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<1>
Accession Number
2038801721
Title
Clinical Response to Resynchronization Therapy: Conduction System Pacing
vs Biventricular Pacing: The CONSYST-CRT Trial.
Source
JACC: Clinical Electrophysiology. 11(8) (pp 1820-1831), 2025. Date of
Publication: 01 Aug 2025.
Author
Pujol-Lopez M.; Graterol F.R.; Borras R.; Garcia-Ribas C.; Guichard J.B.;
Regany-Closa M.; Jimenez-Arjona R.; Niebla M.; Poza M.; Carro E.; Castel
M.A.; Arbelo E.; Porta-Sanchez A.; Sitges M.; Roca-Luque I.; Doltra A.;
Guasch E.; Tolosana J.M.; Mont L.
Institution
(Pujol-Lopez, Graterol, Borras, Guichard, Regany-Closa, Jimenez-Arjona,
Niebla, Poza, Carro, Castel, Arbelo, Porta-Sanchez, Sitges, Roca-Luque,
Doltra, Guasch, Tolosana, Mont) Institut Clinic Cardiovascular (ICCV),
Hospital Clinic, Universitat de Barcelona, Catalonia, Spain
(Pujol-Lopez, Graterol, Borras, Garcia-Ribas, Guichard, Regany-Closa,
Niebla, Poza, Carro, Castel, Arbelo, Porta-Sanchez, Sitges, Roca-Luque,
Doltra, Guasch, Tolosana, Mont) Institut d'Investigacions Biomediques
August Pi i Sunyer (IDIBAPS), Catalonia, Barcelona, Spain
(Borras) Centro de Investigacion Biomedica en Red;, Salud Mental
(CIBERSAM), Instituto de Salut Carlos III, Madrid, Spain
(Guichard, Castel, Arbelo, Sitges, Roca-Luque, Guasch, Tolosana, Mont)
Centro de Investigacion Biomedica en Red, Enfermedades Cardiovasculares
(CIBERCV), Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Background: Randomized studies comparing conduction system pacing (CSP)
with biventricular pacing (BiVP) are scarce and do not include clinical
outcomes. Objective(s): The CONSYST-CRT (Conduction System Pacing vs
Biventricular Resynchronization Therapy in Systolic Dysfunction and Wide
QRS) trial aimed to test the noninferiority of CSP as compared with BiVP
in patients with an indication for cardiac resynchronization therapy, with
respect to a combined clinical endpoint at 1-year follow-up.
 Method(s): A total of 134 patients with cardiac resynchronization
therapy indication were randomized to BiVP or CSP and followed up for 12
months. Crossover was allowed when the primary allocation procedure
failed. The atrioventricular interval was optimized to obtain fusion with
intrinsic conduction. The primary combined endpoint was all-cause
mortality, cardiac transplant, heart failure hospitalization, or left
ventricular ejection fraction (LVEF) improvement <5 points at 12 months.
Secondary endpoints were LVEF increase, LV end-systolic volume (LVESV)
decrease, echocardiographic response (>=15% LVESV decrease), QRS
shortening, septal flash correction, NYHA functional class improvement,
and a combined endpoint of all-cause mortality, cardiac transplantation,
and heart failure hospitalization. Result(s): Sixty-seven patients
were allocated to each group. Eighteen patients (26.9%) crossed from CSP
to BiVP; 5 (7.5%) crossed over from BiVP to CSP. Noninferiority (NI) was
observed for CSP compared with BiVP for the primary endpoint (23.9% vs
29.8%, respectively; mean difference -5.9; 95% CI: -21.1 to 9.2; P = 0.02)
and for the combined endpoint of all-cause mortality, cardiac
transplantation, and heart failure hospitalization (11.9% vs 17.9%; P <
0.01 NI); echocardiographic response (66.6% vs 59.7%; P = 0.03 NI); NYHA
functional class (P < 0.001 NI); and QRS shortening (P < 0.01). LVEF,
LVESV, and septal flash endpoint values were similar, but noninferiority
was not met (14.1% +/- 10% vs 14.4% +/- 10%, -27.9% +/- 27% vs -27.9% +/-
28%, -2.2 +/- 2.7 mm vs -2.7 +/- 2.4 mm, respectively).
 Conclusion(s): CSP was noninferior to BiVP in achieving clinical and
echocardiographic response, suggesting that CSP could be an alternative to
BiVP. (Conduction System Pacing vs Biventricular Resynchronization Therapy
in Systolic Dysfunction and Wide QRS [CONSYST-CRT];
NCT05187611) Copyright © 2025 The Authors

<2>
Accession Number
2039317685
Title
Win Ratio in Biomedical Science: A Bibliometric Analysis.
Source
CJC Open. 7(8) (pp 1097-1107), 2025. Date of Publication: 01 Aug 2025.
Author
Li Z.; Izumi A.; Vervoort D.; Ranadive A.; Verma S.; Fremes S.E.
Institution
(Li) Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
(Li, Izumi, Fremes) Schulich Heart Centre, Sunnybrook Health Sciences
Centre, Toronto, ON, Canada
(Vervoort, Verma, Fremes) Division of Cardiac Surgery, Department of
Surgery, University of Toronto, Toronto, ON, Canada
(Vervoort, Fremes) Institute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, Ontario, Canada
(Ranadive) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Verma) Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto,
ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: The win ratio (WR), introduced in 2012, has emerged as a
method to analyze hierarchical composite outcomes by prioritizing
clinically significant events, unlike traditional composite time-to-event
analyses, which treat events equally. However, use of the WR in biomedical
research beyond cardiovascular trials remains unexplored. The study aims
to investigate trends in the use of the WR in biomedical research and
determine the characteristics of these articles. Method(s):
Biomedical articles indexed in Web of Science and PubMed were retrieved
for 2012-2024. Data extraction included bibliometric information and
content details. Statistical analyses utilized descriptive statistics,
correlation, and linear regression to assess publication trends and the
distribution of WR methodologies across disciplines. Result(s): A
total of 82 studies were analyzed. Publication counts using the WR have
grown significantly since its introduction, with an annual compounded
growth rate of 30.2%. Most articles were randomized controlled trials (n =
68; 82.9%). Of the 68 randomized controlled trials, 46 (67.6%) were in the
field of cardiology. The unmatched WR was the predominant WR approach (n =
57; 69.5%). Mortality was the highest-ranked outcome in most studies (n =
55; 67.1%), and time-to-event variables were the most frequently used
across all hierarchical outcome ranks (n = 173). Conclusion(s): The
WR has gained acceptance as a robust and clinically meaningful method for
analyzing composite endpoints, particularly for cardiovascular trials.
Although challenges remain, its adaptability and ability to prioritize
clinically relevant outcomes make it a promising tool for future
biomedical research across various disciplines. Copyright © 2025
The Authors

<3>
Accession Number
2035723777
Title
Efficacy of artificial intelligence-based FFR technology for coronary CTA
stenosis detection in clinical management of coronary artery disease: a
systematic review.
Source
Frontiers in Physiology. 16 (no pagination), 2025. Article Number:
1635923. Date of Publication: 2025.
Author
Liu T.; Liu M.; Aisika A.; Wumaier P.; Abulizi A.; Wang J.; Nijiati M.
Institution
(Liu, Liu, Aisika, Nijiati) Department of Radiology, Medical Imaging
Center, Xinjiang Medical University Affiliated Fourth Hospital, Urumqi,
China
(Wumaier, Abulizi) Department of Radiology, The First People's Hospital of
Kashi Prefecture, Kashi, China
(Abulizi, Nijiati) Xinjiang Key Laboratory of Artificial Intelligence
assisted Imaging Diagnosis, Kashi, China
(Wang) Department of Deepwise AI Lab, Hangzhou Deepwise & League of PHD
Technology Co., Ltd, Hangzhou, China
Publisher
Frontiers Media SA
Abstract
Coronary computed tomography angiography (CCTA) integrated with artificial
intelligence (AI) technology, particularly AI-based fractional flow
reserve (FFR) assessment, has emerged as a crucial tool in the diagnosis
and treatment of coronary artery disease (CAD). Recent advances in AI
technology have demonstrated promising applications of AI-based FFR in
detecting coronary stenosis through CCTA. Current evidence suggests that
AI-FFR offers significant advantages in diagnostic accuracy and clinical
utility, potentially enhancing the efficiency of CAD management. However,
challenges persist in algorithm robustness, data heterogeneity, and
clinical implementation. This review synthesizes recent developments in
AI-based FFR technology for coronary stenosis detection via CCTA, focusing
on AI-assisted quantitative coronary CTA (AI-QCT), deep learning
algorithms, and their applications in three-dimensional coronary
reconstruction and hemodynamic simulation. We analyze comparative
diagnostic performance between AI-FFR and conventional methods, providing
insights for future research directions and clinical
applications. Copyright © 2025 Liu, Liu, Aisika, Wumaier,
Abulizi, Wang and Nijiati.

<4>
Accession Number
2029409422
Title
Mortality Rates in Patients Undergoing Urgent Versus Elective
Transcatheter Aortic Valve Replacement: A Meta-analysis.
Source
Angiology. 76(8) (pp 784-795), 2025. Date of Publication: 01 Sep 2025.
Author
Apostolos A.; Ktenopoulos N.; Chlorogiannis D.-D.; Katsaros O.;
Konstantinou K.; Drakopoulou M.; Tsalamandris S.; Karanasos A.; Synetos
A.; Latsios G.; Aggeli C.; Panoulas V.; Tsioufis C.; Toutouzas K.
Institution
(Apostolos, Ktenopoulos, Katsaros, Drakopoulou, Tsalamandris, Karanasos,
Synetos, Latsios, Aggeli, Tsioufis, Toutouzas) First, Department of
Cardiology, Medical School, Hippokration General Hospital, National and
Kapodistrian University of Athens, Athens, Greece
(Chlorogiannis) Department of Radiology, Brigham and Women's Hospital,
Boston, MA, United States
(Konstantinou, Panoulas) Department of Cardiology, Royal Brompton and
Harefield Hospitals, Guy's, St Thomas' NHS Foundation Trust, London,
United Kingdom
Publisher
SAGE Publications Inc.
Abstract
Patients with severe aortic stenosis (AoS) often present with acute heart
failure and compensation, frequently leading to cardiogenic shock.
Transcatheter Aortic Valve Replacement (TAVR) has been recently performed
as a bailout treatment in such patients. The aim of our meta-analysis is
to compare urgent TAVR with elective procedures. We systematically
screened three databases searching for studies comparing urgent vs
elective TAVR. Primary endpoint is the 30-days mortality. Secondary
endpoints included in-hospital mortality, device success, periprocedural
vascular complications, 30-days stroke, 30-days acute kidney injury (AKI),
permanent pacemaker implantation (PPM), moderate or severe paravalvular
leakage, and 30-days bleeding. Seventeen studies were included, with a
total of 84,495 patients. Urgent TAVR was associated with an increased
risk for 30-days mortality [Risk Ratio (RR): 2.53, 95% Confidence
Intervals (CI): 1.81-3.54)], in-hospital mortality (RR: 2.67, 95% CI:
1.94-3.68), periprocedural vascular complications (RR: 1.91, 95% CI:
1.28-2.85) and AKI (RR: 2.83, 95% CI: 1.93-4.14), compared with elective
procedure. No differences were observed in the other secondary endpoints.
Urgent TAVR was associated with higher in-hospital and 30-days mortality,
possibly driven by the increased incidence of AKI and vascular
complications in urgent TAVR. The results highlight the importance of
early TAVR in stable AoS patients. Copyright © The Author(s) 2024

<5>
Accession Number
2035742603
Title
Microaxial Support as a Bridge to Repair in Post-Myocardial Infarction
Ventricular Septal Rupture: A Systematic Review and Patient-Level
Analysis.
Source
Artificial Organs. (no pagination), 2025. Date of Publication: 2025.
Author
Nasher N.; Rahimov D.; Mallur K.; Macmillan T.R.; Plestis K.A.; Rajagopal
K.; Hoopes C.W.; Entwistle J.W.; Bavaria J.E.; Tchantchaleishvili V.
Institution
(Nasher, Rahimov, Plestis, Rajagopal, Hoopes, Entwistle, Bavaria,
Tchantchaleishvili) Department of Cardiac Surgery, Thomas Jefferson
University Hospital, Philadelphia, PA, United States
(Mallur, Macmillan) Sidney Kimmel Medical College, Thomas Jefferson
University, Philadelphia, PA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Current guidelines recommend immediate surgical repair for
post-infarct ventricular septal rupture (VSR); however, mortality remains
exceedingly high. We sought to report outcomes following delayed surgical
management bridged with microaxial support. Method(s): A
comprehensive literature search yielded 42 case reports/series comprising
78 patients who were initiated on microaxial support following the
diagnosis of post-infarct VSR. Patient-level data were extracted and
analyzed according to survival status. Result(s): Overall, 78%
(54/69) of patients were male, and the median age was 69 [IQR: 60-74]
years, with no difference in age between survivors and non-survivors.
Those who survived were significantly less likely to have a history of
prior cardiac surgery than non-survivors [3% (1/30) vs. 43% (3/7), p =
0.016], and less likely to have undergone percutaneous coronary
intervention at the time of presentation [41% (22/54) vs. 69% (11/16), p =
0.049]. There were no significant differences in culprit vessel (p =
0.875), VSR size (p = 1), or VSR location (p = 0.253). Those who survived
had a significantly higher median Qp/Qs ratio than non-survivors [3.0
[2.3-3.8] vs. 2.1 [1.9-2.3], p = 0.038]. Patients were successfully
bridged to definitive surgical management in 76% (59/78) of cases at a
median time of 8 [5-14] days following microaxial support placement. The
30-day/in-hospital mortality rate was 22% (17/78), and the overall
mortality rate was 27% (21/78). Conclusion(s): Microaxial devices can
safely and feasibly provide the necessary support to allow for a
successful delayed repair in hemodynamically unstable patients following
post-infarct VSR. Copyright © 2025 International Center for
Artificial Organs and Transplantation and Wiley Periodicals LLC.

<6>
[Use Link to view the full text]
Accession Number
2039191018
Title
Comparison of TAVR with SAVR on clinical outcomes in patients with aortic
stenosis: A systematic review and meta-analysis.
Source
Annals of Medicine and Surgery. 87(6) (pp 3768-3776), 2025. Date of
Publication: 01 Jun 2025.
Author
Khan K.G.; Garcia I.; Rodriguez A.; Wright W.; Shahid H.; Alrashed A.;
Pornchai A.; Manoj M.P.; Fagbamila O.; Mylavarapu M.
Institution
(Khan, Garcia) Department of Internal Medicine, Baqai Medical University,
Karachi, Pakistan
(Khan, Garcia) Department of Internal Medicine, St. George's University,
Grenada
(Rodriguez) Department of Internal Medicine, Universidad de Los Andes,
Merida, Venezuela
(Wright) Department of Internal Medicine, Texila American University,
Georgetown, Guyana
(Shahid) Department of Internal Medicine, Bahcesehir University, Istanbul,
Turkey
(Alrashed) Department of Internal Medicine, Imperial College London,
London, United Kingdom
(Pornchai) Department of Internal Medicine, University of Pittsburg
Medical Center, Pittsburg, PA, United States
(Manoj) Department of General Medicine, Government Medical College,
Kerala, India
(Fagbamila) Department of Anatomy, Saint James School of Medicine, Arnos
Vale, Saint Vincent and the Grenadines
(Mylavarapu) Department of Public Health, Adelphi University, Garden City,
NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: The advances and studies carried out in the area have shown
that patients with aortic stenosis (AS) undergoing surgical valve
replacement (SAVR) did not have encouraging outcomes. This study aims to
compare the different risk factors in patients with AS undergoing
transcatheter aortic valve replacement (TAVR) vs. SAVR, respectively, to
offer options and more favorable results based on the results obtained in
patients with these conditions. Method(s): The study was in
accordance with the PRISMA guidelines. Studies comparing outcomes of
surgical and transaortic catheter valve replacements in adults were
included. Descriptive statistics, binary random effects, and continuous
random effects were used. I2 statistics were used to assess for
heterogeneity. A P-value <=0.05 was considered statistically significant.
 Result(s): In total, eight studies with 18 671 patients were included
in our study. All-cause mortality (2.48% vs. 3.03%), major bleeding
(11.25% vs. 31.05%), and atrial fibrillation (2.39% vs. 50.42%) were lower
in TAVR compared to SAVR. Furthermore, odds of all-cause mortality (odds
ratio [OR]: 0.79; 95% CI: 0.63-1.00; P = 0.05), stroke (OR: 0.71; 95% CI:
0.58-0.87; P = 0.0008), and acute kidney injury (AKI) (OR: 0.38; 95% CI:
0.29-0.49; P < 0.00001) were lower in the TAVR group compared to the SAVR
group. Conclusion(s): TAVR is superior to SAVR and significantly
reduces the risks associated with all-cause mortality, stroke, AKI, and
other clinical outcomes. Furthermore, additional research is regarding the
long-term effects of transcatheter aortic valve replacement. Copyright
© 2025 The Author(s). Published by Wolters Kluwer Health, Inc.

<7>
Accession Number
2034676760
Title
Using a Markov Model and Real-World Evidence to Identify the Most
Cost-Effective Cholesterol Treatment Escalation Threshold for the
Secondary Prevention of Cardiovascular Disease.
Source
Applied Health Economics and Health Policy. 23(5) (pp 869-883), 2025. Date
of Publication: 01 Sep 2025.
Author
Mariani A.; Mohiuddin S.; Muller P.; Samarasekera E.; Swain S.A.; Mills
J.; Patel R.; Preiss D.; Shantsila E.; Downing B.C.; Lonergan M.; Rowark
S.; Welton N.J.; Williams R.; Wonderling D.
Institution
(Mariani, Mohiuddin, Muller, Rowark, Wonderling) Science, Evidence and
Analytics Directorate, National Institute for Health and Care Excellence,
2 Redman Place (2nd Floor), London, United Kingdom
(Samarasekera, Swain) Centre for Guidelines, National Institute for Health
and Care Excellence, London, United Kingdom
(Mills) Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
(Patel) Barts Health NHS Trust, University College London Hospitals NHS
Foundation Trust, London, United Kingdom
(Preiss) Nuffield Department of Population Health, University of Oxford,
Oxford, United Kingdom
(Shantsila) Institute of Population Health, University of Liverpool,
Liverpool, United Kingdom
(Downing, Welton) Population Health Science, Bristol Medical School,
University of Bristol, Bristol, United Kingdom
(Lonergan, Williams) Clinical Practice Research Datalink (CPRD), Safety
and Surveillance Group, Medicines and Healthcare Products Regulatory
Agency, London, United Kingdom
Publisher
Adis
Abstract
Background: Despite the decreased risk of cardiovascular disease (CVD)
with statins, there remains an unfulfilled clinical need to prevent CVD
events and premature mortality through further cholesterol-modifying
interventions. In people with established CVD taking a statin, lipid
therapy escalation to reduce low-density lipoprotein cholesterol (LDL-C)
or non-high-density lipoprotein cholesterol (non-HDL-C) levels may lower
the risk of CVD hospital admissions and improve survival. However, the
cost-effectiveness of different cholesterol treatment escalation
thresholds is uncertain. Objective(s): This study aimed to identify
the most cost-effective cholesterol threshold for escalating lipid therapy
in people with established CVD who are taking a statin, to support the
2023 update of the NICE guideline on CVD in England. Method(s): A
cohort Markov model with a yearly cycle length was developed to compare
the lifetime costs and quality-adjusted life years (QALYs) of various
LDL-C treatment escalation thresholds (0-4.0 mmol/L), using a combination
of treatment effects from an original network meta-analysis of randomised
controlled trials (RCTs), real-world data for estimating baseline
cholesterol levels and CVD event rates from a published meta-analysis of
statin RCTs. The model used the following CVD events: ischaemic stroke;
transient ischaemic attack; peripheral artery disease; myocardial
infarction; unstable angina; coronary revascularisation; and mortality.
The model also used evidence-based estimates of resource use and costs,
and published quality of life data. Baseline LDL-C levels and CVD hospital
admission rates were estimated through a bespoke analysis of the English
primary care data from Clinical Practice Research Datalink (CPRD), linked
to Hospital Episode Statistics Admitted Patient Care (HES) and Office for
National Statistics (ONS) death registrations. Result(s): Data from
590,917 adult individuals (61.7% men) with CVD on a statin in primary care
between 1 January 2013 and 28 February 2020 were included in the
CPRD-HES-ONS analysis. The most cost-effective threshold for lipid therapy
escalation was an LDL-C of 2.2 mmol/L (or equivalent non-HDL-C of 2.9
mmol/L) at NICE's lower cost per QALY of 20,000. An LDL-C of 2.0 mmol/L
(or equivalent non-HDL-C of 2.6 mmol/L) was the most cost-effective
treatment escalation threshold in a significant proportion (38%) of
probabilistic simulations and produced more health. At this threshold, the
model predicted that 42% of people with CVD would require combination
therapy with ezetimibe while 19% would require an injectable drug such as
inclisiran. At NICE's upper cost per QALY of 30,000, the most
cost-effective LDL-C treatment escalation threshold was 1.7 mmol/L (or
equivalent non-HDL-C of 2.2 mmol/L). Conclusion(s): The results
demonstrate the importance of establishing evidence of cost-effectiveness
for cholesterol treatment escalation thresholds. The study's findings
support the updated NICE guideline recommending a threshold of 2.0 mmol/L
LDL-C (or equivalent non-HDL-C of 2.6 mmol/L) for secondary prevention of
CVD. Copyright © Crown 2025.

<8>
Accession Number
2040015945
Title
Spironolactone versus placebo in patients undergoing maintenance dialysis
(ACHIEVE): an international, parallel-group, randomised controlled trial.
Source
The Lancet. 406(10504) (pp 695-704), 2025. Date of Publication: 16 Aug
2025.
Author
Walsh M.; Collister D.; Gallagher M.; Mark P.B.; de Zoysa J.R.; Tyrwhitt
J.; Tennankore K.; Reis G.; Xavier D.; Liu W.J.; Zuo L.; Wang A.Y.; Felix
C.; Sola L.; Arici M.; Villanueva R.; Jha V.; Precoma D.; Rabbat C.G.;
Alavudeen S.S.; Faruqui A.R.; Lopez-Flecher M.; Pyne L.; Wald R.; Yuan F.;
Balasubramanian K.; Lee S.F.; Kuptsova A.; Christou C.; Devereaux P.J.
Institution
(Walsh, Collister, Tyrwhitt, Pyne, Yuan, Balasubramanian, Lee, Kuptsova,
Christou, Devereaux) Population Health Research Institute, Hamilton Health
Sciences/McMaster University, Hamilton, ON, Canada
(Walsh, Reis, Rabbat, Pyne, Lee, Devereaux) Department of Medicine and
Department of Health Research Methods, Evidence and Impact, McMaster
University, Hamilton, ON, Canada
(Collister) Department of Medicine, University of Alberta, Edmonton, AB,
Canada
(Gallagher) South West Sydney Clinical Campus, UNSW, Liverpool, NSW,
Australia
(Gallagher, Wang) The George Institute for Global Health, UNSW, Sydney,
NSW, Australia
(Mark) School of Cardiovascular and Metabolic Health, University of
Glasgow, Glasgow, United Kingdom
(de Zoysa) University of Auckland, Auckland, New Zealand
(de Zoysa) Renal Service, Waitemata Health New Zealand, Auckland, New
Zealand
(Tennankore) Department of Medicine, Division of Nephrology, Dalhousie
University, Halifax, NS, Canada
(Tennankore) Nova Scotia Health, Halifax, NS, Canada
(Reis) Pontificia Universidade Catolica de Minas Gerais, Belo Horizonte,
Brazil
(Xavier, Faruqui) St John's Medical College and Research Institute,
Bangalore, India
(Liu) Department of Nephrology, Hospital Sultanah Aminah Johor Bahru,
Johor Bahru, Malaysia
(Zuo) Department of Nephrology, Peking University People's Hospital,
Beijing, China
(Wang) Faculty of Medicine and Health Sciences, Macquarie University,
Sydney, NSW, Australia
(Wang) Department of Renal Medicine, Concord Repatriation General
Hospital, Concord Clinical School, University of Sydney, Sydney, NSW,
Australia
(Felix, Lopez-Flecher) Grupo de Investigacion CENIEC, Facultad de Ciencias
de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
(Sola) Dialysis Unit, CASMU-IAMPP, Montevideo, Uruguay
(Arici) Faculty of Medicine, Hacettepe University, Ankara, Turkey
(Villanueva) Philippine General Hospital, Manila, Philippines
(Jha) George Institute for Global Health, University of New South Wales,
New Delhi, India
(Jha) School of Public Health, Imperial College London, London, United
Kingdom
(Jha) Prasanna School of Public Health, Manipal Academy of Higher
Education, Manipal, India
(Precoma) Hospital Angelina Caron, Curitiba, Brazil
(Alavudeen) Institute of Nephrology, Madras Medical College, Chennai,
India
(Wald) Division of Nephrology, St Michael's Hospital, Toronto, ON, Canada
(Wald) Department of Nephrology and Hypertension, Tel Aviv Medical Center,
Tel Aviv, Israel
Publisher
Elsevier B.V.
Abstract
Background: Patients undergoing maintenance dialysis for kidney failure
are at substantial risk of cardiovascular morbidity and mortality. We
aimed to establish if spironolactone reduces heart failure and
cardiovascular deaths in these patients. Method(s): ACHIEVE was an
international, parallel-group, randomised controlled trial done in 143
dialysis programmes in 12 countries. Patients were aged 45 years or older,
or aged 18 years or older with a history of diabetes, and were receiving
maintenance dialysis for kidney failure for at least 3 months at the time
of recruitment. Patients who were able to tolerate and adhere to
spironolactone 25 mg daily orally during an open-label run-in were
randomly assigned (1:1) to continue spironolactone or matching placebo,
using a central computerised block randomisation system (block sizes of 4)
stratified by centre. Participants, health-care providers, and those
assessing outcomes were masked to group assignment. The primary outcome
was a composite of cardiovascular mortality or hospitalisation for heart
failure analysed as time-to-event in all randomly assigned participants.
The trial was registered at ClinicalTrials.gov, NCT03020303.
 Finding(s): After a planned interim analysis of 75% of the expected
primary outcome events, the external safety and efficacy monitoring
committee recommended the trial be stopped early for futility. From Sept
19, 2017, to Oct 31, 2024, 3689 patients were screened for inclusion, 3565
of whom were enrolled in the open-label run-in phase, and 2538 were
randomly assigned to spironolactone (n=1260) or placebo (n=1278). 931
(36.7%) participants were female and 1607 (63.3%) were male. Median
follow-up was 1.8 years (IQR 0.85-3.35). The composite primary outcome
occurred in 258 participants (10.46 events per 100 patient-years) in the
spironolactone group and in 276 participants (11.33 per 100 patient-years)
in the placebo group (hazard ratio [HR] 0.92 [95% CI 0.78-1.09]; p=0.35).
Death from any cause was similar between groups (HR 0.95 [0.83-1.09]) as
was hospitalisation for any cause (HR 0.96 [0.87-1.06]).
 Interpretation(s): Among patients receiving maintenance dialysis,
spironolactone 25 mg daily orally did not reduce the composite outcome of
cardiovascular mortality and hospitalisation due to heart failure compared
with placebo. This trial did not identify a benefit of initiating
spironolactone in patients receiving maintenance dialysis. Future research
should consider alternatives to steroidal mineralocorticoid receptor
antagonism to reduce cardiovascular morbidity and mortality in patients
receiving maintenance haemodialysis. Funding(s): The Canadian
Institutes of Health Research, The Medical Research Future Fund, The
Health Research Council, The British Heart Foundation, Population Health
Research Institute/Hamilton Health Sciences Research Institute, St
Joseph's Healthcare Hamilton Division of Nephrology, Accelerating Clinical
Trials Consortium, Can-SOLVE CKD Network, and the Dalhousie Department of
Medicine. Copyright © 2025 Elsevier Ltd

<9>
Accession Number
2038130004
Title
Postoperative Brain Attack: Current Perspectives and Future Directions.
Source
Seminars in Thoracic and Cardiovascular Surgery. 37(3) (pp 281-292), 2025.
Date of Publication: 01 Sep 2025.
Author
Quinlan M.; Arora R.; Cho S.M.
Institution
(Quinlan, Cho) Division of Neurosciences Critical Care, Department of
Anesthesiology & Critical Care Medicine, Johns Hopkins University School
of Medicine, Baltimore, Maryland, United States
(Quinlan, Cho) Department of Neurology, Johns Hopkins University School of
Medicine, Baltimore, Maryland, United States
(Quinlan, Arora, Cho) Case Western Reserve University, Department of
Surgery, Cleveland, Ohio, United States
(Arora) Harrington Heart and Vascular Institute, Division of Cardiac
Surgery, University Hospitals, Cleveland, Ohio, United States
(Cho) Division of Cardiac Surgery, Department of Surgery, Johns Hopkins
University School of Medicine, Baltimore, Maryland, United States
Publisher
W.B. Saunders
Abstract
The incidence of stroke after cardiac surgery poses significant
challenges. This expert review piece explores current knowledge,
challenges, future directions, and offers insights into improving patient
outcomes through optimal prevention, early recognition, and management
strategies. By addressing the challenges and opportunities in this area,
we can enhance patient care, reduce long-term disabilities, and improve
the overall quality of life for affected individuals. This expert review
aims to provide a comprehensive framework for managing postoperative
stroke: mechanisms, risk factors, diagnosis, treatment, systems of care,
and ethical considerations. Copyright © 2025 Elsevier Inc.

<10>
Accession Number
2040031365
Title
Efficacy and safety of paravertebral blockade in paediatric cardiothoracic
surgery: a protocol for systematic review and meta-analysis.
Source
BMJ Open. 15(8) (no pagination), 2025. Article Number: e105008. Date of
Publication: 13 Aug 2025.
Author
Yuan Y.; Zhou J.; Zhang Y.; Zhong W.; Lu X.
Institution
(Yuan, Zhou, Zhong, Lu) Department of Anesthesiology, Henan Provincial
Chest Hospital, Henan, Zhengzhou, China
(Yuan, Zhou, Zhong, Lu) Department of Anesthesiology, Chest Hospital of
Zhengzhou University, Henan, Zhengzhou, China
(Zhang) Big Data Center for Clinical Medicine, The First Affiliated
Hospital of Zhengzhou University, Henan, Zhengzhou, China
Publisher
BMJ Publishing Group
Abstract
Introduction Paravertebral blockade (PVB) is a regional anaesthesia
technique increasingly used in paediatric cardiothoracic surgery for
postoperative pain management. However, its comparative efficacy and
safety relative to other analgesic strategies remain inadequately
synthesised. This systematic review aims to evaluate the effectiveness,
safety and complications of PVB in paediatric patients undergoing
cardiothoracic surgery. Methods and analysis This protocol adheres to the
Preferred Reporting Items for Systematic Review and Meta-Analysis
Protocols guidelines. We will search MEDLINE, EMBASE, Cochrane Library,
Web of Science, Scopus, ClinicalTrials.gov and other relevant sources from
inception to February 2025. Randomised controlled trials (RCTs) comparing
PVB with systemic opioids, epidural analgesia or placebo in patients aged
<18 years will be included. Exclusion criteria include non-RCTs, adult
populations and non-cardiothoracic surgeries. Primary outcomes include
postoperative pain intensity measured using validated scales such as Face,
Legs, Activity, Cry, Consolability Scale or Numeric Rating Scale within
24-48 hours. Secondary outcomes include opioid consumption within 24-48
hours, length of hospital stay, haemodynamic stability and complications
(eg, pneumothorax, local anaesthetic toxicity). Two reviewers will
independently screen studies, extract data and assess the risk of bias
using the Cochrane Risk of Bias-2 tool. A meta-analysis using a
random-effects model or a narrative synthesis will be conducted based on
heterogeneity (I2>=75%). Subgroup analyses will explore
variations by age group, surgical type and PVB technique. Ethics and
dissemination As this study involves secondary analysis of existing data,
ethical approval is not required. The completed review will be submitted
for open-access publication in a peer-reviewed journal to ensure
accessibility for clinicians, researchers and policymakers. PROSPERO
registration number CRD42025644837. Copyright © Author(s) (or
their employer(s)) 2025.

<11>
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.

<12>
Accession Number
2035746629
Title
Lessons Learned From the ACURATE IDE Trial for Transcatheter Aortic Valve
Replacement.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Giordano A.; Biondi-Zoccai G.; Cohen D.J.; Bagur R.; Corcione N.
Institution
(Giordano, Corcione) Unita Operativa di Interventistica Cardiovascolare,
Pineta Grande Hospital, Castel Volturno, Italy
(Biondi-Zoccai) Department of Medical-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
(Biondi-Zoccai) Maria Cecilia Hospital, GVM Care & Research, Cotignola,
Italy
(Cohen) Cardiovascular Research Foundation, New York, NY, United States
(Cohen) St. Francis Hospital, Roslyn, NY, United States
(Bagur) Division of Cardiology, Department of Medicine, London Health
Sciences Centre, Western University, London, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
The recent voluntary withdrawal of the ACURATE neo2 transcatheter aortic
valve replacement device by Boston Scientific offers a compelling case
study in the complex interplay of device design, clinical evidence,
regulatory requirements, and market dynamics in modern structural heart
interventions. Despite promising performance in European and Canadian
registries, the ACURATE neo2 valve failed to demonstrate non-inferiority
compared with commercially available balloon-expandable and self-expanding
platforms in the pivotal ACURATE IDE randomized controlled trial. These
results, coupled with introduction of a new regulatory requirements by the
European notified body ultimately led to the global discontinuation of the
platform. This review critically examines the technological
characteristics of ACURATE neo2, compares it with other leading TAVR
devices, and explores the potential reasons-ranging from clinical to
strategic-that may have led to its market exit. Emphasis is placed on the
role of randomized trials in assessing new structural therapies, including
a discussion of methodological challenges and opportunities for adaptive
trial designs. A structured comparison of device features and withdrawal
rationales is also provided, highlighting lessons relevant to clinicians,
regulators, and industry stakeholders. Ultimately, the ACURATE neo2
experience underscores the need for robust validation strategies,
procedural standardization, and adaptive development pathways in a
saturated and high-stakes market. Lessons learned from this platform
should inform future innovation in TAVR and broader cardiovascular device
development. Copyright © 2025 The Author(s). Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<13>
Accession Number
2040073290
Title
Correction: Study protocol of the multicentre, randomised, triple-blind,
placebo-controlled MERCURI-2 trial: Promoting effective renoprotection in
cardiac surgery patients by inhibition of sodium glucose cotransporter
(SGLT)-2 (BMJ Open (2025) 15 (e095504) DOI: 10.1136/bmjopen-2024-095504).
Source
BMJ Open. 15(8) (no pagination), 2025. Article Number: e095504corr1. Date
of Publication: 16 Aug 2025.
Author
Anonymous
Publisher
BMJ Publishing Group
Abstract
The author has identified errors that need to be corrected for clarity and
accuracy: In the section 'Methods - Study oversight and organisation', the
manuscript incorrectly stated that efficacy outcomes were assessed: 'The
trial is conducted under supervision of an independent Data and Safety
Monitoring Board (DSMB), consisting of two clinical experts and an
epidemiologist. An independent statistician will present unblinded data to
the DSMB. The DSMB reviews the incidence of AKI at two predefined
intervals (after inclusion of 200 and 400 participants) to assess safety
and efficacy outcomes. The DSMB can advise to stop the trial if patient
safety is at risk or in case of overwhelming efficacy.' The correct
description should read: 'The trial is conducted under supervision of an
independent Data and Safety Monitoring Board (DSMB), consisting of two
clinical experts and an epidemiologist. An independent statistician will
present unblinded data to the DSMB. The DSMB reviews the incidence of AKI
in the placebo group after 25% of the participants have been included, in
order to inform the sample size calculation. The DSMB reviews the
incidence of AKI at two predefined intervals (after inclusion of 25% and
50% of participants) to assess safety outcomes including AKI. No specific
stop criteria were determined'. Copyright © Author(s) (or their
employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.

<14>
Accession Number
2035761557
Title
Dexmedetomidine for the prevention of postoperative delirium in patients
undergoing cardiac surgery: a systematic review and meta-analysis with
trial sequential analysis.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 408. Date
of Publication: 01 Dec 2025.
Author
Zhong Y.; Ren Z.; Gao J.; He X.; Li Q.
Institution
(Zhong, Ren, Gao, Li) West China School of Medicine and West China
Hospital, Sichuan University, Chengdu, China
(He) School of Medicine, The Chinese University of Hong Kong, Shenzhen,
China
Publisher
BioMed Central Ltd
Abstract
Background: The efficacy of dexmedetomidine in preventing postoperative
delirium (POD) following cardiac surgery remains controversial. This
systematic review aimed to evaluate whether dexmedetomidine could prevent
POD in patients undergoing cardiac surgery. Method(s): PubMed,
CENTRAL, and Embase were searched up to 1 November 2024. Randomized
controlled trials (RCTs) concerning dexmedetomidine for preventing POD in
patients undergoing cardiac surgery were included. The primary outcome was
the incidence of POD, and the secondary outcome was the incidence of
postoperative atrial fibrillation (POAF). The analyses were performed
using RevMan 5.3 and R 4.4.2 to calculate risk ratio (RR) with 95%
confidence interval (CI). Trial sequential analysis (TSA) was conducted
using TSA 0.9.5.10 Beta. Result(s): Thirty-two studies with 6046
participants were included. Dexmedetomidine notably reduced the incidence
of POD (RR = 0.67, 95% CI 0.59-0.76, P < 0.00001), with sufficient
evidence and conclusive result from TSA. Dexmedetomidine was more
effective in preventing POD compared with both positive control (RR =
0.47, 95% CI 0.38-0.59, P < 0.00001) and placebo control (RR = 0.83, 95%
CI 0.70-0.98, P = 0.02). It reduced the incidence of POD not only in
elderly patients (RR = 0.66, 95% CI 0.54-0.81, P < 0.0001) but also in
normal age patients (RR = 0.68, 95% CI 0.57-0.80, P < 0.00001). Moreover,
dexmedetomidine decreased the incidence of POAF (RR = 0.82, 95% CI
0.74-0.92, P = 0.0005). Conclusion(s): Dexmedetomidine could reduce
the incidence of POD in patients undergoing cardiac surgery and was
associated with a decreased incidence of POAF. The findings should be
interpreted with caution because of the low to moderate quality of
evidence. Further trials are still needed to explore the optimal regimen
of dexmedetomidine. Registration number: INPLASY2024110008. Copyright
© The Author(s) 2025.

<15>
[Use Link to view the full text]
Accession Number
2040098142
Title
Determination of Cerebral Autoregulation at the Bedside: A Narrative
Review.
Source
Critical Care Medicine. (no pagination), 2025. Article Number:
10.1097/CCM.0000000000006790. Date of Publication: 2025.
Author
Vitt J.R.; Tsetsou S.; Galarza L.; Sarwal A.; Rajagopalan S.
Institution
(Vitt) Department of Neurological Surgery and Neurology, Uc Davis Medical
Center, Sacramento, CA, United States
(Tsetsou) Department of Neurology and Neurosurgery, Baylor College of
Medicine, Houston, TX, United States
(Galarza) Department of Intensive Care, Hospital General Universitario de
Castellon, Castellon de la Plana, Spain
(Galarza) Department of Medicine, University Jaume I (UJI), Castellon de
la Plana, Spain
(Sarwal) Department of Neurology, Virginia Commonwealth University School
of Medicine, Richmond, VA, United States
(Rajagopalan) Department of Neurology, Cooper Medical School of Rowan
University, Camden, NJ, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: To summarize the current evidence on cerebral autoregulation
(CAR) monitoring techniques in critical care settings, highlighting their
advantages, limitations, and practical applications at the bedside to
inform understanding and clinical decision-making for various acute brain
injuries and systemic illnesses. Data Sources: Articles were
retrieved using Ovid MEDLINE, PubMed, and Cochrane library using a
comprehensive combination of subject headings and key words including
"cerebral autoregulation,""transcranial Doppler,""near-infrared
spectroscopy,"and "intracranial pressure."See Supplemental Appendix A
(https://links.lww.com/CCM/H763) for complete list of search terms.
Relevant articles as well as those discovered through the review process
(e.g., references in selected articles) were incorporated into the
article. Study Selection: Original research, review articles,
commentaries, and guidelines focusing on bedside CAR monitoring
methodologies, their validation, and applications in critically ill
patients were included. The review encompassed both acute brain injury and
systemic critical illness conditions. Data Extraction: Data from
included publications were evaluated and synthesized into a comprehensive
narrative review examining CAR monitoring methods and clinical
applications. Data Synthesis: Three commonly used bedside approaches
for assessing CAR were identified. Transcranial Doppler ultrasound
measures vessel flow velocity response to blood pressure changes, either
through vasopressor administration or monitoring spontaneous fluctuations.
Near-infrared spectroscopy evaluates regional cerebral oxygenation changes
in response to hemodynamic alterations through continuous, noninvasive
forehead sensors. Intracranial pressure monitoring enables assessment of
pressure reactivity index through analyzing the correlation between
intracranial and arterial blood pressure. CAR impairment is common across
critical illness, from acute brain injury to systemic conditions like
sepsis, cardiac surgery, and hepatic failure, where dysregulation can lead
to secondary brain injury and worse outcomes. While each technique offers
unique insights into CAR status, they vary in invasiveness, continuous
monitoring capability, and technical requirements. Evidence suggests these
methods can help to detect impaired CAR, identify optimal perfusion
targets, and may guide individualized management strategies.
 Conclusion(s): Bedside CAR monitoring represents a promising approach
for personalizing hemodynamic management in critically ill patients. While
current evidence supports its role in prognostication and management
decisions, further research is needed to standardize assessment methods
and validate CAR-guided therapy across different critical care conditions.
Multimodal monitoring approaches may provide complementary information to
optimize patient care. Copyright © 2025 by the Society of
Critical Care Medicine and Wolters Kluwer Health, Inc.

<16>
Accession Number
2035710498
Title
Long-Term Follow-Up of Left Atrial Appendage Exclusion: Results of the
V-CLIP Multi-Center Post-Market Study.
Source
Journal of Clinical Medicine. 14(15) (no pagination), 2025. Article
Number: 5473. Date of Publication: 01 Aug 2025.
Author
Zias E.; Phillips K.G.; Gerdisch M.; Johnson S.; El-Eshmawi A.; Saum K.;
Moront M.; Kasten M.; Singh C.; Bhatia G.; Takayama H.; Damiano R.
Institution
(Zias, Phillips) Department of Cardiothoracic Surgery, New York University
Langone Medical Center, 530 1st Ave, Ste 9V, New York, NY, United States
(Gerdisch) Department of Cardiothoracic Surgery, Franciscan Alliance dba
Franciscan Health Indianapolis, 8111 South Emerson Ave, Indianapolis, IN,
United States
(Johnson) Department of Cardiothoracic Surgery, Aurora Research Institute
LLC, 2901 W Kinnickinnic River Pkwy, Ste 507, Milwaukee, WI, United States
(El-Eshmawi) Department of Cardiothoracic Surgery, Icahn School of
Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, United States
(Saum) Department of Cardiothoracic Surgery, Centra Lynchburg General
Hospital, 1901 Tate Springs Rd, Lynchburg, United States
(Moront) Department of Cardiothoracic Surgery, Toledo Hospital, 1
ProMedica Parkway, Toledo, OH, United States
(Kasten) Department of Cardiothoracic Surgery, Mercy Health Physicians,
1000 N Village Ave, Rockville Centre, NY, United States
(Singh) Department of Cardiothoracic Surgery, Albany Medical Center, 43
New Scotland Ave, Albany, NY, United States
(Bhatia) Department of Cardiothoracic Surgery, Prisma Health-Greenville
Memorial Hospital, 701 Grove Rd, Greenville, SC, United States
(Takayama) Department of Cardiothoracic Surgery, Columbia University
Medical Center, 630 W 168th St, New York, NY, United States
(Damiano) Department of Cardiothoracic Surgery, Washington University
School of Medicine, 660 S Euclid Ave, St. Louis, MO, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Cardiac surgery patients with pre- or post-operative atrial
fibrillation are at an increased risk for thromboembolic stroke, often due
left atrial appendage (LAA) thrombus. Surgical LAA exclusion (LAAE) can be
performed and must be complete to avoid increased thrombus formation.
 Method(s): This prospective, multi-center, post-market study
(NCT05101993) evaluated the long-term safety and performance of the
epicardial V-shape AtriClip device. Patients >=18 years who had received
V-shape AtriClip devices during non-emergent cardiac surgery consented to
a prospective 12-month follow-up visit and LAA imaging. The primary
performance was LAAE without residual left atrium-LAA communication,
assessed by imaging at the last follow-up visit. The primary safety was
device- or implant procedure-related serious adverse events (SAEs) (death,
major bleeding, surgical site infection, pericardial effusion requiring
intervention, myocardial infarction) within 30 days. Result(s): Of
155 patients from 11 U.S. centers, 151 patients had evaluable imaging.
Complete LAAE was obtained in all patients. Primary performance in the
intent-to-treat population was met, with 97% (95% CI 93.52%, 99.29%; p =
0.0001) complete LAAE. Primary safety was met, with 100% (95% CI 97.75%,
100%; p < 0.0001) of patients free from pre-defined SAEs within 30 days.
One device-related SAE was reported, which resolved intraprocedurally.
 Conclusion(s): AtriClip V-Clip showed safe and successful LAAE
through 12 months of follow-up. Copyright © 2025 by the authors.

<17>
Accession Number
2039985604
Title
Transcatheter Mitral Valve Replacement Using Contemporary Dedicated
Devices: A Systematic Review and Meta-Analysis.
Source
Structural Heart. 9(9) (no pagination), 2025. Article Number: 100702. Date
of Publication: 01 Sep 2025.
Author
Zorman M.J.; Dangas K.; Vibhishanan J.; Castle J.; Eastwick-Jones K.;
Coronelli M.; Alabdaljabar M.S.; Foster K.; Silva D.; Patel P.; Johns E.;
Piankova P.; Ordonez-Mena J.; Dawkins S.; Newton J.; Eleid M.F.; Guerrero
M.E.; Cahill T.J.
Institution
(Zorman, Dangas, Vibhishanan, Castle, Eastwick-Jones, Coronelli, Piankova,
Dawkins, Newton, Cahill) Oxford Heart Centre, Oxford University Hospitals
NHS Foundation Trust, Oxford, United Kingdom
(Zorman, Alabdaljabar, Foster, Silva, Patel, Johns, Eleid, Guerrero)
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United
States
(Ordonez-Mena) Nuffield Department of Primary Care Health Sciences,
University of Oxford, Oxford, United Kingdom
Publisher
Cardiovascular Research Foundation
Abstract
Background: Dedicated transcatheter mitral valve replacement (TMVR)
devices have emerged as a promising strategy for treating mitral
regurgitation (MR) in high-risk patients with complex native valve
anatomy. Early experience spans multiple devices utilizing both
transapical and transseptal access. The aim of this study was to evaluate
procedural, 30-day, and midterm outcomes of TMVR with contemporary
dedicated mitral devices in patients with native MR. Method(s): A
systematic search of Medline, Embase, and Cochrane Library (January
2010-January 2025) was conducted. Pooled outcome estimates were derived
using random-effects models, excluding legacy devices and cases of mitral
stenosis. Result(s): Thirteen studies (914 patients) were included in
the analysis. The mean age was 75.4 years, and 69.8% had functional or
mixed MR. Technical success was 96.3%. Residual MR was mild or less in 99%
of patients at 30 days and 98% at 1 year. All-cause mortality was 11.0% at
30 days and 26.4% at 1 year. Over a mean follow-up of 12.1 months, rates
of heart failure (HF) hospitalizations, cerebrovascular events, and valve
reinterventions were 26.2, 5.6, and 6.0 events per 100 patient-years,
respectively. Compared with transseptal access, transapical showed higher
30-day major bleeding (19.2% vs. 10.4%, p = 0.03) and all-cause mortality
at 30 days (14.0% vs. 4.7%, p <0.001) and 1 year (27.7% vs. 13.1%, p =
0.005). Midterm rates of HF readmissions, major bleeding, and valve
reinterventions were comparable between access routes. Conclusion(s):
Contemporary dedicated TMVR devices demonstrate high technical success and
sustained MR reduction. Transseptal access is associated with lower
morbidity and mortality. Further research is needed to improve longer-term
mortality and HF hospitalizations following TMVR with dedicated mitral
devices. Copyright © 2025 The Author(s)

<18>
Accession Number
2040058005
Title
Diagnostic accuracy of intraoperative neuromonitoring during non-tumor
thoracic spine surgeries: A systematic review and meta-analysis.
Source
Journal of Clinical Neuroscience. 141 (no pagination), 2025. Article
Number: 111567. Date of Publication: 01 Nov 2025.
Author
Addanki R.N.D.; Ezhuvathra P.; Al-Qudah A.M.; Lee B.B.; Anetakis K.M.;
Balzer J.R.; Thirumala P.D.
Institution
(Addanki, Ezhuvathra, Lee, Anetakis, Balzer, Thirumala) Department of
Neurosurgery, University of Pittsburgh Medical Center, PA, United States
(Al-Qudah, Thirumala) Department of Neurology, University of Pittsburgh
Medical Center, PA, United States
Publisher
Churchill Livingstone
Abstract
Background: Thoracic spine surgeries carry a higher risk of neurological
complications due to the region's narrow spinal canal and precarious blood
supply, making effective monitoring critical. This study offers the first
meta-analysis assessing accuracy and prognostic value of Intraoperative
neuromonitoring (IONM) in non-tumor thoracic spinal surgeries, filling a
key gap in the literature. Method(s): We adhered to PRISMA-DTA
guidelines, conducting a PubMed search for relevant studies. Included
studies had over 10 patients and excluded spinal cord tumors. Study
quality was evaluated with QUADAS-2. Diagnostic metrics, sensitivity,
specificity, and area under the curve, were calculated using a bivariate
model. Comparisons between IONM methods utilized Z-tests and Bayesian
meta-analysis. Heterogeneity assessments were also performed to ensure
robustness. Result(s): Across 19 studies with 3,261 cases,
postoperative new neurological deficits occurred in 9.3 % of cases.
Multimodal IONM outperformed other methods in detecting these deficits,
achieving 82.0 % sensitivity (95 % CI: 66.7-91.2) and 94.7 % specificity
(95 % CI: 88.4-97.6), compared to somatosensory evoked potentials (65.5 %,
93.0 %) and transcranial motor evoked potentials (79.7 %, 92.1 %). Its
area under the curve reached 94.5 %, highlighting excellent accuracy.
Notably, recovered IONM alerts correlated with a less rate of
postoperative deficits (10.7-13.8 %). Conclusion(s): Multimodal IONM,
combining SSEP and TcMEP, surpasses single modalities in detecting and
preventing neurological damage in thoracic spine surgeries. Immediate
intervention after alerts, evidenced by low deficit rates with recovered
alerts, makes it the optimal strategy. Adopting these insights into
clinical protocols enhances patient safety and outcomes in this high-risk
surgical context. Copyright © 2025 Elsevier Ltd

<19>
Accession Number
2035713997
Title
Thoracic Paravertebral Block with Liposomal Bupivacaine Versus Plain
Bupivacaine in Patients Undergoing Thoracoscopic Lung Resection: A
Randomized Controlled Study.
Source
Drug Design, Development and Therapy. 19 (pp 6955-6964), 2025. Date of
Publication: 2025.
Author
Yang Z.; Liu M.; Wang C.; Song Y.; Wu J.; Wu D.; Yao M.; Yang Y.; Miao C.;
Liang C.
Institution
(Yang, Liu, Wang, Song, Wu, Wu, Yao, Yang, Miao, Liang) Department of
Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China
Publisher
Dove Medical Press Ltd
Abstract
Background: The effectiveness of a thoracic paravertebral blockade with
liposomal bupivacaine for thoracic surgery pain management is not well
examined. This study compared the effects of liposomal bupivacaine and
plain bupivacaine on a thoracic paravertebral blockade in adult patients
undergoing video-assisted thoracoscopic surgery (VATS). Method(s):
Consenting participants (114) scheduled for VATS were randomly assigned to
thoracic paravertebral blockade at T4-5 and T7-8 levels with 20 mL (266
mg) liposomal bupivacaine (LB) or 20 mL (37.5 mg) plain bupivacaine (PB)
groups. The primary endpoint was opioid consumption at 48 hours
postoperatively. Additional main outcomes included the opioid consumption
24 and 72 hours postoperatively; the pain score at rest and coughing 24,
48, and 72 hours postoperatively; Quality of Recovery-15 (QoR-15) scores
24 hours postoperatively, the time to the first analgesia request.
 Result(s): Opioid consumption did not differ between the groups at 48
hours postoperatively. The QoR-15 scores 24 hours after surgery were
higher in the LB group than in the PB group (mean [SD], 120.2 [7.1] vs
116.5 [7.8]; P = 0.009). The time to the first analgesia request was
longer in the LB group than in the PB group (mean [SD], 585.8min [211.7]
vs 315.3min [101.7]; P <0.001). The areas under the curve for the NRS
score at rest were 21.2 and 35.8 for the LB and PB groups, respectively (P
= 0.002). The NRS scores during coughing did not differ between the two
groups, nor did the CPSP three months postoperatively. Conclusion(s):
Liposomal bupivacaine offers limited but measurable clinical benefits when
used for thoracic paravertebral blockade in patients undergoing VATS.
Registration: Chinese Clinical Trial Registry; Registration number:
ChiCTR2400081544, URL:
https://www.chictr.org.cn/showproj.html?proj=221025. Copyright ©
2025 Yang et al.

<20>
Accession Number
2039570708
Title
Impact of superficial and deep parasternal blocks on recovery after
cardiac surgery with sternotomy: a randomised controlled trial.
Source
British Journal of Anaesthesia. 135(3) (pp 764-771), 2025. Date of
Publication: 01 Sep 2025.
Author
Demarquette A.; Jeanneteau A.; Blanchard-Daguet A.; Fouquet O.;
Parot-Schinkel E.; Lasocki S.; Rineau E.; Leger M.
Institution
(Demarquette, Jeanneteau, Blanchard-Daguet, Lasocki, Rineau, Leger)
Departement d'Anesthesie Reanimation, Centre Hospitalier Universitaire
d'Angers, Angers, France
(Fouquet) Service de Chirurgie Cardiaque, Centre Hospitalier Universitaire
d'Angers, Angers, France
(Fouquet, Lasocki, Rineau) Univ Angers, INSERM, CNRS, MITOVASC, Equipe
CARME, SFR ICAT, Angers, France
(Parot-Schinkel) Departement de Biostatistique et Methodologie, Centre
Hospitalier Universitaire d'Angers, Angers, France
(Leger) INSERM UMR 1246 - SPHERE, Nantes University, Tours University,
Nantes, Centre Hospitalier Universitaire d'Angers, Angers, France
(Leger) UCSF Medical Center, Department of Anesthesia and Perioperative
Care, San Francisco, CA, United States
Publisher
Elsevier Ltd
Abstract
Background: Pain is common after cardiac surgery and can impair recovery.
Regional anaesthesia has been proposed to limit pain, but its impact on
recovery is unknown. This study compared the impact of superficial or deep
parasternal intercostal plane blocks (SPIP or DPIP) in addition to
standard care vs standard care alone on postoperative quality of recovery
(QoR) after cardiac surgery with sternotomy. Method(s): In this
single-centre, randomised, single-blind, controlled trial, adult patients
undergoing cardiac surgery with sternotomy were randomly assigned to one
of three groups (with a 1:1:1 allocation ratio): control group (standard
care without regional anaesthesia), SPIP group, or DPIP group. The primary
endpoint was QoR assessed using a French validated version of the Quality
of Recovery-15 questionnaire at 24 h after surgery. Secondary outcomes
included postoperative pain scores, analgesic consumption, ICU and
hospital length of stay, and adverse events. Result(s): Between July
1, 2022, and August 30, 2023, we randomised 254 patients (81.1% men, 65.5
[27-85] yr). The French validated version of the Quality of Recovery-15
scores did not significantly differ between any parasternal block group
(SPIP or DPIP) and the standard care group (P=0.248). Postoperative pain
and analgesic consumption were similar across groups, with low pain scores
(median [interquartile range] 24-h numerical rating scale: 2.0 [3.0-0.0]).
There were more pneumothoraces in the DPIP group (P=0.032). No significant
differences were observed for other complications. Conclusion(s):
Regional anaesthesia by parasternal intercostal plane blocks after
sternotomy did not improve QoR at 24 h compared with standard care.
Clinical trial registration: NCT05345639. Copyright © 2025
British Journal of Anaesthesia

<21>
[Use Link to view the full text]
Accession Number
2039222437
Title
Bridging surgical oncology and personalized medicine: the role of
artificial intelligence and machine learning in thoracic surgery.
Source
Annals of Medicine and Surgery. 87(6) (pp 3566-3572), 2025. Date of
Publication: 01 Jun 2025.
Author
Ijlal A.; Mumtaz H.; Hassan S.M.; Mustafa Q.-U.-A.; Khalil A.B.B.; Ali U.;
Tanveer Z.K.; Sajjad L.
Institution
(Ijlal) Jinnah Sindh Medical University, Karachi, Pakistan
(Mumtaz) BPP University, London, United Kingdom
(Hassan, Ali) Karachi Medical and Dental College, Karachi, Pakistan
(Mustafa) South City Institute of Physical Therapy and Rehabilitation,
Karachi, Pakistan
(Khalil) Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi,
Pakistan
(Tanveer) University College of Medicine and Dentistry, Lahore, Pakistan
(Sajjad) Dow Medical College, Karachi, Pakistan
Publisher
Lippincott Williams and Wilkins
Abstract
Lung cancer remains the leading cause of cancer-related deaths globally,
often detected in advanced stages with poor prognosis. While surgical
resection is the mainstay of curative treatment, early detection remains a
significant challenge. Advances in personalized medicine, including
genomic profiling and low-dose CT scans, have led to more tailored
therapies, offering improved outcomes. Integrating artificial intelligence
(AI) and machine learning (ML) into oncology has the potential to
revolutionize lung cancer management by enhancing early detection,
improving treatment precision, and supporting surgical decision-making.
AI-driven technologies, such as deep learning algorithms and predictive
models, have demonstrated effectiveness in identifying lung nodules,
predicting immunotherapy response, and reducing diagnostic errors.
Additionally, AI-powered robotics have contributed to improved surgical
precision and better patient recovery. However, the widespread adoption of
AI in clinical practice faces challenges, including data standardization,
ethical concerns, and the need for robust validation. This study explores
the question: How can AI and ML optimize thoracic surgical oncology by
improving early detection, enhancing surgical precision, and enabling
personalized care? This review highlights the significance of AI and ML in
thoracic surgery and oncology, discussing their current applications,
limitations, and future potential to advance personalized cancer care and
improve patient outcomes. Copyright © 2025 The Author(s)

<22>
Accession Number
2040104637
Title
Effects of ciprofol on postoperative delirium and outcomes in older
patients undergoing major thoracic surgery: Protocol for a multicentre,
prospective, single-blinded, randomised controlled study.
Source
BMJ Open. 15(8) (no pagination), 2025. Article Number: 105818. Date of
Publication: 19 Aug 2025.
Author
Hong P.; Liu Q.; Ouyang W.; Luo A.; Wang E.; Gu X.; Wang L.; Chen S.; Wang
H.; Xiao W.; Wang T.
Institution
(Hong, Liu, Xiao, Wang) Department of Anesthesiology, Xuanwu Hospital
Capital Medical University, Beijing, China
(Hong) Department of Anesthesiology, Zhujiang Hospital, Southern Medical
University, Guangdong, Guangzhou, China
(Ouyang) Department of Anesthesiology, Third Xiangya Hospital, Central
South University, Hunan, Changsha, China
(Luo) Department of Anesthesiology, Huazhong University of Science and
Technology, Tongji Medical College, Tongji Hospital, Hubei, Wuhan, China
(Wang) Department of Anesthesiology, Xiangya Hospital, Central South
University, Hunan, Changsha, China
(Gu) Department of Anesthesiology, Nanjing University, Medical School,
Affiliated Nanjing Drum Tower Hospital, Jiangsu, Nanjing, China
(Wang) Department of Anesthesiology, The First Hospital of Hebei Medical
University, Hebei, Shijiazhuang, China
(Chen) Department of Anesthesiology, First Affiliated Hospital of Nanchang
University, Jiangxi, Nanchang, China
(Wang) Department of Anesthesiology, Jinan University First Affiliated
Hospital, Guangdong, Guangzhou, China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative delirium (POD) is a notable complication in
older adults undergoing major thoracic surgery and is associated with poor
clinical outcomes. Ciprofol, an innovative sedative known for its
haemodynamic stability, holds the potential to lower the risk of POD.
However, high-quality evidence supporting this claim is limited. The
objective of this study is to evaluate the effect of ciprofol compared
with propofol on the incidence of POD and postoperative outcomes in older
patients undergoing thoracic surgeries. Methods and analysis This
multicentre, prospective, single-blinded, randomised controlled trial will
recruit patients aged >=65 years scheduled for elective thoracoscopic
lobectomy or segmentectomy, with an anticipated anaesthesia duration of at
least 2 hours. Participants will be randomised to receive either ciprofol
(0.25-1.5 mg/kg/hour) or propofol (1-6 mg/kg/hour) in a 1:1 ratio. The
primary outcome is the incidence of POD within 7 days postoperatively,
assessed via the three-dimensional confusion assessment method. Secondary
outcomes include emergence delirium assessed using the confusion
assessment method for the intensive care unit, the incidence of combined
adverse events during induction and maintenance of anaesthesia, duration
of intraoperative hypotension, minimum mean intraoperative arterial
pressure, duration of Wavelet Index <40, other adverse events identified
during the follow-up period, length of stay, first exhaust time and
postoperative first time to taking food. A non-inferiority margin of 5% is
applied for sample size calculation, yielding a total of 214 participants,
adjusted for a 10% attrition rate. Ethics and dissemination Approval on
ethical grounds has been received from the ethics committee of Xuanwu
Hospital, Capital Medical University (LinYanShen (2024)-NO.201-003-Revised
V.1). We will publish the findings in peer-reviewed journals. Trial
registration number NCT06674226. Copyright © Author(s) (or their
employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ Group.

<23>
Accession Number
2035746752
Title
The Incidence of Pressure Ulcers in Surgical Patients: A Systematic
Review.
Source
International Wound Journal. 22(8) (no pagination), 2025. Article Number:
e70738. Date of Publication: 01 Aug 2025.
Author
Kurian S.; Moore Z.; Patton D.; George S.
Institution
(Kurian, Moore, Patton, George) School of Nursing & Midwifery, Royal
College of Surgeons, University of Medicine and Health Sciences, Dublin 2,
Ireland
(Kurian) St. Vincent's University Hospital, Dublin 4, Ireland
(Moore, Patton) School of Nursing & Midwifery, Griffith University,
Brisbane, Australia
(Moore) National Health and Medical Research Council Centre of Research
Excellence in Wiser Wound Care, Menzies Health Institute Queensland,
Casuarina, Australia
(Moore) School of Health Sciences, Faculty of Life and Health Sciences
Ulster University, Belfast, United Kingdom
(Moore) Cardiff University, Cardiff, United Kingdom
(Moore, Patton) Department of Nursing, Fakeeh College for Medical
Sciences, Jiddah, Saudi Arabia
(Moore) Department of Public Health, Faculty of Medicine and Health
Sciences, Ghent University, Gand, Belgium
(Moore) Lida Institute, Shanghai, China
(Patton) University of Wollongong, Wollongong, Australia
Publisher
John Wiley and Sons Inc
Abstract
The aim is to assess the incidence of pressure ulcers among adults
undergoing surgery. Systematic review methodology was employed. Databases
including Cochrane, Ovid Medline, Embase, EBSCO, CINAHL Plus and Scopus
were searched in August 2024. The data extracted were imported into Excel
for analysis. Simple descriptive statistics were used for the analysis
purposes. The data are presented using means and standard deviations. The
evidence-based Librarian checklist was used for the quality appraisal. The
Systematic Review Protocol was registered in PROSPERO (CRD42023449194). A
total of 35 studies were included. The mean pressure ulcer incidence was
17.22% (range from 0.05% to 74.2%). Studies from orthopaedics, mainly
including patients undergoing hip surgeries, reported the highest pressure
ulcer incidence. The most commonly reported pressure ulcer grade was stage
one, and the most common anatomical locations were the sacral region and
heels. Pressure ulcers remain a significant concern for surgical patients,
especially those undergoing orthopaedic and cardiac surgeries. Most
develop in early stages, often affecting the sacral and heel regions.
However, gaps in data make it difficult to fully synthesise the scope of
the problem. Standardised reporting and targeted prevention efforts are
essential to reducing incidence and improving patient care. Copyright
© 2025 The Author(s). International Wound Journal published by
Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<24>
[Use Link to view the full text]
Accession Number
2040041398
Title
Sex-Related Prognosis of VA-ECMO-Treated Cardiogenic Shock: A Post Hoc
Analysis of the HYPO-ECMO Trial.
Source
Circulation: Heart Failure. 18(8) (pp e012702), 2025. Date of Publication:
01 Aug 2025.
Author
Baudry G.; Girerd N.; Duarte K.; Monzo L.; Delmas C.; Van Spall H.G.C.;
Kimmoun A.; Levy B.
Institution
(Baudry, Girerd, Duarte, Monzo) Universite de Lorraine, Inserm, Centre
d'Investigation Clinique Plurithematique 1433, Inserm U1116, Chru de
Nancy, France
(Baudry, Girerd, Duarte, Monzo) INI-CRCT (Cardiovascular and Renal
Clinical Trialists), F-CRIN Network, Nancy, France
(Baudry, Delmas) Reicatra, Recherche et Enseignement en Ic Avancee
Transplantation Assistance, Vandoeuvre-les-Nancy, France
(Delmas) Intensive Cardiac Care Unit, Rangueil University Hospital,
Toulouse, France
(Van Spall) Department of Medicine, McMaster University, Hamilton, ON,
Canada
(Van Spall) Population Health Research Institute, Hamilton, ON, Canada
(Van Spall) Research Institute of St. Joseph's, Hamilton, ON, Canada
(Van Spall) Baim Institute for Clinical Research, Boston, MA, United
States
(Kimmoun, Levy) Medecine Intensive et Reanimation, Chru Nancy, Pole
Cardio-Medico-Chirurgical, Vandoeuvre-les-Nancy, France
(Kimmoun, Levy) Inserm U1116, Faculte de Medecine, Vandoeuvre-les-Nancy,
France
(Kimmoun, Levy) Universite de Lorraine, Nancy, France
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The sex-related prognosis of patients with cardiogenic shock
undergoing venoarterial extracorporeal membrane oxygenation remains
unclear. Our analyses aim to assess sex-specific outcomes in patients with
cardiogenic shock receiving venoarterial extracorporeal membrane
oxygenation and explore whether the effect of moderate hypothermia on
clinical outcomes was modified by sex. METHOD(S): In this post hoc
analysis of the HYPO-ECMO trial (Hypothermia During ECMO), clinical
outcomes were compared by sex. The primary outcome was 30-day all-cause
mortality. Key secondary outcomes included all-cause mortality and a
composite outcome of all-cause mortality, heart transplant, escalation to
left ventricular assist device implantation, or stroke at 30, 60, and 180
days. RESULT(S): Among the 334 patients enrolled in the trial, 81
(24%) were female. At 30 days, 45.7% of female and 46.6% of male patients
experienced the primary outcome, with no sex differences (adjusted odds
ratio, 1.01 [0.57-1.78]; P=0.98 and log-rank test; P=0.93). No significant
sex differences were observed in all-cause mortality at 60 and 180 days
(adjusted odds ratio, 0.87 [0.49-1.52]; P=0.61 and 0.83 [0.47-1.46];
P=0.51, respectively) or in the composite outcome up to 180 days (P>0.2
for all). The effect of moderate hypothermia on the primary outcome
(adjusted odds ratio, 0.73 [0.43-1.25]; P=0.25 and 0.67 [0.26-1.76];
P=0.41, in male and female, respectively, interaction P=0.88) and
secondary outcomes (interaction P>0.3 for all) was not modified by sex.
 CONCLUSION(S): In this post hoc analysis of the HYPO-ECMO trial, male
and female patients experienced similar outcomes in cardiogenic shock
treated with venoarterial extracorporeal membrane oxygenation. Sex did not
significantly modify the effect of moderate hypothermia on outcomes.
REGISTRATION: URL: https://clinicaltrials.gov/study/NCT02754193; Unique
identifier: NCT02754193. Copyright © 2025 American Heart
Association, Inc.

<25>
Accession Number
2035724074
Title
The Effects of Low-Dose Esketamine Combined with Paravertebral Block on
Postoperative Hyperalgesia and Enhanced Recovery in Non-Intubated
Video-Assisted Thoracic Surgery: A Randomized Controlled Trial.
Source
Drug Design, Development and Therapy. 19 (pp 7033-7043), 2025. Date of
Publication: 2025.
Author
Zhang R.; Luo Z.; Zhang H.; Wang Q.; Luo C.; He J.; Wang T.
Institution
(Zhang, Wang) Department of Thoracic Surgery, The Third Affiliated
Hospital of Chongqing Medical University, Yubei District, Chongqing City,
China
(Luo, Zhang, Luo, Wang) Department of Thoracic Surgery, The Third
Affiliated Hospital of Chongqing Medical University, Chongqing City, China
(He) Department of Ultrasound, Renji Hospital Affiliated to Chongqing
University (Chongqing Fifth People's Hospital), Chongqing City, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: Non-intubated video-assisted thoracic surgery (NIVATS) reduces
airway trauma but may lead to postoperative hyperalgesia and opioid
dependence, contradicting enhanced recovery after surgery (ERAS)
principles. We hypothesized that combining low-dose esketamine with a
paravertebral block (PVB) may mitigate hyperalgesia, decrease opioid
requirements, and improve recovery quality in NIVATS. Patients and
Methods: This prospective single-center, double-blind randomized
controlled trial (RCT) enrolled 82 patients undergoing uniportal NIVATS.
Patients were randomized into two groups: esketamine (0.25 mg/kg
pre-induction + 0.15 mg/kg/h intraoperatively) and control. Both groups
received ultrasound-guided T4 and T6 PVB (with 0.375% ropivacaine). The
primary outcome was mechanical pain threshold (MPT; central/peripheral),
quantified preoperatively and at 0.5-48 h postoperatively using pressure
algometry after laryngeal mask airway (LMA) removal. Secondary outcomes
included quality of recovery-40 (QoR-40) scores, intraoperative
sufentanil/norepinephrine use, postoperative rescue analgesia use, and
other related complications. Result(s): Compared to controls, the
esketamine group exhibited significantly higher MPT at 6 h postoperatively
(central: 2.77 +/- 0.80 vs 2.17 +/- 0.59 kgf/cm2, P < 0.001; and
peripheral: 2.95 +/- 0.89 vs 2.17 +/- 0.62 kgf/cm2, P < 0.001). It also
showed markedly improved QoR-40 scores (POD1: 182.3 +/- 6.0 vs 175.8 +/-
7.2, P < 0.001; and POD3: 190.3 +/- 2.9 vs 186.8 +/- 3.6, P < 0.001).
Compared to controls, the esketamine group also showed significantly lower
intraoperative sufentanil consumption (median 5.0 vs 17.5 mug) and
norepinephrine requirement (219.1 +/- 124.7 vs 393.7 +/- 182.3 mug), as
well as postoperative rescue analgesia use (P < 0.05). Except for
postoperative nausea and vomiting (PONV) incidence (P < 0.05), both groups
had similar profiles in other adverse events. Conclusion(s): Low-dose
esketamine combined with PVB attenuates postoperative hyperalgesia,
reduces intraoperative opioid use by 71.4%, and enhances recovery in
NIVATS, offering a clinically effective opioid-sparing strategy for ERAS
protocols. Copyright © 2025 Zhang et al.

<26>
Accession Number
2040056872
Title
Rationale and design of SCOPE trial: a prospective, multicentre,
open-label, randomised controlled trial to evaluate the overall efficacy
and safety of a shortterm anticoagulation strategy versus conventional
single antiplatelet therapy in patients with severe aortic stenosis
without indications for anticoagulation or dual antiplatelet therapy
posttranscatheter aortic valve replacement.
Source
BMJ Open. 15(8) (no pagination), 2025. Article Number: e098551. Date of
Publication: 16 Aug 2025.
Author
Yan Y.; Liu R.; Zhang L.; Liu X.; Yuan F.; Jiang Z.; Luo T.; Lu Z.; Wang
Y.; Zhu Y.; Tang Y.-D.; Zhang H.; Wu W.; Li Y.; Guo L.; Pocock S.; Song G.
Institution
(Yan, Li, Liu, Liu, Yuan, Jiang, Luo, Lu, Song) Interventional Center of
Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical
University, Beijing, China
(Zhang) National Clinical Research Center for Cardiovascular Diseases, NHC
Key Laboratory of Clinical Research for Cardiovascular Medications, State
Key Laboratory of Cardiovascular Disease Fuwai Hospital, Chinese Academy
of Medical Sciences, Peking Union Medical College, National Center for
Cardiovascular Diseases, Beijing, China
(Wang, Zhu) Medical Research and Biometrics Center, National Clinical
Research Center for Cardiovascular Diseases, Fuwai Hospital, National
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences,
Peking Union Medical College, Beijing, China
(Tang) Department of Cardiology, Institute of Vascular Medicine, Peking
University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular
Biology and Regulatory Peptides, Key Laboratory of Molecular
Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of
Cardiovascular Receptors Research, Beijing, China
(Zhang) Cardiology Department, Beijing Hospital, National Center of
Gerontology, Beijing, China
(Wu) Department of Cardiology, Peking Union Medical College Hospital,
Chinese Academy of Medical Science, Peking Union Medical College, Beijing,
China
(Li) Department of Cardiology, Tangdu Hospital, Airforce Medical
University, Beijing, China
(Guo) Department of Cardiovascular Medicine, The First Hospital of China
Medical University, Shenyang, China
(Pocock) EPH, London School of Hygiene and Tropical Medicine, London,
United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction While transcatheter aortic valve replacement (TAVR) has
become a well-established standard of care for patients with symptomatic
severe aortic stenosis, the optimal antithrombotic strategy post-TAVR
remains a subject of debate, particularly in patients without clear
indications for anticoagulation or dual antiplatelet therapy. This study
aims to investigate the safety and efficacy of rivaroxaban compared with
antiplatelet monotherapy in this specific patient population. Methods and
analysis This study is designed as a prospective, multicentre, open-label,
randomised controlled trial. A total of 454 patients, who have
successfully undergone TAVR and do not have indications for long-term
anticoagulation or dual antiplatelet therapy, will be consecutively
enrolled from seven centres across China. Participants will be randomly
assigned to receive either anticoagulation with rivaroxaban (20/15 mg) or
conventional antiplatelet therapy (aspirin or clopidogrel) for 1 month.
Follow-up evaluations are scheduled at 1, 3, 6 and 12 months
post-procedure. After the initial 1-month antithrombotic therapy, the
regimen may be adjusted by the investigator based on the patient's
clinical and imaging follow-up results. The primary endpoint is a
hierarchical composite of cardiovascular death, first occurrence of
myocardial infarction or stroke, first occurrence of life-threatening,
disabling or major bleeding, and grade 3 or higher hypo-attenuated leaflet
thickening and reduced leaflet motion at 12 months post-TAVR. The win
ratio method will be employed to analyse the primary
endpoint. Copyright © Author(s) (or their employer(s)) 2025.

<27>
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

<28>
[Use Link to view the full text]
Accession Number
647787766
Title
Comment on "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(8) (pp 5758-5759),
2025. Date of Publication: 01 Aug 2025.
Author
Yan J.; Wei J.
Institution
(Yan) Department of Cardiology, Sanya People's Hospital, West China
(Sanya) Hospital, Hainan, China
(Wei) Department of Cardiology, Dongying People's Hospital, Shandong,
China

<29>
Accession Number
2038782589
Title
Study protocol of the multicentre, randomised, triple-blind,
placebo-controlled MERCURI-2 trial: promoting effective renoprotection in
cardiac surgery patients by inhibition of sodium glucose cotransporter
(SGLT)-2.
Source
BMJ Open. 15(5) (no pagination), 2025. Article Number: e095504. Date of
Publication: 16 May 2025.
Author
Oosterom-Eijmael M.; Monteiro De Oliveira N.P.; Niesten E.D.; Tolsma M.;
Snellen F.T.F.; Gerritse B.M.; Scohy T.V.; Rettig T.; Godfried M.B.; Voogd
M.F.; Wink J.; Van Der Werff L.M.M.; Eberl S.; Preckel B.; Hermanides J.;
Van Raalte D.H.; Hulst A.H.
Institution
(Oosterom-Eijmael, Eberl, Preckel, Hermanides, Hulst) Department of
Anesthesiology, Amsterdam University Medical Center, Amsterdam,
Netherlands
(Oosterom-Eijmael, Van Raalte) Department of Endocrinology, Amsterdam
University Medical Center, Amsterdam, Netherlands
(Oosterom-Eijmael, Van Raalte) Amsterdam Cardiovascular Sciences Research
Institute, Amsterdam, Netherlands
(Monteiro De Oliveira, Niesten) Department of Anesthesiology, Medisch
Spectrum Twente, Enschede, Netherlands
(Tolsma, Snellen) Department of Anesthesiology and Intensive Care, Isala
Clinics, Zwolle, Netherlands
(Gerritse, Scohy) Anaesthesiology, Amphia Ziekenhuis, North Brabant,
Breda, Netherlands
(Rettig) Anesthesiology, Intensive Care and Pain Medicine, Amphia Hospital
Site Molengracht, Noord-Brabant, Breda, Netherlands
(Godfried) Department of Anesthesiology, Onze Lieve Vrouwe Gasthuis,
Noord-Holland, Amsterdam, Netherlands
(Voogd) Department of Anesthesiology, Medisch Centrum Leeuwarden,
Leeuwarden, Netherlands
(Wink, Van Der Werff) Department of Anesthesiology, Leiden University
Medical Center, Leiden, Netherlands
Publisher
BMJ Publishing Group
Abstract
Introduction Acute kidney injury (AKI) is a major complication after
cardiac surgery and is associated with postoperative morbidity and
mortality. Currently, no effective therapy exists to reduce the incidence
of postoperative AKI. Sodium-glucose cotransporter-2 (SGLT2) inhibitors
are effective in reducing AKI in outpatient settings for patients with
chronic kidney disease. We hypothesised that perioperative SGLT2
inhibition will also reduce AKI incidence after cardiac surgery according
to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Methods and
analysis We designed a multicentre, randomised, placebo-controlled,
triple-blinded, superiority trial. A total of 784 patients, aged above 18
years, undergoing cardiac surgery will be included with stratification for
sex and type 2 diabetes in a 1:1 ratio. Patients will receive either
dapagliflozin 10 mg or placebo from the day before until 2 days after
surgery. Serum creatinine will be measured preoperatively and daily for
the first 7 days after the operation, and urine output will be measured
until the urinary catheter is removed. The primary outcome is the
incidence of postoperative AKI according to the KDIGO criteria. Ethics and
dissemination The medical ethics committee of the Amsterdam University
Medical Centre (UMC) and the Dutch competent authority approved the study
protocol (currently, version 9, 19 January 2024). This is an
investigator-initiated study. The Amsterdam UMC, as sponsor, retains
ownership of all data and publication rights. After completion of the
trial, results will be disseminated to participants, patient societies and
physicians via a network meeting and digital newsletter. Results will be
submitted for publication in a peer-reviewed international medical journal
and presented on (inter)national congresses. Trial registration number
Clinicaltrials.gov identifier: NCT05590143. Copyright © 2025 BMJ
Publishing Group. All rights reserved.

<30>
Accession Number
2035666609
Title
En Bloc Heart-Lung Transplantation: Past and Present. A Systematic Review.
Source
Clinical Transplantation. 39(8) (no pagination), 2025. Article Number:
e70270. Date of Publication: 01 Aug 2025.
Author
EL-Andari R.; Fialka N.M.; Alam A.; Khonde I.; Weatherald J.; Halloran K.;
Nagendran J.
Institution
(EL-Andari, Fialka, Khonde, Nagendran) Division of Cardiac Surgery,
Department of Surgery, University of Alberta, Edmonton, AB, Canada
(Alam) Faculty of Medicine and Dentistry, University of Alberta, Edmonton,
AB, Canada
(Weatherald, Halloran) Division of Pulmonary Medicine, Department of
Medicine, University of Alberta, Edmonton, AB, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: En bloc heart-lung transplantation (HLTx) has been utilized
for the past 50 years for the treatment of end-stage heart and lung
disease, with significant evolution in the field over that time. This is a
systematic review of HLTx and a description of the evolution and outcomes
in this patient population. Method(s): Pubmed and Embase were
searched for all articles on HLTx from the time of database inception. A
total of 1513 articles were screened, and after exclusion, 29 were
included in this systematic review. Result(s): Reported cases of HLTx
were more common in the early era (before 2000), for the indications of
cystic fibrosis, Eisenmenger's syndrome, and pulmonary hypertension. In
the contemporary era (2000-present), patients were not as commonly
transplanted for cystic fibrosis, with pulmonary hypertension and
congenital heart disease comprising the majority of cases. Rates of
short-term mortality tended to be lower in more recent studies, with only
recent studies reporting long-term survival. Discussion(s): HLTx has
evolved substantially. In tandem with isolated heart and lung
transplantation, the indications for transplant, medical therapy, and
outcomes have changed over time. While HLTx is used less frequently in
contemporary times compared to the early days of cardiothoracic
transplantation, indications for HLTx continue to exist, and the use of
HLTx will continue to be indicated. Centers with experience in HLTx should
continue to report trends in patient management and outcomes, to continue
to guide continued refinement in the field of HLTx. Copyright ©
2025 The Author(s). Clinical Transplantation published by Wiley
Periodicals LLC.

<31>
Accession Number
2034828373
Title
Stroke prevention in atrial fibrillation: A narrative review of current
evidence and emerging strategies.
Source
European Journal of Clinical Investigation. 55(9) (no pagination), 2025.
Article Number: e70082. Date of Publication: 01 Sep 2025.
Author
Askarinejad A.; Lane D.A.; Sadeghipour P.; Haghjoo M.; Lip G.Y.H.
Institution
(Askarinejad, Lane, Lip) Liverpool Centre for Cardiovascular Sciences at
University of Liverpool, Liverpool John Moores University and Liverpool
Heart & Chest Hospital, Liverpool, United Kingdom
(Askarinejad, Lane, Lip) Department of Cardiovascular and Metabolic
Medicine, Institute of Life Course and Metabolic Medicine, University of
Liverpool, Liverpool, United Kingdom
(Lane, Lip) Department of Clinical Medicine, Aalborg University, Aalborg,
Denmark
(Sadeghipour, Haghjoo) Rajaie Cardiovascular, Medical, and Research
Center, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Lip) Medical University of Bialystok, Bialystok, Poland
Publisher
John Wiley and Sons Inc
Abstract
Background: Atrial fibrillation (AF), the most prevalent cardiac
arrhythmia, is associated with a significantly increased risk of mortality
and morbidity from stroke, thromboembolism and dementia. Recent advances
in stroke prevention strategies necessitate an updated approach to
management. Result(s): Published evidence shows that the Atrial
Fibrillation Better Care (ABC) pathway significantly improves stroke
prevention outcomes in AF patients, reducing mortality, stroke incidence
and bleeding events. Characterisation of AF using the 4S-AF framework
helped guide personalised treatment selection and was associated with
improved clinical outcomes. For patients unsuitable for anticoagulation,
left atrial appendage occlusion has been identified as a viable
alternative. Digital health technologies demonstrate increasing utility in
early AF detection to enable timely stroke prevention interventions. There
is evidence for the dynamic nature of stroke (and bleeding) risk, as well
as arrhythmia burden and AF progression over time, in addition to changes
in ABC pathway adherence. Conclusion(s): Effective stroke prevention
in AF requires a comprehensive holistic approach incorporating appropriate
risk stratification, guideline-adherent anticoagulation and management of
underlying cardiovascular conditions and other comorbidities. The ABC
pathway, supported by characterisation using the 4S-AF framework, provides
a structured approach to optimise outcomes. Regular reassessment of risk,
along with careful selection of anticoagulation strategies, remains
crucial. Integration of digital health technologies and structured care
pathways shows promise in improving patient outcomes. 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.

<32>
Accession Number
2039825866
Title
Safety, Efficacy, and Effectiveness of Coronary Sinus Reducer Implantation
in Refractory Angina: A Meta-Analysis.
Source
JACC: Cardiovascular Interventions. 18(15) (pp 1864-1877), 2025. Date of
Publication: 11 Aug 2025.
Author
Ojha U.; Mohsin M.; Macierzanka K.; Ahmed-Jushuf F.; Rajkumar C.A.; Chotai
S.; Simader F.A.; Shun-Shin M.J.; Foley M.J.; Al-Lamee R.K.
Institution
(Ojha) East Kent Hospitals University NHS Foundation Trust, Queen
Elizabeth The Queen Mother Hospital, Margate, United Kingdom
(Mohsin, Macierzanka, Ahmed-Jushuf, Rajkumar, Chotai, Simader, Shun-Shin,
Foley, Al-Lamee) National Heart and Lung Institute, Imperial College
London, London, United Kingdom
(Ahmed-Jushuf, Rajkumar, Chotai, Simader, Shun-Shin, Foley, Al-Lamee)
Imperial College Healthcare NHS Trust, Hammersmith Hospital, London,
United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Previous coronary sinus reducer (CSR) meta-analyses in
refractory angina (RA) focused on single-arm studies, capturing observed
effectiveness-comprising the physical effect of CSR, contextual effects
(eg, placebo), and non-treatment-related phenomena (eg, confounding).
Efficacy evaluation requires comparative estimates from randomized
controlled trials (RCTs), ideally double blind and placebo controlled, to
isolate the physical effect. Objective(s): The aims of this study
were to evaluate the safety and efficacy of CSR in RA and to compare its
efficacy with observed effectiveness. Method(s): The study was
preregistered with the International Prospective Register of Systematic
Reviews (CRD42023399099). Electronic databases were searched until April
2024. Random-effects models separately pooled single-arm, isolated RCT
intervention-arm, and RCT placebo-controlled estimates. Therapeutic
outcomes included improvements in Canadian Cardiovascular Society
classification, Seattle Angina Questionnaire scores, and treadmill
exercise time. Safety outcomes, summarized descriptively, comprised
procedural success and adverse events. Result(s): Three double-blind,
placebo-controlled RCTs (n = 180) and 13 single-arm studies (n = 668) were
analyzed. The overall unweighted procedural success rate was 98.3% (95%
CI: 97.0%-99.1%). Single-arm studies and RCT intervention arms
demonstrated statistically significant improvements across therapeutic
outcomes. For Canadian Cardiovascular Society classification,
placebo-controlled rates were 26% (95% CI: 11%-38%; P < 0.001) for
>=1-class improvement and 17% (95% CI: 2%-37%; P = 0.02) for >=2-class
improvement, representing approximately one-third of single-arm
improvement rates. Seattle Angina Questionnaire domain analyses
demonstrated insufficient placebo-controlled evidence of benefit.
Placebo-controlled exercise time change was 49.62 seconds (95% CI:
1.84-97.40 seconds; P = 0.04). Conclusion(s): CSR implantation is
safe and feasible and demonstrates promising antianginal efficacy in
patients with RA. However, uncertainty in current efficacy findings and
susceptibility of effectiveness data to nonphysical influences preclude
definitive conclusions about clinical utility, warranting larger
placebo-controlled trials. Copyright © 2025 The Authors

<33>
Accession Number
2034574383
Title
Quercetin Reduces Vascular Senescence and Inflammation in Symptomatic Male
but Not Female Coronary Artery Disease Patients.
Source
Aging Cell. 24(8) (no pagination), 2025. Article Number: e70108. Date of
Publication: 01 Aug 2025.
Author
Mury P.; Dagher O.; Fortier A.; Diaz A.; Lamarche Y.; Noly P.-E.; Ibrahim
M.; Page P.; Demers P.; Bouchard D.; Bernier P.-L.; Poirier N.; Moss E.;
Durrleman N.; Jeanmart H.; Pellerin M.; Lettre G.; Thorin-Trescases N.;
Carrier M.; Thorin E.
Institution
(Mury, Dagher, Lamarche, Noly, Ibrahim, Page, Demers, Bouchard, Bernier,
Poirier, Moss, Durrleman, Jeanmart, Pellerin, Lettre, Thorin-Trescases,
Carrier, Thorin) Montreal Heart Institute, Research Center, Universite de
Montreal, Montreal, QC, Canada
(Mury, Dagher) Department of Pharmacology & Physiology, Faculty of
Medicine, Universite de Montreal, Montreal, QC, Canada
(Dagher) Department of Cardiac Sciences, Libin Cardiovascular Institute,
Calgary, AB, Canada
(Fortier) Department of Biostatistics, Montreal Health Innovations
Coordinating Centre (MHICC), Montreal, QC, Canada
(Diaz) CIUSSS-MCQ, Universite de Montreal, Campus Mauricie,
Trois-Rivieres, QC, Canada
(Lamarche, Noly, Ibrahim, Page, Demers, Bouchard, Bernier, Poirier, Moss,
Durrleman, Jeanmart, Pellerin, Carrier, Thorin) Faculty of Medicine,
Department of Surgery, Universite de Montreal, Montreal, QC, Canada
(Lettre) Department of Medicine, Faculty of Medicine, Universite de
Montreal, Montreal, QC, Canada
Publisher
John Wiley and Sons Inc
Abstract
Recent studies suggest that vascular senescence and its associated
inflammation fuel the inflammaging to favor atherogenesis; whether these
pathways can be therapeutically targeted in coronary artery disease (CAD)
patients remains unknown. In a randomized, double-blind trial, 97 patients
(78 men) undergoing coronary artery bypass graft surgery were treated with
either quercetin (500 mg twice daily, 47 patients) or placebo (50
patients) for two days pre-surgery through hospital discharge. Primary
outcomes were reduced inflammation and improved endothelial function ex
vivo. Exploratory analyses included plasma proteomics and single-nuclei
RNA sequencing of internal thoracic artery (ITA) samples. Quercetin
treatment showed a trend toward reduced C-reactive protein at discharge (p
= 0.073) and differentially modulated circulating inflammatory protein
expression between men and women, with a pro-inflammatory effect of
quercetin in females. Endothelial acetylcholine-induced relaxation
improved significantly with quercetin (p = 0.049), with effects in men (p
= 0.043) but not in women (p = 0.852). ITA transcriptomics revealed the
overexpression of senescence and inflammaging pathways in male vascular
cells, which quercetin reversed. In female cells, quercetin had minimal
endothelial benefit and increased inflammaging in fibroblasts. In male
cells, a candidate target of quercetin involves interactions between the
receptor PLAUR and its ligands PLAU and SERPINE1. Post-operative atrial
fibrillation incidence was significantly lower with quercetin,
representing 4% of the patients compared to 18% in the placebo group (p =
0.033). In conclusion, short-term quercetin treatment effectively targeted
vascular senescence in male CAD patients, improving inflammatory and
functional outcomes. However, these benefits were not observed in female
patients. Trial Registration: https://clinicaltrials.gov,
NCT04907253. Copyright © 2025 The Author(s). Aging Cell published
by Anatomical Society and John Wiley & Sons Ltd.

<34>
Accession Number
2039597528
Title
Improving Repair Durability in Severe Ischemic Mitral Regurgitation:
Revisiting Patient Selection and Adjunctive Repair Techniques.
Source
Seminars in Thoracic and Cardiovascular Surgery. 37(3) (pp 257-262), 2025.
Date of Publication: 01 Sep 2025.
Author
Li R.; Hu M.; Fang J.; Wei X.; Wan S.
Institution
(Li, Hu, Fang, Wei, Wan) Division of Cardiovascular Surgery, Department of
Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of
Science and Technology, Wuhan, China
Publisher
W.B. Saunders
Abstract
Ischemic mitral regurgitation (IMR) is a complex heterogeneous
complication following myocardial infarction, characterized by left
ventricular (LV) remodeling and subsequent valvular distortion. The
primary mechanisms include papillary muscle displacement, mitral leaflet
tethering, and impaired coaptation following annular dilatation. IMR is
associated with poor prognosis and an increased incidence of heart
failure. We reviewed studies on the surgical management of IMR published
over the past 2 decades. While mitral valve repair has been favored for
its advantages of low perioperative mortality and LV function
preservation, high rates of mitral regurgitation recurrence limit its
long-term durability. Regarding repair strategy, apart from restrictive
mitral annuloplasty, the adjunctive techniques of papillary muscle
relocation, papillary muscle approximation, and leaflet augmentation have
been proposed. These approaches aim to address LV remodeling and improve
leaflet coaptation by mitigating subvalvular tethering. Moreover, the
application of true-size annuloplasty and "functional repair" strategies
in IMR patients with enlarged LV emphasizes the need to tailor
interventions to patients' LV dimensions and dynamic changes. Accumulating
clinical evidence highlights the importance of meticulous patient
selection and functional mitral valve repair, which remains a promising
approach contingent on enhanced understanding of IMR's pathophysiology and
its interplay with LV remodeling. The current review summarizes our
patient selection criteria and indications for surgical repair (including
the use of adjunctive techniques of subvalvular intervention) or mitral
valve replacement. Copyright © 2025 Elsevier Inc.

<35>
Accession Number
2039377138
Title
Cardiovascular Prehabilitation in Patients Awaiting Heart Transplantation-
Addressing Clinical Needs (the PREHAB HTx Study).
Source
CJC Open. 7(8) (pp 1110-1119), 2025. Date of Publication: 01 Aug 2025.
Author
Reed J.L.; Tulloch H.E.; Ross H.; Terada T.; Mistura M.; Marcal I.R.; Oh
P.; Chih S.
Institution
(Reed, Tulloch, Terada, Mistura, Marcal, Chih) University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Reed, Marcal) School of Human Kinetics, Faculty of Health Sciences,
University of Ottawa, Ottawa, ON, Canada
(Reed) School of Epidemiology and Public Health, Faculty of Medicine,
University of Ottawa, Ottawa, ON, Canada
(Tulloch) Department of Medicine, Faculty of Medicine, University of
Ottawa, Ottawa, ON, Canada
(Ross) Toronto General Hospital Research Institute, University of Toronto,
Toronto, ON, Canada
(Terada) School of Life Sciences, Division of Physiology, Pharmacology,
and Neuroscience, University of Nottingham, Nottingham, United Kingdom
(Oh) Toronto Rehabilitation Institute, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: To compare the effects of a 12-week prehabilitation (PREHAB)
program vs usual care (UC) on functional capacity in adults listed for
heart transplantation. Secondary aims included comparing peak oxygen
uptake (VO<inf>2</inf>peak), frailty, physical activity, mental health,
cognitive function, quality of life (QoL), and dietary habits.
 Method(s): A multicentre randomized controlled trial was conducted.
Participants were randomized to PREHAB or UC. The 12-week PREHAB program
included twice weekly high-intensity interval training sessions on an
upright cycle ergometer, a stress management course, and a nutrition
workshop. The primary outcome was functional capacity (6-minute walk test
distance) from baseline to 12 weeks of follow-up. Secondary outcomes
included changes in VO<inf>2</inf>peak, frailty, physical activity,
severity of anxiety, depression, and stress, cognitive function, QoL, and
dietary habits. Result(s): Trial recruitment began in October 2018
and closed, due to the COVID-19 pandemic, in October 2020. Of 84 patients
screened, 17 were recruited (age: 44 +/- 9 years, 71% male), and 4 were
randomized (PREHAB = 2; UC = 2). Both patients completed PREHAB, and 1
patient completed UC. Reasons for dropout throughout the trial included
the following: receiving a transplant; medication and device
contraindications; commitment and travel constraints; and lack of
interest. PREHAB showed potential for improvements in the 6-minute walk
test distance (Baseline [B]: 343 +/- 120; follow-up [FU]: 465 m),
VO<inf>2</inf>peak (B: 14.9 +/- 0.1; FU: 15.8 +/- 0.4 mL/kg/min), and QoL
measured using the Minnesota Living with Heart Failure Questionnaire (B:
41 +/- 33; FU: 26 +/- 1 points). Conclusion(s): Recruitment for and
completion of PREHAB for patients listed for heart transplantation proved
challenging. Given wait-time limitations, future research should examine
alternative PREHAB programming, offered sooner following listing, that
addresses reported barriers to participation. Clinical Trial Registration:
NCT02957955. Copyright © 2025 The Authors

<36>
Accession Number
2035732708
Title
From expectations to experiences: a systematic review of patient and
public perspectives on robotic surgery.
Source
Journal of Robotic Surgery. 19(1) (no pagination), 2025. Article Number:
484. Date of Publication: 01 Dec 2025.
Author
Jauniaux B.; Anand A.; Abbas R.; Harji D.P.
Institution
(Jauniaux, Harji) Department of Colorectal Surgery, Manchester University
NHS Foundation Trust, Manchester, United Kingdom
(Anand, Abbas) University of Manchester, Manchester, United Kingdom
(Harji) Robotics and Digital Surgery Initiative, Royal College of Surgeons
of England, London, United Kingdom
(Harji) Clinical Trials Research Unit, Leeds Institute of Clinical Trials
Research, University of Leeds, Leeds, United Kingdom
Publisher
Springer Nature
Abstract
The adoption of robotic-assisted surgery (RAS) provides opportunities for
improved clinical and patient-reported outcomes. However, there are
patient and public misconceptions regarding robotic surgery, its
associated risks, and surgeon involvement. It is the surgical community's
responsibility to empower and educate patients regarding emerging
technologies to improve understanding and shared decision-making. This
systematic review aimed to summarize the current understanding,
perceptions, expectations, preferences, and experiences of patients and
the public with RAS as identified in all primary quantitative,
qualitative, and mixed-methods studies and across all surgical
specialities. Using the PRISMA 2020 guideline, a mixed-methods systematic
review was undertaken with searches conducted in Medline, Embase, and
Cochrane Library databases from conception to November 2024. Each study
was evaluated regarding its design and methodology. Data quality was
reviewed in accordance with the Critical Appraisal Skills Programme
Checklist for quantitative and qualitative data, respectively. A narrative
synthesis was undertaken using the principles of content analysis to
identify emerging themes. Of the 7889 references identified, twelve
quantitative, four qualitative, and two mixed-methods studies were
included, assessing 2789 patients and 1244 members of the public. All
studies were retrospective and assessed cohorts across five specialities,
including gynecology, colorectal, urology, orthopedic, and cardiothoracic
surgery. Six themes were identified: factual knowledge, awareness,
preference, perception and expectations, experiences, and willingness to
pay. Patients and the public hold diverse views on robotic-assisted
surgery, influenced by multiple factors and various misconceptions.
Structured pre-operative education programs generally lead to high
satisfaction rates, along with increased knowledge and
awareness. Copyright © The Author(s) 2025.

<37>
Accession Number
2033204427
Title
Prognostic Value of Perioperative Near-Infrared Spectroscopy Monitoring
for Postoperative Acute Kidney Injury in Pediatric Cardiac Surgery: A
Systematic Review.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 29(3) (pp 209-218),
2025. Date of Publication: 01 Sep 2025.
Author
Niezen C.K.; Modestini M.; Massari D.; Bos A.F.; Scheeren T.W.L.; Struys
M.M.R.F.; Vos J.J.
Institution
(Niezen, Modestini, Massari, Scheeren, Struys, Vos) Department of
Anesthesiology, University Medical Center Groningen, University of
Groningen, Groningen, Netherlands
(Niezen) Department of Anesthesiology, Isala Hospital, Zwolle, Netherlands
(Bos) Department of Neonatology, Beatrix Children's Hospital, University
Medical Center Groningen, University of Groningen, Groningen, Netherlands
(Struys) Department of Basic and Applied Medical Sciences, Ghent
University, Gent, Belgium
Publisher
SAGE Publications Inc.
Abstract
Introduction: Postoperative acute kidney injury (AKI) is a common
postoperative complication in cardiac surgery, with varying reported
incidences and prognostic factors. Renal hypoperfusion is believed to be a
key factor contributing to postoperative AKI. Near-infrared spectroscopy
(NIRS) monitoring, which assesses regional tissue saturation
(RSO<inf>2</inf>), has been suggested as a tool to predict postoperative
AKI. The aim of this systematic review was to examine the prognostic value
of perioperative NIRS monitoring in predicting postoperative AKI in
pediatric patients. Methods and Results: After a systematic search in
PubMed, EMBASE, and Cochrane library, twenty studies (1517 patients) were
included. The inter-rater agreement on study quality was strong, yet a
high risk of bias was identified. Conclusion(s): The heterogeneity of
the results-in part attributable to several potential confounding factors
regarding study population, monitoring technique and the definition of
AKI-together with the lack of a clear and consistent association between
RSO<inf>2</inf> values and AKI, currently preclude recommending NIRS
monitoring as a reliable and valid clinical tool to "predict" AKI in the
individual patient. Copyright © The Author(s) 2025. This article
is distributed under the terms of the Creative Commons Attribution 4.0
License (https://creativecommons.org/licenses/by/4.0/) which permits any
use, reproduction and distribution of the work without further permission
provided the original work is attributed as specified on the SAGE and Open
Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).

<38>
[Use Link to view the full text]
Accession Number
2039349302
Title
Cardiac CT Versus Transesophageal Echocardiography Following Left Atrial
Appendage Closure: A Systematic Review and Meta-Analysis.
Source
Circulation: Cardiovascular Imaging. 18(8) (no pagination), 2025. Article
Number: e018151. Date of Publication: 01 Aug 2025.
Author
Tan B.E.-X.; Baqai F.; Padilla F.; Nimri N.; Cheung J.W.; Kottam A.;
Medina H.M.
Institution
(Tan, Nimri, Kottam) Section of Cardiology, Department of Medicine, United
States
(Baqai, Padilla) Section of General Internal Medicine, Department of
Medicine, United States
(Cheung) Baylor College of Medicine, Houston, TX, United States
(Cheung) Division of Cardiology, Department of Medicine, Weill Cornell
Medicine, New York, NY, United States
(Medina) Department of Cardiology, The Texas Heart Institute, Baylor
College of Medicine, Houston, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: In the landmark WATCHMAN trials, transesophageal
echocardiography (TEE) was used to evaluate peri-device leak (PDL) and
device-related thrombus (DRT) after percutaneous left atrial appendage
closure (LAAC). We aimed to investigate the diagnostic utility of cardiac
computed tomography angiography (CCTA) compared with TEE for post-LAAC
device surveillance. METHOD(S): We conducted a literature search of 5
electronic databases to identify studies that included patients who
underwent both CCTA and TEE after LAAC. We performed a meta-analysis by
pooling outcomes for residual leak (left atrial appendage patency), any
PDL, large PDL (>5 mm), and DRT. RESULT(S): We included 17 cohort
studies with 1313 patients who underwent both CCTA and TEE after LAAC.
CCTA was associated with higher odds of detecting residual leak (58.8%
versus 34.6%, odds ratio, 2.26 [95% CI, 1.48-3.44], P=0.0002;
I2=73%; 15 studies, 975 patients; moderate certainty) and any
PDL (51.6% versus 35.5%, odds ratio, 1.59 [95% CI, 1.01-2.51], P=0.04;
I2=73%; 12 studies, 870 patients; moderate certainty) when
compared with TEE. There were no significant differences in the detection
rates of large PDL (>5 mm) between CCTA and TEE (2.8% versus 0.8%, odds
ratio, 3.12 [95% CI, 0.73-13.36], P=0.13; I2=0%; 5 studies, 338
patients; moderate certainty). The incidence of DRT was low (1.7%), and
the detection rate did not differ between the 2 modalities (1.7% versus
1.7%, odds ratio, 1.0 [95% CI, 0.41-2.42], P=1.0; I2=0%; 6
studies, 584 patients; high-certainty). CONCLUSION(S): Following
LAAC, CCTA had higher odds of detecting residual leak and any PDL compared
with TEE, whereas there were no significant differences in the detection
of large PDL (> 5mm) and DRT between the 2 modalities. The findings of
this meta-analysis should provide reassurance to patients and clinicians
who prefer CCTA over TEE after LAAC. While DRT and left atrial appendage
patency with visible PDL are known to be associated with thromboembolism,
the clinical significance of left atrial appendage patency without visible
PDL is uncertain and warrants further investigation. REGISTRATION: URL:
https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42024578802.
GRAPHICAL ABSTRACT: A graphical abstract is available for this
article. Copyright © 2025 American Heart Association, Inc.

<39>
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

<40>
Accession Number
2034565169
Title
Prostate cancer active surveillance in solid organ transplant: a matched
study and literature review.
Source
BJU International. 136(3) (pp 464-472), 2025. Date of Publication: 01 Sep
2025.
Author
Alshak M.N.; Higgins M.I.; Grutman A.J.; Campbell J.; Cheaib J.G.; Rivera
Lopez C.A.; Spann M.; Jing Y.; Pavlovich C.P.
Institution
(Alshak, Higgins, Campbell, Cheaib, Rivera Lopez, Jing, Pavlovich) The
James Buchanan Brady Urological Institute, Johns Hopkins School of
Medicine, Baltimore, MD, United States
(Grutman) Johns Hopkins School of Medicine, Baltimore, MD, United States
(Spann) Welch Medical Library, Johns Hopkins School of Medicine,
Baltimore, MD, United States
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To evaluate outcomes of prostate cancer (PCa) active
surveillance (AS) in patients with versus without solid organ transplant
(SOT), as the safety of PCa AS in patients with SOT remains understudied.
We also performed a literature review to identify all studies describing
PCa AS in patients with SOT. Patients and Methods: A retrospective
study was conducted for patients with SOT (kidney, liver, heart, lung)
with a diagnosis of PCa enrolled into AS either before or after SOT. Using
prospectively collected information, they were matched with non-SOT AS
patients at PCa diagnosis by age, race, prostate-specific antigen, and
Gleason Grade Group (GGG). A scoping review was performed in accordance
with Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines. Result(s): A total of 32 SOT AS patients were matched
with 99 non-SOT AS patients. After matching, there was no significant
difference in baseline demographics. 34% were enrolled into AS before SOT.
The median time on AS for patients with and without SOT was 4.7 and 4.98
years, respectively (P = 0.87). In all, 53% of patients with SOT and 54.5%
those without SOT were still on AS (P = 0.99). In all, 28.1% of patients
with and 39.4% without SOT progressed to definitive treatment (P = 0.30),
and there were no differences in rates of grade re-classification or GGG
at definitive treatment. No systemic disease progression or PCa-specific
deaths occurred. In the literature, we identified and reviewed 11 studies
and found 99 patients enrolled into AS either before (n = 33) or after (n
= 66) SOT. We did not identify a safety signal. Conclusion(s): We
present the largest series of patients with PCa on AS with SOT. In
patients with SOT and PCa on AS, a surveillance strategy appears safe and
has similar outcomes as those without SOT on AS. Our review found a
paucity of AS data in the SOT setting suggesting that further research is
warranted. Copyright © 2025 BJU International.

<41>
Accession Number
2039997694
Title
Short- and Long-Term Effects of Pulsed Ultrasound Cavitation Therapy of
Calcified Valvular Interstitial Cells in Culture.
Source
Ultrasound in Medicine and Biology. (no pagination), 2025. Date of
Publication: 2025.
Author
Clift C.L.; Goudot G.; Bogut G.; Kasai T.; van Kampen A.; Negrao Pantaleao
A.; Messas E.; Aikawa M.; Singh S.A.; Levine R.A.; Pernot M.; Aikawa E.
Institution
(Clift, Bogut, Kasai, Aikawa, Singh, Aikawa) Division of Cardiovascular
Medicine, Department of Medicine, Center for Interdisciplinary
Cardiovascular Sciences, Brigham and Women's Hospital, Harvard Medical
School, Boston, MA, United States
(Goudot, van Kampen, Negrao Pantaleao, Aikawa, Levine) Division of
Cardiology, Department of Medicine, Massachusetts General Hospital,
Boston, MA, United States
(Goudot, Messas) Universite Paris Cite, Hopital Europeen Georges Pompidou,
APHP, INSERM PARCC U970, Paris, France
(Pernot) Physics for Medicine Paris, INSERM U1273, ESPCI Paris, CNRS 8063,
PSL University, Paris, France
(Aikawa) Division of Cardiovascular Medicine, Department of Medicine,
Center for Excellence in Vascular Biology, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Objective: Calcific aortic valve disease advances via increased fibrosis
and calcification deposition, leading to progressive narrowing of the
outflow tract, left ventricular hypertrophy and cardiac failure.
Currently, surgical repair and replacement are the only strategies for
intervention. While transcatheter aortic valve replacement offers a less
invasive alternative to surgical intervention, implanted bioprosthetic
valves have limited durability. Non-invasive ultrasound therapy was shown
to not damage normal porcine aortic valve, and successfully reduced
stenosis of calcified bioprosthetic valves in vivo, as well as decrease
stenosis of native severely calcified aortic stenosis in a first-in-human
study. However, critical questions regarding the effect of ultrasound
therapy on valvular cells remain. In this study, we aimed to optimize
pulsed ultrasound cavitation (PUC) treatment for cell culture studies and
evaluate the acute and persistent effects on human valvular interstitial
cells (hVICs) in calcifying conditions. Method(s): We utilized
viability, metabolism and calcification assays as well as mass
spectrometry-based proteomics to holistically characterize the effects of
PUC treatment in hVICs. Result(s): hVICs viability and metabolism
were not significantly altered as a function of PUC treatment at short-
(48 hour) or long-term (21 day) time points. Furthermore, PUC treatment
did not increase hVICs calcification in vitro. Proteomic profiling of
hVICs showed that PUC treatment had limited persistent changes to protein
profiles compared with the acute effects of PUC treatment.
 Conclusion(s): These studies suggest that ultrasound therapy,
currently limited to very severe aortic stenosis, could be of interest at
an earlier stage of the disease. Copyright © 2025 The Authors

<42>
Accession Number
2035692568
Title
Effect of dual direct and alternating currents on pain induced by blood
sampling and intramuscular injection processes.
Source
Pain Management. (no pagination), 2025. Date of Publication: 2025.
Author
Ezzati E.; Mahooti R.; Mohammadi S.; Kavyannejad R.
Institution
(Ezzati, Mohammadi) Department of Anesthesiology, School of Paramedical,
Kermanshah University of Medical Sciences, Kermanshah, Iran, Islamic
Republic of
(Mahooti) Emam Khomeini Hospital, Kermanshah University of Medical
Sciences, Kermanshah, Iran, Islamic Republic of
(Kavyannejad) Department of Physiology, School of Medicine, Kermanshah
University of Medical Sciences, Kermanshah, Iran, Islamic Republic of
Publisher
Taylor and Francis Ltd.
Abstract
Objective: This study investigates the effects of cathodal, anodal, and
intermittent electrical stimulation on pain intensity associated with
arterial blood sampling, venous blood sampling, and intramuscular
injection. Method(s): In a triple-blind clinical trial, 160 patients
requiring arterial, venous blood sampling, and intramuscular injection
were randomly divided into four groups. Three intervention groups received
5 mA anodal, cathodal direct, or alternating currents during the
procedure, while the control group received only a topical eutectic
mixture of local anesthetics (EMLA). Pain intensity was measured using the
visual analog scale (VAS) immediately after the procedure, while procedure
duration, number of attempts, and heart rate changes were recorded as
secondary outcome. Result(s): All forms of electrical stimulation
significantly reduced procedural pain compared to EMLA. Cathodal direct
current demonstrated the greatest analgesic effect, with mean VAS score
reductions of 2-3 points across all procedures. The time required for
arterial blood sampling in the cathodal group was significantly less than
with EMLA, while no difference was observed in the procedure time and
frequency of attempts in other processes. Furthermore, electrical
stimulation groups, particularly the cathodal mode, exhibited lower
post-procedure heart rates, suggesting attenuated physiological stress
responses. Conclusion(s): We found that applying electric currents
during the procedure reduces the pain of blood sampling or injections. The
greatest analgesia was observed with cathodal direct current stimulation
compared to other groups. Clinical trial registration: Date of
registration: 27 January 2024. Clinical Trials.gov Identifier:
IRCT20240123060780N1. URL:
https://irct.behdasht.gov.ir/trial/75119. Copyright © 2025
Informa UK Limited, trading as Taylor & Francis Group.

<43>
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.

<44>
[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.

<45>
Accession Number
2037753661
Title
Multivitamins After Myocardial Infarction in Patients With Diabetes A
Randomized Clinical Trial.
Source
JAMA Internal Medicine. 185(5) (pp 540-548), 2025. Date of Publication: 05
May 2025.
Author
Ujueta F.; Lamas G.A.; Anstrom K.J.; Navas-Acien A.; Boineau R.; Rosenberg
Y.; Stylianou M.; Jones T.L.Z.; Joubert B.R.; Yu Q.; Wen J.; Nemeth H.;
Huang Z.; Fonseca V.; Nathan D.M.; Uwaifo G.; Arenas I.A.; Luo L.; Baker
J.; Visentin D.; Paixao A.; Schmedtje J.F.; Mark D.B.
Institution
(Ujueta) Brigham and Women's Hospital Division of Cardiovascular Medicine,
Boston, MA, United States
(Lamas) Columbia University Division of Cardiology, Mount Sinai Medical
Center, Miami Beach, FL, United States
(Anstrom) Gillings School of Global Public Health, University of North
Carolina, Chapel Hill, United States
(Navas-Acien) Department of Environmental Health Sciences, Columbia
University Mailman School of Public Health, New York, NY, United States
(Boineau) National Center for Complementary and Integrative Health,
National Institutes of Health, Bethesda, MD, United States
(Rosenberg, Stylianou) National Heart, Lung and Blood Institute, National
Institutes of Health, Bethesda, MD, United States
(Jones) National Institute of Diabetes and Digestive and Kidney Diseases,
National Institutes of Health, Bethesda, MD, United States
(Joubert) National Institute of Environmental Health Sciences, National
Institutes of Health, Durham, NC, United States
(Wen, Nemeth, Huang, Mark) Duke Clinical Research Institute, Duke
University, Durham, NC, United States
(Fonseca) Tulane University School of Medicine, New Orleans, LA, United
States
(Nathan) Massachusetts General Hospital Diabetes Research Center, Harvard
Medical School, Boston, United States
(Uwaifo) Southern Illinois University School of Medicine, Springfield,
United States
(Arenas) Salem Health, Salem, OR, United States
(Baker) Central Florida Heart Center, Ocala, United States
(Visentin) Clinical Research Prime, Idaho Falls, ID, United States
(Visentin) South Simcoe Cardiac Services, Barrie, ON, Canada
(Paixao) Arkansas Heart Hospital, Little Rock, United States
(Schmedtje) Roanoke Heart Institute, Roanoke, VA, United States
Publisher
American Medical Association
Abstract
IMPORTANCE In 2013, the Trial to Assess Chelation Therapy (TACT) reported
that in 1708 patients with stable coronary disease and prior myocardial
infarction (MI), oral multivitamins and multiminerals (OMVMs), in a
factorial design with edetate disodium (EDTA) chelation therapy, did not
reduce cardiovascular events relative to placebo OMVMs, but active EDTA
combined with active OMVMs was superior to placebo OMVM/placebo EDTA.
OBJECTIVE To compare OMVM vs placebo in terms of efficacy for reducing
major adverse cardiovascular events in patients with diabetes and prior
MI. DESIGN, SETTING, AND PARTICIPANTS The TACT2 randomized, multicenter
double-masked 2 x 2 factorial clinical trial took place across 88 sites in
the US and Canada. Participants were 50 years or older, had diabetes, and
had an MI 6 weeks ago or more. TACT2 participants were enrolled between
September 2016 and December 2020. Data were collected between October 2016
and June 2023. INTERVENTIONS Six caplets daily of a 28 component OMVM or
matching OMVM placebo, and 40 weekly infusions of an EDTA-based chelation
solution or matching placebo, in a 1:1:1:1 allocation ratio. MAIN OUTCOMES
AND MEASURES The primary end point was the composite of all-cause
mortality, MI, stroke, coronary revascularization, or hospitalization for
unstable angina. RESULTS A total of 1000 participants were randomized (500
in the active OMVM group and 500 in the placebo group). The median (IQR)
age was 67 (60-72) years, and 730 (73%) were male. Median (IQR) follow-up
was 48 (34-58) months. The primary end point occurred in 175 participants
(35%) in the active OMVM group and 175 (35%) in the placebo group (hazard
ratio [HR], 0.99 [95% CI, 0.80-1.22]; P = .92). The 5-year event rate for
the primary end point in the EDTA chelation + active OMVM group was 34.0%;
in the EDTA chelation + placebo OMVM group, 35.7%; in the placebo infusion
+ active OMVM group, 36.0%; and in the placebo infusion + placebo OMVM
group, 34.3%. The comparison of the active infusion + active OMVM with the
placebo infusion + placebo OMVM was not significant (HR, 0.91 [95% CI,
0.67-1.23]; P = .54). Although nonsignificant, there was a numerically
higher event rate of MI, stroke, mortality from cardiovascular causes in
the active OMVM compared to placebo OMVM group. CONCLUSIONS AND RELEVANCE
The results of this randomized clinical trial demonstrated that, for
participants with chronic coronary disease, diabetes, and a previous MI,
high-dose OMVM alone or in conjunction with EDTA-based chelation did not
reduce cardiovascular events. Copyright © 2025 Ujueta F et al.

<46>
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.

<47>
[Use Link to view the full text]
Accession Number
2040022692
Title
Continued Versus Interrupted Oral Anticoagulation During Transcatheter
Aortic Valve Replacement in Patients With Atrial Fibrillation: A
Meta-Analysis.
Source
American Journal of Therapeutics. (no pagination), 2025. Article Number:
10.1097/MJT.0000000000002042. Date of Publication: 2025.
Author
Faheem M.S.B.; Zahid M.R.
Institution
(Faheem) Karachi Institute of Medical Sciences, KIMS, Karachi, Pakistan
(Zahid) Sialkot Medical College, Sialkot, Pakistan
Publisher
Lippincott Williams and Wilkins

<48>
Accession Number
2040018278
Title
Sex-related differences in survival and safety outcomes after
transcatheter aortic valve replacement: a meta-analysis of reconstructed
time-to-event data.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 11(5) (pp
642-653), 2025. Date of Publication: 01 Aug 2025.
Author
Tavakoli K.; Mohammadi N.S.H.; Fallahtafti P.; Khamene S.S.; Taheri M.;
Ebrahimi P.; Bahiraie P.; Karimi E.; Alishahi M.M.; Pazoki M.; Anaraki N.;
Kazemian S.; Khanipour R.; Khalique O.K.; May H.T.; Thachil R.; Iskander
M.H.; Waheed A.; Hosseini K.
Institution
(Tavakoli, Mohammadi, Fallahtafti, Khamene, Bahiraie, Karimi, Pazoki,
Anaraki, Kazemian, Hosseini) Tehran Heart Center, Cardiovascular Diseases
Research Institute, Tehran University of Medical Sciences, North Karegar
Ave, Tehran, Iran, Islamic Republic of
(Taheri) Faculty of Medicine, Cardiology Research Center, Hamadan
University of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Ebrahimi) Accident and Emergency Department (A&E), Royal Hampshire County
Hospital, Winchester, United Kingdom
(Alishahi) Faculty of Medicine, Islamic Azad University, Tehran Medical
Branch, Tehran, Iran, Islamic Republic of
(Khanipour) Department of Internal Medicine and Cardiology, HCA Florida
Bayonet Point Hospital, University of South Florida, Hudson, FL, United
States
(Khalique) Department of Cardiology, St. Francis Hospital & Heart Center,
Roslyn, NY, United States
(May) Intermountain Heart Institute, Intermountain Medical Center, Murray,
UT, United States
(Thachil) Department of Cardiology, Elmhurst Hospital, Mount Sinai College
of Medicine, New York, NY, United States
(Iskander) Department of Cardiovascular Medicine, Medical College of
Wisconsin, Milwaukee, WI, United States
(Waheed) Department of Family and Community Medicine, Pennsylvania State
University, Hershey, PA, United States
Publisher
Oxford University Press
Abstract
Aims The impact of sex-related differences on outcomes following
transcatheter aortic valve replacement (TAVR) remains inconclusive. This
study investigates sex-related differences in survival and safety outcomes
in patients with aortic stenosis undergoing TAVR. Methods and results We
systematically searched PubMed, Embase, Scopus, and Cochrane Library until
November 2024. Individual patient data (IPD) were reconstructed from
published Kaplan-Meier curves and compared using Cox-proportional hazards
model for overall survival and cardiovascular mortality. Pooled risk
ratios (RR) for safety outcomes at 30-days and 1 year were estimated using
a random-effects model. A total of 48 studies (69 355 women and 65 580
men) were included. Meta-analysis of reconstructed IPD showed that men
were at higher risk of all-cause mortality at 5 years [hazard ratio (HR):
1.24, 95% confidence interval (CI): 1.20-1.28, P < 0.001] and
cardiovascular mortality at 4 years (HR: 1.34, 95% CI: 1.21-1.49, P <
0.001) compared with women. In random-effects meta-analysis, men faced a
higher risk of permanent pacemaker implantation (RR: 1.29, 95% CI:
1.16-1.44, P < 0.001) during the first year. Men experienced a lower risk
of stroke (RR: 0.75, 95% CI: 0.64-0.87, P < 0.001) and major vascular
complications (RR: 0.58, 95% CI: 0.49-0.69, P < 0.001) at 30 days, and a
lower risk of major bleeding (RR: 0.77, 95% CI: 0.70-0.84, P < 0.001) as
well as major vascular complications (RR: 0.54, 95% CI: 0.43-0.68, P <
0.001) within the first year. Conclusion Men demonstrated poorer 5-year
overall survival and 4-year cardiovascular survival following TAVR
compared with women. Future research with extended follow-up is needed to
understand the mechanism underlying sex-specific TAVR
outcomes. Copyright © The Author(s) 2025. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved.

<49>
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.

<50>
Accession Number
2035689837
Title
On-Table Extubation After Pediatric Cardiac Surgery: A Systematic Review.
Source
Paediatric Anaesthesia. (no pagination), 2025. Date of Publication: 2025.
Author
Tapioca V.; Caetano L.; Gibicoski T.; Alrayashi W.; Amaral S.
Institution
(Tapioca) Department of Medicine, Bahiana School of Medicine and Public
Health, Salvador, Brazil
(Caetano) Department of Medicine, Federal University of Paraiba, Joao
Pessoa, Brazil
(Gibicoski) Department of Medicine, Federal University of Health Sciences
of Porto Alegre, Porto Alegre, Brazil
(Alrayashi) Department of Anesthesiology, Harvard Medical School, Boston,
MA, United States
(Amaral) Department of Anesthesiology, Duke University Medical Center,
Durham, NC, United States
Publisher
John Wiley and Sons Inc
Abstract
Context: On-table extubation after pediatric cardiac surgery has been
increasingly considered a safe and effective strategy to reduce
postoperative ventilation time. However, concerns regarding reintubation
risk, patient selection, and variability in outcomes remain.
 Objective(s): To systematically review the available literature on
the effectiveness and safety of on-table extubation compared to off-table
extubation in pediatric cardiac surgery. Primary outcomes were
reintubation rate, mortality, intensive care unit (ICU) and hospital
length of stay (LOS). Secondary outcomes were arterial pH, lactate, and
PaCO<inf>2</inf> after surgery. Data Sources: MEDLINE, Cochrane
Library, Web of Science, and Embase were searched from inception to
January 8th, 2025, without language or date restrictions. Additional
studies were identified through the backward snowballing technique. Study
Selection: We included randomized controlled trials (RCTs) and
observational studies comparing on-table and off-table extubation in
pediatric patients (< 18 years) undergoing cardiovascular surgery. Studies
with overlapping populations or conference abstracts were excluded.
 Data Extraction: Two independent reviewers screened studies completed
a quality assessment, and extracted data. Result(s): Twenty-nine
studies (2 RCTs, 27 observational), including 9070 patients, met the
eligibility criteria. On-table extubation was associated with lower
reintubation rates in most studies, though findings were not consistent
across all. Mortality rates were generally comparable between groups. ICU
and hospital LOS were consistently shorter in the on-table group.
Postoperative blood gas analyses showed a better arterial pH, lactate, and
PaCO<inf>2</inf> profile in the on-table group. The risk of bias was
elevated between observational studies. Limitation(s): Selection bias
was present, as the majority of studies were observational, and the
decision for on-table extubation was largely based on clinician assessment
of suitability and stability at the end of surgery. High heterogeneity
across studies limited meta-analysis feasibility. Conclusion(s):
Although this systematic review suggests that on-table extubation may be
associated with potentially better outcomes following pediatric cardiac
surgery, no safe conclusions can be drawn about its benefit due to the
high heterogeneity and potential high risk of bias of most included
studies. Well-designed RCTs are needed to confirm the benefits and safety
of on-table extubation and to guide appropriate patient selection. Trial
Registration: International Prospective Register of Systematic Reviews
(PROSPERO): CRD42025644238. Copyright © 2025 John Wiley & Sons
Ltd.

<51>
[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.

<52>
Accession Number
2035650274
Title
Comparison of continuous Serratus Anterior Plane Block (cSAPB) with
bupivacaine versus single liposomal bupivacaine block in postoperative
analgesia after Video-Assisted Thoracoscopic Surgery (VATS): a randomized
controlled trial.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 399. Date
of Publication: 01 Dec 2025.
Author
Zhang M.; Zheng Z.; Xie X.; Dai Y.; Zhao M.; Gao K.; Liu S.
Institution
(Zhang, Zheng, Xie, Liu) Department of Anesthesiology, Chengdu Second
People's Hospital, Sichuan Province, Chengdu, China
(Dai) Department of Pain Clinic, School of Medicine, Sichuan Provincial
People's Hospital, University of Electronic Science and Technology of
China, Chengdu, China
(Zhao, Gao) Department of Thoracic Surgery, Chengdu Second People's
Hospital, Sichuan Province, Chengdu, China
Publisher
BioMed Central Ltd
Abstract
Background: Video-Assisted Thoracoscopic Surgery (VATS) is a commonly used
minimally invasive technique in thoracic surgery. The continuous serratus
anterior plane block (cSAPB) involves the placement of a catheter deep in
the serratus anterior fascia for the slow and continuous infusion of local
anesthetics. Liposomal bupivacaine is a formulation of bupivacaine
encapsulated in liposomes, which prolongs the release of the drug. This
study compares the impact of cSAPB with bupivacaine and single-shot SAPB
with liposomal bupivacaine on postoperative recovery quality and pain
control after VATS. Method(s): This study is a Randomized Controlled
Trial. Patients were randomly assigned to two groups: one receiving cSAPB
with conventional bupivacaine (cSAPB + CB) (n = 35) and the other
receiving SAPB with liposomal bupivacaine (SAPB + LB) (n = 35). The
primary outcome measure was the Quality of Recovery (QoR-15) scores at 24
and 48 h post-surgery. Secondary outcomes included: pain intensity
assessed using the Visual Analog Scale (VAS) pain scale at rest and during
deep breathing at 24 and 48 h postoperatively, postoperative pulmonary
function, total opioid consumption during and after surgery, and adverse
events. Result(s): QoR-15 scores were significantly elevated in the
SAPB + LB group at both 24 and 48 h post-surgery(24 h: p = 0.001; 48 h: p
= 0.02). Comparative analysis revealed no statistically significant
differences between the SAPB + CB group and the SAPB + LB group in terms
of VAS scores for pain at rest at 24 and 48 h (24 h: p = 0.06; 48 h: p =
0.46), or during deep breathing (24 h: p = 0.45; 48 h: p = 0.73).
Additionally, there were no significant differences in lung function tests
(FEV1/FVC ratio, p = 0.95), total intraoperative opioid consumption (p =
0.76), or total postoperative opioid consumption (p = 0.69). However, the
incidence of local complications such as swelling and pain was
significantly reduced in the SAPB + LB group (p = 0.03).
 Conclusion(s): The use of single liposomal bupivacaine serratus
anterior plane block provides superior early postoperative recovery
quality and reduces the incidence of local complications. Trial
registration: Chinese Clinical Trial Registry, identifier
ChiCTR2100054089, June 28,2024. Copyright © The Author(s) 2025.

<53>
Accession Number
645979408
Title
Non-Pharmacological Sleep Interventions after Cardiac Surgery: A
Systematic Review and Meta-Analysis of Randomised Controlled Trials.
Source
Journal of clinical nursing. 34(9) (pp 3785-3810), 2025. Date of
Publication: 01 Sep 2025.
Author
Lee S.; Chen P.; Park C.; Zhu B.; Balserak B.I.
Institution
(Lee) Marcella Niehoff School of Nursing, Loyola University Chicago,
Maywood, IL, United States
(Chen, Park, Balserak) College of Nursing, University of Illinois Chicago,
Chicago, IL, United States
(Zhu) School of Nursing, Shanghai Jiao Tong University, Shanghai, China
Abstract
AIM: To synthesise up-to-date research evidence for non-pharmacological
interventions to improve various sleep outcomes (e.g., sleep quality,
duration) in postsurgical cardiac patients. BACKGROUND: Sleep disturbances
are common amongst postsurgical cardiac patients, yet the effectiveness of
non-pharmacological interventions in improving various sleep outcomes has
not been comprehensively reviewed. DESIGN: A systematic review and
meta-analysis guided by the PRISMA protocol. METHOD(S): CINAHL,
PubMed, PsycINFO, Embase, Web of Science, and Cochrane Library were
searched for relevant research in May 2023. Included studies used a
randomised controlled trial design that applied a non-pharmacological
intervention for postsurgical cardiac patients and reported sleep as an
outcome. For the meta-analysis, mean effect sizes were separately
calculated for studies with regular and reverse-scored scales.
 RESULT(S): Of 37 studies included, the most common cardiac surgery
was coronary artery bypass graft. Most interventions were performed within
the first postoperative week and assessed sleep quality outcomes using the
Pittsburgh Sleep Quality Index. The interventions are categorised into
five types. Human resource-based strategies emerged as the most effective.
The meta-analysis of 27 eligible studies showed a mean effect size of 0.76
for studies with regular scoring scales and - 1.04 for those with
reverse-scored scales, indicating medium to large effect sizes.
 CONCLUSION(S): Our findings provide strong evidence that
non-pharmacological interventions, particularly human resource-based
strategies, significantly improve sleep quality in postsurgical cardiac
patients. The medium to large effect sizes underscore the clinical
significance of these findings. IMPLICATIONS: Healthcare professionals
should consider incorporating non-pharmacological interventions,
especially human resource-based strategies, in care plans for postsurgical
cardiac patients to improve sleep outcomes and promote recovery. These
interventions should be tailored to individual physical and cultural
differences for maximum effectiveness. Future research should evaluate the
long-term effects of these interventions on various sleep outcomes, using
both objective and subjective measures to provide a comprehensive
assessment of their efficacy. REPORTING METHOD: This study adheres to the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) protocol. NO PATIENT OR PUBLIC CONTRIBUTION: Patient and public
contributions were not required for this review. Copyright © 2024
The Author(s). Journal of Clinical Nursing published by John Wiley & Sons
Ltd.

<54>
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.

<55>
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.

<56>
Accession Number
2039925050
Title
Preoperative Colchicine and Conduction Disturbances After Transcatheter
Aortic Valve Implantation: A US Retrospective Cohort Analysis.
Source
Journal of the American Heart Association. 14(15) (no pagination), 2025.
Article Number: e043791. Date of Publication: 29 Jul 2025.
Author
Abdelsayed K.; Amer B.E.; Mohamed A.A.; Fouad M.; Amin A.M.; Ibrahim M.M.;
Thangjui S.; Abdelazeem B.; Balla S.; Latib A.
Institution
(Abdelsayed) Heart Rhythm Science Center, Minneapolis Heart Institute
Foundation, Minneapolis, MN, United States
(Abdelsayed) Clinical Research Department, Aswan Heart Centre, Magdi
Yacoub Foundation, Aswan, Egypt
(Amer) Faculty of Medicine, Benha University, Benha, Egypt
(Mohamed) Department of Medicine, Cardiovascular Division, University of
Minnesota Twin Cities, Minneapolis, MN, United States
(Fouad) Faculty of Medicine, Alexandria University, Alexandria, Egypt
(Amin) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Ibrahim) McLaren Health Care, Flint, MI, United States
(Ibrahim) Michigan State University, East Lansing, MI, United States
(Thangjui, Abdelazeem, Balla) Department of Cardiology, West Virginia
University, Morgantown, WV, United States
(Latib) Montefiore-Einstein Center for Heart and Vascular Care, Montefiore
Medical Center, Albert Einstein College of Medicine, Bronx, NY, United
States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Conduction disturbances are frequent complications following
transcatheter aortic valve intervention (TAVI), partially driven by
inflammation. The anti-inflammatory role of colchicine on these disorders
post TAVI has not been studied yet. Therefore, we investigated the
association between preoperative colchicine use and conduction
disturbances after TAVI. METHOD(S): We used the TriNetX platform, a
data repository of health record data from health care organizations in
the United States, to identify patients receiving any colchicine
prescription within 3months before their first TAVI and compared them to
propensity score matched patients never exposed to colchicine up to 1year
after the procedure. Primary outcomes included new-onset or worsening
atrioventricular or left bundle-branch block (LBBB) and heart block (HB)
postoperatively. Outcomes were assessed within 1 and 6months after TAVI
with an E-sensitivity analysis assessing the impact of unmeasured
confounders. RESULT(S): Of 52860 patients, 705 were on preoperative
colchicine. After matching, each group included 702 patients. Colchicine
was associated with a statistically significant reduction of new-onset or
worsening atrioventricular/left bundle-branch block and heart block post
TAVI at 1month (relative risk [RR], 0.867 [95% CI, 0.756-0.994], P=0.041;
RR, 0.887 [95% CI, 0.788-0.999], P=0.047, respectively) but not at 6months
(RR, 0.886 [95% CI, 0.779-1.077], P=0.064; RR, 0.913 [95% CI,
0.817-1.020], P=0.109, respectively). The E-value was >1.5 for the
statistically significant outcomes. CONCLUSION(S): Preoperative
colchicine was associated with a lower incidence of new-onset or worsening
atrioventricular/left bundle-branch block and heart block after TAVI at
1month. However, no significant difference was observed at 6months. Future
prospective studies are needed to evaluate the definitive role of
colchicine in improving TAVI outcomes. Copyright © 2025 The
Author(s). Published on behalf of the American Heart Association, Inc., by
Wiley. This is an open access article under the terms of the Creative
Commons Attribution-NonCommercial-NoDerivs License, which permits use and
distribution in any medium, provided the original work is properly cited,
the use is non-commercial and no modifications or adaptations are made.

<57>
Accession Number
2035662408
Title
Effect of driving pressure-guided positive end-expiratory pressure on
respiratory mechanics and clinical outcomes in surgical patients: a
systematic review and meta-analysis of randomized controlled trials.
Source
Annals of Medicine. 57(1) (no pagination), 2025. Article Number: 2543978.
Date of Publication: 2025.
Author
Sun Y.-H.; Yang X.-L.; Dong B.-B.; Liu Q.
Institution
(Sun, Yang, Dong, Liu) Department of Emergency, Emergency Intensive Care
Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou,
China
(Sun, Yang, Dong, Liu) Translational Medicine Center, The First Affiliated
Hospital of Zhengzhou University, Zhengzhou, China
(Sun) Chengguan Branch Hospital of Luanchuan County People's Hospital
Medical Community, Luoyang, China
Publisher
Taylor and Francis Ltd.
Abstract
Background: Intraoperative driving pressure-guided positive end-expiratory
pressure (PEEP<inf>dp</inf>) is effective for reducing postoperative
pulmonary complications (PPCs). However, its impact on respiratory
mechanics and clinical outcomes requires further elaboration.
 Method(s): PubMed, the Cochrane Library, Web of Science and Embase
were searched from inception to May 2024 for randomized controlled trials
(RCTs) comparing the effect of PEEP<inf>dp</inf> with conventional fixed
positive end-expiratory pressure (PEEP) in patients undergoing surgery.
The primary outcomes were the effects on the driving pressure (DP), static
respiratory compliance and plateau pressure (P<inf>plat</inf>). Secondary
outcomes included the effects on common clinical outcomes and the
incidence of PPCs. Risk ratios or mean differences were pooled using
fixed- or random-effects models. Result(s): Nineteen RCTs involving
3744 patients were included. The mean of PEEP<inf>dp</inf> was 8.2
cmH<inf>2</inf>O with 95% CI from 7 cmH<inf>2</inf>O to 9.5
cmH<inf>2</inf>O, while the median of PEEP in the conventional group was 5
cmH<inf>2</inf>O with an interquartile range of 1 cmH<inf>2</inf>O.
Patients in the PEEP<inf>dp</inf> group were ventilated with lower DP
(mean: 10 cmH<inf>2</inf>O, 95% CI [8.8, 11.1] vs. mean: 11.9
cmH<inf>2</inf>O, 95% CI [10.6, 13.3]; p < .00001), and increased
respiratory compliance (mean: 46.4 ml/cmH<inf>2</inf>O, 95% CI [42.1,
50.7] vs. mean: 39 ml/cmH<inf>2</inf>O, 95% CI [35.2, 42.8]; p < .0001)
with nonsignificant P<inf>plat</inf>. PEEP<inf>dp</inf> did not
significantly affect intensive care unit (ICU) admission, mortality or
length of hospital and ICU stay (p > .05), but it reduced the incidence of
PPCs (p = .001). The benefits were especially evident in patients
undergoing abdominal surgery, those with DP less than 10 cmH<inf>2</inf>O
or those with PEEP<inf>dp</inf> ranging from 5 to 10 cmH<inf>2</inf>O or
when PEEP<inf>dp</inf> was titrated via a stepwise increase method (p <
.05). Conclusion(s): PEEP<inf>dp</inf> allows for ventilation with
lower DP, improved static respiratory compliance and fewer PPCs. No
significant effects were observed on broader clinical outcomes per current
data. Copyright © 2025 The Author(s). Published by Informa UK
Limited, trading as Taylor & Francis Group.

<58>
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.

<59>
Accession Number
2039969332
Title
Surgical ablation in non-mitral valve cardiac surgeries: a meta-analysis
of early outcomes.
Source
Heart. (no pagination), 2025. Date of Publication: 2025.
Author
Barbosa G.S.; Katsuyama E.S.; Fukunaga C.K.; Fernandes J.M.; Coan A.C.C.;
Palatianos Y.; Fabiano R.C.; Gioli-Pereira L.; Kirov H.; Doenst T.;
Caldonazo T.
Institution
(Barbosa, Kirov, Doenst) Department of Medicine, Faculdade Santa
Marcelina, Sao Paulo, Brazil
(Katsuyama, Fukunaga) Faculdade de Medicina do ABC, Santo Andre, Brazil
(Fernandes) Department of Medicine, Albert Einstein Instituto Israelita de
Ensino e Pesquisa, Sao Paulo, Brazil
(Coan) Department of Medicine, Universidade Federal do Espirito Santo,
Vitoria, Brazil
(Palatianos) Department of Internal Medicine, Northwestern Medicine
McHenry Hospital, McHenry, IL, United States
(Fabiano) Department of Medicine, Brigham and Women's Hospital, Boston,
MA, United States
(Gioli-Pereira) Albert Einstein Israelite Hospital, Sao Paulo, Brazil
(Caldonazo) Jena University Hospital, Jena, Germany
Publisher
BMJ Publishing Group
Abstract
Background Surgical ablation (SA) is a key treatment for atrial
fibrillation (AF) patients undergoing heart surgery. However, direct
comparisons between SA and non-mitral valve (non-MV) surgery alone are
lacking. We performed a systematic review and meta-analysis comparing
concomitant SA to isolated non-MV surgery in AF patients. Methods MEDLINE,
Embase and Cochrane were searched. Outcomes of interest were: (1)
postoperative AF (POAF); (2) early all-cause mortality; (3) postoperative
pacemaker implantation and (4) stroke. Additionally, a subgroup analysis
comparing randomised controlled trials (RCTs) and propensity score-matched
studies (PSM) was conducted. Risk ratios (RRs) and their respective 95% CI
were calculated using a random effects model. Results After screening 6423
citations, we included 2 RCTs and 5 PSM studies encompassing 39 348 AF
patients undergoing non-MV surgery, of whom 18 394 (46.7%) underwent SA.
Compared with isolated non-MV surgery, SA was associated with significant
POAF reduction (RR: 0.73; 95% CI: 0.67 to 0.79; I2=0%) and
higher risk of postoperative pacemaker implantation (RR: 1.34; 95% CI:
1.14 to 1.57, I2=0%) compared with surgery alone. No
differences were found in early all-cause mortality (RR: 0.96; 95% CI:
0.76 to 1.22; I2=65%) and postoperative stroke (RR: 1.06; 95%
CI: 0.89 to 1.26; I2=0%). The subgroup analysis comparing RCTs
and PSM showed significant consistency among the different designs.
Conclusions In this meta-analysis, SA was associated with POAF reduction
in non-MV surgery. In terms of safety, it was suggested that although no
difference in early mortality and postoperative stroke was observed, SA
had a higher risk of pacemaker implantation than isolated non-MV
surgery. Copyright © Author(s) (or their employer(s)) 2025. No
commercial re-use. See rights and permissions. Published by BMJ Group.

<60>
Accession Number
2037620716
Title
Polymer-free sirolimus- and probucol-eluting stents versus durable
polymer-based everolimus-eluting stents for percutaneous coronary
revascularization: A prospective multicenter randomized clinical trial.
Source
Journal of Cardiology. 86(2) (pp 148-154), 2025. Date of Publication: 01
Aug 2025.
Author
Ikuta A.; Yajima J.; Okazaki S.; Yonetsu T.; Ando J.; Takamisawa I.; Ito
Y.; Saito S.; Sakurada M.; Yoshida Y.; Ozaki Y.; Amano T.; Fujii K.; Shite
J.; Ono K.; Nakamura S.; Takaya T.; Hirohata A.; Kishi K.; Ando K.;
Kawasaki T.; Shibata Y.; Kozuma K.; Ikari Y.; Ueno T.; Muramatsu T.; Hibi
K.; Morino Y.; Kadota K.
Institution
(Ikuta, Kadota) Department of Cardiovascular Medicine, Kurashiki Central
Hospital, Kurashiki, Japan
(Yajima) Department of Cardiovascular Medicine, The Cardiovascular
Institute, Tokyo, Japan
(Okazaki) Department of Cardiovascular Biology and Medicine, Juntendo
University Graduate School of Medicine, Tokyo, Japan
(Yonetsu) Department of Cardiovascular Medicine, Tokyo Medical and Dental
University, Tokyo, Japan
(Ando) Department of Cardiovascular Medicine, The University of Tokyo
Hospital, Tokyo, Japan
(Takamisawa) Hypertrophic Cardiomyopathy Center, Sakakibara Heart
Institute, Tokyo, Japan
(Ito) Division of Cardiology, Saiseikai Yokohama City Eastern Hospital,
Kanagawa, Japan
(Saito) Department of Cardiology, Shonan Kamakura General Hospital,
Kamakura, Japan
(Sakurada) Department of Cardiology, Tokorozawa Heart Center, Saitama,
Japan
(Yoshida) Department of Cardiology, Nagoya Daini Red Cross Hospital,
Nagoya, Japan
(Ozaki) Department of Cardiology, Fujita Health University Okazaki Medical
Center, Aichi, Japan
(Amano) Department of Cardiology Aichi Medical University Aichi, Japan
(Fujii) Department of Cardiology, Sakurabashi Watanabe Hospital, Osaka,
Japan
(Shite) Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka,
Japan
(Ono) Department of Cardiovascular Medicine, of Medicine, Kyoto
University, Kyoto, Japan
(Nakamura) Department of Cardiology, Kyoto Katsura Hospital, Kyoto, Japan
(Takaya) Division of Cardiovascular Medicine, Hyogo Prefectural
Harima-Himeji General Medical Center, Himeji, Japan
(Hirohata) Department of Cardiology, Sakakibara Heart Institute of
Okayama, Japan
(Kishi) Department of Cardiology, Tokushima Red Cross Hospital, Tokushima,
Japan
(Ando) Department of Cardiology, Kokura Memorial Hospital, Kitakyushu,
Japan
(Kawasaki) Department of Cardiology, Tenjinkai Shin-Koga Hospital, Kurume,
Japan
(Shibata) Department of Cardiology, Miyazaki Medical Association Hospital,
Miyazaki, Japan
(Kozuma) Department of Cardiology, Teikyo University Hospital, Tokyo,
Japan
(Ikari) Department of Cardiology, Tokai University School of Medicine,
Kanagawa, Japan
(Ueno) Department of Cardiovascular Medicine, Marine Hospital, Fukuoka,
Japan
(Muramatsu) Department of Cardiology, Tokyo Heart Center, Tokyo, Japan
(Hibi) Division of Cardiology, Yokohama City University Medical Center,
Yokohama, Japan
(Morino) Division of Cardiology, Department of Internal Medicine, Iwate
Medical University, Japan
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background: Owing to the advent of new generation drug-eluting stents,
percutaneous coronary intervention (PCI) outcomes are improving. However,
the polymers, which have been the most common type of coatings used in
drug-eluting stents, have some issues. The study aim was to evaluate the
clinical outcomes of patients undergoing PCI with polymer-free sirolimus-
and probucol-eluting stents (NP023). Method(s): This clinical trial
was a prospective multicenter single-blind noninferiority randomized study
performed at 22 hospitals in Japan. We randomly assigned patients in a 2:1
ratio to undergo PCI with either NP023 or durable polymer-based
everolimus-eluting stents (control stents) with a 5-year follow-up. The
primary outcome was freedom from target lesion failure (TLF) at 9 months,
defined as patient-oriented composite of cardiac death, ischemia-driven
target vessel-related myocardial infarction, or ischemia-driven target
lesion revascularization. The secondary outcome included adverse outcomes
at 5 years following the index procedure. Result(s): Overall, 432
patients (463 lesions) were treated at 22 sites in Japan [mean age, 68
years; males, 345 (80 %); chronic coronary artery diseases, 322 (74.5 %)].
Of the participants, 91 % completed the 5-year follow-up. The Kaplan-Meier
estimates of the percentages of patients who were free from TLF were 95.8
% and 97.3 % with NP023 and control stents, respectively (hazard ratio,
0.98; 95 % confidential interval, 0.80-1.21; p < 0.01 for noninferiority).
At the 5-year follow-up, the secondary endpoint for safety was not
different between the two groups. Conclusion(s): The results of this
study showed similar outcomes for polymer-free sirolimus- and
probucol-eluting stents and durable polymer-based everolimus-eluting
stents regarding freedom from TLF at 9 months and other outcomes at 5
years among patients undergoing PCI. Copyright © 2025

<61>
Accession Number
2039919169
Title
Oxidized phospholipid dynamics in the early post-infarction period:
Effects of PCSK9 inhibition with evolocumab.
Source
Atherosclerosis. 409 (no pagination), 2025. Article Number: 120469. Date
of Publication: 01 Oct 2025.
Author
Atallah M.; Harb T.; Nasrallah N.; Jones S.R.; Gerstenblith G.; Tsimikas
S.; Leucker T.M.
Institution
(Atallah, Harb, Nasrallah, Jones, Gerstenblith, Leucker) Division of
Cardiology, Department of Medicine, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
(Tsimikas) Division of Cardiology, Department of Medicine, University of
California San Diego, La Jolla, CA, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background and aims: The peri- and early post-infarction period carries an
increased risk of recurrent ischemic events. Oxidized phospholipids
(OxPLs) are pro-inflammatory and contribute to plaque instability and
thrombosis. This study aimed to: (1) assess changes, during the early
post-MI period in OxPL-apo(a) and OxPL-apoB, (2) evaluate the effect of
PCSK9 inhibition on these changes, and (3) explore their relationships
with the changes in Lp(a) and LDL-C. Method(s): Ninety-six
participants with NSTEMI or STEMI were randomized to receive placebo (n =
48) or 420 mg subcutaneous evolocumab (n = 48) within 24 h of admission.
OxPL-apo(a), OxPL-apoB, Lp(a), and LDL-C levels were measured at baseline
and 30 days post-MI. Result(s): In the placebo group, OxPL-apo(a)
increased from 52.6 [19.3, 106.5] nmol/L at baseline to 61.7 [31.5, 116.9]
nmol/L at 30 days (p = 0.014), and OxPL-apoB rose from 6.7 [3.1, 21]
nmol/L to 8.8 [3.7, 23] nmol/L (p = 0.0045). In contrast, no significant
changes were observed for OxPL-apo(a) (p = 0.17) or OxPL-apoB (p = 0.058)
in the evolocumab group. OxPL-apo(a) correlated strongly with Lp(a) at
baseline (r = 0.93, p < 0.001) and 30 days (r = 0.94, p < 0.001), and
OxPL-apoB correlated similarly (baseline: r = 0.92, p < 0.001; 30 days: r
= 0.93, p < 0.001). No correlation was observed between OxPLs and LDL-C.
 Conclusion(s): OxPL-apo(a) and OxPL-apoB levels were strongly
correlated with Lp(a) and increased during the early post-infarction
period. This increase was prevented by in-hospital administration of a
PCSK9 inhibitor. These findings provide new insights into early changes in
OxPLs following acute MI and suggest a protective role for PCSK9
inhibition during this critical period. Copyright © 2025 The
Authors

<62>
Accession Number
2035665985
Title
Optimizing Culotte Technique With Double Kissing Balloon Inflation.
Source
Journal of Cardiovascular Translational Research. (no pagination), 2025.
Date of Publication: 2025.
Author
Serter B.; Akman C.; Uysal H.; Dogan A.; Guner A.
Institution
(Serter, Akman, Uysal, Dogan, Guner) Department of Cardiology, Istanbul
Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and
Research Hospital, Turgut Ozal Bulvari No:11, Kucukcekmece, Istanbul,
Turkey
Publisher
Springer

<63>
[Use Link to view the full text]
Accession Number
2039994846
Title
Effectiveness and Safety of Enhanced Postoperative Care Units for
Noncardiac, Non-Neurological Surgery: A Systematic Review.
Source
A and A Practice. 19(8) (pp e02008), 2025. Date of Publication: 01 Aug
2025.
Author
Tran L.; Stern C.; Harford P.; Ludbrook G.; Whitehorn A.
Institution
(Tran, Stern, Harford, Whitehorn) JBI, Faculty of Health and Medical
Sciences, School of Public Health, University of Adelaide, Adelaide, SA,
Australia
(Tran, Harford, Ludbrook) Department of Anaesthesia, Central Adelaide
Local Health Network, Adelaide, SA, Australia
(Tran) Department of Anaesthesia, Flinders Medical Centre, Southern
Adelaide Local Health Network, Adelaide, SA, Australia
(Ludbrook) Discipline of Acute Care Medicine, The University of Adelaide,
Adelaide, SA, Australia
Publisher
Wolters Kluwer Health
Abstract
High rates of postoperative deterioration among certain patient groups on
general surgical wards have driven interest in high-acuity postoperative
care facilities, which provide an intermediate level of care between
standard surgical wards and intensive care units (ICUs). These facilities,
nominally termed enhanced postoperative care units (EPCUs), provide many
key critical care elements outside the ICU, including increased
nurse-to-patient ratios, specialized medical personnel, and critical care
interventions, such as vasopressor therapy. While the current organization
and terminology of these units vary widely, emerging evidence suggests
they may have a clinical impact, especially within anesthesia-led models,
though research remains limited. This review aimed to assess existing
literature on the effectiveness and safety of EPCUs on patient and health
service outcomes in adults after noncardiac, non-neurological surgery. The
Cochrane Library, MEDLINE, Embase, and Scopus were searched from 2010 to
April 2025. Inclusion criteria included adult patients undergoing any
noncardiac, non-neurological surgery admitted to an EPCU. Experimental,
quasi-experimental and observational study designs were eligible. Two
reviewers assessed titles, abstracts and full-text papers against
inclusion criteria, evaluated the risk of bias using JBI standardized
instruments, and applied the GRADE approach to assess the certainty of
evidence. Due to clinical and methodological heterogeneity, a
meta-analysis was not possible, and a narrative synthesis is provided.
From 9774 records, 13 reports from 12 studies met the inclusion criteria.
The narrative synthesis showed that while some studies observed positive
effects in favor of the intervention, the overall findings were mixed. Two
studies reported a statistically significant decrease in 30-day mortality
in favor of EPCUs compared to usual care. One study reported a
statistically significant increase in days at home at 30 days for patients
admitted to an EPCU. Three studies found that EPCU admission had a
statistically significant positive effect on hospital length of stay. The
included studies had low to moderate risk of bias, with small sample sizes
and an overall very low certainty of evidence. Current evidence is
insufficient to definitively establish the effectiveness and safety of
EPCUs after noncardiac, non-neurological surgery. Only a small number of
studies were identified, with considerable clinical and methodological
heterogeneity among the studies. Although the current research is not yet
comprehensive, the initial findings suggest potential benefits of EPCUs in
this patient population that warrant further consideration and
exploration. Additional high-quality research is needed, and any expansion
of EPCUs should proceed cautiously with thorough evaluation to ensure
effectiveness and safety. Copyright © 2025 International
Anesthesia Research Society. Unauthorized reproduction of this article is
prohibited.

<64>
Accession Number
2040018293
Title
Feasibility of coronary access after transcatheter aortic valve
implantation (TAVI): a systematic review and meta-analysis of
observational studies.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 11(5) (pp
565-579), 2025. Date of Publication: 01 Aug 2025.
Author
Giacobbe F.; Morena A.; Bruno F.; Nebiolo M.; De Filippo O.; Odeh Y.; Di
Pietro G.; Cabau J.R.; Conrotto F.; Kini A.; Giannino G.; Latib A.; Omede
P.; Noble S.; La Torre M.W.; Barbanti M.; Tarantini G.; Kim W.-K.;
Blumenstein J.; Boukantar M.; Htun W.W.; De Ferrari G.M.; Salizzoni S.;
D'Ascenzo F.
Institution
(Giacobbe, Morena, Bruno, Nebiolo, De Filippo, Odeh, Conrotto, Giannino,
Omede, De Ferrari, D'Ascenzo) Division of Cardiology, Cardiovascular and
Thoracic Department, Citta della Salute e della Scienza, Corso Bramante
88, Turin, Italy
(Giacobbe, Morena, Nebiolo, Odeh, Giannino, De Ferrari, D'Ascenzo)
Division of Cardiology, Department of Medical Sciences, University of
Turin, Italy
(Di Pietro) Department of Clinical, Internal, Anesthesiology and
Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
(Cabau) Quebec Heart & Lung Institute, Laval University, Quebec City, QC,
Canada
(Kini) Division of Cardiology, Mount Sinai Medical Center, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Latib) Montefiore-Einstein Center for Heart and Vascular Care, Montefiore
Medical Center, Albert Einstein College of Medicine, Bronx, NY, United
States
(Noble) Cardiology Division, University Hospital of Geneva, Switzerland
(La Torre, Salizzoni) Division of Cardiac Surgery, Cardiovascular and
Thoracic Department, Citta della Salute e della Scienza, Turin, Italy
(Barbanti) Universita degli Studi di Enna "Kore", Enna, Italy
(Tarantini) Cardiology Clinic, Department of Cardiac, Thoracic, and
Vascular Sciences and Public Health Padova, University of Padua, Italy
(Kim, Blumenstein) Department of Cardiology, Kerckhoff Heart and Thorax
Center, Bad Nauheim, Germany
(Boukantar) Department of Cardiovascular, Henri Mondor University
Hospital, Creteil, France
(Htun) Department of Cardiology, Detroit Medical Center, Wayne State
University, Detroit, MI, United States
(Htun) Department of Cardiothoracic Surgery, Northwell Health, Lenox Hill
Hospital, NY, United States
Publisher
Oxford University Press
Abstract
Introduction The expanding indications for transcatheter aortic valve
implantation (TAVI) to younger, lower-risk patients, entails assessing not
only the short-term clinical outcomes but also the long-term
considerations for future interventions. The prevalence of coronary artery
disease in TAVI patients is relevant, and the optimal timing of
percutaneous coronary intervention remains a question. Methods and result
We conducted a systematic literature review and meta-analysis including 20
eligible studies involving 1660 patients who underwent coronary
angiography after TAVI. The primary endpoint was the incidence of
successful selective coronary re-access. Secondary endpoints included
semi-selective and non-selective access rates. The analysis was stratified
by balloon-expandable (BEVs) and self-expandable valve (SEVs) types.
Successful coronary access after TAVI was feasible in the majority of
patients, with a higher success rate observed for the left main (LM)
compared to the right coronary artery (RCA). BEVs demonstrated the highest
success rates in coronary ostia cannulation, achieving nearly 100% success
for both LM and RCA. Among SEVs, the Acurate Neo and Evolut R/PRO showed
superior success rates in selective coronary access (68 and 77% for LM; 57
and 72% for RCA, respectively) compared to the CoreValve (46% for LM and
49% for RCA). Notably, the majority of coronary angiograms were performed
due to acute coronary syndrome, primarily non-ST-segment elevation
myocardial infarction, and unstable angina. Selective coronary engagement
after TAVI is generally achievable, with BEVs demonstrating superior
success rates compared to SEVs. Among SEVs, the Acurate NEO showed better
outcomes than the other types. Copyright © The Author(s) 2025.
Published by Oxford University Press on behalf of the European Society of
Cardiology.

<65>
Accession Number
2039879241
Title
Long-term effect of biodegradable vs. durable polymer everolimus-eluting
stents on neoatherosclerosis in ST-segment elevation myocardial
infarction: the CONNECT trial.
Source
European Heart Journal. 46(29) (pp 2906-2916), 2025. Date of Publication:
01 Aug 2025.
Author
Taniwaki M.; Haner J.D.; Kakizaki R.; Ohno Y.; Yahagi K.; Higuchi Y.;
Siontis G.C.M.; Ando K.; Stortecky S.; Suzuki N.; Morf L.; Watanabe N.;
Lanz J.; Ueki Y.; Otsuka T.; Biccire F.G.; Sakurada M.; Losdat S.; Raber
L.
Institution
(Taniwaki, Sakurada) Department of Cardiology, Tokorozawa Heart Center,
Saitama, Japan
(Haner, Kakizaki, Siontis, Stortecky, Morf, Lanz, Biccire, Raber)
Department of Cardiology, Bern University Hospital, Inselspital,
University of Bern, Freiburgstrasse 18, Bern, Switzerland
(Ohno) Department of Cardiology, Tokai University, School of Medicine,
Isehara, Japan
(Yahagi) Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan
(Higuchi) Cardiovascular Division, Osaka Police Hospital, Osaka, Japan
(Ando) Department of Cardiology, Kokura Memorial Hospital, Fukuoka, Japan
(Suzuki) Division of Cardiology, Teikyo University, Mizonokuchi Hospital,
Kawasaki, Japan
(Watanabe) Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan
(Ueki) Department of Cardiovascular Medicine, Shinshu University, School
of Medicine, Nagano, Japan
(Otsuka) Department of Cardiology, Itabashi Chuo Medical Center, Tokyo,
Japan
(Losdat) CTU Bern, Department of Clinical Research, University of Bern,
Bern, Switzerland
Publisher
Oxford University Press
Abstract
Background and Aims Neoatherosclerosis is a leading cause of late (>1
year) stent failure following drug-eluting stent implantation. The role of
biodegradable (BP) vs. durable polymer (DP) drug-eluting stents on
long-term occurrence of neoatherosclerosis remains unclear. Superiority of
biodegradable against durable polymer current generation thin-strut
everolimus-eluting stent (EES) was tested by assessing the frequency of
neoatherosclerosis 3 years after primary percutaneous coronary
intervention (pPCI) among patients with ST-segment elevation myocardial
infarction (STEMI). Methods The randomized controlled, multicentre (Japan
and Switzerland) CONNECT trial (NCT03440801) randomly (1:1) assigned 239
STEMI patients to pPCI with BP-EES or DP-EES. The primary endpoint was the
frequency of neoatherosclerosis assessed by optical coherence tomography
(OCT) at 3 years. Neoatherosclerosis was defined as fibroatheroma or
fibrocalcific plaque or macrophage accumulation within the neointima.
Results Among 239 STEMI patients randomized, 236 received pPCI with stent
implantation (119 BP-EES; 117 DP-EES). A total of 178 patients (75%; 88 in
the BP-EES group and 90 in the DP-EES group) underwent OCT assessment at 3
years. Neoatherosclerosis did not differ between the BP-EES (11.4%) and
DP-EES (13.3%; odds ratio 0.83, 95% confidence interval 0.33-2.04, P =.
69). There were no differences in the frequency of fibroatheroma (BP-EES
9.1% vs. DP-EES 11.1%, P =. 66) or macrophage accumulation (BP-EES 4.5%
vs. DP-EES 3.3%, P =. 68), and no fibrocalcific neoatherosclerosis was
observed. Rates of target lesion failure did not differ between groups
(BP-EES 5.9% vs. DP-EES 6.0%, P =. 97). Conclusions The use of BP-EES for
primary PCI in patients presenting with STEMI was not superior to DP-EES
regarding frequency of neoatherosclerosis at 3 years. Copyright ©
2024 The Author(s). Published by Oxford University Press on behalf of the
European Society of Cardiology. All rights reserved.

<66>
Accession Number
2035659617
Title
Nitric oxide for the prevention of postoperative acute kidney injury in
patients undergoing surgery for Stanford type A aortic dissection: study
protocol for a randomized controlled trial.
Source
Trials. 26(1) (no pagination), 2025. Article Number: 284. Date of
Publication: 01 Dec 2025.
Author
Chen Z.; Han X.; Li L.; Liu M.; Yu L.; Cheng S.; Yu Y.; Liu N.
Institution
(Chen, Li, Liu, Yu, Cheng, Yu, Liu) Center for Cardiac Intensive Care,
Beijing Anzhen Hospital, Capital Medical University, Beijing, China
(Han) Department of Emergency, University of Health and Rehabilitation
(Qingdao Municipal Hospital), Qingdao, Qingdao Hospital, China
Publisher
BioMed Central Ltd
Abstract
Background: Acute kidney injury (AKI) is a frequent and serious
complication following surgery for acute type A aortic dissection (ATAAD).
Nitric oxide (NO) may reduce AKI incidence through renal-protective
mechanisms, but evidence in the ATAAD population remains limited. This
trial aims to evaluate whether perioperative administration of NO can
reduce the incidence of postoperative AKI in this population.
 Method(s): This single-center, randomized, parallel-group superiority
trial will enroll 106 adult patients undergoing ATAAD emergency surgery.
Participants will be randomly allocated in a 1:1 ratio to either receive
60 parts per million of NO during cardiopulmonary bypass and for 12 h
post-surgery, or to receive standard care without NO. The primary outcome
is AKI incidence within 48 h postoperatively, defined by Kidney Disease:
Improving Global Outcomes (KDIGO) criteria. Secondary outcomes include AKI
severity, urine output, vasoactive-inotropic score, neutrophil
gelatinase-associated lipocalin levels, sequential organ failure
assessment score, ventilator support duration, intensive care unit (ICU)
and hospital length of stay, and major adverse kidney events, cumulative
mediastinal and pericardial drainage volume. Discussion(s): This
trial will evaluate whether perioperative NO administration can reduce
early AKI and improve renal and clinical outcomes in high-risk ATAAD
patients. Findings may provide evidence for a novel nephroprotective
strategy in aortic surgery. Trial registration: ClinicalTrials.gov
NCT06622291. Registered on June 26, 2024. Copyright © The
Author(s) 2025.

<67>
Accession Number
2037015708
Title
The effect of reflexology on blood pressure and heart rate in
cardiovascular patients: a meta-analysis study.
Source
Revista da Associacao Medica Brasileira. 71(7) (no pagination), 2025.
Article Number: e20250059. Date of Publication: 2025.
Author
Camci G.; Bayrak B.
Institution
(Camci) Marmara University, Faculty of Health Sciences, Department of
Nursing, Department of Internal Medicine Nursing, Istanbul, Turkey
(Bayrak) Suleyman Demirel University, Faculty of Health Sciences,
Department of Nursing, Department of Internal Medicine Nursing, Isparta,
Turkey
Publisher
Associacao Medica Brasileira
Abstract
OBJECTIVE: The aim of the study was to conduct a meta-analysis of studies
on the effect of reflexology on blood pressure and heart rate in patients
with cardiovascular disease. METHOD(S): The study collected data from
PubMed, ScienceDirect, MEDLINE, Web of Science, Google Scholar, and
Cochrane Library databases. The study had randomized-controlled,
non-randomized-controlled, and quasi-experimental designs. Patients aged
>18 years with coronary artery disease, coronary angiography, percutaneous
coronary intervention, open-heart surgery, or coronary bypass were
included. All analyses were performed using Comprehensive Meta-Analysis.
 RESULT(S): This study included 1,041 patients aged 18-75 years from
12 studies. According to the random-effects model, reflexology
significantly reduced systolic blood pressure (95%CI, Hedges' g=-0.41,
Z=-2.27, p=0.02) and diastolic blood pressure (95%CI, Hedges' g=-0.38,
Z=-2.69, p=0.01). However, reflexology did not affect the heart rate
(95%CI, Hedges' g=0.16, Z=-1.54, p=0.12). CONCLUSION(S): The results
suggest that reflexology has a positive effect on the systolic and
diastolic blood pressures of cardiovascular patients, but no significant
effect on the heart rate was observed. Copyright © 2025,
Associacao Medica Brasileira. All rights reserved.

<68>
Accession Number
2040152425
Title
Response to letter to the editor: "Prevalence of postoperative
neurocognitive disorders in older non-cardiac surgical patients: A
systematic review and meta-analysis".
Source
Journal of Clinical Anesthesia. 106 (no pagination), 2025. Article Number:
111973. Date of Publication: 01 Sep 2025.
Author
Huang W.W.Y.; Fan S.; Li W.-Y.; Thangavelu V.; Saripella A.; Englesakis
M.; Yan E.; Chung F.
Institution
(Huang) School of Medicine, University of Limerick, Limerick, Ireland
(Fan) Schulich School of Medicine and Dentistry, Western University,
London, ON, Canada
(Li, Saripella, Yan, Chung) Department of Anesthesia and Pain Management,
Toronto Western Hospital, University Health Network, University of
Toronto, ON, Canada
(Thangavelu, Yan, Chung) Institute of Medical Science, Temerty Faculty of
Medicine, University of Toronto, ON, Canada
(Englesakis) Library & Information Services, University Health Network,
Toronto, ON, Canada
Publisher
Elsevier Inc.

<69>
Accession Number
2035808896
Title
Optimizing antithrombotic therapy following mitral valve repair: a
comprehensive network meta-analysis.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
628. Date of Publication: 01 Dec 2025.
Author
Gbreel M.I.; Elkasaby M.H.; Hassan M.; Becher M.U.; Balata M.
Institution
(Gbreel) Faculty of Medicine and Surgery, October 6 University, Giza,
Egypt
(Gbreel) Department of Cardiology, Epyptian Railway Medical Centre (ERMC),
Cairo, Egypt
(Elkasaby) Faculty of Medicine and Surgery, Al-Azhar University, Cairo,
Egypt
(Hassan) Department of Immunology, Theodor Bilharz Research Institute,
Giza, Egypt
(Becher) Department of Cardiology, Stadtisches Klinikum Solingen,
Solingen, Germany
(Balata) Department of cardiology, University hospital Rostock, Rostock,
Germany
Publisher
BioMed Central Ltd
Abstract
Background: Mitral regurgitation (MR) presents either as primary or
secondary, with options for surgical or transcatheter repair.
Thromboembolic risks following surgery are significant despite the use of
antithrombotic medications, and guidelines for postoperative
anticoagulation therapy lack consistency. This systematic review aims to
compare antithrombotic medications after mitral valve repair (MVR). In
this study, we intend to compare antithrombotic medications after MVR.
 Material(s) and Method(s): The study followed the Cochrane handbook
and PRISMA guidelines. We systematically searched databases (PubMed,
Scopus, Ovid, Cochrane, Web of Science) until June 2024 for TMVR studies
using specific criteria. Quality assessment utilized the Newcastle-Ottawa
scale. Data extraction encompassed study characteristics and outcomes.
Primary outcomes included thromboembolic events and bleeding within six
months. Statistical analysis employed R software to assess heterogeneity
and publication bias. Result(s): From the 121 articles screened, 12
were included in the study. These cohort studies, involving 20,644
participants, spanned from 2008 to 2022. While most studies were of good
to high quality, some exhibited lower quality. Analysis favored oral
anticoagulants (OAC) over single antiplatelet therapy (SAPT) for reducing
bleeding risk (RR = 0.31, 95% CI: [0.11-0.87], P < 0.05), with moderate
heterogeneity. Thromboembolic events did not significantly differ among
interventions. Transient ischemic attacks and stroke outcomes were similar
between SAPT and vitamin K antagonists (VKA). Six-month mortality rates
were comparable between SAPT and VKA, with notable heterogeneity and
higher mortality with SAPT in one study. Qualitative synthesis highlighted
procedural success rates and bleeding complications across different
interventions in transcatheter mitral valve repair studies.
 Conclusion(s): OACs showed a lower risk of bleeding compared to
antiplatelet therapies, while VKAs and OAC + SAPT may reduce
thromboembolic events. No significant differences were found in stroke,
TIA, or short-term mortality. These findings support individualized
therapy and highlight the need for further randomized
trials. Copyright © The Author(s) 2025.

<70>
Accession Number
2035790658
Title
Tricuspid transcatheter edge-to-edge repair versus surgery for tricuspid
regurgitation: a systematic review and meta-analysis.
Source
Expert Review of Cardiovascular Therapy. (no pagination), 2025. Date of
Publication: 2025.
Author
Penteris M.; Lampropoulos K.
Institution
(Penteris) Department of Medicine, Democritus University of Thrace,
Alexandroupolis, Greece
(Lampropoulos) School of Medicine, European University of Cyprus, Nicosia,
Cyprus
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: To perform a systematic review and meta-analysis to compare
the safety, early and late mortality, morbidity and long-term function of
the tricuspid valve (TV) following tricuspid transcatheter edge-to-edge
repair (T-TEER) compared to surgical tricuspid valve (TV)
repair/replacement (TVR) for tricuspid regurgitation (TR). Method(s):
This review investigates through two different databases for original
studies that evaluated patients with TR who underwent either T-TEER or TVR
was until December 2024. The outcomes of interest were safety, morbidity,
mortality and long-term function following T-TEER vs TVR. Result(s):
We identified three retrospective observational studies, including a total
of 1612 patients with TR. Short-term (OR, 0.36; 95% CI, 0.13-1.04; p =
0.06) and long-term mortality was similar between T-TEER and TVR. There
was a lower risk of acute kidney injury (AKI) (OR, 0.31; 95% CI,
0.23-0.43; p < 0.00001) and permanent pacemaker implantation (PPI) (OR,
0.19; 95% CI, 0.10-0.35; p < 0.00001) with T-TEER, while there was no
significant difference in terms of stroke events (OR, 1.17; 95% CI,
0.68-2.01; p = 0.58) and risk of bleeding (OR, 0.81; 95% CI, 0.45-1.44; p
= 0.47) compared to TVR. Conclusion(s): In conclusion, T-TEER appears
to have a comparable safety profile to TVR with a lower risk of AKI and
PPI. However, these findings are based on limited observational data and
should be interpreted as hypothesis-generating rather than conclusive.
Registration: This systematic review and meta-analysis was prospectively
registered on the international prospective register of systematic reviews
(PROSPERO; CRD42024622555). Copyright © 2025 Informa UK Limited,
trading as Taylor & Francis Group.

<71>
Accession Number
2040108019
Title
Long-term outcome of surgery for lung cancer in Africa: a systematic
review and meta-analysis.
Source
ecancermedicalscience. 19 (no pagination), 2025. Article Number: 1951.
Date of Publication: 2025.
Author
Gift A.B.; Otorkpa M.J.; Olayode O.O.; Joseph E.D.; Abdulhakeem A.;
Nchonganyi E.J.P.; Anele F.C.; Habib A.A.; Ghislain F.S.; Akintoye O.O.;
Benjamin O.
Institution
(Gift, Otorkpa, Olayode, Joseph, Abdulhakeem, Nchonganyi, Anele, Habib,
Ghislain, Akintoye, Benjamin) Cardiothoracic Surgery, Surgery Interest
Group of Africa, Lagos, Nigeria
Publisher
ecancer Global Foundation
Abstract
Background: Lung cancer is the leading cause of cancer death worldwide,
with an estimated 1.8 million deaths in 2020. Despite the advancement of
new treatment strategies that have emerged over time, surgery remains a
very important aspect of cancer treatment. This study aims to highlight
the long-term outcomes of surgery as well as the healthcare gaps in the
diagnosis and treatment of Lung cancer in Africa by providing a
comprehensive systematic review and meta-analysis. Method(s): This
systematic review was conducted using database searches from PubMed and
Google Scholar to identify published data reporting on the surgical
outcomes of lung cancer in Africa from inception till August 2024. We
followed the Preferred Reporting Items for Systematic Reviews and
Meta-Analysis guidelines to conduct this study. The primary outcomes of
interest were overall mortality, 1- and 5-year survival rates, metastasis,
morbidity and recurrence. Data were pooled together and analysed using a
random-effect model for meta-analysis with R software. Out of a total of
381 articles identified, only eight papers met our inclusion criteria
following deduplication and screening. The five countries with published
research on our topic include Egypt, Kenya, Tunisia, Nigeria and Morocco,
with a total sample size of 2150 patients. Result(s): The
meta-analysis of the reported outcomes produced an overall mortality rate
of 27%, a 1-year survival rate of 56%, a 5-year survival rate of 13%,
metastases of 76.9%, morbidity of 7.7% and recurrence of 11.4%.
 Conclusion(s): The burden of lung cancer is relatively high across
the African continent, with surgical treatment significantly underutilised
due to several factors, including an inadequate number of skilled
healthcare workers, limited cardiothoracic surgical services and the
advanced stage at which most patients present. Nevertheless, there is room
for improvement by addressing these gaps through targeted investments in
cardiothoracic surgical training, research and infrastructure, alongside
increased awareness of lung cancer and the benefits of screening services
across Africa. These measures, combined with joint international and
governmental funding efforts, could significantly improve survival
outcomes. Copyright © the authors; licensee
ecancermedicalscience.

<72>
Accession Number
2040124339
Title
A Single-blind, Randomized Controlled Trial Comparing Postoperative
Analgesic Effects of Superficial and Deep Parasternal Intercostals Blocks
in Patients Undergoing Coronary Artery Bypass Grafting Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Korkmaz Toker M.; Yazman S.; Altiparmak B.; Uysal A.I.; Harmandar B.
Institution
(Korkmaz Toker, Altiparmak) Department of Anesthesiology and Reanimation,
Mugla Sitki Kocman University, Mugla, Turkey
(Yazman, Harmandar) Department of Cardiovascular Surgery, Mugla Sitki
Kocman University, Mugla, Turkey
(Uysal) Department of Anesthesiology and Reanimation, Mugla Training and
Research Hospital, Mugla, Turkey
(Korkmaz Toker) Anesteziyoloji ve Reanimasyon A.D., Kotekli Mah, Mugla
Sitki Kocman Universitesi Tip Fakultesi, Merkez, Mugla, Turkey
Publisher
W.B. Saunders
Abstract
Objective: To compare the analgesic efficacy of anesthesiologist-performed
ultrasound-guided superficial parasternal intercostal plane block (SPIPB)
and surgeon-performed deep parasternal intercostal plane block (DPIPB) in
patients undergoing coronary artery bypass grafting (CABG) via median
sternotomy. Design(s): A prospective, randomized, single-blind
clinical trial. Setting(s): A single, tertiary care university
hospital. Participant(s): Seventy-five participants (aged 45-80
years, ASA III-IV) scheduled for elective isolated CABG surgery.
 Intervention(s): Participants were randomly assigned to the SPIPB,
DPIPB, or control groups. Regional blocks were performed either under
ultrasound guidance after sternal closure and sterilization of the
surgical site (SPIPB) or intraoperatively under direct vision (DPIPB).
Postoperative pain was managed with multimodal analgesia protocols.
 Measurements and Main Results: Outcomes included pain scores and
tramadol administration at the 1st, 4th, 12th, and 24th postoperative
hours, as well as after extubation. The cumulative 24-hour tramadol
administration (primary outcome) was significantly lower in the DPIPB
group (95 +/- 44 mg) compared with the SPIPB (141 +/- 58 mg) and control
groups (176 +/- 61 mg) (p < 0.001). Compared with the control group, the
DPIPB group had a significantly reduced likelihood of requiring high-dose
tramadol (odds ratio [OR]: 0.18, 95% confidence interval [CI]: 0.06-0.56,
p = 0.003). The SPIPB group showed an intermediate effect compared with
control (OR: 0.52, 95% CI: 0.23-1.18, p = 0.095). When directly compared,
DPIPB was associated with significantly lower tramadol use than SPIPB (OR:
0.34, 95% CI: 0.16-0.72, p < 0.001). Pain scores at all time points were
significantly lower in both block groups compared with control (p < 0.05),
with DPIPB showing the most pronounced effect. No block-related
complications were observed. Conclusion(s): Both parasternal
intercostal blocks improved postoperative analgesia compared with standard
care. The SPIPB was performed under ultrasound guidance, whereas the DPIPB
was applied under direct vision by the surgeon. The DPIPB demonstrated
superior opioid-sparing effects and improved dynamic pain control. These
findings support the use of parasternal fascial plane blocks, whether
performed under ultrasound guidance or direct vision, as effective
components of multimodal analgesia in cardiac surgery. Copyright
© 2025 Elsevier Inc.

<73>
[Use Link to view the full text]
Accession Number
2040086808
Title
Comparative Outcomes of Multiarterial Versus Single Arterial Grafting in
Patients with Reduced Left Ventricular Ejection Fraction Undergoing
Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis.
Source
Cardiology in Review. (no pagination), 2025. Article Number:
10.1097/CRD.0000000000001022. Date of Publication: 2025.
Author
Javed J.; Bacha Z.; Fida A.; Sajjad F.; Ali M.A.; Khan A.; Rath S.; Afridi
A.; Alam U.; Henna F.; Noor H.; Naintara F.N.U.
Institution
(Javed) Department of Internal Medicine, Jinnah Sindh Medical University,
Karachi, Pakistan
(Bacha, Fida, Sajjad, Ali, Khan, Afridi, Alam, Noor) Department of
Internal Medicine, Khyber Medical College, Peshawar, Pakistan
(Rath) Department of Internal Medicine, All India Institute of Medical
Sciences, Bhubaneswar, India
(Henna) Department of Internal Medicine, Dubai Medical College for Girls,
Dubai, United Arab Emirates
(Naintara) Department of Internal Medicine, Wellspan Health York Hospital,
PA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Ischemic cardiomyopathy with reduced left ventricular ejection fraction
presents considerable outcome-related challenges, even with the
development of surgical revascularization. Coronary artery bypass grafting
continues to be a key therapy, yet the best grafting technique, single
arterial grafting (SAG) versus multiarterial grafting (MAG) for patients
with reduced EF, is uncertain. This systematic review and meta-analysis
aims to assess the comparative outcomes of MAG versus SAG in this
high-risk group. Fourteen cohort studies consisting of 19,976 patients
were studied, with 10,306 receiving MAG and 9670 receiving SAG. The
primary outcomes are 5-year overall survival, cardiac death, and
in-hospital mortality, while secondary outcomes include major adverse
cardiovascular events, perioperative myocardial infarction, repeat
revascularization, atrial fibrillation, postoperative dialysis, stroke,
intensive care unit/hospital stay, and sternal wound infection. MAG was
notably related to improved 5-year survival [odds ratio (OR), 1.50; 95%
confidence interval (CI), 1.32-1.70; P < 0.00001] and reduced in-hospital
mortality (OR, 0.66; 95% CI, 0.55-0.79; P < 0.00001). While cardiac
mortality was not statistically significant, secondary outcomes were
generally similar between groups. Sensitivity analyses validated the
robustness of findings, and Grading of Recommendations Assessment,
Development, and Evaluation assessments confirmed moderate to high
certainty of evidence. No considerable publication bias was noted. Despite
the lack of randomized controlled trials, this review underscores the
improved survival of MAG without increased perioperative risk in patients
with left ventricular ejection fraction <50%. These outcomes indicate that
MAG may be suitable in select cases, though further randomized studies are
required to confirm these results and guide optimized
decision-making. Copyright © 2025 Wolters Kluwer Health, Inc. All
rights reserved.

<74>
[Use Link to view the full text]
Accession Number
2040108414
Title
Comments on "effects of music therapy on anxiety among patients undergoing
cardiac procedures: A systematic review and meta-analysis".
Source
Annals of Medicine and Surgery. 87(8) (pp 5340-5341), 2025. Date of
Publication: 01 Aug 2025.
Author
Farnoosh N.; Shakeri A.
Institution
(Shakeri, Farnoosh) Department of Anesthesiology, School of Allied Medical
Sciences, Zahedan University of Medical Sciences, Zahedan, Iran, Islamic
Republic of
(Shakeri) Department of Neurosurgery, School of Medicine, Arak University
of Medical Sciences, Arak, Iran, Islamic Republic of
Publisher
Lippincott Williams and Wilkins

<75>
[Use Link to view the full text]
Accession Number
2040111102
Title
Efficacy and safety of transradial versus transfemoral approach for
secondary access in transcatheter aortic valve implantation: a systematic
review and meta-analysis.
Source
Annals of Medicine and Surgery. (no pagination), 2025. Article Number:
3562. Date of Publication: 2025.
Author
Bacha Z.; Fatima N.; Shah I.M.; Haris M.; Ali M.H.; Khan N.A.; Khan S.;
Shah M.Q.; Jan A.; Khan S.U.; Tariq U.; Raza I.; Rehman M.E.U.; Hameed
M.S.; Zaidi S.R.H.; Omarzai R.G.
Institution
(Bacha, Shah, Khan, Khan) Department of Medicine, Khyber Medical College,
Peshawar, Pakistan
(Fatima) Department of Medicine, Gomal Medical College, Dera Ismail Khan,
Pakistan
(Haris) Department of Medicine, Khyber Teaching Hospital, Peshawar,
Pakistan
(Ali, Jan, Khan) Department of Medicine, Lady Reading Hospital, Peshawar,
Pakistan
(Shah, Tariq) Department of Medicine, Saidu Group of Teaching Hospitals,
Swat, Pakistan
(Raza) Department of Medicine, Federal Medical and Dental College,
Islamabad, Pakistan
(Rehman, Hameed) Department of Medicine, Rawalpindi Medical University,
Rawalpindi, Pakistan
(Zaidi) Department of Medicine, Parkview Medical Center, Pueblo, United
States
(Omarzai) Department of Medicine, Nangarhar Medical University, Jalalabad,
Afghanistan
Publisher
Lippincott Williams and Wilkins
Abstract
Background Transcatheter aortic valve implantation (TAVI) requires a
primary access to deliver the valve and a secondary access for
angiographic guidance. Although transfemoral access (TFA) is most commonly
employed, alternative access sites are gaining traction. This systematic
review and meta-analysis compares the efficacy and safety of transradial
(TRA) and TF secondary access. Methods A literature search was performed
on MEDLINE, Embase, Cochrane and Clinicaltrials.gov from their inception
to January 2025. Risk ratios (RR) with 95% confidence intervals (CI) were
pooled using the Mantel-Haenzel method for dichotomous outcomes. Mean
differences (MD) with 95% confidence intervals (CI) were pooled using the
inverse variance method for continuous outcomes. Random-effects
meta-analyses were undertaken. Results Seven studies, with 15,283
patients, were included. TRA had a significantly lower risk of vascular
complications (RR 0.47, 95% CI 0.25-0.89), major vascular complications
(RR 0.45, 95% CI:0.27-0.73), bleeding (RR 0.53, 95% CI 0.36-0.78), major
bleeding (RR 0.55, 95% CI 0.34-0.90), stroke (RR 0.62, 95% CI 0.39-0.99),
all-cause mortality (RR 0.45, 95% CI 0.36-0.57) and acute kidney injury
(RR 0.48, 95% CI 0.38-0.60). Both groups were comparable in terms of
life-threatening bleeding, myocardial infarction, permanent pacemaker
requirement, length of hospital stay, contrast volume, procedure time and
fluoroscopy time. Conclusion TRA is associated with superior outcomes
compared to TFA for secondary access in TAVI. Further large-scale
randomized trials are needed to clarify the most optimal access sites for
TAVI. Copyright © 2025 The Authors.

<76>
[Use Link to view the full text]
Accession Number
2040076395
Title
Surgical closure versus transcatheter closure for ventricular septal
defect post-infarction: A meta-analysis.
Source
Annals of Medicine and Surgery. 86(9) (pp 5276-5282), 2024. Date of
Publication: 01 Sep 2024.
Author
Aramin M.A.S.; Abuhashem S.; Faris K.J.; Omar B.M.M.; Burhanuddin M.; Teja
P.S.; Ibraheim M.
Institution
(Aramin, Abuhashem, Faris, Omar) Faculty of Medicine, Al-Quds University,
Jerusalem, Palestine
(Burhanuddin, Teja) Department of Internal Medicine, Bhaskar Medical
college, Telangana, India
(Ibraheim) Department of Cardiothoracic Surgery, Alexandria University
Hospitals, Alexandria, Egypt
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Surgical correction of post-infarct ventricular septal defect
(PIVSD) is associated with a significant incidence of morbidity and
mortality. The authors aimed to evaluate the effectiveness and safety of
surgical versus transcatheter approaches in the management of PIVSD.
 Method(s): A systematic review and meta-analysis of retrospective
from five databases including the Cochrane Library, PubMed, Web of
Science, Ovid, and Scopus) until 9 March 2024 was conducted. Risk ratio
(RR) for dichotomous outcomes was used and data with a 95% CI are
presented. Result(s): A total of 7 retrospective observational
studies with 603 patients were included in the analysis. Surgical closure
was associated with a significantly lower short-term mortality and lower
number of residual shunt or re-intervention rate compared to percutaneous
closure, with a relative risk (RR) of 1.21 (95% CI:1:00-1.46, P = 0.05)
and 2.68 (95% CI: 1.46-4.91, P = 0.001), respectively. Surgical closure
was associated with a non-significantly lower long-term mortality rate
compared to percutaneous closure, with a relative risk (RR) of 1.10 (95%
CI: 0.82-1.48, P = 0.52). No difference is reported when time from acute
myocardial infarction (AMI) or PIVSD to intervention is compared groups,
with a relative risk (RR) of -0.24 (95% CI: -4.49 to 4.2, P = 0.91).
 Conclusion(s): Our meta-analysis shied the light on the significance
of surgical closure in terms of short-term mortality and the need for
re-intervention. However, no significant difference was observed in terms
of long-term mortality and time to intervention. Copyright © 2024
The Author(s).

<77>
Accession Number
2040124511
Title
Quality of evidence: Randomized trials in coronary disease and moving the
goalposts.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2025.
Date of Publication: 2025.
Author
Alshneikat M.; Awad A.K.; Bakaeen F.G.
Institution
(Alshneikat, Awad, Bakaeen) Department of Thoracic and Cardiovascular
Surgery, Cleveland Clinic, Cleveland, Ohio, United States
Publisher
Elsevier Inc.

<78>
Accession Number
2040111795
Title
Incidence of Coronary Obstruction During Aortic Valve Implantation:
Meta-Analysis and Mixt-Treatment Comparison of Self-Expandable Versus
Balloon-Expandable Valve Prostheses.
Source
Reviews in Cardiovascular Medicine. 26(7) (no pagination), 2025. Article
Number: 36208. Date of Publication: 01 Jul 2025.
Author
Wang Y.F.; Liu Z.Q.; Ma X.T.; Yang L.X.; Wang Z.J.; Zhou Y.J.
Institution
(Wang) Cardiology Division, Beijing Jishuitan Hospital, Capital Medical
University, Beijing, China
(Liu, Ma, Yang, Wang, Zhou) Department of Cardiology, Beijing Anzhen
Hospital, Capital Medical University, Beijing, China
(Wang, Zhou) Beijing Institute of Heart Lung and Blood Vessel Disease, The
Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of
Education, Beijing, China
Publisher
IMR Press Limited
Abstract
Background: Recently, the transcatheter aortic valve replacement (TAVR)
indications have expanded; meanwhile, valve systems have continuously
evolved and improved. However, coronary occlusion (CO), a rare but
catastrophic consequence of TAVR surgery, limits the expansion of
indications for TAVR. Moreover, comparisons between different systems
remain scarce. This study aimed to evaluate the incidence of CO associated
with TAVR, specifically comparing self-expanding valves (SEVs) and
balloon-expandable valves (BEVs), and further assess the safety profile of
these valve subtypes. Method(s): The primary outcome of interest was
the incidence of CO during TAVR using BEVs or SEVs. Electronic databases
were searched from January 2009 to June 2023, and this study included
randomized controlled trials, observational studies, and propensity
pair-matched studies. Heterogeneity and inter-study variance were assessed
using Cochran's Q, I2, and tau2 (Sidik-Jonkman
estimator). Random effects models were used based on the Bayesian theory
framework. The node-splitting approach was generated to determine study
network inconsistency. The convergence of the model was evaluated using
the trajectory map, density map, and the potential scale reduction factor
(PSRF). Rank sort graphs illustrate the best valve deployment techniques
or valve types. Result(s): A total of 830 articles were searched
referring to the incidence of CO using the valve deployment system of SEVs
or BEVs during the TAVR procedure, from which 51 were included (27,784
patients). The procedure incidence of coronary obstruction was 0.4% for
the SEVs and 0.6% for the BEVs. Treatment ranking based on network
analysis revealed SAPIEN 3 (Edwards Lifesciences (Irvine, CA, USA))
possessed the best procedural CO incidence (0.05%) performance, whereas
SAPIEN (Edwards Lifesciences (Irvine, CA, USA)) produced the worst
(1.04%). Conclusion(s): Our study indicates that CO incidence was not
reduced during TAVR with BEVs compared to SEVs. SAPIEN 3 and SAPIEN had
the lowest and highest TAVR-associated CO rates, respectively. These
findings suggest that the SAPIEN 3 valve may be the best choice for
reducing CO risk, and future studies should focus on its applicability in
different populations. More randomized controlled trials with head-to-head
comparisons of SEVs and BEVs are needed to address this open question. The
PROSPERO registration: CRD42024528269,
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024528269. Copyright
© 2025 The Author(s). Published by IMR Press.

<79>
Accession Number
2040123398
Title
Ipsilateral High Thoracic Ultrasound-Guided Erector Spinae Plane Block for
Post-Thoracotomy Shoulder Pain in Thoracic Cancer Surgeries: A Randomized
Controlled Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Kotb T.A.; Tantawy A.M.; Mahran E.; Elbosraty O.M.M.; Saad F.S.; Megahed
M.M.; Elshiha R.; Samy S.F.
Institution
(Kotb, Tantawy, Mahran, Elbosraty, Saad, Megahed, Samy) Anesthesia,
Surgical Intensive Care, and Pain Relief Department, National Cancer
Institute, Cairo University, Cairo, Egypt
(Elshiha) Clinical and Chemical Pathology Department, National Nutrition
Institute, Cairo, Egypt
Publisher
W.B. Saunders
Abstract
Objectives: To assess the safety and efficacy of ultrasound-guided high
thoracic erector spinae plane block (HT-ESPB) in the management of
post-thoracotomy ipsilateral shoulder pain (PTISP). Design(s):
Randomized, double-blind, parallel-group, controlled, clinical trial.
 Setting(s): The National Cancer Institute. Participant(s):
Seventy-six adult patients undergoing thoracic cancer surgery.
 Intervention(s): Patients were randomized into two equal groups: A
control group received thoracic epidural analgesia (TEA) alone (TEA
group), and a study group received ultrasound-guided HT-ESPB plus TEA
(ESPB group). Measurements and Main Results: Outcomes included the
incidence of PTISP, time to first rescue analgesia and total rescue
analgesic doses for ISP, intraoperative fentanyl consumption, heart rate,
mean arterial pressure, oxygen saturation, and complications. The ESPB
group had a significantly lower incidence of ISP in the first
postoperative hour compared to the TEA group (60.5% v 97.4%, p < 0.001).
The ESPB group also exhibited lower postoperative visual analog scale
scores, longer time to first rescue analgesia, and a reduced number of
rescue analgesic doses for ISP, as well as lower heart rate and mean
arterial pressure. No significant complications were reported.
 Conclusion(s): Ultrasound-guided HT-ESPB is a safe and efficacious
strategy for the management of PTISP. It demonstrated a significant
reduction in the incidence and severity of ISP and postoperative analgesic
requirements when compared to TEA alone. This approach enhanced
hemodynamic stability without significant complications. Copyright
© 2025 Elsevier Inc.

<80>
Accession Number
648303638
Title
Combined regional anesthetic techniques enhance postoperative recovery
after cardiac surgery: a randomized controlled trial.
Source
Postgraduate medical journal. (no pagination), 2025. Date of Publication:
15 Aug 2025.
Author
Dou D.; Wang L.; Yuan S.; Jia Y.; Yan F.
Institution
(Dou, Wang, Yuan, Jia, Yan) Department of Anesthesiology, State Key
Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for
Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking
Union Medical College, No. 167 BeilishiRd, Xicheng District, Beijing,
China
Abstract
BACKGROUND: Regional anesthetic techniques are applied in cardiac surgery
to improve postoperative pain and accelerate recovery. Pecto-intercostal
fascial block (PIFB) combined with rectus sheath block (RSB) has been
proved to provide ideal analgesia for cardiac surgery, but the effects of
combing regional anesthetic techniques on postoperative recovery are
uncertain. METHOD(S): This is a prospective and randomized controlled
trial at Fuwai Hospital from 1 June 2024 to 3 July 2024. Eighty patients
undergoing elective cardiac surgery via cardiopulmonary bypass were
randomized at a 1:1 ratio to be allocated in the intervention group (PIFB
combined with RSB) or control group (without regional blocks). The primary
outcome was the global score of the 15-item quality of recovery (QoR-15)
questionnaire at 24 h after surgery. Secondary outcomes included QoR-15 at
72 h, postoperative pain scores, time to extubation, length of stay,
medical expenses in hospital and postoperative morbidities.
 RESULT(S): The QoR-15 global score at 24 h after cardiac surgery was
122.35 +/- 6.71 in the intervention group vs 115.30 +/- 5.90 in the
control group (P < .001). The proportion of patients experiencing better
quality of recovery (Qor-15 >= 118) was higher in the intervention group
(77.5% vs 55%, P = .033). Postoperative pain scores were 1.90 +/- 0.18 in
the intervention group compared to 2.95 +/- 0.99 in the control group (P =
.027) at 24 h. Time to extubation was earlier in the intervention group
(274.40 +/- 98.36 vs 741.28 +/- 93.82 min, P < .001). There were no
statistically differences in Qor-15 at 72 h and other recovery outcomes.
 CONCLUSION(S): The administration of PIFB combined with RSB could
improve quality of recovery and relieve postoperative pain for patients
following cardiac surgery. Key message What is already known on this topic
Previous studies have demonstrated that ultrasound-guided nerve blocks
effectively reduce postoperative pain in cardiac surgery patients.
However, whether these techniques further enhance overall postoperative
recovery remained unclear. What this study adds This trial revealed that
ultrasound-guided nerve blocks improved postoperative QoR-15 scores, and
combined regional techniques further improved recovery without
compromising analgesia. How this study might affect research, practice, or
policy The findings support applying combined nerve blocks into enhanced
recovery protocols for cardiac surgery, offering evidence to optimize
postoperative analgesia strategies. Copyright © The Author(s)
2025. Published by Oxford University Press on behalf of the Fellowship of
Postgraduate Medicine. All rights reserved. For commercial re-use, please
contact reprints@oup.com for reprints and translation rights for reprints.
All other permissions can be obtained through our RightsLink service via
the Permissions link on the article page on our site-for further
information please co

<81>
Accession Number
2035770429
Title
Pulmonary protective and antiinflammatory effects of dexmedetomidine in
cardiac surgery with cardiopulmonary bypass: a systematic review and
metaanalysis.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 414. Date
of Publication: 01 Dec 2025.
Author
Liu J.; Gao R.; Ma J.; Han J.; Guo Z.
Institution
(Liu, Gao, Han) Department of Anesthesiology, chest hospital, Tianjin
University, Tianjin, China
(Liu, Gao, Ma, Han, Guo) Tianjin Key Laboratory of Cardiovascular
Emergency and Critical Care, Tianjin Municipal Science and Technology
Bureau, Tianjin, China
(Liu, Gao, Ma, Han, Guo) Tianjin Cardiovascular Institute, Tianjin, China
(Guo) Department of Cardiovascular Surgery, Tianjin Chest Hospital,
Tianjin, China
Publisher
BioMed Central Ltd
Abstract
Objective: This study aims to investigate pulmonary protective and
antiinflammatory effects of dexmedetomidine (DEX) in patients undergoing
cardiac surgery with cardiopulmonary bypass (CPB) by meta-analysis.
 Method(s): Six databases were searched to collect trials on the
pulmonary protective and anti-inflammatory effects of DEX in cardiac
surgery with CPB. The search period was from the establishment of each
database to August 1, 2024. Alveolar arterial oxygen partial pressure
difference (AaDO2), Oxygenation index (OI), respiratory index (RI), IL-6,
TNF-alpha, and CRP values were collected in CPB progress, end of
operation, postoperative 6 h(POH6), and postoperative 24 h(POH24). The
control group was treated with normal saline after anesthesia induction,
while the experimental group with DEX. Result(s): A total of 9
articles were included. In the overall analysis, AaDO2 (SMD=-1.03,
95%CI:-1.62 to -0.44) and RI (SMD=-1.03, 95%CI:-1.90 to -0.16) in the DEX
group were significantly lower than those in the control group, whereas OI
was significantly increased (SMD = 0.44, 95%CI: 0.29-0.60). For
inflammatory markers, levels of IL-6 (SMD= -1.96, 95%CI: -2.31-1.62) and
TNF-alpha (SMD= -1.81, 95%CI: -2.36-1.26) were significantly decreased in
the DEX group. Subgroup analyses based on the course of surgery presented
a significant reduction in AaDO2 at the end of operation. At the end of
operation, OI was significantly increased, while IL-6 and TNF-alpha were
significantly decreased at POH6 and POH12. At POH24, no significant
difference was found in CRP between the two groups (P > 0.05).
 Conclusion(s): DEX has pulmonary protective and anti-inflammatory
effects in patients undergoing cardiac surgery with CPB. Copyright
© The Author(s) 2025.

<82>
Accession Number
2040121167
Title
Two-year follow-up outcomes of renal denervation in polymorbid patients
with true resistant hypertension, type 2 diabetes mellitus and coronary
artery disease.
Source
Vessel Plus. 9 (no pagination), 2025. Date of Publication: 2025.
Author
Arablinskiy N.A.; Feshchenko D.A.; Vasiliev D.K.; Shanoyan A.S.; Shukurov
F.B.; Taliuridze M.T.; Kiselev A.R.; Drapkina O.M.
Institution
(Arablinskiy, Feshchenko, Vasiliev, Shanoyan, Shukurov, Taliuridze,
Kiselev, Drapkina) National Medical Research Center for Therapy and
Preventive Medicine, Moscow, Russian Federation
Publisher
OAE Publishing Inc.
Abstract
Aim: To study the clinical effects and long-term outcomes of
radiofrequency renal denervation (RDN) in patients with true resistant
arterial hypertension, type 2 diabetes mellitus, and coronary artery
disease after completed myocardial revascularization. Method(s): 75
patients were randomized into RDN and control groups (1:1.5). RDN was
performed via femoral access using a Spyral catheter (Medtronic, USA). The
primary endpoint was the change in blood pressure (BP). Secondary
endpoints were: the development of cardiovascular and cerebral
complications, changes in laboratory and instrumental parameters, changes
in antihypertensive medication, late lumen loss (LLL) in the stented
segments [measured by computer-assisted quantitative coronary angiography
analysis (QCA)], and the frequency of de novo stenosis. Result(s): In
the RDN group, there was a significant decrease in both office (o) and
average daily (ad) systolic (S) and diastolic (D) BP (oSBP: -8 mmHg; oDBP:
-6 mmHg; adSBP: -11 mmHg; adDBP: -8 mmHg - P < 0.05); decreased activity
of plasma renin DELTA-2.44 ng/mL/h; concentrations of angiotensin I DELTA
-1.27 ng/mL and aldosterone DELTA -13 pg/mL - P < 0.05); decrease in
fasting glycemia (DELTA -2.73 mmol/l - P < 0.05), HbA1c (DELTA -1% - P <
0.05) and the level of insulin resistance according to HOMA-IR index
(DELTA -1.78 - P < 0.05), as well as a decrease in the concentration of
C-reactive peptide in the blood (DELTA -1.84 mg/L - P < 0.05). No
significant dynamics of these indicators were recorded in the control
group. The effectiveness of RDN was highest in the cohorts of obese
patients - OR 1.31 (95%CI: 1.17-1.44), patients with obstructive sleep
apnea syndrome - OR 1.73 (95%CI: 1.23-2.26) and tachycardia - OR 2.02
(95%CI: 1.69-3.10); P < 0.001 in all cases. The incidence of major adverse
cardiovascular events (26.7% in the RDN group; 24.4% in the control
group), the average LLL (24.7% in the RDN group; 28.1% in the control
group), and the incidence of de novo stenosis (23.3% in the RDN group;
22.2% in the control group) did not differ between the groups.
 Conclusion(s): The use of RDN in the cohort of comorbid patients is
safe and enables better control of modifiable risk factors of progression
of resistant arterial hypertension and type 2 diabetes mellitus due to an
improvement of BP, carbohydrate metabolism parameters, regulatory factors
of the renin-angiotensin-aldosterone system (RAAS), and factors of the
systemic inflammatory response. Copyright © The Author(s) 2025.

<83>
[Use Link to view the full text]
Accession Number
2040108451
Title
Global status and research trends of combined heart and lung
transplantation: A bibliometrics analysis.
Source
Annals of Medicine and Surgery. 87(8) (pp 4988-4996), 2025. Date of
Publication: 01 Aug 2025.
Author
Huang J.; Sun G.; Li C.; Zhang C.; Qin J.; Jiang X.; Ke L.
Institution
(Huang, Li, Zhang, Jiang, Ke) Department of Thoracic Surgery, The First
Affiliated Hospital of USTC, Division of Life Sciences and Medicine,
University of Science and Technology of China, Hefei, China
(Sun) Department of Cardiology, Anhui Provincial Chest Hospital, Hefei,
China
(Qin) The Transplantation Center, The First Affiliated Hospital of the
USTC, Division of Life Sciences and Medicine, University of Science and
Technology of China, Hefei, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Combined heart and lung transplantation represents a critical
therapeutic approach for addressing end-stage cardiac and pulmonary
diseases. This study seeks to conduct a comprehensive analysis of the
global literature on combined heart and lung transplantation from 1980 to
2024, with the objective of identifying key research trends and emerging
areas of interest within this domain. Method(s): A systematic search
and compilation of bibliometric data related to combined heart and lung
transplantation, published between 1980 and 2024, was conducted using the
Web of Science Core Collection. Subsequent bibliometric and knowledge
mapping analyses were performed utilizing CiteSpace 6.1.R6 (Basic) and
VOSviewer (1.6.18). Result(s): A total of 1746 articles were
retrieved, indicating a stable upward trend in the field of combined heart
and lung transplantation, particularly in the number of published papers
over the past two decades. The United States leads in the number of
published articles (1066), followed by Germany (155) and the United
Kingdom (140). In terms of keyword analysis, the most frequently used
keywords are "lung transplantation"(226), "transplantation"(172), and
"survival"(146). An analysis of cited keywords reveals that "severe
combined immunodeficiency"was the most prominent keyword prior to 2000,
whereas "Outcome"has emerged as the most significant keyword since 2000.
 Conclusion(s): Over the past four decades, the field of combined
heart and lung transplantation has undergone consistent and rapid
advancement. The findings from this bibliometric analysis offer valuable
insights and serve as a reference point for future research endeavors and
for stakeholders engaged in this area. Copyright © 2025 The
Author(s). Published by Wolters Kluwer Health, Inc.

<84>
Accession Number
2040121123
Title
Predictors of short-term mortality in patients undergoing emergency
coronary artery bypass grafting: a systematic review and meta-analysis.
Source
Vessel Plus. 8 (no pagination), 2024. Article Number: 32. Date of
Publication: 2024.
Author
Comanici M.; Nadia B.; Raja S.G.
Institution
(Comanici, Nadia, Raja) Department of Cardiac Surgery, Harefield Hospital,
London, United Kingdom
Publisher
OAE Publishing Inc.
Abstract
Aim: Emergency coronary artery bypass grafting (CABG) is a critical
intervention for patients with acute coronary syndrome (ACS), particularly
in high-risk cases where rapid revascularization is necessary. Despite
advancements in surgical techniques, early mortality rates remain high.
This study aims to identify predictors of short-term mortality in patients
undergoing emergency CABG for ACS through a comprehensive systematic
review and meta-analysis. Method(s): A PRISMA-based systematic review
was performed using major databases up to May 2024. Inclusion criteria
focused on studies reporting short-term mortality outcomes and associated
predictors in patients undergoing emergency CABG for ACS. Data extraction
and quality assessment were performed independently by multiple reviewers.
Statistical analysis included pooled odds ratios (OR) and confidence
intervals (CI) for identified predictors using random-effects models.
 Result(s): A total of 20 studies encompassing 4,777 patients met the
inclusion criteria. Key predictors of short-term mortality include
advanced age (OR 1.40, 95%CI: 1.07-1.82), cardiogenic shock (OR 5.35,
95%CI: 3.27-8.74), chronic kidney disease (OR 3.55, 95%CI: 1.30-9.71), and
preoperative use of an intra-aortic balloon pump (OR 2.46, 95%CI:
1.00-6.04). Timing of surgery within the first 48 h post-ACS was also
associated with higher mortality rates. Conclusion(s): This
systematic review and meta-analysis highlight important predictors of
short-term mortality in patients undergoing emergency CABG for ACS. These
findings underscore the importance of tailored perioperative management
strategies to improve outcomes in this high-risk patient
population. Copyright © The Author(s) 2024.

<85>
Accession Number
2040116202
Title
Meta-Analysis of Coronary Bypass Graft Patency Assessment With Invasive vs
Computed Tomographic Angiography.
Source
Annals of Thoracic Surgery. (no pagination), 2025. Date of Publication:
2025.
Author
Mantaj P.; Hirofuji A.; Dell'Aquila M.; Demetres M.; Gregg A.; Krieger K.;
Abdalla S.; Kennedy M.; Savic M.; Ahmadi-Hadad A.; Rossi C.S.; Soletti G.;
Nikolikj A.; Rahouma M.; Sandner S.; Gaudino M.
Institution
(Mantaj, Hirofuji, Dell'Aquila, Demetres, Gregg, Krieger, Abdalla, Rossi,
Soletti, Rahouma, Gaudino) Department of Cardiothoracic Surgery, Weill
Cornell Medicine, New York, New York, United States
(Mantaj) Department of Cardiac Surgery, Medical University of Graz, Graz,
Austria
(Dell'Aquila) Department of Cardiothoracic Surgery, Catharina Hospital,
Eindhoven, Netherlands
(Kennedy) University of Notre Dame, Notre Dame, Indiana, United States
(Savic) Johannes Kepler University, Linz, Austria
(Ahmadi-Hadad) Department of Cardiac Surgery, University of Naples
Federico II, Naples, Italy
(Nikolikj) Department of Cardiac Surgery, Acibadem Sistina Hospital,
Skopje, North Macedonia
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
Publisher
Elsevier Inc.
Abstract
Background: Computed tomographic (CT) coronary angiography has emerged as
a noninvasive alternative for evaluating graft patency after coronary
artery bypass grafting (CABG), but there is ongoing debate regarding its
diagnostic performance compared with invasive coronary angiography,
particularly for arterial and composite grafts. Method(s): MEDLINE
(Medical Literature Analysis and Retrieval System Online), Embase, and
Cochrane databases were searched to identify studies comparing CT coronary
angiography with invasive coronary angiography for detection of graft
occlusion in patients who had undergone CABG. Outcomes included
sensitivity, specificity, positive predictive value, negative predictive
value, and diagnostic accuracy. Meta-regression explored key modifiers.
Pooled estimates were calculated using random-effects models, with
heterogeneity measured by I2. Result(s): Fifty studies met
inclusion criteria, including 3449 patients (25% women). CT coronary
angiography sensitivity for graft occlusion was 0.96 (I2 =
48%), specificity was 0.97 (I2 = 46%), positive predictive
value was 0.94 (I2 = 62%), negative predictive value was 0.98
(I2 = 41%), and overall diagnostic accuracy was 0.97
(I2 = 58%). The pooled incidence rate of graft occlusion across
7506 included grafts was 0.08 per graft-year (95% CI, 0.06-0.10) using a
random-effects model and 0.07 per graft-year (95% CI, 0.07-0.08) using a
fixed-effects model. At meta-regression, study year, sample size,
beta-blocker use, number of slices, and time since surgery, but not type
and configuration of CABG grafts, were significantly associated with CT
coronary angiography sensitivity. Conclusion(s): CT coronary
angiography detects CABG graft occlusion with a high degree of sensitivity
and specificity independently of graft type and configuration and can be
used for imaging of every type of CABG graft. Copyright © 2025
The Society of Thoracic Surgeons

<86>
Accession Number
648307205
Title
History and Application of Mechanical Assist Devices as a Bridge to Heart
Transplant: A Review and Perspectives in Brazil.
Source
Brazilian journal of cardiovascular surgery. (no pagination), 2025. Date
of Publication: 14 Aug 2025.
Author
Perazzo A.; Gaiotto F.A.; Steffen S.P.; Gaspar S.F.D.; Faria V.S.;
Ferreira R.C.S.; Carbonera A.; Guazzelli D.L.; Gamboa J.A.R.; Ideal L.F.;
Gomes H.L.; Falcao A.T.G.; Fernandes A.L.; Campos L.H.; Steffen C.L.;
Limongi C.; Varjao R.L.; Avila M.S.; Seguro L.F.B.D.C.; Mangini S.;
Marcondes-Braga F.G.; Aulicino G.B.; Campos I.W.; Santos R.H.B.; Lourenco
D.D.; Kowalewski M.; Ronco D.; Matteucci M.; Meani P.; Russo C.F.; Mauro
M.D.; Mariani S.; Loforte A.; Wiedmann D.; Bacal F.; Whitman G.; Punjabi
P.; Lorusso R.; Jatene F.B.
Institution
(Perazzo, Gaiotto, Steffen, Gaspar, Faria, Ferreira, Carbonera, Guazzelli,
Gamboa, Steffen, Avila, Seguro, Mangini, Marcondes-Braga, Aulicino,
Campos, Santos, Lourenco, Bacal, Jatene) Universidade de Sao Paulo
Faculdade de Medicina Nucleo de Transplante do Instituto do Coracao do
Hospital das Clinicas Sao Paulo AP Brazil Nucleo de Transplante do
Instituto do Coracao do Hospital das Clinicas da Faculdade de Medicina da
Universidade de Sao Paulo, Sao Paulo, Brazil
(Perazzo, Gaiotto, Steffen, Gaspar, Ideal, Gomes, Falcao, Fernandes,
Varjao, Santos, Lourenco, Jatene) Universidade de Sao Paulo Faculdade de
Medicina Departamento de Cirurgia Cardiovascular do Instituto do Coracao
do Hospital das Clinicas Sao Paulo SP Brazil Departamento de Cirurgia
Cardiovascular do Instituto do Coracao do Hospital das Clinicas da
Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
(Perazzo, Kowalewski, Ronco, Matteucci, Meani, Mauro, Mariani, Lorusso)
Maastricht University Medical Centre Heart and Vascular Centre
Cardio-Thoracic Surgery Department Maastricht The Netherlands
Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht
University Medical Centre (MUMC), Cardiovascular Research Centre
Maastricht (CARIM), Netherlands
(Campos) Faculdade Israelita de Ciencias da Saude Albert Einstein Sao
Paulo SP Brazil Faculdade Israelita de Ciencias da Saude Albert Einstein
(FICSAE), Sao Paulo, Brazil
(Limongi) Santa Casa de Curitiba Departamento de Cirurgia Cardiovascular
Curitiba PR Brazil Departamento de Cirurgia Cardiovascular, Santa Casa de
Curitiba, Curitiba, Brazil
(Kowalewski) National Medical Institute of the Ministry of Interior and
Administration Department of Cardiac Surgery and Transplantology Varsovia
Poland Department of Cardiac Surgery and Transplantology, National Medical
Institute of the Ministry of Interior and Administration, Poland
(Ronco, Russo) Niguarda Hospital Cardiac Surgery and Heart Transplant Unit
Cardiac Thoracic and Vascular Department Milao Italy Cardiac Surgery and
Heart Transplant Unit, Cardiac Thoracic and Vascular Department, Niguarda
Hospital, Italy
(Meani) ASST Grande Ospedale Metropolitano Cardiothoracic and vascular
Anestesia and Intensive Care Niguarda Milao Italy Cardiothoracic and
vascular Anestesia and Intensive Care, ASST Grande Ospedale Metropolitano,
Italy
(Mariani) Fondazione IRCCS San Gerardo dei Tintori Cardiac Surgery Unit
Monza Italy Cardiac Surgery Unit, Fondazione IRCCS San Gerardo dei
Tintori, Italy
(Loforte) University of Turin Turin Italy Mechanical Circulatory Support
Program, University of Turin, Italy
(Wiedmann) University of Wien Cardiac Surgery and Mechanical Circulatory
Support Department Wien Austria Cardiac Surgery and Mechanical Circulatory
Support Department, University of Wien, Austria
(Whitman) Johns Hopkins School of Medicine Faculty Cardiovascular Surgery
Department Baltimore USA Cardiovascular Surgery Department, Johns Hopkins
School of Medicine Faculty
(Punjabi) National Heart and Lung Institute Imperial College London
Cardiothoracic Surgery Department Londres United Kingdom Cardiothoracic
Surgery Department, Imperial College London, National Heart and Lung
Institute, Londres - United Kingdom, United Kingdom
Abstract
INTRODUCTION: Mechanical circulatory support (MCS) devices have evolved
significantly over the past decades and play a vital role in managing
end-stage heart failure, especially as a bridge to heart transplantation.
From the pioneering heart-lung machines to third-generation ventricular
assist devices (VADs), MCS technology has advanced to provide more
durable, efficient, and safer options for both shortand long-term support.
This review outlines the historical development of mechanical assist
devices, the types of available supports - ranging from intra-aortic
balloon pumps and extracorporeal membrane oxygenation to implantable
devices like HeartMate 3 - and their clinical indications and
complications. Special attention is given to right ventricular
dysfunction, thromboembolic and hemorrhagic complications, and infections,
which remain major challenges in the management of patients with MCS
devices.In Brazil, despite the growing evidence supporting MCS in
critically ill patients, access remains limited due to financial and
systemic constraints. The review explores the current landscape of device
availability in the country, national guidelines, cost-effectiveness data,
and the impact of recent changes in transplant allocation criteria that
prioritize patients receiving mechanical support. Notably, the approval of
long-term VADs for destination therapy in the public health system in 2024
marks a significant milestone.This review offers a comprehensive
perspective on MCS utilization, highlighting both global advances and
Brazil-specific challenges. By identifying gaps in access and proposing
future directions, it advocates for expanded use of these life-saving
technologies to improve survival and quality of life in advanced heart
failure patients.

<87>
Accession Number
2040124687
Title
Psychological well-being and the effects of supportive coaching during
SPECT myocardial perfusion imaging in patients with suspected ischemic
heart disease.
Source
Journal of Psychosomatic Research. 197 (no pagination), 2025. Article
Number: 112355. Date of Publication: 01 Oct 2025.
Author
Roovers T.; Vermeltfoort I.A.C.; Widdershoven J.W.; Kop W.J.
Institution
(Roovers, Widdershoven, Kop) Department of Medical and Clinical
Psychology, Center of Research on Psychological Disorders and Somatic
Diseases (CoRPS), Tilburg University, Tilburg, Netherlands
(Vermeltfoort) Department of Nuclear Medicine, Institute Verbeeten,
Tilburg, Netherlands
(Widdershoven) Department of Cardiology, Elisabeth-TweeSteden Hospital,
Tilburg, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Diagnostic procedures for ischemic heart disease are common,
but the consequences for the patient's psychological well-being are not
well understood. The current study investigates changes in negative affect
as a measure of psychological well-being during myocardial perfusion
imaging (MPI-SPECT) and whether supportive coaching during diagnostic
testing improves well-being, reduces symptom burden, and increases patient
satisfaction. Method(s): Patients undergoing MPI-SPECT were randomly
assigned to a supportive coaching intervention group or a care-as-usual
control group. Negative affect was assessed at nine time-points throughout
the 2-day diagnostic MPI visits. Anginal and adenosine-related symptoms
were evaluated during cardiac stress testing (CST) and patient
satisfaction at completion of MPI-SPECT. Data were analyzed using
regression analysis, t-tests, and linear mixed models. Result(s): A
total of 149 patients were randomized (mean age = 68.5 [SD = 9.6] years,
41.6 % women; 74 intervention and 75 control condition). Negative affect
changed significantly throughout the MPI procedure (F(8, 244.098) = 8.689,
p < .001), with the highest level occurring during the peak phase of CST.
Negative affect was associated with higher concurrent anginal (beta =
0.285, p = .001) and adenosine-related symptoms (beta = 0.252, p = .004)
during CST. No significant benefits of supportive coaching were found for
well-being or symptoms, inducibility of ischemia, or patient satisfaction
(all p-values > .200). Conclusion(s): Negative affect during
MPI-SPECT is associated with cardiac symptoms during CST. No benefits were
found of the short-term supportive coaching intervention during the
MPI-SPECT procedure. Patient well-being might be improved by providing
support during the entire diagnostic phase for ischemic heart disease
rather than just during the MPI-SPECT procedure. Trial registration
#NCT05896982. Open science statement/Preregistration: Medical Ethics
Committee METC-Brabant NL81600.028.22 / P2234. Copyright © 2025
The Authors

<88>
Accession Number
648326133
Title
Optimising cardiac surgery outcomes in people with diabetes: the OCTOPuS
pilot feasibility study.
Source
Health technology assessment (Winchester, England). 29(39) (pp 1-31),
2025. Date of Publication: 01 Aug 2025.
Author
Holt R.I.; Barnard-Kelly K.; Patel M.; Newland-Jones P.; Luthra S.; Picot
J.; Partridge H.; Cook A.
Institution
(Holt) School of Human Development and Health, Faculty of Medicine,
University of Southampton, Southampton, United Kingdom
(Holt) National Institute for Health and Care Research Southampton
Biomedical Research Centre, University Hospital Southampton NHS Foundation
Trust, Southampton, United Kingdom
(Barnard-Kelly) Barnard Health - Health Psychology Research, Fareham,
United Kingdom
(Patel, Newland-Jones) Diabetes Department, University Hospital
Southampton NHS Foundation Trust, Southampton, United Kingdom
(Luthra) Cardiothoracic Surgery Department, University Hospital
Southampton NHS Foundation Trust, Southampton, United Kingdom
(Picot) Southampton Health Technology Assessments Centre, University of
Southampton, Southampton, United Kingdom
(Partridge) Diabetes Department, University Hospitals Dorset NHS
Foundation Trust, Bournemouth, United Kingdom
(Cook) Clinical Trials Unit, Faculty of Medicine, University of
Southampton, Southampton, United Kingdom
Abstract
Background: Surgical outcomes are worse in people with diabetes, in part,
because of the effects of hyperglycaemia, obesity and other comorbidities.
Two important uncertainties in the management of people with diabetes
undergoing major surgery exist: (1) how to improve diabetes management
prior to an elective procedure and (2) whether that improved management
leads to better post-operative outcomes. Objective(s): The Optimising
Cardiac Surgery ouTcOmes in People with diabeteS project aimed to assess
whether a pre-operative outpatient intervention delivered by a
multidisciplinary specialist diabetes team could improve diabetes
management and cardiac surgical outcomes for people with diabetes.
Although the intervention could be applied to any surgical discipline,
cardiothoracic surgery was chosen because 30-40% of those undergoing
elective cardiac revascularisation have diabetes. Method(s): The
project had three phases: (1) designing the intervention, (2) a pilot
study of the intervention and (3) a multicentre randomised controlled
study in United Kingdom cardiothoracic centres to assess whether the
intervention could improve surgical outcomes. The first two phases were
completed, but the COVID-19 pandemic and its subsequent effects on
cardiothoracic services and research capacity in the United Kingdom meant
that the randomised controlled study could not be undertaken. Intervention
development: Two rapid literature reviews were undertaken to understand
what factors influence surgical outcomes in people with diabetes and what
interventions have previously been tested. The Optimising Cardiac Surgery
ouTcOmes in People with diabeteS intervention was based on an existing
nurse-led outpatient intervention, delivered in the 3 months before
elective orthopaedic surgery. This intervention reduced pre-operative
glycated haemoglobin and reduced length of stay. We undertook a survey of
United Kingdom cardiothoracic surgeons, which found limited and
inconsistent pre-operative management of people with diabetes awaiting
cardiothoracic surgery. A prototype intervention was developed following
discussions with relevant stakeholders. Pilot study: The pilot feasibility
study recruited 17 people with diabetes and was undertaken by the diabetes
and cardiothoracic surgery departments at University Hospital Southampton
NHS Foundation Trust. Biomedical data were collected at baseline and prior
to surgery. We assessed how the intervention was used. In-depth
qualitative interviews with participants and healthcare professionals
explored perceptions and experiences of the intervention and how it might
be improved. Thirteen people completed the study and underwent
cardiothoracic surgery. All components of the Optimising Cardiac Surgery
ouTcOmes in People with diabeteS intervention were used, but not all parts
were used for all participants. Minor changes were made to the
intervention following feedback from the participants and healthcare
professionals. Median (interquartile range) glycated haemoglobin fell 10
mmol/mol (3-13) prior to surgery. The median duration of admission for
surgery was 7 (interquartile range 6-9) days. Multicentre randomised
controlled study of the United Kingdom cardiothoracic centres: We could
not proceed to the multicentre randomised controlled study because of the
impact of COVID-19 on the delivery of cardiothoracic surgical services and
research capacity. Conclusion(s): There remains an urgent need to
improve the surgical outcomes for people with diabetes. This project
demonstrated that it is possible to develop a clinical pathway to improve
diabetes management prior to admission. Limitation(s): We could not
test the effectiveness of the intervention in a multicentre randomised
controlled trial because of the COVID-19 pandemic. Future work: The
intervention is available for future research or clinical implementation.
 Funding(s): This synopsis presents independent research funded by the
National Institute for Health and Care Research (NIHR) Health Technology
Assessment programmme as award number 16/25/12.

<89>
Accession Number
2040145522
Title
Comparative outcomes of robotic surgery vs conventional sternotomy for
cardiac myxoma excision: A meta-analysis.
Source
World Journal of Cardiology. 17(8) (no pagination), 2025. Article Number:
111159. Date of Publication: 26 Aug 2025.
Author
Khawar M.M.H.; Ejaz H.; Jaffar M.S.; Kashif M.; Habib M.; Mukhtar A.; Riaz
H.; Shah S.A.; Muhammad A.; Ali U.; Saeed H.; Buhadur Ali M.K.; Chhetri R.
Institution
(Khawar, Ejaz, Jaffar, Kashif, Habib, Mukhtar, Riaz) Department of
Cardiology, Services Institute of Medical Sciences, Punjab, Lahore,
Pakistan
(Chhetri) Department of Cardiology, Nepalgunj Medical College, Kohal,
Nepal
(Shah, Muhammad, Ali, Saeed, Buhadur Ali) Department of Cardiology, King
Edward Medical University, Punjab, Lahore, Pakistan
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Cardiac myxoma, a benign intracardiac tumor, is traditionally
excised via conventional sternotomy, which is invasive and associated with
longer recovery times. Minimally invasive robotic surgery has emerged as a
potential alternative, offering reduced trauma and faster recovery. This
meta-analysis compares the efficacy and safety of robotic surgery vs
conventional sternotomy for cardiac myxoma excision. We hypothesized that
robotic surgery would provide comparable safety outcomes with improved
postoperative recovery, such as shorter hospital stays and reduced
transfusion rates, despite potentially longer operative times. AIM To
assess robotic surgery vs sternotomy for cardiac myxoma regarding
operative times, hospital stay, transfusions, and complications. METHODS A
systematic review was performed using EMBASE, OVID, Scopus, PubMed,
Cochrane, and ScienceDirect databases to identify studies comparing
robotic surgery and sternotomy for cardiac myxoma excision. Continuous
outcomes were analyzed using mean differences (MDs), and categorical
outcomes with odds ratios (ORs) and 95% confidence intervals (95%CIs). A
random-effects model was used to pool data, accounting for study
heterogeneity. RESULTS Six studies involving 425 patients (180 robotic,
245 conventional) were included. Robotic surgery significantly increased
cross-clamp time (MD = 12.03 minutes, 95%CI: 2.14-21.92, P = 0.02) and
cardiopulmonary bypass time (MD = 28.37 minutes, 95%CI: 11.85-44.89, P =
0.001). It reduced hospital stay (MD = -1.86 days, 95%CI: -2.45 to -1.27,
P < 0.00001) and blood transfusion requirements (OR = 0.30, 95%CI:
0.13-0.69, P = 0.007). No significant differences were observed in atrial
arrhythmia (OR = 0.55, 95%CI: 0.27-1.12) or ventilation time (MD = -1.72
hours, 95%CI: -5.27 to 1.83, P = 0.34). CONCLUSION Robotic surgery for
cardiac myxoma excision prolongs operative times but shortens hospital
stays and reduces transfusion needs, suggesting enhanced recovery without
compromising safety. Copyright ©The Author(s) 2025. Published by
Baishideng Publishing Group Inc. All rights reserved.

<90>
Accession Number
2040105332
Title
A review on fungal surgical site infections: epidemiology, risk factors,
main fungal agents, and prevention.
Source
Iranian Journal of Microbiology. 17(4) (pp 516-527), 2025. Date of
Publication: 01 Jun 2025.
Author
Shirani K.; Seifi A.; Assadi A.; Mortazavi A.; Seyed Alinaghi S.A.
Institution
(Shirani) Department of Infectious Diseases, Nosocomial Infection Research
Center, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic
Republic of
(Seifi) Department of Infectious Diseases, Research Center for Antibiotic
Stewardship and Antimicrobial Resistance, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Assadi) Department of Infectious Diseases, Infectious Diseases and
Tropical Medicine Research Center, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Mortazavi) Department of Infectious Diseases, Immunodeficiency Diseases
Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
(Seyed Alinaghi) Iranian Research Center for HIV/AIDS, Iranian Institute
for Reduction of High-Risk Behaviors, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Seyed Alinaghi) Research Development Center, Arash Women's Hospital,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Tehran University of Medical Sciences
Abstract
Fungal surgical site infections (SSIs) may be less common than bacterial
SSIs but are a significant clinical issue due to their challenging
diagnosis, higher morbidity, and rising incidence, particularly in
immunocompromised patients. The epidemiology, risk factors, prevalent
fungal pathogens, and prevention of SSIs caused by fungi are discussed in
this narrative review. Systematic literature search for the period 2000 to
2024 was conducted on top databases using relevant MeSH keywords. The most
frequent solitary pathogens were Candida spp., followed by Aspergillus and
Mucor spp., especially in transplant, cardiac, and GI infections. The
greatest challenge is extended length of hospital stay, broad-spectrum
antibiotics, immunosuppression, and invasive interventions with prosthetic
device or shunts. While it creates added burden, fungal SSIs go unnoticed
by clinical practice and are rarely included in SSI prevention strategies.
The review declares the significance of enhanced clinical vigilance and
tailored antifungal prophylaxis in high-risk exposure surgical procedures.
The review, based on the integration of existing information, provides
clinicians and infection control practitioners with a framework of fungal
SSIs so that they can be better equipped to assess risk, detect infection
sooner, and focus prevention efforts. Copyright © 2025 The
Authors.

<91>
Accession Number
648305326
Title
The effectiveness and side effects of anti-coagulant drugs in pregnant
women with mechanical or bio-prosthetic heart valves: A systematic review
and Meta-analysis study.
Source
Journal of cardiology. (no pagination), 2025. Date of Publication: 13 Aug
2025.
Author
Shishesaz M.I.; Eshraghi R.; Bahrami A.; Farzan M.; Hajibeygi R.; Fathi
M.; Yaghoobpoor S.; Tavasol A.; Gorjizad M.; Dehghani M.; Akbari A.;
Rafiei N.; Roostaie M.; Eslami S.; Taherkhani M.; Movahed M.R.
Institution
(Shishesaz) School of Medicine, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Eshraghi) Social Determinants of Heath Research Center, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Bahrami) Student Research Committee, Kashan University of Medical
Sciences, Iran, Islamic Republic of
(Farzan) Medical Plants Research Center, Basic Health Sciences Institute,
Shahrekord University of Medical Sciences, Iran, Islamic Republic of
(Farzan) Medical Plants Research Center, Basic Health Sciences Institute,
Shahrekord University of Medical Sciences, Shahrekord, Iran; Student
Research Committee, Shahrekord University of Medical Sciences, Shahrekord,
Iran
(Hajibeygi) School of Medicine, Tehran University of Medical Science,
Tehran, Iran, Islamic Republic of
(Fathi, Yaghoobpoor, Tavasol, Gorjizad, Akbari) School of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Dehghani, Rafiei) School of Medicine, Isfahan University of Medical
Sciences, Isfahan, Iran, Islamic Republic of
(Roostaie) School of Medicine, Islamic Azad University Tehran Medical
Branch, Tehran, Iran, Islamic Republic of
(Eslami) Firoozgar Hospital, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Taherkhani) Cardiovascular Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Movahed) University of Arizona Sarver Heart Center, Tucson, AZ, USA;
University of Arizona College of Medicine, Phoenix, AZ, USA. Electronic
address: rmova@aol.com
Abstract
BACKGROUND AND OBJECTIVES: Patients with pregnancy and mechanical or
bio-prosthetic heart valves (BHVs) need tailored antithrombotic therapy to
prevent thromboembolism. The goal of this study was to evaluate the
effects and complications of various anticoagulation strategies used
during pregnancy in these patients using a meta-analysis. METHOD(S):
We searched PubMed, Google Scholar, Scopus, EMBASE, and Web of Science
databases and discovered 24 articles. We also discarded some articles when
evaluating them in detail due to inadequate information. Finally, 24
studies were included in the systematic review. We compared pregnancy
outcomes in three groups of pregnant women: 1) Those taking warfarin; 2)
Those taking LMWH (Low Molecular Weight Heparin) or UFH (Unfractionated
Heparin); 3) Those on no anticoagulant therapy. RESULT(S): The
incidence of maternal thromboembolic events was higher in the UFH or LMWH
group, but fetal complications (FC) were lower in this group. Using
warfarin during the first trimester was associated with a higher abortion
rate, embryopathies, and FCs overall. Using <5 mg of warfarin daily to
maintain their targeted INR had a lower risk of developing. Preterm labor
and spontaneous abortion were observed in 0.09 (95 % CI = 0.04-0.14) and
0.08 (95 % CI = 0.01-0.14) of cases in the LMWH/UFH subgroup. In terms of
maternal complications (MCs) in Warfarin subgroup, maternal hemorrhagic
complications, maternal thromboembolic events, and valve thrombosis were
respectively observed in 2.0 (95 % CI = 0-3), 0.01 (95 % CI = 0.00-0.03),
0.01 (95 % CI = 0.00-0.03); in LMWH subgroup the rates were 0.18 (95 % CI
= 0.09-0.27), 0.03 (95 % CI = 0.00-0.06), and 0.28 (95 % CI = 0.15-0.71);
and finally in those taking no anticoagulant therapy, the rates were 0.02
(95 % CI = 0.03-0.06), 0.07 (95 % CI = 0.06-0.19). CONCLUSION(S):
According to the results, preterm labor is a significant fatal
complication in pregnant women on warfarin. Maternal hemorrhagic
complications and thromboembolic events occur in the LMWH subgroup. There
are no significant differences in other complications between the three
subgroups. Copyright © 2025. Published by Elsevier Ltd.

<92>
Accession Number
2035758971
Title
Safety review of antithrombotic therapy options after left atrial
appendage occlusion.
Source
Expert Opinion on Drug Safety. (no pagination), 2025. Date of
Publication: 2025.
Author
Sawhney A.; Gupta R.; Mahajan P.; Agrawal A.; Cossu S.; Lakkireddy D.R.
Institution
(Sawhney) Department of Internal Medicine, Crozer Chester Medical Center,
Upland, PA, United States
(Gupta) Department of Cardiology, Yale New Haven School of Medicine, New
Haven, CT, United States
(Mahajan, Agrawal) Lehigh Valley Health Network, Allentown, PA, United
States
(Cossu, Lakkireddy) Kansas City Heart Rhythm Institute and Research
Foundation, Overland Park, KS, United States
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Left atrial appendage occlusion (LAAO) is a viable
alternative to anticoagulation for treatment in patients with non-valvular
atrial fibrillation (NVAF) who cannot tolerate anticoagulation.
Post-procedure patients are generally prescribed oral anticoagulation
(OAC) for 45 days, while the device is undergoing endothelialization,
following which patients are continued on antiplatelet agents.
Recommendations for antithrombotic agents following LAAO arrived by
consensus, which are not tolerated by all patients. Areas covered: This
review covers the safety profile of antithrombotic therapy options after
LAAO. We discuss the side effect profiles including device-related
thrombosis (DRT), bleeding, and thromboembolic events. The new randomized
controlled trials and meta-analysis compared combinations of DOAC with
single antiplatelet therapy (SAPT), dual antiplatelet therapy (DAPT), VKA,
or only SAPT and studied the incidence of major bleeding, DRT, and
thromboembolic events. This review is a comprehensive summary of different
antithrombotic agents' combinations along with the duration
recommendations and emphasizes the importance of a discussion among
involved team members and patients. Expert opinion: In patients with NVAF
undergoing LAAO, initial post-procedural antithrombotic monotherapy with
DOAC is associated with low rates of thromboembolism, DRT, and major
bleeding followed by DAPT. DAPT is associated with lower incidence of
thromboembolic events in comparison to SAPT. Copyright © 2025
Informa UK Limited, trading as Taylor & Francis Group.

<93>
Accession Number
648332543
Title
Early Aortic Valve Replacement of Asymptomatic Severe Aortic Stenosis: A
Meta-Analysis of Randomized Controlled Trials.
Source
Journal of the American Heart Association. 14(16) (pp e041283), 2025. Date
of Publication: 19 Aug 2025.
Author
Song Q.; Liu R.; Yang K.; Tu X.; Tan H.; Fan C.; Li X.
Institution
(Song, Liu, Tu, Tan, Fan) Department of Cardiovascular Surgery, The Second
Xiangya Hospital Central South University Changsha Hunan China
(Yang) Department of Plastic and Aesthetic(Burn)Surgery, Second Xiangya
Hospital Central South University Changsha China
(Li) Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya
Hospital Central South University Changsha China
Abstract
BACKGROUND: Asymptomatic severe aortic stenosis may lead to the
progression to both symptoms and adverse outcomes if left untreated. The
appropriate timing of intervention for these patients remains
controversial, and any decision requires careful assessment.
 METHOD(S): We searched PubMed, Web of Science, EMBASE, and Cochrane
Library for randomized controlled trials comparing early aortic valve
replacement with conservative management in asymptomatic patients with
severe aortic stenosis until December 2024. The primary efficacy outcome
was a composite of all-cause mortality, hospitalization for cardiovascular
causes, stroke, and myocardial infarction. We expressed outcome data as
risk ratios (RRs) with 95% CIs. RESULT(S): We included 4 randomized
controlled trials involving 1427 patients. Early aortic valve replacement
significantly reduced the incidence of the composite outcome when compared
with conservative management (29.2% versus 53.7%; RR, 0.56 [95% CI,
0.49-0.64]; I2=60%). Significant reductions were also detected in
all-cause mortality (10.0% versus 13.7%; RR, 0.74 [95% CI, 0.55-0.99];
I2=58%), hospitalization for cardiovascular causes (14.6% versus 32.5%;
RR, 0.48 [95% CI, 0.39-0.58]; I2=26%), and stroke (4.5% versus 7.2% RR,
0.62 [95% CI, 0.40-0.95]; I2=0%). No significant difference was observed
in cardiac-specific mortality (8.3% versus 16% RR, 0.68 [95% CI,
0.40-1.16]; I2=65%) and myocardial infarction (0.6% versus 4.6%; RR, 0.21
[95% CI, 0.04-1.19]; I2=0%). CONCLUSION(S): Our meta-analysis of
randomized controlled trials showed that among patients with asymptomatic
severe aortic stenosis, a strategy of early aortic valve interventions was
superior to conservative treatments in reducing the primary composite
outcome of all-cause mortality, hospitalization for cardiovascular causes,
stroke, and myocardial infarction. However, significant differences in the
rates of cardiac-specific mortality were not apparent.

<94>
[Use Link to view the full text]
Accession Number
2040086815
Title
Incidence, Predictors, and Mortality of Acute Coronary Syndrome after
Transcatheter Aortic Valve Replacement: A Systematic Review and
Meta-Analysis.
Source
Cardiology in Review. (no pagination), 2025. Article Number:
10.1097/CRD.0000000000001024. Date of Publication: 2025.
Author
Ong L.T.; Balasubramaniam R.; Chee N.M.Z.
Institution
(Ong, Balasubramaniam, Chee) Faculty of Medicine, University of Malaya,
Kuala Lumpur, Malaysia
Publisher
Lippincott Williams and Wilkins
Abstract
Transcatheter aortic valve replacement (TAVR) is a crucial intervention
for patients with severe aortic stenosis. There is limited data regarding
the occurrence of coronary events post-TAVR and the adverse outcomes. This
study aimed to establish the prevalence, mortality rate, and predictive
factors of acute coronary syndrome (ACS) post-TAVR. A systematic
literature search was conducted via PubMed, SCOPUS, and Ovid SP to
retrieve studies reporting the incidence of ACS following TAVR. Pooled
incidence and pooled odds ratios (ORs) were calculated using the generic
inverse variance method. A total of 10 studies involving 462,060 patients
underwent TAVR and 11,402 patients diagnosed with ACS following TAVR were
included in this meta-analysis. The incidence of ACS following TAVR was
1.9% [95% confidence interval (CI): 0.8-4.2%]. Further analysis
demonstrated that the incidence of ST-elevation myocardial infarction,
non-ST-elevation myocardial infarction, and unstable angina was 8.9% (95%
CI: 5.2-14.7%), 77.6% (95% CI: 59.0-89.3%), and 18.0% (95% CI: 2.6-63.8%),
respectively. Notably, 33.5% (95% CI 13.1-62.8%) of the patients were
managed with percutaneous coronary intervention. The mortality rate was
11.1% (95% CI: 7.1-17.2%). History of percutaneous coronary intervention
(OR: 1.48, 95% CI: 1.31-1.67) and diabetes (OR: 1.21, 95% CI: 1.03-1.43)
were predictors of development of ACS after TAVR. The incidence of ACS in
post-TAVR patients is low but is associated with a significant mortality
rate. Copyright © 2025 Wolters Kluwer Health, Inc. All rights
reserved.

<95>
Accession Number
2035653926
Title
Rationale and design of the TRIC-I-HF-DZHK24 (TRICuspid Intervention in
Heart Failure) trial.
Source
European Journal of Heart Failure. (no pagination), 2025. Date of
Publication: 2025.
Author
von Bardeleben R.S.; Leistner D.M.; Kehl V.; Grzeschniok M.; Hagendorff
A.; Hausleiter J.; Stocker T.J.; Massberg S.; Stolz L.; Nabauer M.;
Weckbach L.; Doldi P.; Novotny J.; Geisler T.; Gawaz M.; Goldschmidt A.;
Zdanyte M.; Rottbauer W.; Kessler M.; Lubos E.; Frerker C.; Saraei R.;
Eitel I.; Schmidt T.; Stiermaier T.; Dejanovikj M.; Kupp S.; Alhagi M.;
Schofer N.; Kalbacher D.; Frank J.; Frank D.; Lutz M.; Saad M.; von
Bardeleben S.; Lurz P.; Ruf T.; Gossler T.; Rudolph V.; Friedrichs K.P.;
Rudolph T.; Ivannikova M.; Scholtz W.; Omran H.; Kister T.; Thiele H.;
Osteresch R.; Hambrecht R.; Lauten A.; Rassaf T.; Mahabadi A.A.; Rothe J.;
Besler C.; Wild M.; Westermann D.; Loffelhardt N.; Pfister R.; Baldus S.;
Iliadis C.; Mehrkens D.; Xhepa E.; Joner M.; Trenkwalder T.; Covarrubias
H.A.; Schurmann F.; Schunkert H.; Leistner D.; Polzin A.; Kelm M.; Horn
P.; Westenfeld R.; Tigges E.; Nickenig G.; Weber M.; Schulz M.; Vogelhuber
J.; Nelles D.; Butter C.; Konstandin M.; Frey N.; Nikolai P.; Bekeredjian
R.; Wolf A.; Vorpahl M.M.; Landmesser U.; Barbieri M.R.F.; Schofer J.;
Brinkmann C.; Unsold B.; Piayda K.; Mobius-Winkler S.; Schulze C.
Institution
(Stocker, Stolz, Massberg, Hausleiter) Department of Cardiology,
Department of Medicine I, LMU University Hospital, LMU Munich, Munich,
Germany
(Stocker, Stolz, Massberg, Hausleiter) German Center for Cardiovascular
Research (DZHK), partner site Munich Heart Alliance, Munich, Germany
(Geisler) Department of Cardiology and Angiology, Eberhard Karls
University Tubingen, Tubingen, Germany
(Rottbauer) Department of Cardiology, University Heart Center, Ulm,
Germany
(Lubos) Department of Internal Medicine and Cardiology, Katholisches
Marienkrankenhaus, Hamburg, Germany
(Frerker) University Heart Center, Schleswig-Holstein University, Lubeck,
Germany
(Frerker, Schofer, Frank) German Center for Cardiovascular Research
(DZHK), partner site Hamburg-Kiel-Lubeck, Lubeck, Germany
(Schofer) Department of Cardiology, University Heart and Vascular Center
Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Frank) Department of Internal Medicine III, Cardiology, Angiologyand
Intensive Care Medicine, University Hospital Schleswig-Holstein Kiel,
Kiel, Germany
(von Bardeleben, Lurz) Department of Cardiology, Universitatsmedizin
Johannes Gutenberg-University, Mainz, Germany
(von Bardeleben, Leistner, Lurz) German Center for Cardiac and Vascular
Research (DZHK), partner site Rhein-Main, Germany
(Kister) Department of Cardiology, Heart Center Leipzig at University of
Leipzig, Leipzig, Germany
(Osteresch) Bremen Institute for Heart and Circulation Research (BIHKF) at
the Klinikum Links der Weser, Bremen, Germany
(Lauten) Department of General and Interventional Cardiology and
Rhythmology, Helios Klinikum Erfurt, Erfurt, Germany
(Rassaf) Department of Cardiology and Vascular Medicine, West German Heart
and Vascular Center, University Hospital Essen, Essen, Germany
(Rothe) Division of Cardiology and Angiology, University Heart Center
Freiburg-Bad Krozingen, Bad Krozingen, Germany
(Leistner) Department of Cardiology and Angiology, Goethe University,
Frankfurt am Main, Germany
(Kehl, Grzeschniok) Munchner Studienzentrum (MSZ), TUM School of Medicine
and Health, Technical University of Munich, Munich, Germany
(Hagendorff) Department of Cardiology, Leipzig University Hospital,
Leipzig, Germany
(Rudolph) General and Interventional Cardiology, Heart & Diabetes Center
NRW, Bad Oeynhausen, Germany
(Baldus) Department of Cardiology, University of Cologne, Cologne, Germany
Publisher
John Wiley and Sons Ltd
Abstract
Aims: Tricuspid regurgitation (TR) is a detrimental disease frequently
diagnosed in patients with right-sided heart failure (HF). While
transcatheter tricuspid valve interventions (TTVI) effectively reduce TR
and improve quality of life (QoL) in earlier stages of the disease, their
effect on reducing HF hospitalizations (HFH) and improving survival
remains unclear. Method(s): TRIC-I-HF-DZHK24 (NCT04634266) is an
investigator-initiated, prospective, randomized, open-label, multicentre
strategy trial. Approximately 360 patients with severe TR and manifest
right-sided HF will be enrolled. In contrast to previous trials, subjects
with increased risk for HFH will be selected as facilitated by specific
inclusion criteria: HFH in the previous year, or presence of cardio-renal
syndrome, or evidence for cardio-hepatic syndrome. Subjects will be
randomized 2:1 to TTVI and optimal medical therapy (OMT) or continuation
of OMT alone. All CE-marked transcatheter repair devices including
tricuspid transcatheter edge-to-edge repair (T-TEER) or transcatheter
tricuspid annuloplasty can be used for TTVI. The participating 29 study
sites are highly experienced and treated a mean of 176 patients in 4.5
years with T-TEER before study activation. The primary outcome will be
assessed at 1 year. First, a composite of all-cause mortality, HFH, and
QoL improvement will be tested hierarchically. If positive, the
combination of hard clinical endpoints including all-cause mortality and
HFH will be tested. Patients will be followed for a total of 3 years. The
safety outcome comprises complications of TTVI, life-threatening bleeding
and death. Conclusion(s): The TRIC-I-HF-DZHK24 trial will define the
role of TTVI in patients with severe TR and right-sided HF. Copyright
© 2025 The Author(s). European Journal of Heart Failure published by
John Wiley & Sons Ltd on behalf of European Society of Cardiology.

<96>
Accession Number
2035729881
Title
Comparison of different timings of percutaneous coronary intervention in
patients with transcatheter aortic valve implantation: a network
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1596208. Date of Publication: 2025.
Author
Wen Q.; Yang J.; Xu G.; Wang D.
Institution
(Wen) Cardiovascular Medicine Department, Hulunbuir People's Hospital,
Inner Mongolia, Hulunbuir, China
(Yang, Xu, Wang) Department of Cardiovascular and Structural Heart
Disease, Inner Mongolia Forestry General Hospital, Inner Mongolia,
Yakeshi, China
Publisher
Frontiers Media SA
Abstract
Background: The combination of selective percutaneous coronary
intervention (PCI) and transcatheter aortic valve implantation (TAVI) is a
safe and feasible therapy and has become our preferred treatment option
for patients with severe aortic stenosis and high-risk coronary heart
disease. However, the timing of staged PCI is uncertain. The purpose of
this meta-analysis is to compare the benefits and risks of TAVI alone, PCI
before TAVI, simultaneous TAVI and PCI, and PCI after TAVI in TAVI
patients, and to provide guidance for clinical decision-making on the
timing of PCI in TAVI patients. Method(s): We searched Pubmed,
Embase, the Cochrane Library and Web of Science as of April 2025. By
employing Bayesian network meta-analysis, with the aid of R software
(V4.3.2) and in combination with Stata (V15), the analysis included
outcomes such as all-cause mortality, cardiovascular mortality, stroke,
bleeding and myocardial infarction (MI). Pooled analysis was performed
utilizing risk ratios (RR) and 95% confidence intervals (CI).
 Result(s): A total of 13 studies involving 304,181 patients were
included in the analysis. The research findings showed that the
application of TAVI alone significantly reduced the all-cause mortality
compared to PCI after TAVI (RR = 0.35, 95% CrI: 0.13, 0.88), and the
lowest all-cause mortality rate was observed in the cumulative ranking
(SUCRA = 75.89%). Compared with PCI after TAVI (RR = 0.57, 95% CrI: 0.41,
0.79) and TAVIplus PCI (RR = 0.72, 95% CrI: 0.54, 0.97), PCI before TAVI
significantly reduced cardiovascular mortality and was found the lowest
cardiovascular mortality in the cumulative ranking (SUCRA = 98.37%). In
comparison to TAVIplus PCI (RR = 0.44, 95% CrI: 0.27, 0.71), PCI after
TAVI significantly reduced the stroke rate and found the lowest stroke
rate in the cumulative ranking (SUCRA = 97.21%). The application of TAVI
alone significantly reduced the bleeding rate compared to TAVIplusPCI (RR
= 0.61, 95% CrI: 0.60, 0.62), and the lowest bleeding rate was observed in
the cumulative ranking (SUCRA = 88.14%). Compared with PCI before TAVI (RR
= 0.12, 95% CrI: 0.04, 0.29) and TAVI (RR = 0.21, 95% CrI: 0.12, 0.34),
TAVIplusPCI significantly reduced the incidence of myocardial infarction
and was found the lowest incidence of myocardial infarction in the
cumulative ranking (SUCRA = 96.44%). Conclusion(s): The timing of
application of TAVI combined with PCI affects mortality and the incidence
of cardiovascular events. Among them, PCI after TAVI may effectively
reduce all-cause mortality, cardiovascular mortality, and stroke, but the
interval between the two procedures remains uncertain. Future studies
should investigate the optimal interval between PCI and TAVI to maximize
clinical benefits. Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/, PROSPERO. Copyright 2025 Wen,
Yang, Xu and Wang.

<97>
Accession Number
2040111255
Title
The Use of Perceval Valves in Older Patients: A Systematic Review.
Source
Reviews in Cardiovascular Medicine. 26(7) (no pagination), 2025. Article
Number: 39463. Date of Publication: 01 Jul 2025.
Author
Deblier I.; De Bock D.; Rodrigus I.; Mistiaen W.
Institution
(Deblier) Department of Cardiovascular Surgery, ZAS Middelheim Hospital,
Antwerp, Belgium
(De Bock, Rodrigus) Department of Cardiovascular Surgery, UZA - University
Hospital Antwerp, Edegem, Belgium
(Rodrigus, Mistiaen) Faculty of Medicine & Health Sciences, University of
Antwerp, Antwerp, Belgium
Publisher
IMR Press Limited
Abstract
Background: The Perceval device is a sutureless, rapid-deployment valve
designed to shorten aortic cross-clamp (ACC) and cardiopulmonary bypass
(CPB) times, with the aim of improving postoperative outcomes in older,
high-risk patients. Method(s): A systematic review was conducted for
full articles published between 2020 and 2024, comparing the Perceval
valve with conventionally sutured valves, with a focus on preoperative and
operative data, as well as postoperative outcomes. Single-arm series were
retained for the same purpose. Articles with at least 100 valves were
included. Result(s): A total of six propensity score-matched series
and four randomized controlled trials were identified after removing
articles with data from the same patient population. Consequently, age and
risk scores were comparable. The use of a minimally invasive approach and
the association of other procedures, such as coronary artery bypass
grafting (CABG), varied depending on the research design. Adverse
postoperative events were comparable for both valve types, except for the
development of conduction defects, which required the implantation of a
permanent pacemaker (PPM). The initial PPM implantation rate was higher
for the Perceval valve, as shown in 5 of the 14 comparative series;
however, this rate decreased after the adaptation of surgical techniques.
A meta-analysis showed that the CPB and ACC times were significantly
shorter using the Perceval valve, at 14.9 (8.2-21.5) minutes and 16.6
(12.1-21.2) minutes, respectively. Platelet counts after implantation were
lower with no clinical consequences, and the hemodynamic performance of
the Perceval device was acceptable and stable over time. The survival and
durability of the Perceval valve were also acceptable, with a reoperation
rate of 1% at the 5-year follow-up. Conclusion(s): The Perceval valve
appears to be a suitable alternative for older, high-risk patients
undergoing aortic valve replacement. Notably, the Perceval valve is
associated with shorter surgical times and could facilitate the advantage
of minimally invasive surgery. The need for postoperative PPM implantation
remains an issue. Copyright © 2025 The Author(s).

<98>
Accession Number
648298886
Title
Commentary to: Sex-Related Differences in Survival and Safety Outcomes
After Transcatheter Aortic Valve Replacement: A Meta-Analysis of
Reconstructed Time-to-Event Data: marathons for women and sprints for men:
shall we all run togheter?.
Source
European heart journal. Quality of care & clinical outcomes. (no
pagination), 2025. Date of Publication: 13 Aug 2025.
Author
Saitto G.; Luzi G.
Institution
(Saitto, Luzi) San Camillo Forlanini Hospital, Cardiac Surgery and Heart
Transplantation Unit

<99>
Accession Number
2035713590
Title
The Clinical and Medico-Legal Aspects in the Challenge of Transfusion-Free
Organ Transplants: A Scoping Review.
Source
Journal of Clinical Medicine. 14(15) (no pagination), 2025. Article
Number: 5444. Date of Publication: 01 Aug 2025.
Author
Bolcato M.; Fava L.; Shander A.; Zenger C.; Trentino K.M.; Chisari M.;
Agostini V.; Beverina I.; Biancofiore G.L.; De Angelis V.
Institution
(Bolcato) Department of Medicine, Saint Camillus International University
of Health and Medical Sciences, Rome, Italy
(Fava) MESIT Foundation of Social Medicine and Innovation Tecnology, Rome,
Italy
(Shander) Department of Anesthesiology and Critical Care, Englewood
Health, Englewood, NJ, United States
(Zenger) Center for Health Law and Management, University of Bern, Bern,
Switzerland
(Trentino) Medical School, The University of Western Australia, Perth, WA,
Australia
(Chisari) Rodolico-San Marco Hospital, Catania, Italy
(Agostini) Transfusion Medicine, IRCCS Ospedale Policlinico San Martino,
Genoa, Italy
(Beverina) Transfusion Medicine, ASST Valle Olona, Busto Arsizio, Italy
(Biancofiore) Transplant Anesthesia and Critical Care, University Hospital
of Pisa, Pisa, Italy
(De Angelis) National Blood Centre, Italian National Institute of Health,
Rome, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Patient blood management (PBM) strategies have been shown to
significantly reduce the use of blood products and enabled surgical
procedures to be carried out safely without the need for transfusions.
This evidence has raised questions about the possibilities of the
"extreme" application of PBM strategies for complex surgical
interventions, such as organ transplants, even in patients in whom it is
not possible to proceed with transfusion. The aim of this scoping review
was to identify and describe the current evidence available in the medical
literature on the transplant of the four main solid organs: kidney, heart,
liver, and lung in patients declining blood transfusions. Method(s):
A comprehensive literature search was conducted using PubMed from January
2000 to February 2025. Only articles reporting cases, case series,
population samples, or comparative studies describing solid organ
transplantation without the use of blood components were included. The
results are presented separately for each solid organ. Result(s):
Kidney: Nine studies were included, seven of which reported case reports
or case series of kidney or kidney-pancreas transplants, and two articles
were comparative studies. Liver: Nine studies reported bloodless liver
transplants, eight were case reports or case series, and one was a
comparative observational study. Heart: Five studies were included, four
of which were case reports of heart transplants; in addition there was a
comparative study describing eight heart transplants without the use of
blood components to 16 transfusable transplant patients. Lung: Five
studies reporting lung transplant without transfusion were reported, four
of which were case reports performed in the absence of deaths, and two of
which were bilateral. Furthermore, there was an article describing two
single lung transplants without the use of blood components compared to
ten transfusable transplant patients. Conclusion(s): The analysis
performed demonstrates the possibility, depending on the organ, of
performing solid organ transplant procedures without the use of blood
components in selected and carefully prepared patients by experienced
multidisciplinary teams. Copyright © 2025 by the authors.

<100>
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Accession Number
648293207
Title
Causal Factors of Nonischemic Cardiomyopathy: A Contemporary Review of
Mendelian Randomization Studies.
Source
Cardiology in review. (no pagination), 2025. Date of Publication: 13 Aug
2025.
Author
Dhabuwala A.; Senapati S.G.; Lapsiwala B.; Wala L.; Madhavaram N.J.; Kolli
D.; Desai R.
Institution
(Dhabuwala) From the Department of Internal Medicine, Government Medical
College, Surat, India
(Senapati) Department of Internal Medicine, Texas Tech University Health
Sciences Center, El Paso, TX, United States
(Lapsiwala) Department of Internal Medicine, Arlington, TX, United States
(Wala) Department of Internal Medicine, Shantabaa Medical College, Amreli,
India
(Madhavaram) Department of Internal Medicine, BLDE University, Bijapur,
India
(Kolli) Department of Internal Medicine, Kasturba Medical College,
Manipal, India
(Desai) AtlantaGAUnited States
Abstract
Nonischemic cardiomyopathies (NICMs), encompassing hypertrophic (HCM),
dilated (DCM), restrictive, arrhythmogenic right ventricular
cardiomyopathy/dysplasia, and nondilated left ventricular
cardiomyopathies, contribute significantly to cardiovascular morbidity,
representing nearly 50% of cardiac transplants. Despite improved genetic
and imaging techniques, underdiagnosis persists, particularly for HCM.
Mendelian randomization (MR) studies provide a powerful method to identify
causal risk factors, overcoming limitations of observational studies and
randomized controlled trials. This manuscript reviews MR studies to
identify causal factors for NICM, including endocrine, neurological,
psychological, musculoskeletal, and microbial influences, and evaluates
their implications for diagnostics and therapeutics. We reviewed MR
studies using genetic variants as instrumental variables to establish
causality. Studies employed one-sample and 2-sample MR, univariable and
multivariable analyses, and large-scale genome-wide association study
data. Causal relationships between exposures (eg, thyroid dysfunction,
type-1 diabetes, iron overload, gut microbiome) and NICM subtypes were
assessed, focusing on mediators such as inflammatory biomarkers. MR
studies confirmed causal links between NICM and autoimmune
endocrinopathies (eg, Hashimoto's thyroiditis and type-1 diabetes), iron
overload, obesity, smoking, stress/irritability, and gut microbial taxa.
Inflammatory biomarkers, such as monokine induced by interferon-gamma,
mediated endocrine pathways. Alzheimer's disease showed a protective
effect, while bone mineral density and homocysteine lacked causality.
Genetic loci (eg, SVIL and RBM20) were implicated in HCM and DCM.
Population stratification biased results, limiting generalizability. MR
studies reveal diverse NICM causal factors, supporting precision medicine
via enhanced screening and therapies targeting inflammatory mediators and
microbial influences. Future research should improve population diversity,
validate causal pathways, and explore the cardiac-gut-microbiome
axis. Copyright © 2025 Wolters Kluwer Health, Inc. All rights
reserved.

<101>
Accession Number
2040110911
Title
Short-term Effects of High Thoracic Epidural Blockade in Patients With
Ischemic Heart Disease and Heart Failure: A Systematic Review and Data
Synthesis.
Source
Reviews in Cardiovascular Medicine. 26(7) (no pagination), 2025. Article
Number: 37886. Date of Publication: 01 Jul 2025.
Author
Guo D.; Chen M.; Zhu C.; Liu Y.
Institution
(Guo, Zhu, Liu) Department of Internal Medicine and Pediatrics, Clinical
College of Qilu Medical University, Shandong, Zibo, China
(Chen) Department of Nursing Science, Clinical College of Qilu Medical
University, Shandong, Zibo, China
(Liu) Department of Cardiology, Affiliated Hospital of Qilu Medical
University, Shandong, Zibo, China
Publisher
IMR Press Limited
Abstract
Background: High thoracic epidural blockade (HTEB) with local
anti-sympathetic effects modulates cardiac performance in patients
undergoing cardiac or non-cardiac surgeries. However, the short-term
cardio-protective effects of HTEB in non-operative patients with ischemic
heart disease (IHD) and heart failure (HF) remain unclear. Our study aimed
to pool evidence regarding the benefits of adjunctive HTEB intervention in
patients with IHD and HF. Method(s): Exposures were defined as
non-operative patients with IHD and HF who received adjunctive HTEB
intervention and/or conventional medical treatment (CMT). The primary
outcomes were clinical recovery indicator assessments,
electrocardiographic and ultrasonic index improvement, laboratory tests,
and hemodynamic benefits provided by adjunctive HTEB treatment. The
secondary outcome was the effectiveness rate and adverse side effects
after HTEB intervention. The pooled analyses of continuous variables were
conducted using a fixed-effects model and the effects were represented by
the weighted mean difference (WMD) and a 95% confidence interval (CI). The
effective rates of HTEB treatment were represented using odds ratios (ORs,
95% CI) or effect size (ES, 95% CI). The I2 statistic was used
to identify any inconsistency in the pooled results from individual
trials. A meta-regression and subgroup analysis were conducted when
inconsistencies in individual trials were detected. Result(s): HTEB
treatment was associated with a significant 10% increase in left
ventricular ejection fraction (summary WMD, 9.651 [95% CI: 9.082 to
10.220]), a decline in neuroendocrine hormone levels, myocardial ischemia
relief, improvement in hemodynamics, and the reversal of decompensated
cardiac remodeling. HTEB treatment is more effective than conventional
medical treatment (odds ratio, 5.114 [95% CI: 3.189 to 8.203]) in treating
HF and angina pectoris. Conclusion(s): Our results suggest that HTEB
intervention may be a complementary approach for cardiac rehabilitation in
patients with IHD and HF. However, more data are necessary to confirm
these findings due to the significant heterogeneity of the included
studies. Copyright © 2025 The Author(s). Published by IMR Press.

<102>
Accession Number
648298540
Title
Half-dose versus full dose of aprotinin in cardiac surgery: a post-hoc
analysis of the aprotinin European Registry.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2025.
Date of Publication: 13 Aug 2025.
Author
Colson P.H.; Gaudriot B.; Provenchere S.; Rozec B.; Cholley B.; Mauriat
P.; Senard M.; Fellahi J.-L.
Institution
(Colson) CHU Montpellier, France
(Gaudriot) CHU Rennes, France
(Provenchere) AP-HP, Bichat-Claude Bernard hospital, France
(Rozec) CHU Nantes, France
(Cholley) Service d'Anesthesie-Reanimation, Hopital Europeen Georges
Pompidou, AP-HP, France
(Mauriat) CHU Bordeaux, France
(Senard) CHU Liege, Belgium
(Fellahi) HCL, Louis Pradel Hospital, France
Abstract
OBJECTIVES: To compare the effectiveness and safety of the full and half
doses of aprotinin, using the extended version of the Nordic aprotinin
patient registry, which was imposed by the European Medicines Agency
following the reintroduction of aprotinin in cardiac surgery in the
European market. METHOD(S): A post-hoc analysis was performed on data
prospectively collected from adult patients exposed to aprotinin during
cardiac surgery, in 83 cardiovascular surgical centres in nine European
countries, from 26-Feb.-2016 to 5-Oct.-2022. Full-dose (FD) and half-dose
(HD) regimens were used at the surgical team's discretion. The FD loading,
priming, and infusion doses were 2MKIU, 2MKIU, and 0.5MKIU/h,
respectively. Incidence of re-exploration for bleeding/tamponade 2 days
after surgery (2 D-re-exploration), 7 D-mortality, 3 D-MACCE (major
adverse cardiac and cerebral events), and 1 D-AKI (acute kidney injury)
were compared between FD and HD patients using propensity score methods to
reduce confounders. RESULT(S): 2,961 (44.4%) patients received the FD
regimen, and 3,703 (55.6%) the HD regimen. After adjustment, the incidence
of 2 D-re-exploration was estimated at 3.2% in the FD group and 4.4% in
the HD group: OR [95% CI] = 0.70 [0.53-0.94] (p = 0.015). No difference in
7 D-mortality or 3 D-MACCE was observed between the two regimens. The
incidence of 1 D-AKI was higher in patients with preoperative renal
dysfunction who received the FD regimen. CONCLUSION(S): Patients
receiving the FD aprotinin regimen had less surgical re-exploration than
those receiving the HD regimen. An increased risk of early postoperative
AKI was observed in the FD group, mainly for patients with preoperative
chronic kidney disease. Copyright © The Author(s) 2025. Published
by Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<103>
Accession Number
648302816
Title
The Effect of Specialized Collaborative Nursing on the Awakening Quality
and Stress Status of Elderly Patients Undergoing Coronary Artery Bypass
Surgery: A Randomized Controlled Study.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. (no pagination), 2025. Date of
Publication: 14 Aug 2025.
Author
Lv L.; Wang M.
Institution
(Lv) Department of Anesthesia, Affiliated Chenggong Hospital of Xiamen
University (73rd Army Group Hospital), Xiamen, Fujian, China
(Wang) Department of Anesthesia, Affiliated Chenggong Hospital of Xiamen
University (73rd Army Group Hospital), Xiamen, Fujian, China
Abstract
PURPOSE: Exploring the effect of specialized collaborative nursing model
during the awakening period for elderly patients undergoing coronary
artery bypass surgery. DESIGN: Prospective randomized controlled trial.
 METHOD(S): A total of 200 elderly patients who underwent coronary
artery bypass surgery at our hospital from January 2020 to January 2023
were selected as study subjects. They were randomly divided into a control
group and an observation group, with 100 patients in each group. The
control group received routine nursing care, while the observation group
received specialized collaborative nursing care during the awakening
period. The stress status during the awakening period [heart rate (HR),
systolic blood pressure (SBP), diastolic blood pressure (DBP), mean
arterial pressure (MAP)], awakening time, awakening quality [Observer
Assessment of Alertness and Sedation (OAAS)], and the incidence of
complications were compared between the two groups. FINDINGS: At the time
of extubation and 2 minutes after extubation, the levels of HR, SBP, DBP,
and MAP in both groups were higher than at the time of eye opening.
However, the levels of these indicators in the observation group were
lower than those in the control group, with statistically significant
differences (P < 0.05). The OAAS scores at different time points after
extubation in the observation group were higher than those in the control
group. The times for the recovery of spontaneous breathing, extubation,
eye opening upon calling, and length of stay in the postanesthesia care
unit were shorter in the observation group compared to the control group,
with statistically significant differences (P < 0.05). The incidence of
complications in the observation group was lower than in the control
group, with statistically significant differences (P < 0.05).
 CONCLUSION(S): Specialized collaborative nursing during the awakening
period can significantly reduce the stress status of elderly patients
undergoing coronary artery bypass surgery, improve the quality of
awakening, and reduce the incidence of related
complications. Copyright © 2025. Published by Elsevier Inc.

<104>
Accession Number
648265944
Title
Pleural drain placement following lung resection in children: A
prospective observational study of the Western Pediatric Surgery Research
Consortium.
Source
Journal of pediatric surgery. (pp 162541), 2025. Date of Publication: 09
Aug 2025.
Author
Kahan A.M.; Kelley-Quon L.I.; Acker S.N.; Vincent S.; Chao S.D.;
Nepomuceno H.; Lee J.H.; Padilla B.E.; Ignacio R.C.; Fialkowski E.A.;
Fowler K.L.; Cairo S.B.; Munar D.; Pandya S.R.; Russell K.W.; Fenton S.J.;
Lee S.L.; Rothstein D.H.
Institution
(Kahan, Russell, Fenton) Department of Surgery, Division of Pediatric
Surgery, University of Utah, Salt Lake City, UT, United States
(Kelley-Quon) Division of Pediatric Surgery, Children's Hospital Los
Angeles; Department of Surgery, Keck School of Medicine of University of
Southern California, Los Angeles, CA
(Acker, Vincent) Department of Pediatric Surgery, University of Colorado
School of Medicine, Children's Hospital Colorado, Aurora, CO, United
States
(Chao, Nepomuceno) Division of Pediatric Surgery, Stanford Children's
Hospital, Palo Alto, CA, United States
(Lee, Padilla) Division of Pediatric Surgery, Phoenix Children's Hospital,
University of Arizona College of Medicine, Phoenix, AZ, United States
(Ignacio) Division of Pediatric Surgery, Department of Surgery, University
of California San Diego, Rady Children's Hospital San Diego, CA, United
States
(Fialkowski, Fowler) Division of Pediatric Surgery, Doernbecher Children's
Hospital, Oregon Health and Science University, Portland, OR
(Cairo, Munar) Department of Surgery, University of California San
Francisco School of Medicine, CA; Division of Pediatric Surgery,
University of California San Francisco Benioff Children's Hospitals, San
Francisco, CA
(Pandya) Department of Pediatric General and Thoracic Surgery, University
of Texas Southwestern, Dallas, TX, United States
(Lee, Rothstein) Department of Pediatric General and Thoracic Surgery,
Seattle Children's Hospital, Seattle, WA, United States
Abstract
PURPOSE: Pleural drains are used routinely after thoracic surgery in
children despite evidence that drainage is not always necessary. The
purpose of this study was to assess the necessity of intraoperative drain
placement after resectional lung surgery in children, provide a
contemporary characterization of the use of pleural drains, and evaluate
the utility of intraoperative air leak testing. METHOD(S): A
multi-institutional prospective cohort study was performed at 10
free-standing children's hospitals in the United States from 2023-2024.
Patients <18 years old who underwent open or thoracoscopic wedge resection
or lobectomy were included. Patients undergoing operation for spontaneous
pneumothorax or trauma, those on extra-corporeal life support, those
undergoing bi-lobectomy or pneumonectomy, and those undergoing reoperation
in the affected hemithorax were excluded. Operative parameters,
intra-operative air leak, length of post-operative drain placement, and
number of post-operative chest x-rays were evaluated using bivariate
comparisons. RESULT(S): Among 229 patients (58% male, median age 12.3
years [IQR 5-16]), 113 (49%) underwent wedge resection and the remaining
116 (51%) underwent lobectomy. 201 patients (87.8%) had a pleural drain vs
28 (12.2%) without. Air leak testing was performed for 198 children: among
those with a negative leak test (168, 73.4%), 144 (85.7%) had a pleural
drain placed. Of the 90 children undergoing wedge resection with air leak
test results available, 78 (87%) had a negative leak test and 57 (73%) of
those patients still received pleural drainage. None of the 28 cases
initially without pleural drainage required post-operative insertion of a
pleural drain. Children with pleural drainage had significantly more
post-operative chest x-rays compared to those without (median 5 vs 2,
p<0.001), and a significantly longer post-operative length of stay (median
3 vs 1 days, p<0.001). CONCLUSION(S): Pleural drain placement after
lung resection in pediatric patients is routine but may not be necessary.
Patients with pleural drain incur significantly higher postoperative
radiation exposure compared to those without. Randomized control trials of
pleural drainage after resectional lung surgery are needed to examine
further if the routine use of pleural drainage is
necessary.III. Copyright © 2025 The Author(s). Published by
Elsevier Inc. All rights reserved.

<105>
[Use Link to view the full text]
Accession Number
2040070927
Title
Transfusion of Amustaline/Glutathione Pathogen-Reduced Red Blood Cells in
Cardiac Surgery - A Randomized Phase III Clinical Trial.
Source
Anesthesiology. (no pagination), 2025. Article Number:
10.1097/ALN.0000000000005716. Date of Publication: 2025.
Author
Sekela M.E.; Snyder E.L.; Welsby I.J.; Toyoda Y.; Alsammak M.; Sodha N.R.;
Beaver T.M.; Pelletier J.P.R.; Gorham J.D.; Mcneil J.S.; Sniecinski R.M.;
Pearl R.G.; Nuttall G.A.; Sarode R.; Reece T.B.; Benjamin R.J.; Kaplan A.;
Davenport R.D.; Ipe T.S.; Benharash P.; Lopez-Plaza I.; Sadler P.; Reik
R.; Gammon R.R.; Pitman J.P.; Liu K.; Bentow S.; Corash L.; Mufti N.;
Varrone J.
Institution
(Sekela) Gill Heart Institute University of Kentucky, Lexington, KY,
United States
(Snyder) Yale University School of Medicine, New Haven, CT, United States
(Welsby) Duke University Medical Center, Durham, NC, United States
(Toyoda) Temple University Hospital, Philadelphia, PA, United States
(Alsammak) Temple University Health System, Philadelphia, PA, United
States
(Sodha) Rhode Island Hospital, Providence, RI, United States
(Beaver) University of Florida, Gainesville, FL, United States
(Pelletier) University of Florida, Gainesville, FL, United States
(Gorham) University of Virginia Health System, Charlottesville, VA, United
States
(Mcneil) University of Virginia Health System, Charlottesville, VA, United
States
(Sniecinski) Emory University, Atlanta, GA, United States
(Pearl) Stanford University, Stanford, CA, United States
(Nuttall) Mayo Clinic, Rochester, MN, United States
(Sarode) University of Texas Southwestern Medical Center, Southwestern,
Dallas, TX, United States
(Reece) University of Colorado Hospital, Denver, CO, United States
(Benjamin) Chief Medical Officer, Cerus Corporation, Concord, CA, United
States
(Pearl) Stanford University School of Medicine, Stanford, CA, United
States
(Kaplan) University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Davenport) University of Michigan, Ann Arbor, MI, United States
(Ipe) Our Blood Institute, Oklahoma City, OK, United States
(Benharash) UCLA, Los Angeles, CA, United States
(Lopez-Plaza) Henry Ford Hospital, Detroit, MI, United States
(Sadler) Central California Blood Center, Fresno, CA, United States
(Reik) OneBlood, Orlando, FL, United States
(Gammon) OneBlood, Orlando, FL, United States
(Pitman) Cerus Corporation, Concord, CA, United States
(Liu) Cerus Corporation, Concord, CA, United States
(Bentow) Cerus Corporation, Concord, CA, United States
(Corash) Cerus Corporation, Concord, CA, United States
(Mufti) Cerus Corporation, Concord, CA, United States
(Varrone) Clinical Operations, Cerus Corporation, Concord, CA, United
States
(Pelletier) Shands UF Blood Bank, United States
(Pearl) Perioperative and Pain Medicine, United States
(Kaplan) Vitalant, Pittsburgh, PA, United States
(Davenport) Blood Bank, Cytopathology and Transfusion Medicine, United
States
(Ipe) University of Arkansas for Medical Sciences, Little Rock, AR, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Transfusion has a persistent low risk of
transfusion-transmitted infection and transfusion-associated
graft-versus-host disease that may be addressed using pathogen-reduction.
The Red Cell Pathogen Inactivation (ReCePI) trial tested whether
amustaline/glutathione pathogen-reduced Red Cells are non-inferior to
conventional transfusions for support of acute surgical blood loss.
 Method(s): A Phase III, double-blinded, non-inferiority trial
randomized cardiac or thoracic-aorta surgery patients with increased risk
of Red Cell transfusion to receive pathogen-reduced or conventional Red
Cells during and for seven days post-surgery. The primary endpoint was the
proportion of patients with acute kidney injury (AKI) defined as an
increase from baseline of >=0.3 mg/dL serum creatinine within 48 hours of
surgery. Non-inferiority was claimed if the upper bound 95%C.I. of the
treatment difference was less than half (50%) of the observed conventional
arm incidence. Adverse events and treatment-emergent Red Cell antibodies
were assessed for 28 and 75-days, respectively. Result(s): Five
hundred eighty-one subjects were randomized and 321 (55%) transfused with
study Red Cells. Transfused subjects in both arms had similar baseline
demographics, medical histories, hemoglobin levels and surgical
procedures. Hemoglobin Day 3 nadir levels (8.6g/dL [7.8-9.2]
pathogen-reduced; 8.4g/dL [7.8-9.3] conventional arm, P=0.52) were
comparable. Incidence of AKI by 48 hours was 46/157 (29.3%) in the
pathogen-reduced, and 45/161 (28.0%) in the conventional arm (treatment
difference 0.7%, 95%C.I. -8.9, 10.4%, non-inferiority margin 14.0%,
P=0.001 for non-inferiority). AKI within 7 days by KDIGO staging criteria
was not different (59/159 [37.1%] pathogen-reduced; 55/162 [34.0%]
conventional arm; p=0.53) but stage III was more common in the
pathogen-reduced arm (pathogen-reduced 15/159 [9.4%]; conventional arm
7/162 [4.3%], p=0.075). Five of 159 (3.1%) pathogen-reduced Red Cell
recipients developed specific, low-titer antibodies without evidence of
hemolysis. Conclusion(s): The incidence of AKI in recipients of
pathogen-reduced Red Cells was non-inferior to conventional Red Cell
transfusion. Treatment-emergent antibodies were uncommon and not
clinically significant. Copyright © 2025 The Author(s). Published
by Wolters Kluwer Health, Inc., on behalf of the American Society of
Anesthesiologists.

<106>
[Use Link to view the full text]
Accession Number
648263381
Title
Treatment strategies for patients with ischemic mitral regurgitation: a
systematic review and meta-analysis.
Source
International journal of surgery (London, England). (no pagination),
2025. Date of Publication: 12 Aug 2025.
Author
Li Q.; Liang M.; Gao M.; Liu W.; Bie D.; Luo X.
Institution
(Li, Liang, Luo) Department of Cardiology, Fuwai Shenzhen Hospital,
Chinese Academy of Medical Sciences, Shenzhen, Guangdong, China
(Li) Medical Research and Biometrics Center, National Clinical Research
Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of
Medical Sciences & Peking Union Medical College/National Center for
Cardiovascular Diseases, Beijing, China
(Gao) Department of Nutrition, Fuwai Hospital, National Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking
Union Medical College, Beijing, China
(Liu) Peking Union Medical College Hospital, State Key Laboratory for
Complex Severe and Rare Diseases, Institute of Clinical Medicine, Chinese
Academy of Medical Sciences, Beijing, China
(Bie) Department of Anaesthesiology, Fuwai Hospital, National Centre for
Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking
Union Medical College, Beijing, China
Abstract
BACKGROUND: Treatments for ischemic mitral regurgitation (IMR) include
coronary artery bypass grafting combined with mitral valve replacement
(CABG + MVR), percutaneous coronary intervention (PCI) alone, and PCI
combined with transcatheter edge-to-edge repair (TEER), but comparative
evidence remains limited. We aimed to systematically evaluate
perioperative characteristics, in-hospital and long-term outcomes of these
strategies. MATERIALS AND METHODS: This PRISMA 2020-compliant systematic
review and meta-analysis searched PubMed, EMBASE, Web of Science, Cochrane
Library, and ClinicalTrials.gov through 12 November 2024. We included
studies reporting outcomes for CABG + MVR, PCI alone, or PCI + TEER in
IMR, excluding non-human studies, reviews, case reports, editorials, etc.
The endpoints included in-hospital/30-day mortality, long-term mortality,
cardiovascular mortality, procedural metrics (cardiopulmonary bypass and
cross-clamp time), hospital stay, ICU stay, reoperation, readmission,
cerebrovascular events, atrial fibrillation, and low cardiac output
syndrome. Data were pooled using random-effects models. RESULT(S):
Thirty-three studies (1 RCT, 32 cohorts; n = 3,001 patients: 1,355 CABG +
MVR, 1,617 PCI, and 29 PCI + TEER) were analyzed. In-hospital/30-day
mortality was 13.8% (95% CI 3.9%-31.7%) for PCI + TEER, 11.8% (95% CI
8.4%-16.5%) for CABG + MVR, and 9.4% (95% CI 7.7%-11.5%) for PCI.
Five-year mortality was 37.5% for CABG + MVR vs. 41.8% for PCI. The pooled
cardiopulmonary bypass and cross-clamp time for CABG + MVR was 140.2 min
and 101.0 min respectively. PCI + TEER had shorter hospital stays (17.3
days) than CABG + MVR (22.4 days). Hospital/30-day IABP rate was lower in
CABG + MVR (7.9%) than PCI + TEER (24.1%). 30-day/in-hospital
complications included cerebrovascular events (CABG + MVR: 4.1%, PCI:
0.7%), atrial fibrillation (CABG + MVR: 22.9%), and low cardiac output
syndrome (CABG + MVR: 19.6%). 1-year readmission and 10-year reoperation
rates post-CABG + MVR were 7.4% and 31.1%. CONCLUSION(S): CABG + MVR
demonstrated superior long-term survival and lower cardiovascular
mortality than PCI, but carried higher perioperative risks and
complication rates. PCI + TEER showed shorter hospital stays but
insufficient data to assess long-term efficacy. Treatment selection
requires balancing comorbidities, surgical risk, and MR severity through
multidisciplinary decision-making. Robust comparative trials are needed to
optimize IMR management. Copyright © 2025 The Author(s).
Published by Wolters Kluwer Health, Inc.

<107>
[Use Link to view the full text]
Accession Number
648290255
Title
The Use of Protamine in Transcatheter Aortic Valve Replacement: A
Meta-analysis.
Source
American journal of therapeutics. (no pagination), 2025. Date of
Publication: 13 Aug 2025.
Author
Al-Abdouh A.; Kumar S.; Jabri A.; Mhanna M.; Alhuneafat L.; Paul T.K.;
Villablanca P.; Khalife W.
Institution
(Al-Abdouh) Department of Medicine, University of Kentucky, KY, United
States
(Kumar) Division of Cardiology, Creighton University School of Medicine,
Phoenix, AZ, United States
(Jabri) Department of Cardiology, Corewell Health William Beaumont
University Hospital, Royal Oak, MI, United States
(Mhanna) Department of Cardiology, University of Iowa, IA, United States
(Alhuneafat) Department of Cardiology, University of Minnesota,
Minneapolis, MN, United States
(Paul) University of Tennessee/Ascension St Thomas Hospital, Nashville,
TN, United States
(Villablanca) Division of Cardiology, Department of Structural Heart
Disease, Henry Ford Health System, Detroit, United States
(Khalife) Department of Cardiology, University of Texas Medical Branch,
Galveston, TX, United States

<108>
[Use Link to view the full text]
Accession Number
2040081727
Title
Effect of vitamin D supplementation on cardiovascular outcomes: An updated
meta-analysis of RCTs.
Source
Annals of Medicine and Surgery. 86(11) (pp 6665-6672), 2024. Date of
Publication: 01 Nov 2024.
Author
Mirza A.M.W.; Almansouri N.E.; Muslim M.F.; Basheer T.; Uppalapati S.V.;
Lakra S.; Fatima H.; Adhnon A.; Filho I.W.; Mahmood R.; Kumar M.; Kandel
K.; Ayyan M.
Institution
(Mirza) Department of Internal Medicine, Jinnah Medical & Dental College,
Karachi, Pakistan
(Ayyan) Department of Internal Medicine, Mayo Hospital, Pakistan
(Muslim) Department of Internal Medicine, Allama Iqbal Medical College,
Lahore, Pakistan
(Fatima) Department of Internal Medicine, Federal Medical College,
Islamabad, Pakistan
(Basheer) Department of Internal Medicine, Karuna Medical College, Kerala,
India
(Lakra) Department of Internal Medicine, Holy Heart Hospital, Haryana,
Rohtak, India
(Kumar) Department of Internal Medicine, Sardar Patel Medical College,
Rajasthan, Bikaner, India
(Mahmood) Department of Internal Medicine, Deccan College of Medical
Sciences, Telangana, Hyderabad, India
(Filho) Department of Internal Medicine, Faculdade Pernambucana de Saude
(FPS), Recife, Brazil
(Adhnon) Department of Internal Medicine, Dubai Medical College for Girls,
Dubai, United Arab Emirates
(Uppalapati) Department of Internal Medicine, All American Institute of
Medical Sciences, Jamaica, Jamaica
(Kandel) Department of Medicine, Kathmandu University, Kathmandu, Nepal
(Almansouri) Department of Internal Medicine, University of Tripoli
Faculty of Medicine, Tripoli, Libyan Arab Jamahiriya
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: To evaluate the effect of vitamin D supplementation on
cardiovascular outcomes. Method(s): After searching different
databases, we retrieved and included randomized controlled trials on
long-term supplementation of vitamin D (>=1-year intervention) and
reporting cardiovascular outcomes. We calculated risk ratio (RR) with 95%
confidence intervals (CI) for dichotomous outcomes. Result(s):
Compared to the control group, the vitamin D group was not associated with
a statistically significant decrease in the incidence of major adverse
cardiovascular events (MACE) [risk ratio=0.99; 95% CI: 0.94-1.03]. We
found no difference between the vitamin D group and the control group for
the outcomes of incidences of myocardial infarction, heart failure,
coronary revascularization, cardiovascular death, and all-cause mortality.
The heterogeneity was low for all outcomes. Conclusion(s): According
to our meta-analysis, vitamin D supplementation did not reduce major
adverse cardiovascular events, other cardiovascular parameters, and
all-cause mortality. Copyright 2024 The Author(s).

<109>
[Use Link to view the full text]
Accession Number
2040081695
Title
Breaking boundaries: Exploring recent advances in anticoagulation and
thrombosis management: A comprehensive review.
Source
Annals of Medicine and Surgery. 86(11) (pp 6585-6597), 2024. Date of
Publication: 01 Nov 2024.
Author
Qureshi Z.; Altaf F.; Jamil A.; Siddique R.; Shah S.
Institution
(Qureshi) The Frank H. Netter M.D. School of Medicine at Quinnipiac
University, Bridgeport, CT, United States
(Altaf) Department of Internal Medicine, Icahn School of Medicine at Mount
Sinai/BronxCare Health System, New York, United States
(Jamil) Department of Medicine, Samaritan Medical Centre Watertown, New
York, United States
(Siddique) WatertownNYUnited States
(Shah) Nepalgunj Medical College, Chisapani, Nepal
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Thromboembolic disorders globally contribute to morbidity and
mortality, emphasizing adequate anticoagulation and thrombosis management.
Therapeutic advances are essential in preventing complications like
pulmonary embolism, stroke, and myocardial infarction. This review
summarizes recent anticoagulation advances, current challenges, future
directions, and novel anticoagulants and drug delivery systems on clinical
outcomes. Method(s): This paper assesses the effectiveness and safety
of new anticoagulants through a systematic review of recent clinical
trials, meta-analyses, and guideline publications. Key studies, including
PACIFIC-AF, RIVER, ENAVLE, ENVISAGE-TAVI AF, and ARCADIA, were analyzed to
provide a perspective on therapeutic advancements. Result(s): The
review highlights key findings from vital clinical trials. Asundexian, in
the PACIFIC-AF trial, demonstrated a 34% reduction in bleeding events
compared to Apixaban. In the RIVER trial, Rivaroxaban reduced significant
bleeding events by 20% compared to warfarin in patients with bioprosthetic
mitral valves. In the ENAVLE trial, Edoxaban achieved a 3.7% decrease in
thromboembolic events compared to warfarin without increasing significant
bleeding rates. In the ENVISAGE-TAVI AF trial, edoxaban was noninferior to
VKAs in preventing thromboembolic events but showed a slight increase in
major bleeding events by 1.5%. Lastly, the ARCADIA trial highlighted that
apixaban did not significantly reduce recurrent stroke risk compared to
aspirin, with both treatments having an annualized stroke rate of 4.4%.
 Conclusion(s): Advances in anticoagulant therapies and drug delivery
systems aim to enhance patients' clinical outcomes for thromboembolic
disorders. While recent trials show promising data, ongoing
patient-specific responses and monitoring challenges require further
research. Continuous innovation and investigation are essential to refine
anticoagulation practices and tailor treatments. Copyright 2024 The
Author(s).

<110>
Accession Number
648294746
Title
Age-Stratified Effect of Rivaroxaban Monotherapy for Atrial Fibrillation
in Stable Coronary Artery Disease: A Post Hoc Analysis of the AFIRE
Randomized Clinical Trial.
Source
JAMA cardiology. (no pagination), 2025. Date of Publication: 13 Aug 2025.
Author
Yamaguchi J.; Arashi H.; Hagiwara N.; Yasuda S.; Kaikita K.; Akao M.; Ako
J.; Matoba T.; Nakamura M.; Miyauchi K.; Matsui K.; Ogawa H.
Institution
(Yamaguchi, Arashi, Hagiwara) Department of Cardiology, Tokyo Women's
Medical University, Tokyo, Japan
(Yasuda) Department of Cardiovascular Medicine, Tohoku University Graduate
School of Medicine, Miyagi, Japan
(Yasuda) National Cerebral and Cardiovascular Center, Osaka, Japan
(Kaikita) Department of Cardiovascular Medicine, Graduate School of
Medical Sciences, Kumamoto University, Kumamoto, Japan
(Kaikita) Division of Cardiovascular Medicine and Nephrology, Department
of Internal Medicine, Faculty of Medicine, University of Miyazaki,
Miyazaki, Japan
(Akao) Department of Cardiology, National Hospital Organization Kyoto
Medical Center, Kyoto, Japan
(Ako) Department of Cardiovascular Medicine, Kitasato University School of
Medicine, Kanagawa, Japan
(Matoba) Department of Cardiovascular Medicine, Faculty of Medical
Sciences, Kyushu University, Fukuoka, Japan
(Nakamura) Division of Cardiovascular Medicine, Toho University Ohashi
Medical Center, Tokyo, Japan
(Miyauchi) Department of Cardiovascular Medicine, Juntendo Tokyo Koto
Geriatric Medical Center, Tokyo, Japan
(Matsui) Department of General Medicine and Primary Care, Kumamoto
University Hospital, Kumamoto, Japan
(Ogawa) Kumamoto University, Kumamoto, Japan
Abstract
Importance: Antithrombotic therapy is crucial for older patients with
coronary artery disease (CAD) and atrial fibrillation (AF) who are at a
high risk of bleeding and thrombotic events. Objective(s): To examine
the age-stratified effects of rivaroxaban monotherapy compared with those
of rivaroxaban plus antiplatelet agent combination therapy. Design,
Setting, and Participant(s): This was a post hoc secondary analysis of the
Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With
Stable Coronary Artery Disease (AFIRE) open-label randomized clinical
trial. This was a multicenter study conducted in Japan from February 23,
2015, to July 31, 2018. Patients with AF and stable CAD who had undergone
percutaneous coronary intervention or coronary artery bypass grafting 1 or
more years earlier or who had angiographically confirmed CAD that did not
require revascularization were enrolled. Participants were stratified into
4 groups by age (<70 years, 70-74 years, 75-79 years, and >=80 years).
Study data were analyzed from August 2024 to July 2025.
 Intervention(s): Rivaroxaban monotherapy or rivaroxaban plus
antiplatelet agent therapy. Main Outcomes and Measures: The primary
efficacy end point was a major adverse cardiovascular event, defined as a
composite of stroke, systemic embolism, myocardial infarction, unstable
angina requiring revascularization, or death from any cause. The primary
safety end point was major bleeding. Result(s): This study included a
total of 2215 participants (mean [SD] age, 74.3 [8.2] years; 1751 male
[79.1%]). The incidence of primary efficacy end points per patient-year
for rivaroxaban monotherapy vs rivaroxaban plus antiplatelet agent therapy
was 3.2% vs 4.3% (<70 years), 3.2% vs 2.8% (70-74 years), 3.8% vs 5.3%
(75-79 years), and 6.2% vs 10.3% (>=80 years). The hazard ratios were 0.74
(95% CI, 0.40-1.37) for those younger than 70 years, 1.16 (95% CI,
0.55-2.45) for those aged 70 to 74 years, 0.72 (95% CI, 0.41-1.26) for
those aged 75 to 79 years, and 0.61 (95% CI, 0.40-0.93) for those 80 years
and older (P for interaction =.51). For the primary safety end points, the
incidence was 0.5% vs 2.3% (<70 years), 2.2% vs 2.4% (70-74 years), 1.1%
vs 2.1% (75-79 years), and 2.9% vs 4.3% (>=80 years). The hazard ratios
were 0.23 (95% CI, 0.06-0.79) for those younger than 70 years, 0.91 (95%
CI, 0.39-2.15) for those aged 70 to 74 years, 0.52 (95% CI, 0.19-1.42) for
those aged 75 to 79 years, and 0.67 (95% CI, 0.35-1.27) for those 80 years
and older (P for interaction =.33). Conclusions and Relevance:
Results of this post hoc analysis of the AFIRE randomized clinical trial
reveal that rivaroxaban monotherapy reduced the risk of major
cardiovascular events and major bleeding across the broad range of age in
patients with AF and stable CAD. Possible age-related differences in
trends, with more pronounced efficacy in older patients and more
pronounced safety in younger patients, should be considered as hypothesis
generating and require further research. Trial Registration:
ClinicalTrials.gov Identifier: NCT02642419.

<111>
Accession Number
2040069183
Title
Half-Dose Anticoagulation versus Antiplatelet Therapy to Reduce Silent
Cerebral Embolism after Left Atrial Appendage Occlusion (HALO-SCE Study):
Rationale and Design of a Randomized Clinical Trial.
Source
Cerebrovascular Diseases. (no pagination), 2025. Date of Publication:
2025.
Author
Wang K.; Shi L.; Ruan Z.; Jin C.; Li M.; Liu H.; Chen H.; Ju W.; Chen M.
Institution
(Wang, Jin, Li, Liu, Chen, Ju, Chen) Department of Cardiology, The First
Affiliated Hospital, Nanjing Medical University, Nanjing, China
(Shi) Department of Cardiology, Affiliated Hospital of Nantong University,
Nantong, China
(Ruan) Department of Cardiology, Taizhou People's Hospital, Taizhou, China
Publisher
S. Karger AG
Abstract
Introduction: Patients with atrial fibrillation (AF) continue to face
thrombotic risks even after the left atrial appendages have been occluded,
which may manifest as silent cerebral embolisms (SCEs). Half-dose
anticoagulation (Hd-OAC) is a pathophysiologically more reasonable therapy
in addressing this issue than antithrombotic therapy, but it still lacks
strong evidence. Method(s): The trial (NCT05671276) is a multicenter,
randomized controlled trial comparing the efficacy of two antithrombotic
strategies (Hd-OAC therapy vs. standard antithrombotic therapy) in AF
patients after left atrial appendage occlusion (LAAO). The primary
endpoint is the incidence of newly detected SCEs on any magnetic resonance
imaging conducted during the follow-up period. The secondary endpoints
are: (1) more than two new SCEs during the follow-up, their size, and
distribution; (2) cognitive function, and (3) a composite endpoint of
all-cause mortality, clinical thromboembolic events, and major bleeding
events. Follow-up is scheduled at 90 +/- 15 days, 180 +/- 15 days, and 365
+/- 15 days after LAAO. Conclusion(s): This trial aimed to determine
whether Hd-OAC therapy can reduce the incidence of SCE and protect
cognitive function in patients who have successfully undergone LAAO,
compared to standard antithrombotic therapy. Copyright © 2025 S.
Karger AG, Basel.

<112>
Accession Number
2040071748
Title
Improving therapeutic education with 3D printing models of congenital
heart disease.
Source
Archives of Cardiovascular Diseases. Conference: 21st FCPC Medico-Surgical
Congress. Deauville France. 118(8 9S) (pp S277), 2025. Date of
Publication: 01 Sep 2025.
Author
Hong Do P.; El Arid J.M.; Neville P.; Lefort B.
Institution
(Hong Do, El Arid, Neville) Institut des Cardiopathies Congenitales de
Tours, CHRU de Tours, Hopital pediatrique Clocheville, Tours, France
(Lefort) Institut des Cardiopathies Congenitales de Tours, CHRU de Tours,
Tours, France
Publisher
Elsevier Masson s.r.l.
Abstract
Introduction: Explaining the anatomy and surgical repear of a congenital
heart defect (CHD) during a consultation is a crucial moment for patients
and their families. A good understanding of heart disease is essential for
adherence to therapy and reducing anxiety. We aim to evaluate the impact
of CHD 3D models on improving understanding and reducing anxiety in
parents prior to surgery. Method(s): Parents of children scheduled
for cardiac surgery were prospectively included and randomized into 2
groups: a control group who received a conventional explanation using
drawing, and a 3D group who additionally received an explanation using a
3D model of the heart defect (Figure 1). Before and after the surgical
consultation, each participant completed the same questionnaire assessing
knowledge and understanding of the disease and surgery (5-point Lickert
scale), and the same questionnaire assessing anxiety (State-Trait Anxiety
Inventory Y-A). Result(s): 22 parents of 15 children were assigned to
the "control group" (n = 10) or the "3D group" (n = 12). The 2 groups had
comparable levels of anxiety about surgery and understanding of pathology
and treatment before the consultation. With the 3D model, the level of
understanding and knowledge improved significantly more than with a
conventional explanation (understanding score 27.7 +/- 2.3 vs. 24.8 +/-
3.9; p = 0.04). At the same time, the anxiety score decreased more
significantly in the 3D group (STAI Y-A score 52.0 +/- 5.8 vs. 46.3 +/-
7.4; p = 0.05). Conclusion(s): Our preliminary results suggest an
improvement in parental understanding and a reduction in anxiety prior to
surgery, surpassing traditional methods of explanation. They constitute an
effective tool for educating parents and managing their preoperative
anxiety, thereby improving the therapeutic alliance. Copyright ©
2025

<113>
Accession Number
648263386
Title
A Pilot Study in Transcatheter Aortic Valve Replacement Patients to
Examine the Effects of Resistance Training and Protein Supplementation
Through Telehealth.
Source
Journal of aging and physical activity. (pp 1-14), 2025. Date of
Publication: 11 Aug 2025.
Author
Schattinger C.M.; Newlin-Bradner M.K.; Kviatkovsky S.A.; Smith G.L.;
Olsson S.E.; Thompson C.A.; Noel T.E.; Ormsbee M.J.; Panton L.B.
Institution
(Schattinger, Ormsbee, Panton) Department of Health, Nutrition, Food
Sciences, Florida State University, Tallahassee, FL, United States
(Newlin-Bradner) College of Nursing, Florida State University,
Tallahassee, FL, United States
(Newlin-Bradner, Panton) Institute of Successful Longevity, Florida State
University, Tallahassee, FL, United States
(Kviatkovsky) Department of Orthopedic Surgery and Department of
Physiology and Cell Biology, University of Arkansas for Medical Sciences,
Little Rock, AR, United States
(Smith, Olsson, Thompson, Noel) Southern Medical Group P.A., Tallahassee,
FL, United States
(Ormsbee) Institute of Sports Sciences and Medicine, Florida State
University, Tallahassee, FL, United States
(Ormsbee) Discipline of Biokinetics, Exercise and Leisure Sciences,
University of KwaZulu-Natal, Durban, South Africa
Abstract
BACKGROUND/OBJECTIVES: Approximately 70% of transcatheter aortic valve
replacement (TAVR) patients prior to TAVR have low muscle mass, increased
mortality risk, and reduced quality of life (QoL) with little improvement
in muscle mass and QoL after TAVR. Resistance training (RT) with protein
supplementation is effective for maintaining and increasing muscle mass
but has not been studied in TAVR patients. This study evaluated the
effects of a 12-week telehealth program of RT combined with protein
supplementation (RT + PRO; n = 11) versus PRO alone (n = 11) on body
composition, inflammation, strength, physical function, and QoL in TAVR
patients (75.7 +/- 6.5 years; body mass index: 31.3 +/- 6.4 kg/m2).
 METHOD(S): RT + PRO completed a RT program of 12 exercises, 2x/week,
8-15 repetitions, for 1-3 sets and consumed 75 g (37.5 g 2x/day) of whey
protein. PRO consumed the same protein but did not exercise.
 RESULT(S): There were no reported injuries. Adherence to the exercise
and protein supplementation was greater than 90%. RT + PRO had greater
improvements in strength (30-s chair stands: RT + PRO pre: 11 +/- 3 vs.
post: 13 +/- 3; PRO pre: 12 +/- 2 vs. post: 12 +/- 3 repetitions; p =
.003; time to complete five sit-to-stands: RT + PRO pre: 12.3 +/- 3.8 vs.
post: 9.6 +/- 2.7; PRO pre: 11.2 +/- 2.4 vs. post: 10.9 +/- 2.9 s; p =
.011) and QoL (Sarcopenia QoL Questionnaire: RT + PRO pre: 63.7 +/- 12.9
vs. post: 74.0 +/- 14.6; PRO pre: 69.7 +/- 13.6 vs. post: 69.2 +/- 16.1
points; p = .002). CONCLUSIONS/IMPLICATIONS: The telehealth exercise
program was safe and well attended. The RT + PRO protocol significantly
improved some measures of muscular strength and QoL in TAVR patients. A
telehealth exercise program may serve as an alternative to traditional in
person cardiac rehabilitation programs.

<114>
Accession Number
2040111085
Title
Six-Year Outcomes of CABG vs PCI in Diabetic Patients with Multivessel
Coronary Disease.
Source
Medical Science Monitor. 31 (no pagination), 2025. Article Number:
e948348. Date of Publication: 2025.
Author
Jonik S.; Piasecki A.; Jastrzebska A.; Opolski G.; Grabowski M.; Huczek
Z.; Kochman J.
Institution
(Jonik, Piasecki, Jastrzebska, Opolski, Grabowski, Huczek, Kochman) 1st
Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
Publisher
International Scientific Information, Inc.
Abstract
Background: Material/Methods: Results: Conclusion(s): Many randomized
controlled trials have explored the optimal revascularization strategy for
patients with di-abetes, but real-life outcomes are still poorly
investigated. We assessed the complete 6-year outcomes of diabetic
individuals with multivessel coronary artery disease (MVD) treated either
with coronary artery bypass grafting (CABG) or percutaneous coronary
intervention (PCI). We reviewed data of all patients from 176 local Heart
Team meetings and their treatment recommendations and assessed primary and
secondary endpoints of 317 MVD patients with diabetes qualified either for
CABG or PCI (98 and 219 patients, respectively) with subsequent optimal
medical therapy. At 6 years, no significant difference in overall
mortality was observed (16.3% vs 20.5% for PCI, P=0.38). The incidence of
myocardial infarction (MI) was higher in patients treated percutaneously
(4.1% vs 12.3% for PCI, P=0.02), while those undergoing CABG had
significantly longer postprocedural hospital stay (10.7 vs 4.4 days for
PCI, P<0.01). The occurrence of major adverse cardiac and cerebrovascular
events (MACCE), mainly driven by the increased rate of repeat
revascularization (RR), was higher in the PCI group (83.6% vs 44.9%,
P<0.01 and 47.0% vs 17.3%, P<0.01, respectively). The rates of stroke and
in-hospital mortality were similar between the 2 groups. For MVD patients
with diabetes, CABG was superior in real-life clinical practice in terms
of rates of MI, RR, and MACCE, while postprocedural hospital stays were
shorted with PCI. The rates of all-cause death, stroke, and in-hospital
mortality were comparable between groups. Copyright © Med Sci
Monit.

<115>
Accession Number
2040068578
Title
Prevalence and associated outcomes of right ventricular dysfunction in
peripartum cardiomyopathy: A systematic review, meta-analysis and
meta-regression.
Source
Open Heart. 12(2) (no pagination), 2025. Article Number: e003253. Date of
Publication: 17 Aug 2025.
Author
Wijayanto M.A.; Tristan C.D.; Lukas G.A.; Rahma A.A.; Ilyas M.F.; Myrtha
R.; Muliawan H.S.; Siswanto B.B.
Institution
(Wijayanto, Tristan, Lukas, Rahma, Ilyas) Faculty of Medicine, Universitas
Sebelas Maret, Central Java, Surakarta, Indonesia
(Myrtha) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, Universitas Sebelas Maret, Central Java, Surakarta, Indonesia
(Myrtha) Department of Cardiology and Vascular Medicine, Universitas
Sebelas Maret Hospital, Central Java, Sukoharjo, Indonesia
(Muliawan, Siswanto) Department of Cardiology and Vascular Medicine,
Faculty of Medicine, Universitas Indonesia, Jakarta, Central Jakarta,
Indonesia
(Muliawan) Department of Cardiology and Vascular Medicine, Universitas
Indonesia Hospital, West Java, Depok, Indonesia
(Siswanto) National Cardiovascular Center Harapan Kita, West Jakarta,
Jakarta, Indonesia
Publisher
BMJ Publishing Group
Abstract
Introduction Recent studies have highlighted the presence of right
ventricular dysfunction (RVD) in a substantial proportion of peripartum
cardiomyopathy (PPCM), with evidence suggesting that RVD is associated
with worse outcomes and a lower likelihood of left ventricular (LV)
recovery. This study aims to comprehensively assess the pooled prevalence,
associated outcomes and LV recovery of RVD in PPCM. Methods PubMed, Scopus
and ScienceDirect were used to identify relevant literature prior to 19
January 2025. Statistical analysis was conducted using RStudio. All
meta-analyses were performed using random effects, with subsequent
subgroup analysis and univariate meta-regression conducted for prevalence
meta-analysis. Results The pooled prevalence of RVD in PPCM was 0.48 (95%
CI: 0.36 to 0.59; I2 95.3%) across 14 studies (1385 patients). RVD was
diagnosed using multimodality imaging (e.g., echocardiography and cardiac
magnetic resonance imaging), with diagnostic criteria defined in the
original studies. Meta-regression showed a decreasing trend in RVD
prevalence in more recent publications (p=0.03), with variability based on
study design, location and diagnostic modality on subgroup analysis.
Patients with RVD had a significantly higher risk of composite adverse
outcomes (including death, LV assist device implantation, heart
transplantation or the use of extracorporeal membrane oxygenation; hazard
ratio 2.71; 95% CI 1.08 to 6.84; p=0.04; three studies) and heart
transplantation (risk ratio (RR) 4.71; 95% CI 1.82 to 12.20; p<0.01; two
studies). Additionally, RVD was associated with a lower baseline LV
ejection fraction (mean difference -10.94; 95% CI -14.80 to -7.08; p<0.01;
six studies) and an increased risk of unrecovered LV function (RR 1.62;
95% CI 1.25 to 2.11; p<0.01; four studies). Conclusion RVD occurs in
nearly half of patients with PPCM and is associated with a poor prognosis.
It may represent a crucial marker for prognostic stratification,
particularly for the risk of unrecovered LV function. PROSPERO
registration number CRD42025626739. Copyright © Author(s) (or
their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial
re-use. See rights and permissions. Published by BMJ Group.

<116>
Accession Number
2036987137
Title
Post-heart Surgery and Levothyroxine Therapy: A Narrative Review.
Source
Journal of Comprehensive Pediatrics. 16(4) (no pagination), 2025. Article
Number: e161996. Date of Publication: 30 Nov 2025.
Author
Mirhaghjoo Z.S.; Hassanzadeh Rad A.; Nikpour S.
Institution
(Mirhaghjoo, Hassanzadeh Rad, Nikpour) Pediatric Diseases Research Center,
Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of
Publisher
Brieflands
Abstract
Context: Cardiopulmonary bypass (CPB), commonly used in cardiac surgeries,
often disrupts thyroid hormone levels, leading to conditions like sick
euthyroid syndrome (SES), which can impair myocardial function and delay
recovery. Objective(s): This narrative review examines the impact of
levothyroxine therapy on cardiac performance and survival outcomes in
patients undergoing heart surgery, particularly those with thyroid
dysfunction. Method(s): This narrative review was conducted through a
literature search on articles in English with the relevant keywords.
 Result(s): The review highlights that levothyroxine, a synthetic
thyroid hormone, helps restore normal thyroid function, improving
hemodynamic stability and cardiac output, and reducing postoperative
complications. Studies suggest that levothyroxine therapy facilitates
faster recovery, shorter ICU stays, and potentially lower mortality rates.
However, the optimal dosing, timing, and duration of therapy remain
unclear. Conclusion(s): While short-term benefits are evident,
further research is needed to evaluate the long-term effects of
levothyroxine on cardiac function and survival. Copyright © 2025,
Mirhaghjoo et al.

<117>
Accession Number
648237980
Title
Safety of Transcatheter Aortic Valve Replacement for High-Risk Patients
with Severe Aortic Stenosis.
Source
Kardiologiia. 65(7) (pp 63-73), 2025. Date of Publication: 06 Aug 2025.
Author
Meng Q.; Ye M.; Zhang H.
Institution
(Meng, Ye, Zhang) First Affiliated Hospital of Army Medical University,
Department of Cardiac Surgery
Abstract
Background Severe aortic stenosis (AS) is a life-threatening condition
that necessitates prompt intervention, even in high-risk patients with
contraindications to surgical aortic valve replacement (SAVR).
Transcatheter aortic valve replacement (TAVR) has become a transformative
treatment, utilizing various access routes, including transfemoral (TF),
transapical, and other, alternative pathways. The selection of the access
route significantly impacts procedural safety and outcomes. The purpose of
this study is to compare the safety profiles of different TAVR access
routes in high-risk patients with severe AS.Material and methods Following
the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines, a comprehensive literature search was performed in PubMed and
Cochrane Library databases to identify studies that evaluated the safety
outcomes of TAVR via various access routes in high-risk patients. Key
endpoints analyzed were procedural complications, 30-day mortality,
cardiac electrophysiological abnormalities, stroke incidence, and vascular
complications. Meta-analysis utilizing RevMan 5.3 was performed, employing
fixed or random effects models based on heterogeneity.Results Seven
studies encompassing 2,351 patients were included in the analysis. The
pooled analysis revealed that the non-TF access routes were associated
with a significantly higher risk ratio (RR) for procedural complications
[RR=1.76; 95 % confidence interval (CI): 1.63-1.89, p<0.00001] compared
to the TF approach. No statistically significant difference in 30-day
mortality was observed among the access routes [OR=0.79; 95 % CI:
0.60-1.05, p=0.11]. However, alternative routes had increased odds
ofcardiac electrophysiological abnormalities [OR=1.44; 95 % CI: 1.12-1.84,
p=0.004]. There was no significant difference in stroke incidence between
access routes [OR=1.16; 95 % CI: 0.75-1.79, p=0.51], but vascular
complications were significantly more frequent with non-femoral routes
[OR=1.70; 95 % CI: 1.29-2.24, p=0.0001].Conclusion This meta-analysis
underscores the critical role of access route selection in the safety of
TAVR. While the TF approach remains the gold standard due to its lower
complication rates, alternative routes are indispensable for anatomically
or clinically challenging cases. Refinements in procedural techniques,
patient selection, and advanced imaging are essential to optimizing
outcomes across all access routes. Further large-scale studies are
warranted to validate these findings and enhance clinical decision-making.

<118>
Accession Number
648255859
Title
Efficacy and Safety Profile of Low-Dose Tranexamic Acid Regimen in Cardiac
Surgery: A Meta-Analysis.
Source
Brazilian journal of cardiovascular surgery. 40(5) (pp e20240022), 2025.
Date of Publication: 07 Aug 2025.
Author
Wardhana A.; Ghea C.; Nugroho A.; Kinasih N.C.P.; Nugroho J.
Institution
(Wardhana) Department of Anesthesiology, Faculty of Medicine, Universitas
Surabaya, Surabaya, East Java, Indonesia
(Ghea, Nugroho) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, Airlangga University, Dr. Soetomo General Hospital, Surabaya,
East Java, Indonesia
(Nugroho, Kinasih) Faculty of Medicine, Public Health and Nursing, Gadjah
Mada University, Special Region of Yogyakarta, Yogyakarta, Indonesia
Abstract
INTRODUCTION: Various dosing regimens of tranexamic acid have been
reported to exhibit varying efficacy and safety profiles. Herein, we
conducted a meta-analysis to evaluate the efficacy and safety of low-dose
regimens in open-heart surgery. METHOD(S): Three databases were
systematically searched for randomized trials examining the bleeding
reduction effect of tranexamic acid in open-heart surgery. The pooled data
of the low-dose group was then compared with the control, high-dose, and
epsilon aminocaproic acid groups. The boundary between the lowand
high-dose groups was a bolus of 30 mg/kg followed by 16 mg/kg/hour.
 RESULT(S): The meta-analysis included 81 studies. The low-dose
tranexamic acid regimen was associated with a decreased incidence of
reoperation (risk ratio: 0.52; 95% confidence interval: 0.39-0.69; high
quality of evidence), perioperative myocardial infarction (risk ratio:
0.64; 95% confidence interval: 0.43-0.95; high quality of evidence), the
amount of postoperative bleeding in 24 hours, and the need for transfusion
of packed red cells compared to control, without increasing the rates of
mortality, venous thromboembolism, or stroke. Compared with the high-dose
group, the low-dose group had a lower incidence of seizures and stroke.
The low-dose of tranexamic acid group also showed significantly reduced
postoperative bleeding; however, the cost of an increased risk of seizure
events was higher in the low-dose group than in the epsilon aminocaproic
acid group. CONCLUSION(S): Low-dose tranexamic acid effectively
reduced bleeding, the risk of reoperation, and myocardial infarction
without increasing the risk of adverse events.

<119>
[Use Link to view the full text]
Accession Number
2040020308
Title
The Use of Protamine in Transcatheter Aortic Valve Replacement: A
Meta-analysis.
Source
American Journal of Therapeutics. (no pagination), 2025. Article Number:
10.1097/MJT.0000000000002023. Date of Publication: 2025.
Author
Al-Abdouh A.; Kumar S.; Jabri A.; Mhanna M.; Alhuneafat L.; Paul T.K.;
Villablanca P.; Khalife W.
Institution
(Al-Abdouh) Department of Medicine, University of Kentucky, KY, United
States
(Kumar) Division of Cardiology, Creighton University School of Medicine,
Phoenix, AZ, United States
(Jabri) Department of Cardiology, Corewell Health William Beaumont
University Hospital, Royal Oak, MI, United States
(Mhanna) Department of Cardiology, University of Iowa, IA, United States
(Alhuneafat) Department of Cardiology, University of Minnesota,
Minneapolis, MN, United States
(Paul) University of Tennessee, Ascension St Thomas Hospital, Nashville,
TN, United States
(Villablanca) Division of Cardiology, Department of Structural Heart
Disease, Henry Ford Health System, Detroit, United States
(Khalife) Department of Cardiology, University of Texas Medical Branch,
Galveston, TX, United States
Publisher
Lippincott Williams and Wilkins

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