ultrasound-guided bilateral PIFB represents a safe and effective modality
for the management of acute post-operative pain in pediatric patients
undergoing cardiac surgery with CPB. Copyright ©2025 Published by
Scientific Scholar on behalf of Journal of Cardiac Critical Care TSS.

<111>
[Use Link to view the full text]
Accession Number
2039917007
Title
N-Acetylcysteine to Reduce Mortality for Patients Requiring Cardiac
Catheterization or Cardiac Surgery: A Systematic Review and Meta-analysis.
Source
Journal of Cardiovascular Pharmacology. 83(6) (pp 580-587), 2024. Date of
Publication: 01 Jun 2024.
Author
Gakuba C.; Dumitrascu A.-D.; Marsan P.-E.; Legallois D.; Hanouz J.-L.;
Vivien D.; Martinez De Lizarrondo S.; Gauberti M.; Cerasuolo D.
Institution
(Gakuba, Dumitrascu, Marsan, Hanouz) Departement d'Anesthesie Reanimation,
Chu de Caen Normandie, Caen, France
(Gakuba, Hanouz, Vivien, Martinez De Lizarrondo, Gauberti) Departement
PhIND Physiopathology and imaging of Neurological Disorders, Institut
Blood and Brain @ Caen-Normandie, Normandie Univ, Unicaen, Inserm, U1237,
Cyceron, Caen, France
(Legallois) Departement de Cardiologie, Chu de Caen Normandie, EA4650
(SEILIRM), Fhu REMOD-VHF, Caen, France
(Vivien) Departement de Recherche Clinique, Chu de Caen Normandie, Caen,
France
(Gauberti) Departement de Radiologie diagnostique et interventionnelle,
Chu de Caen Normandie, Caen, France
(Cerasuolo) Departement de sante publique, Centre hospitalier
universitaire de Caen, Caen, France
(Cerasuolo) Normandie Univ, Unicaen, Inserm U1086, Anticipe, Caen, France
Publisher
Lippincott Williams and Wilkins
Abstract
Multimers of von Willebrand factor play a critical role in various
processes inducing morbidity and mortality in cardiovascular-risk
patients. With the ability to reduce von Willebrand factor multimers,
N-acetylcysteine (NAC) could reduce mortality in patients undergoing
coronary catheterization or cardiac surgery. However, its impact in
perioperative period has never been studied so far in regard of its
potential cardiovascular benefits. Then, 4 databases were searched for
randomized controlled trials that compared in-hospital mortality between
an experimental group, with NAC, and a control group without NAC, in
patients undergoing coronary catheterization or cardiac surgery. The
primary efficacy outcome was in-hospital mortality. Secondary outcomes
were the occurrence of thrombotic events, major cardiovascular events,
myocardial infarction, and contrast-induced nephropathy. The safety
outcome was occurrence of hemorrhagic events. Nineteen studies totaling
3718 patients were included. Pooled analysis demonstrated a reduction of
in-hospital mortality associated with NAC: odds ratio, 0.60; 95%
confidence interval, 0.39-0.92; P = 0.02. The occurrence of secondary
outcomes was not significantly reduced with NAC except for
contrast-induced nephropathy. No difference was reported for hemorrhagic
events. Subgroup analyses revealed a life-saving effect of NAC in a
dose-dependent manner with reduction of in-hospital mortality for the NAC
high-dose group, but not for the NAC standard-dose (<3500-mg) group. In
conclusion, without being able to conclude on the nature of the mechanism
involved, our review suggests a benefit of NAC in cardiovascular-risk
patients in perioperative period in terms of mortality and supports
prospective confirmatory studies. Copyright © 2024 Wolters Kluwer
Health, Inc.

<112>
Accession Number
2031620702
Title
Short and Long-Term Outcomes of Transcatheter Aortic Valve Implantation in
the Small Aortic Annulus: A Systematic Literature Review.
Source
Journal of Personalized Medicine. 14(9) (no pagination), 2024. Article
Number: 937. Date of Publication: 01 Sep 2024.
Author
Cabrucci F.; Baudo M.; Yamashita Y.; Dokollari A.; Sicouri S.; Ramlawi B.
Institution
(Cabrucci, Baudo, Yamashita, Dokollari, Sicouri, Ramlawi) Department of
Cardiac Surgery Research, Lankenau Institute for Medical Research, Main
Line Health, Wynnewood, PA, United States
(Yamashita, Ramlawi) Department of Cardiac Surgery, Lankenau Heart
Institute, Main Line Health, Wynnewood, PA, United States
(Dokollari) Department of Cardiac Surgery, St. Boniface Hospital,
University of Manitoba, Winnipeg, MB, Canada
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Transcatheter aortic valve implantation has revolutionized the treatment
of aortic stenosis. The small aortic annulus is one of the most
challenging aspects of aortic stenosis treatment and since the beginning,
TAVI has shown promising results in this subgroup of patients. This
systematic literature review aims to investigate the short and long-term
outcomes of TAVI in the small aortic annulus. The literature was
meticulously screened for this topic until April 2024 using the PRISMA
guidelines. Technical aspects, characteristics of this subgroup of
patients, hemodynamic performances, and outcomes are discussed. The
importance of device selection has shown up, with insight into the
differences between self-expandable and the balloon-expandable valves. Two
special populations were also taken into account: outcomes of TAVI in the
small aortic annulus with bicuspid aortic valve and extra-small aortic
annulus. The last 10 years have been paramount in technological
advancements, bringing TAVI to broader use in this population. While
several important trials underscored the usefulness of TAVI in the small
aortic annulus population, the clinical practice still lacks consensus on
the ideal device, and the outcomes are debated. The pivotal role of TAVI
in this context needs to be addressed with a patient-tailored approach to
optimize patient care. Copyright © 2024 by the authors.

<113>
Accession Number
648136210
Title
Quality of Evidence: Randomized Trials in Coronary Disease and Moving the
Goalposts.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2025. Date of Publication: 24 Jul 2025.
Author
Alshneikat M.; Awad A.K.; Bakaeen F.G.
Institution
(Alshneikat, Awad) Department of Thoracic and Cardiovascular Surgery,
Cleveland Clinic, Cleveland, OH, United States
(Bakaeen) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States

<114>
Accession Number
648124958
Title
Effectiveness of deep breathing exercises on anxiety, depression and sleep
quality in patients undergoing coronary artery bypass surgery.
Source
Scientific reports. 15(1) (pp 26797), 2025. Date of Publication: 23 Jul
2025.
Author
Eghbali T.; Rashtabadi O.R.; Ahmadi A.; Nakhaeizadeh R.; Mayel Y.; Forouzi
M.A.
Institution
(Eghbali, Rashtabadi) Nursing Research Center, Kerman University of
Medical Sciences, Kerman, Iran, Islamic Republic of
(Ahmadi) Reproductive and Family Health Research Center, Kerman University
of Medical Sciences, Kerman, Iran, Islamic Republic of
(Nakhaeizadeh, Mayel) Kerman University of Medical Sciences, Kerman, Iran,
Islamic Republic of
(Mayel) Faculty of Medical Sciences, Azad University of Medical Sciences,
Kerman, Iran, Islamic Republic of
(Forouzi) Neuroscience Research Center, Institute of Neuropharmacology,
Kerman University of Medical Sciences, Haft-Bagh Highway, Kerman, Iran,
Islamic Republic of
Abstract
This study investigated the effect of deep breathing exercises on sleep
quality, anxiety, and depression in coronary artery bypass graft patients.
This is a clinical trial with 2 parallel groups (intervention, control)
that was conducted on 80 patients underwent coronary artery bypass
surgery. Participants were randomly assigned to the groups using a
computer-generated random sequence. Allocation was concealed using sealed
opaque envelopes prepared by an independent researcher. The intervention
group performed deep breathing exercises every three hours, 10 breaths
each time, for four days post-surgery. Both groups completed the Hospital
Anxiety and Depression Scale at four time points: before intervention
(T0), discharge (T1), 15 days later (T2), and one month post-discharge
(T3). The Pittsburgh Sleep Quality Index was completed at T0 and T3. Due
to the nature of the intervention, blinding of participants and
intervention providers was not feasible. However, outcome assessor at T2
and T3 and data analyst were blinded to group assignments to minimize
bias. In the intervention group, mean anxiety scores decreased from 10.35
at T0 to 6.97 at T1, 8.92 at T2, and 8.20 at T3 (eta2 = 0.08, p < 0.05).
Depression scores decreased from 10.45 at T0 to 7.92 at T1, 8.77 at T2,
and 7.65 at T3 (eta2 = 0.05, p < 0.05). Sleep quality improved
significantly from 9.72 at T0 to 2.82 at T3 (p = 0.0001). Data were
analyzed using repeated measures ANOVA with Bonferroni post-hoc tests and
independent and paired t-tests. Deep breathing exercises, as a simple and
non-pharmacological nursing intervention, can reduce anxiety and
depression and improve sleep quality in CABG patients. Nurse-led training
of deep breathing is strongly recommended to support psychological
well-being and sleep management in these patients.This research has been
registered in Iran's Clinical Trials Registry on 18/12/2023
(IRCT20231208060294N1). Copyright © 2025. The Author(s).

<115>
Accession Number
2035564827
Title
Methylprednisolone and Endothelial Dysfunction in Cardiac Surgery: A Pilot
Randomized Trial.
Source
Acta Anaesthesiologica Scandinavica. 69(8) (no pagination), 2025. Article
Number: e70109. Date of Publication: 01 Sep 2025.
Author
Halenarova K.W.; De Backer D.; Njimi H.; Taccone F.S.; Van Obbergh L.
Institution
(Halenarova, Njimi, Taccone) Department of Intensive Care, Erasme
Hospital, Hopitaux Universitaires de Bruxelles, Brussels, Belgium
(De Backer) Intensive Care Unit, CHIREC Hospital Group, Universite Libre
de Bruxelles, Brussels, Belgium
(Van Obbergh) Department of Anesthesia, Erasme Hospital, Hopitaux
Universitaires de Bruxelles, Brussels, Belgium
Publisher
John Wiley and Sons Inc
Abstract
Background: Cardiac surgery involving cardiopulmonary bypass (CPB) serves
as a clinical model of ischemia-reperfusion injury and endothelial
dysfunction. Endothelial injury is often manifested clinically by
vasoplegia and microcirculatory disturbances. The administration of a
single dose of corticosteroids at the time of anesthesia induction has
been hypothesized to exert a protective effect. Method(s): In this
parallel-group, randomized, controlled single-center trial, patients
scheduled for elective cardiac surgery with CPB were assigned to receive
intravenous methylprednisolone or placebo at anesthesia induction. The
primary outcome was the occurrence of endothelial dysfunction, assessed
using flow-mediated dilation (FMD) during a vascular occlusion test.
Secondary outcomes included peripheral tissue reperfusion slope measured
by near-infrared spectroscopy (NIRS StO<inf>2</inf>) and syndecan-1
levels, variations of FMD, NIRS StO<inf>2</inf>, and syndecan-1 over time,
and the correlation between the three measurements. Result(s):
Thirty-nine patients were assigned to receive either methylprednisolone (n
= 20) or placebo (n = 20). Maximal post-CPB median FMD was 5.7% (IQR:
3.4%-7.0%) in the methylprednisolone group and 4.7% (2.2%-6.6%) in the
placebo group (difference: 0.60, 95% CI: -1.5 to 2.7; p = 0.57). On the
first postoperative day, median FMD was 6.9% (3.6%-9.8%) in the
methylprednisolone group and 8.1% (4.3%-11.6%) in the placebo group
(difference: -1.0, 95% CI: -3.6 to 1.6; p = 0.46). No other significant
differences between groups were observed for other measurements. A
significant correlation was found between the severity of FMD alteration
and syndecan-1 levels (r = 0.21, p = 0.03). Conclusion(s):
Methylprednisolone did not significantly affect CPB-associated endothelial
dysfunction markers in elective cardiac surgery patients. Nevertheless, a
correlation between syndecan-1 levels and the peak arterial dilation
suggests a link between the severity of glycocalyx damage and vascular
reactivity. Editorial Comment: Glycocalyx damage has been associated with
impaired vascular reactivity. This pilot trial assessed methylprednisolone
effect on flow-mediated arterial dilation and also tissue oxygen
saturation during a vascular occlusion test as well as syndecan-1 levels,
these in an elective cardiac surgical cohort, to see if a single steroid
dose could limit cardiopulmonary bypas-related endothelial dysfunction.
Single steroid dose here did not effect the main outcome, flow mediated
areterial dilation, in this cohort. Copyright © 2025 Acta
Anaesthesiologica Scandinavica Foundation.

<116>
Accession Number
2039849607
Title
Bench Testing of a New Australian Device for Hypothermic Oxygenated
Perfusion (HOPE) of Donated Hearts and Kidneys.
Source
American Journal of Transplantation. Conference: World Transplant Congress
2025. San Francisco United States. 25(8 Supplement 1) (pp S969-S970),
2025. Date of Publication: 01 Aug 2025.
Author
Nazarizadeh-Khangheshlaghi A.; Johnston J.; Nitschke J.; Ou R.; Buttfield
I.; Gaitan-Ortiz R.; Knight J.; Coates T.; Drogemuller C.
Institution
(Nazarizadeh-Khangheshlaghi, Buttfield, Gaitan-Ortiz) Organ Transport Pty
Ltd, Adelaide, Australia
(Johnston, Nitschke, Coates, Drogemuller) Centre for Clinical and
Experimental Transplantation, Royal Adelaide Hospital, Adelaide, Australia
(Ou) Baker Heart and Diabetes Institute, Melbourne, Australia
(Knight) The George Institute for Global Health, Barangaroo, Australia
Publisher
Elsevier B.V.
Abstract
Purpose: Bench measurement of oxygenation, temperature, pressure and flow
over 24 hours in a new Australian medical device designed to deliver HOPE
to donated organs. Background(s): Increasing use of extended criteria
donors in transplantation encourages the use of perfusion devices for
preservation of donated organs during transport. A Cochrane review of
hypothermic machine perfusion of donor kidneys confirmed a significant
reduction in delayed graft function and improved one year graft survival
(Tingle et al. Cochrane Database Syst Rev 2024 Jul 9;7(7):CO011671). A
recent multicentre RCT showed that HOPE reduces primary graft dysfunction
and major adverse events in heart transplantation (Rega et al. Lancet
2024;404:670-682). Method(s): The Organ Angel (OA, Vital Organ
Technologies, Adelaide) is a simple, battery-operated device which can
provide HOPE to donated hearts and kidneys. In initial bench testing a
beta prototype of the OA was run repeatedly over a 24-hour period using a
surrogate organ resistance in the circuit with frequent interval
measurement of temperature, oxygenation, pressure and flow.
 Result(s): Pressure, flow, oxygenation and temperature were
maintained within target ranges throughout the 24 hour period.
 Conclusion(s): On preliminary bench testing, the newly developed
Australian OA transport device offers a stable environment for HOPE
perfusion of donated hearts and kidneys comparable to other devices
currently in use in different geographies around the world. It is expected
that its lower cost and simpler design should offer significant advantages
to users once clinical evaluation and regulatory approval are finalised.
[Formula presented] [Formula presented] CITATION INFORMATION:
Nazarizadeh-Khangheshlaghi A., Johnston J., Nitschke J., Ou R., Buttfield
I., Gaitan-Ortiz R., Knight J., Coates T., Drogemuller C. Bench Testing of
a New Australian Device for Hypothermic Oxygenated Perfusion (HOPE) of
Donated Hearts and Kidneys AJT, Volume 25, Issue 8 Supplement 1
DISCLOSURES: T. Coates: None. Copyright © 2025

<117>
Accession Number
2035557938
Title
Transcatheter Tricuspid Valve Interventions: a Narrative Review of Current
Evidence and Future Directions.
Source
Current Treatment Options in Cardiovascular Medicine. 27(1) (no
pagination), 2025. Article Number: 53. Date of Publication: 01 Dec 2025.
Author
Gupta R.; Abdul-Rahman T.; Gaur A.; Roy P.; Thaalibi H.I.; Kundu M.;
Wireko A.A.; Davila C.D.
Institution
(Gupta, Davila) Yale New Haven Hospital, Yale University School of
Medicine, New Haven, CT, United States
(Abdul-Rahman, Gaur, Roy, Thaalibi, Kundu, Wireko) Department of Research,
Toufik's World Medical Association, Sumy, Ukraine
(Gaur) Yeovil District Hospital, Somerset NHS Foundation Trust, Higher
Kingston, Yeovil, United Kingdom
(Roy) Department of Medicine, North Bengal Medical College and Hospital,
Siliguri, India
(Thaalibi) Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
(Kundu) Institute of Medical Sciences and SUM Hospital, Bhubaneswar, India
Publisher
Springer
Abstract
Purpose of Review: The review aims to delineate the developing role of
transcatheter tricuspid valve interventions (TTVIs) whilst considering the
current state of the evidence, preprocedural workup, developments, and
outcomes based on current literature. Recent Findings: TTVIs have made
significant improvements in reducing TR and improving functional status in
patients, especially in high-risk surgical cohorts. Innovations in device
technology, such as the EVOQUE and LuX valves, have widened the scope of
this intervention, offering tailored solutions for a wide range of
anatomical and clinical challenges. Comparative analyses have indicated
higher procedural success rates and improved patient outcomes compared to
traditional surgical interventions. Summary: TTVIs are redefining the
management of tricuspid valve dysfunction by offering an effective and
less invasive alternative to surgery. Despite promising short-term
outcomes, questions of long-term durability require further research.
Further innovation as well as larger clinical trials, will ensure this
technique becomes a cornerstone in tricuspid valve
management. Copyright © The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2025.

<118>
Accession Number
2039794249
Title
Tracheobronchial Replacement: A Systematic Review.
Source
JAMA Surgery. (no pagination), 2025. Date of Publication: 2025.
Author
Martinod E.; Radu D.M.; Onorati I.; Chapalain X.; Santos Portela A.M.;
Peretti M.; Freynet O.; Uzunhan Y.; Chouahnia K.; Duchemann B.; Juvin C.;
Lebreton G.; Rouard H.; Van Der Meersch G.; Galvaing G.; Chadeyras J.-B.;
Tronc F.; Kuczma P.; Tresallet C.; Venissac N.; Beloucif S.; Huet O.;
Vicaut E.
Institution
(Martinod, Radu, Onorati, Santos Portela, Peretti) Chirurgie Thoracique et
Vasculaire, Hopital Avicenne, Hopitaux Universitaires Paris
Seine-Saint-Denis, Assistance Publique-Hopitaux de Paris (AP-HP), Bobigny,
France
(Martinod, Radu, Onorati) Hypoxie et Poumon, Faculte de Medecine SMBH,
Inserm UMR1272, Universite Sorbonne Paris Nord, Bobigny, France
(Martinod, Radu, Onorati) Laboratoire de Recherche Bio-chirurgicale,
Fondation Alain Carpentier, Hopital Europeen Georges Pompidou, AP-HP,
Universite Paris Cite, Paris, France
(Onorati, Rouard) Banque des Tissus, AP-HP, EFS Ile de France,
Ivry-sur-Seine, France
(Chapalain) Anesthesie-Reanimation, UFR de Medecine, Centre Hospitalier
Universitaire de Brest, Universite de Bretagne Occidentale, Brest, France
(Freynet, Uzunhan) Pneumologie, Hopital Avicenne, Hopitaux Universitaires
Paris Seine-Saint-Denis, AP-HP, Bobigny, France
(Chouahnia, Duchemann) Hopital Avicenne, Hopitaux Universitaires Paris
Seine-Saint-Denis, AP-HP, Bobigny, France
(Juvin, Lebreton) Chirurgie Cardiaque, Hopital la Pitie-Salpetriere,
AP-HP, Sorbonne Universite, Paris, France
(Van Der Meersch) Medecine Intensive Reanimation, Hopital Avicenne,
Hopitaux Universitaires Paris Seine-Saint-Denis, AP-HP, Bobigny, France
(Galvaing, Chadeyras) Service de Chirurgie Thoracique et Endocrinienne,
Centre Jean Perrin, Clermont-Ferrand, France
(Tronc) Chirurgie Thoracique, Hopitaux Universitaires de Lyon, Lyon,
France
(Kuczma, Tresallet) Chirurgie Digestive et Endocrinienne, Hopital
Avicenne, Hopitaux Universitaires Paris Seine-Saint-Denis, AP-HP, Bobigny,
France
(Venissac) Chirurgie Thoracique, Hopitaux Universitaires de Lille, Lille,
France
(Beloucif) Anesthesie-Reanimation, Hopital Avicenne, Hopitaux
Universitaires Paris Seine-Saint-Denis, AP-HP, Bobigny, France
(Huet) Hopital Avicenne, Hopitaux Universitaires Paris Seine-Saint-Denis,
AP-HP, UFR de Medecine, Universite de Bretagne Occidentale, Bobigny,
Brest, France
(Vicaut) Unite de Recherche Clinique, Hopitaux Saint
Louis-Lariboisiere-Fernand Widal, AP-HP, Universite Paris Cite, Paris,
France
Publisher
American Medical Association
Abstract
Importance: Tracheobronchial replacement remains a surgical and biological
challenge despite several decades of experimental and clinical research.
 Objective(s): To compile a comprehensive state-of-the-science review
examining the current indications, techniques, and outcomes of
tracheobronchial replacement in human patients. Evidence Review: A
systematic review of the literature was conducted on July 1, 2024, to
identify studies examining tracheobronchial replacement. This review was
performed according to the Preferred Reporting Items for Systematic
Reviews and Meta-analyses (PRISMA) reporting guidelines and the PRISMA
2020 statement. We selected the following 3 databases: (1) PubMed via the
US National Library of Medicine's PubMed.gov; (2) Embase via Elsevier's
Embase.com; and (3) the Cochrane Central Register of Controlled Trials
(CENTER) via Wiley's Cochrane Library. An additional search was performed
using the following clinical trials registers: the World Health
Organization's International Clinical Trials Registry Platform and
ClinicalTrials.gov, provided by the US National Library of Medicine.
 Finding(s): The initial search produced 6043 results, with a total of
126 publications included in the final review. Only 1 prospective cohort
study and 1 registry, both concerning the use of cryopreserved aortic
allografts, were identified. Most publications were case reports and
series. From July 1, 2002, to July 1, 2024, a total of 137 cases of
tracheobronchial replacement were published. Tracheobronchial replacement
was indicated for extensive neoplastic tumors (108 cases [78.8%]) or
benign stenoses (29 cases [21.2%]). The most common malignancies were
thyroid cancers and adenoid cystic carcinomas. The most frequent
resections involved the upper half of the trachea, with reconstructions
using muscle flaps, or, most notably, cryopreserved aortic allografts,
which have shown promising outcomes and have become the most widely used
method since 2022. In the only available registry, the 30-day
postoperative mortality and morbidity rates were 2.9% and 22.9%,
respectively. Long-term follow-up showed that mortality was related to
local recurrences and metastases in patients with cancer. Conclusions
and Relevance: This systematic review indicates that extensive malignant
lesions are the primary indication for tracheobronchial replacement, with
cryopreserved aortic allografts being the only scientifically evaluated
surgical technique. Postoperative outcomes were comparable to other major
thoracic surgical procedures, while long-term results depended on the
underlying disease, especially in cancer cases. Copyright © 2025
American Medical Association. All rights reserved.

<119>
Accession Number
2035565343
Title
Intraoperative hypotension prediction in cardiac and noncardiac
procedures: is HPI truly worthwhile? A systematic review and
meta-analysis.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 388. Date
of Publication: 01 Dec 2025.
Author
Shirmohamadi E.; Dolama R.H.; Mohammadzadeh N.; Ebrahimi N.; Ghasemloo N.
Institution
(Shirmohamadi, Dolama, Mohammadzadeh, Ebrahimi, Ghasemloo) Surgery
Research Departement, Imam Hospital Complex, Keshavarz blvd, Tehran, Iran,
Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
Background: Intraoperative hypotension (IOH), defined as a mean arterial
pressure (MAP) below 65 mmHg, is a common complication during surgery and
is associated with significant postoperative morbidity, including acute
kidney injury, myocardial injury, stroke, and increased mortality. Despite
the availability of traditional monitoring techniques, predicting and
preventing IOH remains a challenge. The Hypotension Prediction Index
(HPI), a machine-learning algorithm developed by Edwards Lifesciences,
aims to predict IOH by analyzing real-time arterial waveform data,
offering an opportunity for proactive management. Objective(s): This
systematic review and meta-analysis evaluate the efficacy of the HPI in
predicting and preventing IOH in cardiac and non-cardiac surgeries
compared to standard blood pressure monitoring techniques. Method(s):
A comprehensive search was conducted in PubMed, Scopus, Embase, and Web of
Science databases for studies published from January 2019 to May 2024.
Studies were included if they utilized machine learning algorithms,
including HPI, to predict or detect IOH in adult surgical patients.
Sensitivity, specificity, area under the curve (AUC), and time-weighted
average (TWA) of hypotension were the primary outcomes. Subgroup analyses
were performed to evaluate differences between cardiac and non-cardiac
surgeries. Meta-analytic methods were applied using random-effects models
to account for study variability. Result(s): A total of 22 studies
were included, encompassing both cardiac and non-cardiac procedures. The
HPI demonstrated an overall sensitivity of 83% and specificity of 83% in
predicting IOH. The pooled AUC for all surgeries was 0.90. However,
subgroup analysis revealed variability in HPI performance between cardiac
and non-cardiac surgeries, with lower diagnostic odds ratios (DOR) in
cardiac settings. HPI combined with invasive arterial blood pressure
monitoring reduced the TWA of hypotension more effectively than either
invasive or non-invasive methods alone. The comparison of HPI and MAP for
diagnostic accuracy showed minimal differences across all time frames,
with SMD values close to zero. Conclusion(s): Our study shows that
the HPI has high sensitivity and specificity in predicting intraoperative
hypotension, but its clinical advantage over standard MAP-based monitoring
is uncertain. While HPI reduces hypotension duration, this may not improve
cardiovascular or renal outcomes. Further independent trials are needed to
validate its effectiveness before widespread adoption, and it should be
considered alongside simpler interventions like staff education and MAP
targeting in the meantime. Copyright © The Author(s) 2025.

<120>
Accession Number
2039844640
Title
Indications, Selection Criteria, and Outcomes of Combined Heart-Liver
Transplant: A Systematic Review and Meta-Analysis.
Source
American Journal of Transplantation. Conference: World Transplant Congress
2025. San Francisco United States. 25(8 Supplement 1) (pp S716-S717),
2025. Date of Publication: 01 Aug 2025.
Author
Batista de Oliveira L.; Wehrle C.; Ruthmann N.; Khalil M.; Aucejo F.;
Fujiki M.; Kwon D.C.; Kim J.; Tong M.Z.Y.; Unai S.; Pita A.; Diago-Uso T.;
Quintini C.; Miller C.; Haouzi-Judenherc A.; Sims O.; Hashimoto K.;
Schlegel A.; Cywinski J.; Fares M.; Esfeh J.M.
Institution
(Batista de Oliveira) Transplant Surgery, Cleveland Clinic, Cleveland, OH,
United States
(Wehrle, Khalil, Aucejo) Digestive Disease Institute, Cleveland Clinic,
Cleveland, OH, United States
(Ruthmann) Heart, Vascular, and Thoracic Institute, Cleveland Clinic,
Cleveland, OH, United States
(Fujiki, Pita, Miller, Hashimoto, Schlegel, Esfeh) Cleveland Clinic, OH,
United States
(Kwon, Kim, Fares) Cleveland Clinic, Cleveland, OH, United States
(Tong, Unai, Haouzi-Judenherc, Sims, Cywinski) Cleveland Clinic, United
States
(Diago-Uso) Cleveland Clinic, Abu Dhabi, United Arab Emirates
(Quintini) Policlinico, Milan, Italy
Publisher
Elsevier B.V.
Abstract
Purpose: Combined cardiac and liver dysfunction presents a significant
challenge, often precluding surgical intervention on independently.
However, determining which candidates truly require both organs remains
challenging. Our study represents a systematic review and meta-analysis on
the indications reported for heart-liver transplantation (CHLT).
 Method(s): In May 2024, PubMed, MEDLINE, and Google Scholar were
searched for CHLT studies. Four hundred records were assessed. Studies
with clear criteria were included to varying extents. PRISMA guidelines
were followed. Result(s): The mean ICU and hospital length of stay
(LOS) were 12.33 days (95%CI -6.96 - 31.63) and 28.2 days (95%CI 5.57 -
50.83). The 30-day mortality rate was just 5.0% (95%CI -21.35 - 31.35),
with impressive 83.86% (95%CI 61.73 - 105.99) and 72.92% (95%CI -14.03 -
159.87) survival at one- and five years. Conclusion(s): Combined
heart-liver transplantation (CHLT) offers favorable survival rates and low
mortality rates in select patients with concurrent heart and liver
failure. The findings underscore the importance of patient selection,
surgical techniques, and postoperative care protocols in optimizing
outcomes for CHLT patients. [Formula presented] [Formula presented]
CITATION INFORMATION: Batista de Oliveira L., Wehrle C., Ruthmann N.,
Khalil M., Aucejo F., Fujiki M., Kwon D., Kim J., Z Y Tong M., Unai S.,
Pita A., Diago-Uso T., Quintini C., Miller C., Haouzi-Judenherc A., Sims
O., Hashimoto K., Schlegel A., Cywinski J., Fares M., Modaresi Esfeh J.
Indications, Selection Criteria, and Outcomes of Combined Heart-Liver
Transplant: A Systematic Review and Meta-Analysis AJT, Volume 25, Issue 8
Supplement 1 DISCLOSURES: L. Batista de Oliveira: None. Copyright
© 2025

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