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<1>
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Accession Number
646283266
Title
Effectiveness and safety of negative pressure wound therapy in patients
with deep sternal wound infection: a systematic review and meta-analysis.
Source
International journal of surgery (London, England). 110(12) (pp
8107-8125), 2024. Date of Publication: 01 Dec 2024.
Author
Liu Y.-T.; Lin S.-H.; Peng C.; Huang R.-W.; Lin C.-H.; Hsu C.-C.; Chen
S.-H.; Lin Y.-T.; Lee C.-H.
Institution
(Liu, Peng, Huang, Lin, Hsu, Chen, Lin, Lee) Department of Plastic and
Reconstructive Surgery, Chang Gung Memorial Hospital, Taiwan and College
of Medical, Chang Gung University, Taoyuan, Taiwan (Republic of China)
(Lin) School of Medicine, Chang Gung University, Taoyuan, Taiwan (Republic
of China)
(Lin) Center for Vascularized Composite Allotransplantation, Chang Gung
Memorial Hospital, Taoyuan, Taiwan (Republic of China)
Abstract
BACKGROUND: Deep sternal wound infection (DSWI) is a severe and
life-threatening complication following cardiovascular surgery. Negative
pressure wound therapy (NPWT) has emerged as a promising therapeutic
bridging option for DSWI. In this systematic review and meta-analysis, the
authors aimed to evaluate the impact of NPWT on clinical outcomes in
patients with DSWI. MATERIAL AND METHODS: A comprehensive literature
search was conducted according to the PRISMA guideline in electronic
databases, including PubMed, Embase, and Cochrane Library. Data extraction
was performed independently by two reviewers, and risk of bias was
assessed by ROBINS-I tool. The primary outcomes assessed were mortality
rate and reinfection rate. The secondary outcomes assessed were length of
hospital stay and ICU stay. RESULT(S): In this systematic review
identified a total of 36 studies, comprising 3681 patients with DSWI who
received treatment. The meta-analysis revealed that NPWT was associated
with a significant reduction in mortality rate (RR 0.46, 95% CI:
0.35-0.61, P<0.000001) and reinfection rate (RR 0.43, 95% CI: 0.25-0.74,
P=0.002) compared to conventional wound management. Furthermore, pooling
of these studies showed significant difference between the NPWT and
conventional treatment groups in length of hospital stay (mean difference:
-4.49, 95% CI: -8.14 to -0.83; P=0.02) and length of ICU stay (mean
difference: -1.11, 95% CI: -2.18 to -0.04; P=0.04). CONCLUSION(S):
This systematic review and meta-analysis provide evidence that NPWT is
superior to conventional treatment for patients with DSWI following
cardiovascular surgery. Copyright © 2024 The Author(s). Published
by Wolters Kluwer Health, Inc.

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Accession Number
643493472
Title
Concomitant tricuspid valve surgery in patients undergoing left
ventricular assist device: a systematic review and meta-analysis.
Source
International journal of surgery (London, England). 110(5) (pp 3039-3049),
2024. Date of Publication: 01 May 2024.
Author
Luo Y.; Leng J.; Shi R.; Jiang Y.; Chen D.; Wu Q.; Tie H.
Institution
(Luo, Leng, Jiang, Chen, Wu, Tie) Department of Cardiothoracic Surgery,
First Affiliated Hospital of Chongqing Medical University, Chongqing,
China
(Shi) Department of Critical Care Medicine, First Affiliated Hospital of
Sun Yat-sen University, Guangzhou, Guangdong, China
Abstract
INTRODUCTION: This study aims to investigate the effect of concomitant
tricuspid valve surgery (TVS) during left ventricular assist device (LVAD)
implantation due to the controversy over the clinical outcomes of
concomitant TVS in patients undergoing LVAD. METHOD(S): A systematic
literature search was performed in PubMed and EMbase from the inception to
1 August 2023. Studies comparing outcomes in adult patients undergoing
concomitant TVS during LVAD implantation (TVS group) and those who did not
(no-TVS group) were included. The primary outcomes were right heart
failure (RHF), right ventricular assist device (RVAD) implantation, and
early mortality. All meta-analyses were performed using random-effects
models, and a two-tailed P <0.05 was considered significant.
 RESULT(S): Twenty-one studies were included, and 16 of them were
involved in the meta-analysis, with 660 patients in the TVS group and 1291
in the no-TVS group. Patients in the TVS group suffered from increased
risks of RHF [risk ratios (RR)=1.31, 95% CI: 1.01-1.70, P =0.04; I2 =38%,
pH =0.13), RVAD implantation (RR=1.56, 95% CI: 1.16-2.11, P =0.003; I2
=0%, pH =0.74), and early mortality (RR=1.61, 95% CI: 1.07-2.42, P =0.02;
I2 =0%, pH =0.75). Besides, the increased risk of RHF holds true in
patients with moderate to severe tricuspid regurgitation (RR=1.36, 95% CI:
1.04-1.78, P =0.02). TVS was associated with a prolonged cardiopulmonary
bypass time. No significant differences in acute kidney injury,
reoperation requirement, hospital length of stay, or ICU stay were
observed. CONCLUSION(S): Concomitant TVS failed to show benefits in
patients undergoing LVAD, and it was associated with increased risks of
RHF, RVAD implantation, and early mortality. Copyright © 2024 The
Author(s). Published by Wolters Kluwer Health, Inc.

<3>
Accession Number
2031895379
Title
Comparable bleeding and inflammation outcomes between heparin-coated and
uncoated minimal invasive extracorporeal circuits in isolated coronary
artery bypass surgery - A double-blinded randomized control trial.
Source
Perfusion (United Kingdom). 40(5) (pp 1248-1257), 2025. Date of
Publication: 01 Jul 2025.
Author
Jenni H.; Kovacic B.; Mihalj M.; Huber M.; Rieben R.; Carrel T.; Siepe M.;
Kadner A.; Erdoes G.
Institution
(Jenni, Mihalj, Carrel, Siepe, Kadner) Department of Cardiac Surgery,
University of Bern, University Hospital Bern, Bern, Switzerland
(Kovacic, Rieben) Department of BioMedical Research, University of Bern,
Bern, Switzerland
(Mihalj) Department of Advanced Cardiopulmonary Therapies and
Transplantation, University of Texas Health Science Center, Houston, TX,
United States
(Huber, Erdoes) Department of Anesthesiology and Pain Medicine, University
of Bern, University Hospital Bern, Bern, Switzerland
Publisher
SAGE Publications Ltd
Abstract
Objective: Minimally invasive extracorporeal circulation has been shown to
be non-inferior or even superior to conventional cardiopulmonary bypass
circuits in isolated coronary artery bypass grafting, but there is little
evidence whether the addition of a heparin-coated circuit can further
reduce the inflammatory response and amount of bleeding in these patients.
 Method(s): A single-center randomized control trial enrolled 49 adult
patients scheduled to undergo isolated coronary artery bypass grafting
with minimally invasive extracorporeal circulation (MiECC) between January
2015 and December 2018. Patients were randomized 1:1 to either the
heparin-coated circuit group, or the uncoated (control) circuit group. The
primary outcome was chest tube output 18 h after weaning from MiECC, and
secondary outcomes included inflammatory (TNF-alpha, IL-6, IL-8, IL-10)
and complement (C3a, C4d, C5a, sC5b-9) biomarkers, platelet count and
function (D2D, TAT, SDC1, PF4), number of transfused blood products, and
30-day survival. Result(s): Patients were randomized to undergo
myocardial revascularization using heparin-coated circuits (n = 25), and
to the uncoated MiECC circuit (n = 24), with comparable baseline
demographics. No significant difference was observed in chest tube output
and for all secondary outcomes. IL-6 and IL-8 were increased from baseline
at 18 h after weaning (effect size 0.29 and 0.05, respectively) and sC5b-9
was lower (effect size 0.11) in the heparin-coated than in the uncoated
MiECC, although not significantly different. Conclusion(s): Compared
with an uncoated MiECC circuit, heparin-coated MiECC circuit was not
associated with a reduction in postoperative bleeding, transfusion,
inflammation, complement activation, and platelet biomarkers, following
isolated coronary artery bypass grafting. Copyright © The
Author(s) 2024

<4>
Accession Number
2035477295
Title
Quantitative Flow Ratio-Guided vs. Angiography-Guided Percutaneous
Coronary Intervention: A Systematic Review and Meta-Analysis of One-Year
Clinical Outcomes +.
Source
Journal of Clinical Medicine. 14(14) (no pagination), 2025. Article
Number: 5015. Date of Publication: 01 Jul 2025.
Author
Tran V.N.; Dhindsa A.; Agadi K.; Pham H.N.; Truong H.H.; Nguyen C.D.;
Bashir H.; Pham H.D.; Truong T.V.; Tran P.; Nguyen T.
Institution
(Tran, Dhindsa, Agadi) Department of Internal Medicine, Weiss Memorial
Hospital, Chicago, IL, United States
(Pham) Department of Internal Medicine, The University of Arizona, Tucson,
AZ, United States
(Truong) Department of Internal Medicine, Ascension Saint Francis
Hospital, Evanston, IL, United States
(Nguyen) Department of Internal Medicine, Texas Tech University Health
Science Center, Amarillo, TX, United States
(Bashir, Truong) Department of Cardiology, The Christ Hospital Heart and
Vascular Institute, Cincinnati, OH, United States
(Bashir) The Lindner Center for Research and Education, Cincinnati, OH,
United States
(Pham) Department of Internal Medicine, Conemaugh Memorial Medical Center,
Johnstown, PA, United States
(Tran) Department of Internal Medicine, Nam Can Tho University, Can Tho,
Vietnam
(Nguyen) Department of Cardiology, Methodist Hospital, La Porte, IN,
United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Quantitative Flow Ratio (QFR) is a novel, wire-free, and
hyperemia-free physiological assessment for guiding Percutaneous Coronary
Intervention (PCI), which may offer advantages over traditional
angiography-guided PCI. This systematic review with meta-analysis compares
clinical outcomes after one year in patients who underwent QFR-guided
versus angiography-guided PCI. Method(s): This study was conducted
following the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) guidelines and was registered on 4 November 2024 in
PROSPERO (ID: CRD42024609799). A systematic search was performed across
multiple databases to identify clinical trials comparing QFR-guided and
angiography-guided PCI. Random-effects models were used to assess one-year
outcomes of major adverse cardiovascular events (MACEs),
revascularization, and rehospitalization, with heterogeneity measured
using I2, H2, and Cochran's Q statistics. Study
quality was evaluated using the Cochrane Risk of Bias 2 (RoB 2) tool.
 Result(s): Compared to traditional angiography-guided PCI, QFR-guided
PCI was associated with numerically lower but statistically
non-significant risks of MACEs (risk difference: -0.08, 95% CI: -0.20 to
0.04), revascularization (risk difference: -0.02, 95% CI: -0.08 to 0.03),
and rehospitalization (risk difference: -0.02, 95% CI: -0.08 to 0.04) over
one year. Substantial heterogeneity was observed for MACEs (I2
= 84.95%, H2 = 6.64) and revascularization (I2 =
94.18%, H2 = 17.18), whereas rehospitalization exhibited low
heterogeneity (I2 = 17.17%, H2 = 1.21). The risk of
bias was assessed by the RoB 2 tool, which revealed low to some concern
risk of bias across key domains. Conclusion(s): Quantitative Flow
Ratio (QFR) has demonstrated comparable one-year clinical outcomes to
traditional angiography for PCI guidance, with a trend toward improved
results. However, the high heterogeneity among studies and the risk of
bias necessitate the need for larger, high-quality trials to validate
these findings. Copyright © 2025 by the authors.

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Accession Number
641544698
Title
Meta-analysis of post-transcatheter aortic valve replacement outcomes in
patients with cardiac amyloidosis and aortic stenosis.
Source
International journal of surgery (London, England). 109(9) (pp 2872-2874),
2023. Date of Publication: 01 Sep 2023.
Author
Jaiswal V.; Joshi A.; Ishak A.; Nataraj M.; Ang S.P.; Khan N.; Daneshvar
F.; Aguilera-Alvarez V.H.; Verma D.; Shrestha A.B.; Sharma P.
Institution
(Jaiswal) JCCR Cardiology Research, Varanasi, India
(Joshi) Vydehi Institute of Medical Sciences and Research Centre,
Bangalore, India
(Ishak) European University Cyprus, School of Medicine, Nicosia, Cyprus
(Nataraj) Cardio-Pulmonary Physiotherapist and Research, Manipal,
Karnataka, India
(Ang) Division of Internal Medicine, Rutgers Health/Community Medical
Center, NJ, United States
(Khan) Jinnah Sindh Medical University, Karachi, Pakistan
(Daneshvar) Department of Cardiology, FL, United States
(Aguilera-Alvarez) Universidad Autonoma de Baja, CA, United States
(Verma) Janaki Medical College, Nepal
(Shrestha) Department of Internal Medicine, Abdur Rahim Medical College,
Dinajpur, Bangladesh
(Sharma) Division of Cardiology, Department of Internal Medicine, King
George's Medical University, India
Publisher
NLM (Medline)

<6>
Accession Number
2034583143
Title
Percutaneous coronary intervention with drug-eluting stents versus
coronary bypass surgery for coronary artery disease: A Bayesian
perspective.
Source
Journal of Thoracic and Cardiovascular Surgery. 170(2) (pp 558-565.e10),
2025. Date of Publication: 01 Aug 2025.
Author
Kawczynski M.J.; Gabrio A.; Maessen J.G.; van 't Hof A.W.J.; Brophy J.M.;
Gollmann-Tepekoylu C.; Sardari Nia P.; Vriesendorp P.A.; Heuts S.
Institution
(Kawczynski, Maessen, Sardari Nia, Heuts) Department of Cardiothoracic
Surgery, Maastricht University Medical Centre (MUMC+), Maastricht,
Netherlands
(Kawczynski, Maessen, van 't Hof, Sardari Nia, Vriesendorp, Heuts)
Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University, Maastricht, Netherlands
(Gabrio) Department of Methodology and Statistics, University Maastricht,
Maastricht, Netherlands
(van 't Hof, Vriesendorp) Department of Cardiology, Maastricht University
Medical Centre (MUMC+), Maastricht, Netherlands
(van 't Hof) Department of Cardiology, Zuyderland Medisch Centrum,
Heerlen, Netherlands
(Brophy) McGill University Health Centre, Centre for Health Outcome
Research (CORE), Montreal, QC, Canada
(Gollmann-Tepekoylu) Department of Cardiac Surgery, Medical University of
Innsbruck, Innsbruck, Austria
Publisher
Elsevier Inc.
Abstract
Objectives: Coronary revascularization is frequently performed for
coronary artery disease (CAD). This study aims to assess the totality of
randomized evidence comparing percutaneous coronary intervention with
drug-eluting stents (DES-PCI) with coronary artery bypass grafting (CABG)
for CAD. Method(s): A systematic search was applied to 3 electronic
databases, including randomized trials comparing DES-PCI with CABG for CAD
with 5-year follow-up. A Bayesian hierarchical meta-analytic model was
applied. The primary outcome was all-cause mortality at 5 years; secondary
outcomes were stroke, myocardial infarction, and repeat revascularization.
End points were reported in median relative risks (RRs) and absolute risk
differences, with 95% credible intervals (CrIs). Kaplan-Meier curves were
used to reconstruct individual patient data. Result(s): Six studies
comprising 8269 patients (DES-PCI, n = 4134; CABG, n = 4135) were
included. All-cause mortality at 5 years was increased with DES-PCI
(median RR, 1.23; 95% CrI, 1.01-1.45), with a median absolute risk
difference of +2.3% (95% CrI, 0.1%-4.5%). For stroke, myocardial
infarction, and repeat revascularization, the median RRs were 0.79 (95%
CrI, 0.54-1.25), 1.84 (95% CrI, 1.23-2.75), and 1.80 (95% CrI, 1.51-2.16)
for DES-PCI, respectively. In a sample of 1000 patients undergoing DES-PCI
instead of CABG for CAD, a median of 23 additional deaths, 46 myocardial
infarctions, and 85 repeat revascularizations occurred at 5 years, whereas
10 strokes were prevented. Conclusion(s): The current data suggest a
clinically relevant benefit of CABG over DES-PCI at 5 years in terms of
mortality, myocardial infarction, and repeat revascularization, despite an
increased risk of stroke. These findings may guide the heart-team and the
shared decision-making process. Copyright © 2024 The Authors

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

<8>
Accession Number
2035390572
Title
The effect of administration of Del Nido cardioplegia solution containing
vitamin C on myocardial protection and clinical outcomes in patients
undergoing coronary artery bypass graft surgery.
Source
Egyptian Heart Journal. 77(1) (no pagination), 2025. Article Number: 72.
Date of Publication: 01 Dec 2025.
Author
Jalili Shahandashti F.; Mozayan M.; Abdolkarimi L.; Kargar F.; Ghanbari
A.; Heidarinia S.; Totonchi Ghorbani M.Z.; Nabavi S.S.; Hosseini zargaz
S.E.
Institution
(Jalili Shahandashti, Mozayan, Abdolkarimi, Kargar, Ghanbari, Heidarinia,
Totonchi Ghorbani) Rajaie Cardiovascular Medical and Research Institute,
Shaheed Rajaie Cardiovascular Medical and Research Institute, Tehran,
Iran, Islamic Republic of
(Nabavi) Department of General Surgery, School of Medicine, Imam Khomeini
Hospital, Golestan Hospital, Ahvaz Jundishapur University of Medical
Sciences, Ahvaz, Iran, Islamic Republic of
(Hosseini zargaz) Cardiovascular Diseases Research Center, Birjand
University of Medical Sciences, Birjand, Iran, Islamic Republic of
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: A main concern during cardiac surgery is the protection of the
heart. Myocardial ischemia tends to increase the generation of reactive
oxygen species. Based on its oxidation-reduction potentials, vitamin C is
the most powerful antioxidant to counteract the effects of free radicals.
This reason made the researcher to perform this study with the goal to
determine and evaluate the effect of on perioperative clinical outcomes
and laboratory criteria of coronary artery bypass grafting (CABG) cases.
 Method(s): This randomized clinical trial (RCT) was done in 2022 at
Rajaie Cardiovascular Medical and Research Center. Following obtaining
permission from the ethics committee, 62 CABG patients were randomly
allocated to two groups and were included in the study. The control group
received routine Del Nido cardioplegia solution while vitamin C group
received Del Nido cardioplegia solution containing 3gr of vitamin C. In
this study, demographic information and variants like hemodynamic, blood,
and FFP transfusion were evaluated and compared. Data were analyzed by
two-way repeated measures ANOVA. Result(s): According to the
findings, diastolic blood pressure (DBP) in the vitamin C group was lower,
which was significant across both groups (P < 0.05); however, these
alterations were in the normal range. The groups showed no significant
difference in other parameters like fresh frozen plasma (FFP) transfusion
in the intensive care unit (ICU) and return to baseline heart rate (P >
0.05). Also, the average cardiac arrest time (average time to cardiac
arrest from the time of cardioplegia injection) in the controls was
significantly higher compared to the intervention group (P = 0.028).The
data indicate that for CK-MB, the group effect is not statistically
significant, while the effect of time and the interaction effect of group
and time are significant. For troponin, the group effect and the
interaction effect are not significant, although the effect of time is
significant. Therefore, adding vitamin C to the cardioplegia solution does
not significantly affect troponin. Conclusion(s): One of the factors
that contribute to myocardial protection is the reduction in the time to
achieve cardiac arrest. In the group that received vitamin C, this time
was reduced; therefore, it can be concluded that in this group, the risk
of damage due to lack of blood flow and oxygen to the cardiac tissue is
lower. Clinical trial number: This study is a randomized clinical trial
(RCT).IRCTID: IRCT20220716055477N1. Copyright © The Author(s)
2025.

<9>
Accession Number
2038260189
Title
FFR-Guided Percutaneous Coronary Intervention vs Coronary Artery Bypass
Grafting in Patients with Diabetes.
Source
JAMA Cardiology. 10(6) (pp 603-608), 2025. Date of Publication: 11 Jun
2025.
Author
Takahashi K.; Otsuki H.; Zimmermann F.M.; Ding V.Y.; Engstrom T.; Horsted
Thyregod H.G.; Beleslin B.; Putnik S.; Tapp L.; Barker T.; Redwood S.;
Young C.; Bech G.J.-W.; Hoohenkerk G.J.F.; De Bruyne B.; Pijls N.H.J.;
Fearon W.F.
Institution
(Takahashi, Otsuki, Ding, Fearon) Stanford University School of Medicine,
Stanford University, Stanford, CA, United States
(Takahashi, Otsuki, Ding, Fearon) Stanford Cardiovascular Institute,
Stanford University, Stanford, CA, United States
(Zimmermann) St Antonius Hospital, Nieuwegein, Netherlands
(Zimmermann, Pijls) Catharina Hospital, Eindhoven, Netherlands
(Engstrom, Horsted Thyregod) Rigshospitalet, University of Copenhagen,
Copenhagen, Denmark
(Beleslin, Putnik) Medical Faculty, University Clinical Center of Serbia,
University of Belgrade, Belgrade, Serbia
(Tapp, Barker) University Hospitals Coventry and Warwickshire, Coventry,
United Kingdom
(Redwood, Young) St Thomas' Hospital, London, United Kingdom
(Bech, Hoohenkerk) Hagaziekenhuis, The Hague, Netherlands
(De Bruyne) Cardiovascular Center Aalst, Aalst, Belgium
(Fearon) VA Palo Alto Medical Systems, Palo Alto, CA, United States
Publisher
American Medical Association
Abstract
Importance: Outcomes in patients with diabetes after fractional flow
reserve (FFR)-guided percutaneous coronary intervention (PCI) using
current-generation drug-eluting stents (DES) compared with coronary artery
bypass grafting (CABG) are unknown. Objective(s): To investigate the
relative treatment effect of PCI vs CABG according to diabetes status with
respect to major adverse cardiac and cerebrovascular events (MACCE) at 3
years and to evaluate the impact of the SYNTAX score. Design,
Setting, and Participant(s): This is a prespecified subgroup analysis of
the FAME (Fractional Flow Reserve vs Angiography for Multivessel
Evaluation) 3 trial, an investigator-initiated, randomized clinical trial
conducted at 48 centers worldwide. The FAME 3 trial enrolled patients with
3-vessel coronary artery disease not involving the left main undergoing
coronary revascularization between August 2014 and December 2019. Data
analysis was conducted in August 2023. Clinical follow-up was performed at
hospital discharge and at 1 month, 6 months, 1 year, 2 years, and 3 years
after randomization. Intervention(s): Either FFR-guided PCI with
current-generation DES or CABG. Main Outcomes and Measures: The
primary end point was MACCE, defined as the composite of all-cause death,
myocardial infarction, stroke, or repeat revascularization at 3 years.
 Result(s): Of 1500 total patients enrolled, mean (SD) patient age was
65.1 (8.4) years, and 265 patients (17.7%) were female. The FAME 3 trial
included 428 patients with diabetes (28.5%). Patients with diabetes,
especially those receiving insulin, had a higher risk of MACCE at 3 years
compared with those without diabetes. Regarding relative treatment effect,
the risk of MACCE was higher after FFR-guided PCI compared with CABG in
both patients with diabetes (hazard ratio [HR], 1.44; 95% CI, 0.91-2.28; P
=.12) and those without diabetes (HR, 1.50; 95% CI, 1.08-2.07; P =.02),
with no significant interaction (P for interaction =.94). In patients with
a low SYNTAX score (<23), there was no significant difference in MACCE
between PCI and CABG, while in patients with an intermediate to high
SYNTAX score (>=23), PCI had a higher risk of MACCE than CABG, regardless
of diabetes status. Conclusions and Relevance: In this subgroup
analysis of the FAME 3 randomized clinical trial, the relative benefit of
CABG compared with FFR-guided PCI was similar among patients with and
without diabetes. Trial Registration: ClinicalTrials.gov Identifier:
NCT02100722. Copyright © 2025 American Medical Association. All
rights reserved.

<10>
Accession Number
2039334175
Title
Impact of Cardiopulmonary Bypass Duration on the Renal Effects of Amino
Acids Infusion in Cardiac Surgery Patients.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(9) (pp 2296-2306),
2025. Date of Publication: 01 Sep 2025.
Author
Pontillo D.; Rong L.Q.; Pruna A.; Pisano A.; Monaco F.; Bruni A.; Baiardo
Redaelli M.; Ti L.K.; Belletti A.; Bradic N.; Massaro C.; Barucco G.;
Viscido C.; Losiggio R.; Federici F.; Marmiere M.; Silvetti S.; Marchetti
C.; Carmosino M.; Manazza M.; Oliva F.M.; Cortegiani A.; Guarracino F.;
Ranucci M.; Paternoster G.; Landoni G.; Zangrillo A.; Gaudino M.F.L.;
Bellomo R.; Bonaccorso A.; D'Amico F.; D'Andria Ursoleo J.; Lombardi G.;
Marzaroli M.; Mongardini E.; Vietri S.; Ferrod F.; Porta S.; Prezzi L.;
Vignale R.; Gallicchio F.; Neri G.; Mellace F.; Venditto M.; Baryshnikova
E.; Re M.R.; Rocco M.; Baldassarri R.; Salsano A.; Angeletti P.M.
Institution
(Pontillo, Pruna, Monaco, Belletti, Barucco, Losiggio, Marmiere,
Marchetti, Manazza, Oliva, Landoni, Zangrillo) Department of Anesthesia
and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
(Rong) Department of Anesthesiology, Weill Cornell Medicine, New York, NY,
United States
(Pisano) Cardiac Anesthesia and ICU, AORN "Dei Colli", Monaldi Hospital,
Naples, Italy
(Bruni) Anesthesia and Intensive Care Unit, Department of Medical and
Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro,
Italy
(Baiardo Redaelli) Anesthesia and Intensive Care, Department of
Biotechnologies and Life Sciences, University of Insubria, Varese, Italy
(Baiardo Redaelli) Intensive Care Unit, Circolo Hospital, Varese, Italy
(Ti) Department of Anaesthesia, National University Hospital, Singapore
(Bradic) Clinic of Anesthesiology, Resuscitation and Intensive Medicine,
University Hospital Dubrava, Zagreb, Croatia
(Bradic) Department of Nursing, University North, Varazdin, Croatia
(Massaro, Viscido) Department of Cardiovascular Anesthesia and Intensive
Care, A.O. Ordine Maurizio Umberto I di Torino, Turin, Italy
(Federici) Department of Anesthesia and Intensive Care, Azienda
Ospedaliero-Universitaria Sant' Andrea, Rome, Italy
(Silvetti) Department of Cardiac Anesthesia and Intensive Care, Ospedale
Policlinico San Martino IRCCS, IRCCS Cardiovascular Network, Genova, Italy
(Carmosino, Paternoster) Department of Health Science School of Medicine,
University of Basilicata, Potenza, Italy
(Cortegiani) Department of Precision Medicine in Medical, Surgical and
Critical Care Area, University of Palermo, Palermo, Italy
(Cortegiani) Department of Anesthesia Analgesia Intensive Care and
Emergency, University Hospital Policlinico "Paolo Giaccone", Palermo,
Italy
(Guarracino) Department of Cardiothoracic Anaesthesia and Intensive Care,
Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
(Ranucci) Department of Cardiovascular Anesthesia and Intensive Care,
IRCCS Policlinico San Donato, Milan, Italy
(Paternoster) Anesthesia and ICU, San Carlo Hospital, Potenza, Italy
(Landoni, Zangrillo) School of Medicine, Vita-Salute San Raffaele
University, Milan, Italy
(Bellomo) Department of Critical Care, The University of Melbourne,
Melbourne, Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, Australia
(Bellomo) Data Analytics Research and Evaluation Centre, Austin Hospital,
Melbourne, Australia
(Bellomo) Department of Intensive Care, Austin Hospital, Melbourne,
Australia
(Bellomo) Department of Intensive Care, Royal Melbourne Hospital,
Melbourne, Australia
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Bonaccorso, D'Amico, D'Andria Ursoleo, Lombardi, Marzaroli, Mongardini,
Vietri) Departmentof Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Venditto) CardiacAnesthesia and ICU, AORN "Dei Colli", Monaldi Hospital,
Naples, Italy
(Neri, Mellace) Anesthesiaand Intensive Care Unit, Department of Medical
and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro,
Italy
(Ferrod, Porta, Prezzi) S.C.Anestesia, e Rianimazione Cardiovascolare,
A.O. Ordine Maurizio Umberto I di Torino, Turin, Italy
(Rocco) UOCAnestesia e Rianimazione, Azienda Ospedaliero-Universitaria
Sant'Andrea, Azienda Ospedaliero-Universitaria Sant'Andrea, Rome, Italy
(Re) Departmentof Anesthesia Analgesia Intensive Care and Emergency,
University Hospital Policlinico "Paolo Giaccone", Palermo, Italy
(Vignale, Gallicchio) Departmentof Cardiovascular Anesthesia and ICU, San
Carlo Hospital, Potenza, Italy
(Baryshnikova) Departmentof Cardiovascular Anesthesia and Intensive Care,
IRCCS Policlinico San Donato, Milan, Italy
(Baldassarri) Departmentof Cardiothoracic Anaesthesia and Intensive Care,
Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
(Salsano) Divisionof Cardiac Surgery, Ospedale Policlinico San Martino,
Genoa, Italy
(Salsano) Departmentof Integrated Surgical and Diagnostic Sciences,
University of Genoa, Genoa, Italy
(Angeletti) CardiovascularDepartment, UO of Cardiac Anesthesia, IRCCS
Humanitas Research Hospital, Rozzano, Italy
Publisher
W.B. Saunders
Abstract
Objective: To test whether the duration of cardiopulmonary bypass (CPB)
affects the nephroprotective effect of amino acids (AA) infusion in
decreasing the occurrence of acute kidney injury (AKI) among cardiac
surgery patients. Design(s): A post hoc study of the PROTECTION
multicenter randomized double-blind placebo-controlled trial aiming to
assess the effect of CPB duration on the differential impact of AA
infusion on both the absolute and relative risk reduction in AKI incidence
by comparing medians of CPB duration and CPB duration as a continuous
variable. Setting(s): International, multicenter.
 Participant(s): The entire population of the PROTECTION trial,
comprising 3511 adult patients undergoing cardiac surgery with CPB.
 Intervention(s): Intravenous AA infusion at a dosage of 2 g/kg/day,
up to a maximum of 100 g/day. Measurements and Main Results: Compared
with patients with CPB duration above the median (prolonged [P]-CPB
group), patients with CPB duration below the median (brief [B]-CPB group)
had a significantly lower incidence of AKI (23% [n/N =391/1716] vs 36%
[n/N = 617/1723]; relative risk [RR], 0.64; 95% confidence interval [CI],
0.57-0.71; p <0.001). However, in the P-CPB group, AA infusion achieved an
8% absolute risk reduction (32% vs 40%) and a 0.79 RR reduction (95% CI,
0.70-0.90; p < 0.001; number needed to treat, 14). Moreover, AA also
decreased the occurrence of AKI stage 3 (2.2% [n = 19] vs 5.0% [n = 43];
RR, 0.45; 95% CI, 0.26-0.76; p < 0.001) with a >95% probability of this
effect being significantly greater in the P-CPB group compared to the
B-CPB group. Conclusion(s): Cardiac surgery patients with prolonged
CPB exposure had a significantly higher incidence of AKI. Notably, the
P-CPB group received a greater benefit from AA therapy with an absolute
risk and relative risk reduction of both any and severe AKI compared with
the B-CPB group. Patients with prolonged CPB may be the specific targets
of future studies. Copyright © 2025 Elsevier Inc.

<11>
Accession Number
2039206194
Title
Temporal Trends and Severity of Postoperative Delirium in Cardiac Surgery:
Insights from a Systematic Review and Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(9) (pp 2424-2435),
2025. Date of Publication: 01 Sep 2025.
Author
Shamsi T.; Janga S.R.; Baskaran N.U.; Rangasamy V.; Ramachandran R.V.;
Chen M.; Ganesh S.; Novack V.; Subramaniam B.
Institution
(Shamsi, Janga, Baskaran, Rangasamy, Chen) Beth Israel Deaconess Medical
Center, Boston, MA, United States
(Ramachandran) University of Washington Medicine, Seatle, WA, United
States
(Ganesh) New York Institute of Technology College of Osteopathic Medicine,
New York, NY, United States
(Novack) Soroka University Medical Center, Beer-Sheva, Israel
(Subramaniam) Harvard Medical School, Sadhguru Center for a Conscious
Planet, Beth Israel Deaconess Medical Center, Boston, MA, United States
Publisher
W.B. Saunders
Abstract
Postoperative delirium (POD) is one of the most common neurocognitive
complications following cardiac surgery, typically occurring within 72
hours and leading to serious consequences, including falls, prolonged
hospitalization, and increased healthcare costs. Annually, over two
million cardiac surgeries, including coronary artery bypass grafting, are
performed worldwide. This study systematically reviews and meta-analyzes
the incidence, duration, time to onset, and severity of delirium following
cardiac surgery. No previous comprehensive analysis has addressed all
these outcomes, particularly regarding temporal patterns and severity of
POD. A systematic review was performed following PRISMA guidelines. The
studies included adult patients who underwent cardiac surgery and were
assessed for delirium using validated tools. Statistical analyses included
random-effects meta-analysis for incidence rates and subgroup analyses.
Twenty-seven studies involving 5,126 participants from 2009 to March 2024
were included. The overall incidence of POD was 25.1% (95% confidence
interval [CI]: 21.8%-28.3%), with a mean duration of 2.378 days (95% CI:
2.086-2.671), and onset occurring at 1.706 days (95% CI: 1.198-2.214).
Only three studies assessed the severity of delirium, reporting a maximum
Confusion Assessment Method score of 9.308 (95% CI: 7.309-11.307) on a
scale of 0 to 19. Subgroup analyses were conducted to examine
heterogeneity but revealed no significant differences in outcomes.
Therefore, a meta-regression analysis focusing on age, surgery duration,
assessment length, study design, and assessment tools was performed. The
incidence and burden of POD highlight the need for regular screening and
effective management strategies. Copyright © 2025 Elsevier Inc.

<12>
Accession Number
2039728617
Title
Superficial Parasternal Intercostal Plane Block and Full Sternotomy; A
Randomized Trial.
Source
European Journal of Cardio-thoracic Surgery. 67(7) (no pagination), 2025.
Article Number: ezaf226. Date of Publication: 01 Jul 2025.
Author
Kalli A.; Vistbacka J.; Moilanen E.; Jarvela K.; Mennander A.
Institution
(Kalli, Jarvela, Mennander) Faculty of Medicine and Health Technology,
Tampere University, Tampere, Finland
(Kalli, Jarvela, Mennander) Tampere University Hospital, Heart Hospital,
Tampere, Finland
(Vistbacka, Moilanen) The Immunopharmacology Research Group, Faculty of
Medicine and Health Technology, Tampere University, Tampere University
Hospital, Tampere, Finland
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives Cardiac surgery via full sternotomy impacts postoperative lung
function. We studied whether ultrasound-guided superficial parasternal
intercostal plane block (SPIP) before surgical aortic valve replacement
via full sternotomy would ameliorate postoperative lung function and
filtration capacity. Methods A total of 74 consecutive patients undergoing
surgical aortic valve replacement were randomized to receive either or not
additional SPIP. Pre- and postoperative lung function tests were compared
among the patients. Venous and arterial blood samples were collected to
calculate lung filtration (venous/arterial) of the inflammatory factors
chemerin, chitinase-3-like protein 1 (YKL-40), resistin, and interleukin-6
(IL6) immediately before (T1), 1 hour after releasing aortic cross-clamp
(T2), and on the following morning (T3) after surgery in 30 age- and
sex-adjusted patients. Results Patients with SPIP were older as compared
to those without (66.7 [10.7] vs 60.2 [13.4], years, respectively, P <
0.04). Neither other patient characteristics nor preoperative lung
functions differed between the patient groups. Forced expiratory volume in
1 second (FEV), forced volume capacity (FVC), and relative FVC changes
decreased less in patients treated with wound analgesia as compared to
those without (P = 0.024, P = 0.042, and P = 0.042). Total oxycodone
consumption (P = 0.634), YKL-40, and resistin did not differ between the
groups. Arterial chemerin decreased and venous/arterial IL6 ratio
increased in patients with SPIP as compared to those without (P = 0.024
versus P = 0.332, respectfully). Conclusions SPIP before aortic valve
surgery via full sternotomy impacts postoperative respiratory function and
venous/arterial IL6 ratio. Clinical registration number The study was
approved by the institutional review board (Ethical Committee of the
Tampere University Hospital, Tampere, Finland, registration number
R18011M) on March 8, 2018, and the study conforms to the ethical
guidelines of the Declaration of Helsinki. Copyright © 2025 The
Author(s).

<13>
Accession Number
2038828266
Title
Optimizing Tranexamic Acid Use in Adult Cardiac Surgery: From Rationale to
Clinical Practice.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(9) (pp 2439-2445),
2025. Date of Publication: 01 Sep 2025.
Author
La Via L.; Cuttone G.; Terranova C.; Sorbello M.; Martucci G.; Pappalardo
F.
Institution
(La Via) Department of Anesthesia and Intensive Care, University Hospital
Policlinico "G. Rodolico-San Marco", Catania, Italy
(Cuttone, Sorbello, Pappalardo) Faculty of Medicine and Surgery, "Kore"
University of Enna, Enna, Italy
(Cuttone, Terranova, Pappalardo) Policlinico Centro Cuore GB Morgagni,
Catania, Italy
(Sorbello) Department of Anesthesia and Intensive Care, Giovanni Paolo II
Hospital, Ragusa, Italy
(Martucci) Department of Anesthesia and Intensive Care, IRCCS-ISMETT,
UPMC, Palermo, Italy
Publisher
W.B. Saunders
Abstract
Tranexamic acid (TXA) has emerged as a cornerstone in blood conservation
strategies for cardiac surgery. This comprehensive review synthesizes
current evidence on TXA's efficacy, safety, and optimal use in various
cardiac surgical procedures. We examine the pharmacological properties of
TXA, its historical development as an antifibrinolytic agent, and its
evolution in cardiac surgical practice. The review critically evaluates
key clinical trials and meta-analyses demonstrating TXA's efficacy in
reducing blood loss and transfusion requirements across a spectrum of
cardiac surgeries, including coronary artery bypass grafting, valve
procedures, and aortic surgery. Special consideration is given to its use
in pediatric cardiac surgery. We address ongoing debates surrounding
optimal dosing strategies, timing of administration, and integration with
other hemostatic interventions. The safety profile of TXA is thoroughly
examined, with particular focus on the risk of seizures and thromboembolic
events. The review also explores practical aspects of TXA implementation
in clinical practice, including its role in comprehensive blood management
protocols and potential cost-effectiveness. Emerging research areas, such
as pharmacokinetic-guided dosing and topical TXA application, are
discussed. Finally, we outline future directions and research priorities,
including the need for long-term outcome studies and refinement of
patient-specific protocols. This review provides a balanced assessment of
TXA's role in modern cardiac surgery, offering clinicians and researchers
a comprehensive resource for optimizing its use to improve patient
outcomes while minimizing potential risks. Copyright © 2025
Elsevier Inc.

<14>
Accession Number
2039707771
Title
Challenges in antithrombotic treatment and in the management of valvular
heart disease.
Source
European Heart Journal. 46(28) (pp 2717-2721), 2025. Date of Publication:
21 Jul 2025.
Author
Crea F.
Institution
(Crea) Center of Excellence of Cardiovascular Sciences, Ospedale Isola
Tiberina - Gemelli Isola, Rome, Italy
(Crea) Catholic University of the Sacred Heart, Rome, Italy
Publisher
Oxford University Press

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

<16>
[Use Link to view the full text]
Accession Number
643493363
Title
A commentary on 'Transversus thoracic muscle plane block for pain during
cardiac surgery: a systematic review and meta-analysis'.
Source
International journal of surgery (London, England). 110(5) (pp 3103-3104),
2024. Date of Publication: 01 May 2024.
Author
Zhong W.; Zhao B.; Liu L.; Xi G.; Zhou J.
Institution
(Zhong) Department of Anesthesia, Henan Provincial Chest Hospital (Chest
Hospital of Zhengzhou University), Zhengzhou, Henan, China

<17>
Accession Number
2035215299
Title
Efficacy and Safety of Bupivacaine Liposomal in Intercostal Nerve Block
for Postoperative Pain Management Following Uniportal Thoracoscopy: A
Randomized Trial.
Source
Pain Research and Management. 2025(1) (no pagination), 2025. Article
Number: 8816879. Date of Publication: 2025.
Author
Dong L.; Wang X.; Fu L.; Jiang Z.; Wang Y.; Chen A.; Ding J.; Yu G.
Institution
(Dong, Wang, Fu, Ding, Yu) Department of Thoracic Surgery, Shaoxing
People's Hospital, 568-Zhongxing North Road, Zhejiang, Shaoxing, China
(Jiang, Wang) Department of Anesthesiology, Shaoxing People's Hospital,
568-Zhongxing North Road, Zhejiang, Shaoxing, China
(Chen) Department of Nursing, Shaoxing People's Hospital, 568-Zhongxing
North Road, Zhejiang, Shaoxing, China
Publisher
John Wiley and Sons Ltd
Abstract
Background: Postoperative pain in thoracic surgery often requires opioids,
yet can be poorly managed with short-acting anesthetics. Liposomal
bupivacaine (LB) offers prolonged analgesia, potentially improving pain
control and reducing opioid use. This study evaluates LB's effectiveness
and safety in thoracic postoperative pain management, aiming to provide an
alternative to current practices. Method(s): In this single-center,
double-blind, prospective, randomized controlled trial, patients
undergoing uniportal lobectomy, segmentectomy, or wedge resection from
November 2023 to May 2024 were enrolled. Participants were randomly
assigned in a 1:1 ratio to receive either 0.375% ropivacaine (control
group, n = 57) or LB (LB group, n = 56) for intercostal nerve blocks
(ICNBs). Postoperative visual analog scale (VAS) scores, opioid
consumption, overall benefit of analgesia score (OBAS), chest tube
duration, length of hospital stay, and adverse events (AEs) were recorded
and analyzed. Result(s): Data from 57 patients in the control group
and 56 patients in the LB group were included in the analysis, with no
significant demographic differences between the groups. The LB group
demonstrated lower VAS scores at rest and during activity (p > 0.05),
reduced opioid consumption (p = 0.021), and higher OBAS (p < 0.01)
compared with the control group. No significant differences were observed
in chest tube duration, length of hospital stay, or AEs between the
groups. Conclusion(s): LB is safe and effective for ICNB, providing
significant postoperative pain relief for patients undergoing uniportal
thoracoscopic surgery. Trial Registration: Chinese Registry of Clinical
Trials: chiCTR2300075463. Copyright © 2025 Lingjun Dong et al.
Pain Research and Management published by John Wiley & Sons Ltd.

<18>
Accession Number
2039836124
Title
A comparison of antiplatelet and oral anticoagulation strategies to
prevent cerebral microembolism after transcatheter aortic valve
implantation: the AUREA trial.
Source
EuroIntervention. 21(13) (pp 737-748), 2025. Date of Publication: 2025.
Author
Jimenez Diaz V.A.; Juan-Salvadores P.; Bellas Lamas P.; Arias Gonzalez M.;
Santos Armentia E.; Vila Nieto O.; Gonzalez Mao C.; Torrado Chedas T.;
Munoz Garcia A.J.; Blazquez I.G.; Bastos Fernandez G.; De Miguel Castro
A.; Fernandez Barbeira S.; Ortiz Saez A.; Baz Alonso J.A.; Ocampo Miguez
J.; Rioboo Leston L.; Pazos Lopez P.; Calvo Iglesias F.; Salgado Barreira
A.; Diaz Lopez C.M.; Figueiras A.; Veiga Garcia C.; Iniguez Romo A.
Institution
(Jimenez Diaz, Bastos Fernandez, De Miguel Castro, Fernandez Barbeira,
Ortiz Saez, Baz Alonso, Ocampo Miguez, Rioboo Leston, Pazos Lopez, Calvo
Iglesias, Iniguez Romo) Cardiology Department, Hospital Alvaro Cunqueiro,
University Hospital of Vigo, Vigo, Spain
(Jimenez Diaz, Juan-Salvadores, Bellas Lamas, Bastos Fernandez, De Miguel
Castro, Fernandez Barbeira, Ortiz Saez, Baz Alonso, Ocampo Miguez, Rioboo
Leston, Pazos Lopez, Calvo Iglesias, Diaz Lopez, Veiga Garcia, Iniguez
Romo) Cardiovascular Research Group, Galicia Sur Health Research Institute
(IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
(Bellas Lamas) Neurology Department, Hospital Alvaro Cunqueiro, University
Hospital of Vigo, Vigo, Spain
(Arias Gonzalez) Diagnostic Imaging Unit, Galaria, Public Sanitary
Services Company, Vigo, Spain
(Santos Armentia) Radiology Department, Hospital Ribera Povisa, Vigo,
Spain
(Vila Nieto) Diagnostic Imaging Department, Hospital Alvaro Cunqueiro,
University Hospital of Vigo, Vigo, Spain
(Gonzalez Mao) Clinical Diagnostic Unit, Hospital Alvaro Cunqueiro,
University Hospital of Vigo, Vigo, Spain
(Torrado Chedas) Hematology Department, Hospital Alvaro Cunqueiro,
University Hospital of Vigo, Vigo, Spain
(Munoz Garcia) Cardiology Department, Hospital Universitario Virgen de la
Victoria, Malaga, Spain
(Munoz Garcia, Baz Alonso, Iniguez Romo) Center for Biomedical Research in
Cardiovascular Diseases Network (CIBERCV), Madrid, Spain
(Blazquez) Cardiology Department, Hospital Universitario 12 de Octubre,
Madrid, Spain
(Salgado Barreira, Figueiras) Preventive Medicine and Public Health,
University of Santiago de Compostela, Santiago de Compostela, Spain
(Salgado Barreira, Figueiras) Health Research Institute of Santiago de
Compostela (IDIS), University of Santiago de Compostela, Santiago de
Compostela, Spain
(Salgado Barreira, Figueiras) Consortium for Biomedical Research in
Epidemiology and Public Health (CIBER Epidemiology and Public
Health-CIBERESP), Madrid, Spain
Publisher
Europa Group
Abstract
BACKGROUND: The effectiveness of oral anticoagulation (OAC) or dual
antiplatelet therapy (DAPT) in reducing subclinical brain infarcts after
transcatheter aortic valve implantation (TAVI) remains unclear. AIMS: We
aimed to compare the efficacy of DAPT versus OAC in preventing cerebral
microembolism during the first 3 months post-TAVI, assessed by
diffusion-weighted magnetic resonance imaging (DW-MRI). METHOD(S):
Patients with aortic stenosis and no indication for OAC were randomly
assigned to receive either OAC (acenocoumarol) or DAPT
(aspirin+clopidogrel) for 3 months post-TAVI. Brain DW-MRI was performed
at baseline (0-3 days pre-TAVI) and at 6 and 90 days post-TAVI. The
primary objective was the proportion of patients with new cerebral emboli
on DW-MRI at 6 and 90 days. RESULT(S): Of the 123 patients included
in the study, 3.3% had new cerebral emboli on the baseline MRI prior to
TAVI. At 6 days post-TAVI, new cerebral emboli were observed in 81.4% of
OAC patients versus 69.8% of DAPT patients (p=0.209), and at 90 days, in
8.0% versus 8.2%, respectively (p=0.879). However, DAPT patients had a
lower mean total emboli volume at 6 days (265.9 mm3 vs 303.4 mm3; p=0.019)
and cumulatively at 6+90 days (266.45 mm3 vs 331.10 mm3; p=0.008).
 CONCLUSION(S): In patients without an indication for OAC, an OAC
strategy for 3 months post-TAVI did not show any benefit over an
antiplatelet strategy in preventing cerebral microembolism. Patients
treated with DAPT showed a lower mean volume of brain damage on DW-MRI
during the 90 days following TAVI compared to those treated with
acenocoumarol. Copyright © Europa Group 2025. All rights
reserved.

<19>
Accession Number
2039522867
Title
Postoperative Infectious Pneumonia in Cardiothoracic Surgery: A Systematic
Review and Meta-Analysis.
Source
F1000Research. 14 (no pagination), 2025. Article Number: 588. Date of
Publication: 2025.
Author
Khallikane S.; Seddiki R.; Serghini I.
Institution
(Khallikane) Cardiothoracic Anesthesia-Cardiovascular ICU,
Anesthesiology-ICU-Emergency Department, Avicenna Military Hospital,
Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech,
Morocco
(Khallikane) Marrakech-Safi, Marrakeck, Morocco
(Seddiki) Hassan II Military Hospital, Anesthesiology-Critical Care,
Avicenna Military Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad
University, Marrakech, Morocco
(Seddiki) Layun, Layun-Sakia Hamra, Morocco
(Serghini) Intensivist-Anesthesiologist Head of Emergency Department,
Avicenna Military Hospital, Marrakech-Safi, Marrakech, Morocco
Publisher
F1000 Research Ltd
Abstract
Background: Postoperative infectious pneumonia (PIP) is a common and
serious complication following cardiothoracic surgery, including coronary
artery bypass grafting (CABG), valve interventions, and thoracic oncologic
procedures. It is associated with increased morbidity, prolonged intensive
care unit (ICU) stay, and healthcare burden. Method(s): We performed
a systematic review and meta-analysis according to PRISMA 2020 guidelines.
Studies published between January 2021 and December 2023 were identified
from PubMed, Embase, and Scopus. Eligible studies reported the incidence
and/or perioperative risk factors for PIP with odds ratios (ORs) and 95%
confidence intervals (CIs). A random-effects model was used for pooled
estimates. Study quality was assessed using the Newcastle-Ottawa Scale.
The review was prospectively registered in PROSPERO 2025 CRD 420251057914.
Available from https://www.crd.york.ac.uk/PROSPERO/view/CRD420251057914.
 Result(s): Six high-quality cohort studies involving 4,392 patients
were included. The pooled incidence of PIP was 14.8% (95% CI,
10.6%-19.2%). Incidence was highest after thoracic oncologic surgery
(17.2%), followed by valve surgery (15.8%) and CABG (13.5%). Significant
risk factors included prolonged mechanical ventilation >48 hours (OR:
3.46), age >70 years (OR: 2.71), chronic obstructive pulmonary disease
(OR: 2.95), cardiopulmonary bypass time >120 minutes (OR: 2.63), and left
ventricular ejection fraction <40% (OR: 2.38). Heterogeneity was moderate
(I 2 = 46%) with no publication bias. Conclusion(s): PIP
remains a major postoperative concern. Identification of key risk factors
enables targeted preventive strategies-early extubation, pulmonary
optimization, and standardized care pathways-to reduce PIP incidence and
improve outcomes. Copyright: © 2025 Khallikane S et al.

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

<21>
Accession Number
2039758428
Title
Safety of oral intake prior to cardiac catheterization with minimal to
moderate sedation: A systematic review and meta-analysis of randomized
controlled trials.
Source
American Heart Journal. 290 (pp 188-200), 2025. Date of Publication: 01
Dec 2025.
Author
Pir M.S.; Mitchell B.K.; Saqib N.U.; Saleem M.S.; Gertz Z.M.
Institution
(Pir) Christus Heart and Vascular Institute, Christus St. Frances Cabrini
Hospital, Alexandria, LA, United States
(Mitchell) Sentara Health, Norfolk, VA, United States
(Saqib) Tidal Health, Seaford, DE, United States
(Saleem) The Wright Center for Graduate Medical Education, Scranton, PA,
United States
(Gertz) Virginia Commonwealth University, Richmond, VA, United States
Publisher
Elsevier Inc.
Abstract
Fasting prior to percutaneous cardiac procedures is common, despite a lack
of high-quality evidence. We conducted a systematic review and
meta-analysis to assess the safety of a nonfasting strategy. Online
databases Medline, Cochrane CENTRAL, and Google Scholar were searched.
Quantitative analysis was performed using R software (Version 4.1.2) with
meta package. Analyzed outcomes included nausea, vomiting, aspiration,
intubation, hypoglycemia, hypotension, acute kidney injury, patient
satisfaction score, and length of hospital stay. Eight randomized
controlled trials were included with 3,382 patients. There was no
significant difference between fasting and nonfasting for nausea/vomiting
odds ratio (OR) 0.99 (95% CI, 0.68-1.45), hypoglycemia OR 1.28 (95% CI,
0.75-2.18), aspiration OR 0.72 (95% CI, 0.36-1.43), acute kidney injury OR
0.69 (95% CI, 0.38-1.23), and hypotension OR 1.57 (95% CI, 0.47-5.30). No
patient in either group underwent endotracheal intubation. Additionally,
there was no difference in patient satisfaction score and length of
hospital stay with a standardized mean difference (SMD) of 0.23 (95% CI,
-0.62 to 1.07) and 0.0 (95% CI, -0.6 to 0.7) respectively. Sub-group
analysis, however, showed increased odds of nausea/vomiting in the fasting
group compared to nonfasting OR 1.20 (95% CI, 1.04-1.39) and decreased
odds of acute kidney injury in fasting compared to nonfasting group OR
0.50 (95% CI, 0.28-0.89). In conclusion, this analysis shows no
significant difference in most safety outcomes between a fasting and a
nonfasting strategy with potential increase in nausea/vomiting and
decrease in acute kidney injury with fasting. More studies are needed to
better understand these differences. Copyright © 2025 The Authors

<22>
Accession Number
2034076538
Title
Hemoadsorption use in adult cardiac surgery for infective endocarditis: A
comprehensive meta-analysis.
Source
Asian Cardiovascular and Thoracic Annals. 33(2-3) (pp 105-115), 2025. Date
of Publication: 01 Mar 2025.
Author
Dutta P.; Ganduboina R.; Muderrisoglu C.; Obulareddy A.C.R.; Palagati K.;
Areddy V.R.; Reddy G.A.; Sainathan S.
Institution
(Dutta, Muderrisoglu) Department of Surgery, University of Illinois,
Chicago, IL, United States
(Ganduboina) Department of Surgery, NRI Institute of Medical Sciences,
Visakhapatnam, India
(Obulareddy) Division of Surgery, SVS Medical College, Mahbubnagar, India
(Palagati) Division of Surgery, Government Medical College, Anantapur,
India
(Areddy) Division of Surgery, Sri Venkateswara Medical College, Tirupati,
India
(Reddy) Division of Internal Medicine, New York Medical College at St
Mary's General Hospital and St Claire's Health, New York, NY, United
States
(Sainathan) Division of Cardiothoracic Surgery, University of Miami,
Miami, FL, United States
Publisher
SAGE Publications Inc.
Abstract
Introduction: Infective endocarditis (IE) is a severe infection of the
endocardium, primarily affecting the heart valves, exhibiting high
morbidity and mortality rates. Cardiac surgery for IE with cardiopulmonary
bypass (CPB) can further exacerbate the inflammatory response and cytokine
production from IE. The current meta-analysis evaluates the use of
CytoSorb hemoadsorption in IE patients undergoing cardiac
surgery to determine its efficacy in reducing inflammatory mediators and
improving clinical outcomes. Method(s): PubMed, Cochrane, Google
Scholar, Clinical Trials, and Google Scholar were searched for articles
until July 2024. After performing a risk of bias and quality assessment,
data on operative times, mortality, and morbidity were extracted for
meta-analysis. Statistical Software R (version 4.4.0) was used to
calculate odds ratio (OR) and standardized mean differences using a
random-effect model with a 95% confidence interval (CI) and p-value less
than 0.05. Result(s): Eight studies, encompassing 1076 patients, were
included in the analysis. These comprised three randomized controlled
trials and five nonrandomized studies. The majority of these studies
exhibited some concerns regarding bias. Hemoadsorption group showed lower
discharge mortality (OR: 0.58, 95% CI: 0.33-1.00, p = 0.05) compared to
controls, but no significant disparity is observed in other outcomes.
In-hospital outcomes also showed higher heterogeneity, with an I2 value
greater than 50%. Conclusion(s): CytoSorb use in patients undergoing
cardiac surgery with CPB used for IE has no impact on operative mortality
and morbidity but has a beneficial effect on discharge
mortality. Copyright © The Author(s) 2025

<23>
Accession Number
2035477823
Title
Artificial Intelligence in Risk Stratification and Outcome Prediction for
Transcatheter Aortic Valve Replacement: A Systematic Review and
Meta-Analysis.
Source
Journal of Personalized Medicine. 15(7) (no pagination), 2025. Article
Number: 302. Date of Publication: 01 Jul 2025.
Author
Shojaei S.; Mousavi A.; Kazemian S.; Armani S.; Maleki S.; Fallahtafti P.;
Arashlow F.T.; Daryabari Y.; Naderian M.; Alkhouli M.; Rana J.S.; Mehrani
M.; Jenab Y.; Hosseini K.
Institution
(Shojaei, Mousavi, Kazemian, Maleki, Fallahtafti, Mehrani, Jenab,
Hosseini) Tehran Heart Center, Cardiovascular Diseases Research Institute,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Shojaei, Mousavi) School of Medicine, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Shojaei, Mousavi) Students' Scientific Research Center, Tehran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Armani) Heart Failure Research Center, Cardiovascular Research Institute,
Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Arashlow) Medical Students Research Centre, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Daryabari) Pediatric Urology and Regenerative Medicine Research Center,
Children's Medical Center, Gene, Cell & Tissue Research Institute, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Naderian, Alkhouli) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
(Alkhouli) Division of Cardiovascular Diseases, Department of Medicine,
West Virginia University, Morgantown, WV, United States
(Rana) Department of Cardiology, Oakland Medical Center, Kaiser Permanente
Northern California, Oakland, CA, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Transcatheter aortic valve replacement (TAVR) has
been introduced as an optimal treatment for patients with severe aortic
stenosis, offering a minimally invasive alternative to surgical aortic
valve replacement. Predicting these outcomes following TAVR is crucial.
Artificial intelligence (AI) has emerged as a promising tool for improving
post-TAVR outcome prediction. In this systematic review and meta-analysis,
we aim to summarize the current evidence on utilizing AI in predicting
post-TAVR outcomes. Method(s): A comprehensive search was conducted
to evaluate the studies focused on TAVR that applied AI methods for risk
stratification. We assessed various ML algorithms, including random
forests, neural networks, extreme gradient boosting, and support vector
machines. Model performance metrics-recall, area under the curve (AUC),
and accuracy-were collected with 95% confidence intervals (CIs). A
random-effects meta-analysis was conducted to pool effect estimates.
 Result(s): We included 43 studies evaluating 366,269 patients (mean
age 80 +/- 8.25; 52.9% men) following TAVR. Meta-analyses for AI model
performances demonstrated the following results: all-cause mortality (AUC
= 0.78 (0.74-0.82), accuracy = 0.81 (0.69-0.89), and recall = 0.90
(0.70-0.97); permanent pacemaker implantation or new left bundle branch
block (AUC = 0.75 (0.68-0.82), accuracy = 0.73 (0.59-0.84), and recall =
0.87 (0.50-0.98)); valve-related dysfunction (AUC = 0.73 (0.62-0.84),
accuracy = 0.79 (0.57-0.91), and recall = 0.54 (0.26-0.80)); and major
adverse cardiovascular events (AUC = 0.79 (0.67-0.92)). Subgroup analyses
based on the model development approaches indicated that models
incorporating baseline clinical data, imaging, and biomarker information
enhanced predictive performance. Conclusion(s): AI-based risk
prediction for TAVR complications has demonstrated promising performance.
However, it is necessary to evaluate the efficiency of the aforementioned
models in external validation datasets. Copyright © 2025 by the
authors.

<24>
Accession Number
2038828809
Title
Low-dose apixaban in HeartMate 3 LVAD patients, interim analysis of the
ApixiVAD trial, a randomized controlled study.
Source
Journal of Heart and Lung Transplantation. 44(8) (pp 1331-1338), 2025.
Date of Publication: 01 Aug 2025.
Author
Schnegg B.; Deveza R.; Barua S.; Chavali S.; Lo P.; Capek L.; Bruno J.;
Pavlicek-Bahlo M.; Xourgia E.; Neagoe A.; Zurcher K.; Muthiah K.; Robson
D.; Lam K.; Reineke D.; Siepe M.; Hunziker L.; Martinelli M.; Jansz P.;
Watson A.; Macdonald P.; Hayward C.
Institution
(Schnegg, Capek, Bruno, Pavlicek-Bahlo, Xourgia, Neagoe, Zurcher,
Hunziker, Martinelli) Department of Cardiology, Centre for Advanced Heart
Failure, Inselspital, Bern University Hospital, Bern, Switzerland
(Deveza, Barua, Chavali, Lo, Muthiah, Robson, Jansz, Watson, Macdonald,
Hayward) Heart Failure and Transplant Unit, St Vincent's Hospital, Sydney,
NSW, Australia
(Deveza, Jansz, Watson, Macdonald, Hayward) School of Clinical Medicine,
Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
(Lam, Jansz, Watson) Heart Failure and Transplant Unit, Fiona Stanley
Hospital, Murdoch, Australia
(Reineke, Siepe, Jansz, Watson) Department of Cardiac Surgery,
Inselspital, Bern University Hospital, University of Bern, Bern,
Switzerland
(Jansz, Watson, Macdonald, Hayward) Victor Chang Cardiac Research
Institute, Sydney, NSW, Australia
Publisher
Elsevier Inc.
Abstract
Background: Left ventricular assist devices (LVADs) improve outcomes in
advanced heart failure but require anticoagulation. Vitamin K antagonists
(VKAs) have significant limitations, with labile international normalized
ratios and suboptimal time in therapeutic range (TTR), associated with
increased morbidity and mortality. Direct oral anticoagulant therapy has
been contraindicated in LVAD patients. Method(s): The ApixiVAD study,
a 1:1 randomized, open-label pilot trial, compared the reduced-dose
apixaban (2.5 mg twice daily) with standard VKAs in stable HeartMate 3
patients with TTR > 60%. Aspirin was not mandated. Primary outcomes
included thromboembolic events, bleeding, and death. Result(s):
Forty-four patients were randomized, 21 to apixaban and 23 to VKA. Median
age was 55 years (50-64), and 6 were women (14%). The median time from
LVAD implantation to randomization was 6 months (range 5-8). Patients were
followed for a median of 6 months (2-8). Twenty-five (57%) were
transplanted, 12 (27%) were still on treatment, and 5 (11%) had undergone
a primary outcome. Event-free survival was similar between groups (hazard
ratio [HR] 1.46, 95% confidence interval [CI] 0.64-3.35, p = 0.4, Cox
model) as well as Blood product use at transplantation.
 Conclusion(s): These interim results were obtained after the end of
recruitment but before all patients reached the full follow-up duration.
The rates of bleeding observed in the apixaban group were below those
reported in large international studies without any increase in
thrombosis, suggesting that apixaban 2.5 mg twice daily may offer an
effective balance between bleeding risk and anticoagulation efficacy.
These findings should be interpreted as preliminary and
hypothesis-generating. Copyright © 2025 International Society for
the Heart and Lung Transplantation

<25>
Accession Number
2039637651
Title
AI-driven wearable sensors for postoperative monitoring in surgical
patients: A systematic review.
Source
Computers in Biology and Medicine. 196 (no pagination), 2025. Article
Number: 110783. Date of Publication: 01 Sep 2025.
Author
Khan M.M.; Shah N.
Institution
(Khan, Shah) Neurosurgery Department, Hamad General Hospital, Doha, Qatar
Publisher
Elsevier Ltd
Abstract
Introduction: Artificial intelligence used with wearable technology can be
an important modality of treatment in the surgical patient management for
recovery and reduction of complications such as hypoxia and infection,
bleeding, and organ failure. Traditional monitoring systems, based on
periodic measurement of vital signs, often cannot detect subtle
physiological changes that herald early clinical deterioration. This
systematic review discusses how the integration of artificial intelligence
with wearable technology can help address some of the limitations in
postoperative monitoring. Method(s): We did a Systematic review on
literature published between 2000 and 2024 English articles or those with
text English translations. A total of 4 full text articles were selected
for the examination after reviewing and evaluating the reports for quality
and eligibility. Result(s): This review has identified those
AI-enhanced wearable devices and, in the main, biosensors as well as
smartwatches that are mostly good in regard to early diagnosis of
complications-hypoxia, arrhythmias, as well as problems concerning
hemodynamics. These methodologies showed decreases in the rates of
admission, including the staying duration in Intensive Care Units
regarding support via using the AI-built Continuous Remote Early Warning
Scoring system. Conclusion(s): Our Review has elaborated on the role
of wearables in neurological and vital parameter monitoring and
complication prediction, such as seizures and the comfort and compliance
of wearable devices in the early postoperative period for the detection of
anomalies in vital signs and demonstrated the utility of AI-reinforced
sensors in resource-limited settings. Copyright © 2025 The
Authors

<26>
Accession Number
2035429443
Title
How could ultraslow low-dose thrombolytic infusion regimes affect high
thrombosis resolution rates in prosthetic valve thrombosis?.
Source
Expert Review of Cardiovascular Therapy. (no pagination), 2025. Date of
Publication: 2025.
Author
Gunduz S.; Ozkan M.
Institution
(Gunduz) Faculty of Medicine, Department of Cardiology, Bahcesehir
University, Istanbul, Turkey
(Ozkan) Division of Health Sciences, Ardahan University, Ardahan, Turkey
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Prosthetic valve thrombosis (PVT) is a life-threatening
complication of mechanical heart valve replacement. Management has evolved
over decades, from urgent surgical intervention to low dose ultraslow
thrombolytic therapy. Areas covered: This review provides a historical to
present-day analysis of thrombolytic strategies in PVT, comparing
accelerated dosing with slower infusion protocols. We synthesize clinical
evidence and elucidate mechanistic insights into how infusion rate and
dosage influence clot resolution and safety. We searched the PubMed
database from inception to May 2025 using combinations of appropriate
keywords. Expert opinion: The development of lower dose, slower infusion
protocols, notably using Alteplase without bolus, has dramatically
improved outcomes. Clinical trials show comparable or superior thrombosis
resolution rates with ultraslow infusion versus rapid infusion or surgery,
but with markedly reduced complication rates. Mechanistically, ultraslow
infusion may help to localize fibrinolysis to the thrombus site,
minimizing systemic fibrinogen depletion and hemorrhagic risk. Ultraslow
(25 hours) low-dose (25 mg) thrombolysis with Alteplase is a safe and
effective first-line therapy for PVT patients, achieving high success in
clot resolution while limiting bleeding and embolic complications. Ongoing
evidence and mechanistic rationale suggest that, in the absence of
contraindications, this strategy can often be preferable to traditional
rapid high-dose thrombolysis or emergency surgery. Copyright ©
2025 Informa UK Limited, trading as Taylor & Francis Group.

<27>
Accession Number
2038270703
Title
Characterization and Clinical Outcomes of High-Risk Device-Related
Thrombus in the Amulet IDE Trial.
Source
JACC: Clinical Electrophysiology. 11(7) (pp 1543-1554), 2025. Date of
Publication: 01 Jul 2025.
Author
Nielsen-Kudsk J.E.; Schmidt B.; Windecker S.; Shah N.; Gray W.; Ellis
C.R.; Koulogiannis K.; Anderson J.A.; Gage R.; Lakkireddy D.
Institution
(Nielsen-Kudsk) Aarhus University Hospital, Aarhus, Denmark
(Schmidt) Cardioangiologisches Centrum am Bethanien Krankenhaus,
Frankfurt, Germany
(Windecker) Inselspital, Bern University Hospital, University of Bern,
Bern, Switzerland
(Shah) Independence Health Westmoreland Hospital, Greensburg, PA, United
States
(Gray) Lankenau Institute for Medical Research, Wynnewood, PA, United
States
(Ellis) Vanderbilt Heart Institute, Nashville, TN, United States
(Koulogiannis) Cardiovascular Core Lab at Morristown Medical Center,
Morristown, NJ, United States
(Anderson, Gage) Abbott Structural Heart, Plymouth, MN, United States
(Lakkireddy) Kansas City Heart Rhythm Institute and Research Foundation,
Overland Park, KS, United States
Publisher
Elsevier Inc.
Abstract
Background: Characteristics of device-related thrombus (DRT) may differ
between types of left atrial appendage occlusion devices, and the
association of different DRT characteristics to clinical outcomes is
largely unknown. Objective(s): The incidence, characteristics, and
clinical outcomes through 5 years of high- and low-risk DRTs were assessed
in the Amulet IDE trial (AMPLATZER Amulet Left Atrial Appendage Occluder
[LAAO] Investigational Device Exemption [IDE] Trial). Method(s): An
independent core laboratory analyzed all available images at the required
45-day and 12-month visits, and clinical events were reported through 5
years' post-left atrial appendage occlusion. Result(s): Of the 1,788
patients with a successful device implant, DRT was observed in 3.3% (30 of
903) and 4.5% (40 of 885) of Amulet and Watchman 2.5 device patients
throughout 12 months, respectively (P = 0.192). DRTs were successfully
classified as high risk if pedunculated, mobile, >3 mm in thickness, or
without continuation onto the left atrial wall. A significantly higher
incidence of high-risk DRTs was observed on the Watchman 2.5 device (4.0%
[35 of 885]) compared with the Amulet occluder (2.2% [20 of 903]) (P =
0.030). Most low-risk DRTs resolved (12 of 15), whereas high-risk DRTs
remained mostly unresolved (34 of 55). Through 5 years, all clinical
outcome rates were numerically higher in the high-risk DRT group compared
with the low-risk DRT or no-DRT group; significance was observed in the
composite of stroke, systemic embolism, or cardiovascular death (30.4% vs
19.9%; HR: 1.74; 95% CI: 1.03-2.92; P = 0.037) and cardiovascular death
(26.4% vs 14.5%, HR: 2.09; 95% CI: 1.20-3.66; P = 0.009).
 Conclusion(s): High-risk DRTs were observed in a higher number of
Watchman 2.5 device patients compared with Amulet occluder patients. The
composite of stroke, systemic embolism, or cardiovascular death occurred
more often in patients with high-risk DRTs compared with those with
low-risk DRTs or no DRTs. (AMPLATZER Amulet Left Atrial Appendage Occluder
[LAAO] Investigational Device Exemption [Amulet IDE Trial];
NCT02879448) Copyright © 2025 American College of Cardiology
Foundation

<28>
Accession Number
2039682872
Title
Opioid-sparing Anesthesia in Cardiac Surgery: A Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Rauseo M.; Mirabella L.; Carrideo A.A.; Padovano F.P.; Cantatore L.P.;
Vetuschi P.; Da Lima S.; Paternoster G.; Cinnella G.
Institution
(Rauseo, Padovano, Cantatore, Vetuschi, Da Lima) Department of Cardiac
Anesthesia, Policlinico di Foggia, Foggia, Italy
(Rauseo, Mirabella, Carrideo, Cinnella) Department of Anesthesia and
Intensive Care Medicine, Policlinico di Foggia, Foggia, Italy
(Rauseo, Mirabella, Cinnella) Department of Medical and Surgical Science,
University of Foggia, Foggia, Italy
(Paternoster) Department of Health Sciences, School of Medicine,
University of Basilicata, Anesthesia and Intensive Care, San Carlo
Hospital, Potenza, Italy
Publisher
W.B. Saunders
Abstract
This systematic review and meta-analysis evaluated the impact of
opioid-sparing versus opioid-based anesthesia in adult patients undergoing
cardiac surgery. A comprehensive literature search was conducted across
major databases from 2015 to 2025. Eligible studies included randomized
controlled trials and observational cohorts reporting at least one of the
following outcomes: opioid consumption (in morphine milligram equivalents
[MME]), intensive care unit (ICU) length of stay, mechanical ventilation
duration, pain scores, and mortality. A total of 27 studies (8 randomized
controlled trials and 19 observational studies), including 58,998
patients, were analyzed. Opioid-sparing protocols, involving multimodal
analgesia and regional anesthesia, were significantly associated with
reduced intraoperative and postoperative opioid consumption. The pooled
mean difference in opioid consumption was -2.48 MME (95% confidence
interval [CI]: -2.60 to -2.35, p < 0.001). Opioid-sparing strategies were
also associated with shorter ICU length of stay (odds ratio [OR]: 1.32,
95% CI: 1.14-1.51), reduced duration of mechanical ventilation (OR: 1.46,
95% CI: 1.24-1.72), and lower postoperative pain scores at 12 hours (OR:
1.18, 95% CI: 1.07-1.30). No significant difference was observed in
postoperative mortality (OR: 0.20; 95% CI: 0.04-1.14). Narrative outcomes
such as persistent opioid use, postoperative nausea, early mobilization,
and patient satisfaction generally favored opioid-sparing anesthesia,
although reporting was inconsistent. Adverse events related to nonopioid
adjuncts were inconsistently reported. The overall risk of bias was low to
moderate, and heterogeneity was moderate across most outcomes. These
findings support opioid-sparing strategies in selected cardiac surgery
patients as part of multimodal, enhanced recovery protocols, but highlight
the need for standardized definitions and prospective trials with rigorous
safety reporting. Copyright © 2025 The Author(s)

<29>
Accession Number
2039778904
Title
Cardiac patients' death anxiety: A systematic review and meta-analysis.
Source
Journal of Affective Disorders. 391 (no pagination), 2025. Article Number:
119967. Date of Publication: 15 Dec 2025.
Author
Mollaei A.; Zamanzadeh V.; Ranjbar Noei F.; Kamali M.
Institution
(Mollaei, Ranjbar Noei) Student Research Committee, Golestan University of
Medical Sciences, Gorgan, Iran, Islamic Republic of
(Zamanzadeh) Department of Medical-Surgical Nursing, School of Nursing &
Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Kamali) Student Research Committee, School of Nursing and Midwifery,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
Elsevier B.V.
Abstract
Death anxiety (DA) is a critical psychological concern among patients with
cardiovascular diseases (CVDs), yet its prevalence and associated factors
remain understudied. This systematic review and meta-analysis aimed to
determine the level of DA in cardiac patients and identify contributing
factors. A comprehensive search of PubMed, Scopus, Web of Science, and
Google Scholar yielded 27 cross-sectional studies (5292 participants).
Studies were assessed using the AXIS tool, with most rated as high
quality. Pooled estimates revealed moderate DA levels across studies, with
mean scores of 8.46 (95 % CI: 7.05-9.86) for the Templer Death Anxiety
Scale (TDAS) 0-15 range and 45.07 (95 % CI: 34.59-55.55) for the 15-75
range. Subgroup analyses indicated higher DA in Turkey (vs. Iran) and
among coronary artery bypass graft (CABG) patients. Key factors linked to
elevated DA included female gender, younger age, economic hardship,
unemployment, reduced resilience, and diminished religious beliefs.
Meta-regression found no significant moderation by age, sample size, or
gender. These findings determine the need for targeted psychological
interventions addressing modifiable factors like socioeconomic support and
resilience-building in cardiac care. Limitations include reliance on
cross-sectional data and heterogeneity in measurement tools. Future
research should explore longitudinal and culturally diverse cohorts to
clarify causal relationships and optimize DA management
strategies. Copyright © 2025

<30>
Accession Number
2033987874
Title
Invasive Versus Conservative Treatment Strategy in Older Patients With
Non-ST Segment Elevation Acute Coronary Syndromes: A Meta-Analysis of
Randomized Controlled Trials.
Source
Journal of the American Geriatrics Society. 73(7) (pp 2238-2246), 2025.
Date of Publication: 01 Jul 2025.
Author
Ahmed M.; Ahsan A.; Shafiq A.; Hashmi T.M.; Ahmed R.; Alam M.; Shahid F.;
Rana J.S.; Mamas M.A.; Fonarow G.C.
Institution
(Ahmed, Hashmi) Rawalpindi Medical University, Rawalpindi, Pakistan
(Ahsan) Foundation University Medical College, Islamabad, Pakistan
(Shafiq) Dow University of Health Sciences, Karachi, Pakistan
(Ahmed) Department of Cardiology, Royal Brompton Hospital, London, United
Kingdom
(Ahmed) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Alam) Department of Interventional Cardiology, Baylor College of
Medicine, Houston, TX, United States
(Shahid) Department of Interventional Cardiology, Queen Elizabeth
Hospital, Birmingham, United Kingdom
(Rana) Division of Cardiology, Kaiser Permanente Northern California,
Oakland, CA, United States
(Rana) Division of Research, Kaiser Permanente Northern California,
Oakland, CA, United States
(Mamas) Keele Cardiovascular Research Group, Centre for Prognosis
Research, Keele University, Keele, United Kingdom
(Fonarow) Division of Cardiology, Ahmanson-UCLA Cardiomyopathy Center,
University of California Los Angeles, Los Angeles, CA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Non-ST segment elevation acute coronary syndromes (NSTE-ACS)
are a common cause of hospital admission in older patients. Our study aims
to synthesize the available evidence from randomized controlled trials
(RCTs) to compare clinical outcomes with invasive versus conservative
medical management in this population. Method(s): A literature search
of online databases including PubMed/MEDLINE, Embase, and the Cochrane
Library was conducted from inception to September 1, 2024. The search
aimed to identify RCTs that reported clinical outcomes with invasive
versus conservative strategies in older patients (>= 70 years) with
NSTE-ACS. The risk ratios (RRs) were used as summary estimates.
 Result(s): Seven RCTs with 2998 patients were included; 1490 patients
in the invasive group and 1508 patients in the conservatively managed
group. The pooled analysis demonstrated no statistically significant
difference between the two strategies for the risk of all-cause death (RR:
1.03, 95% CI: 0.92-1.15), cardiovascular death (RR: 1.04, 95% CI:
0.82-1.33), stroke (RR: 0.78, 95% CI: 0.53-1.15), and major bleeding (RR:
1.23, 95% CI: 0.90-1.69). However, the invasive strategy was associated
with a significantly reduced risk of myocardial infarction (RR: 0.74, 95%
CI: 0.57-0.96) and unplanned revascularization (RR: 0.29, 95% CI:
0.21-0.40) compared to the conservative strategy. Conclusion(s): In
older patients with NSTE-ACS, an invasive strategy reduces the risk of
repeat myocardial infarction and unplanned revascularization without a
significant increase in stroke or major bleeding. There was no associated
reduction in all-cause or cardiovascular mortality with the invasive
strategy compared to conservative management. Copyright © 2025
The Author(s). Journal of the American Geriatrics Society published by
Wiley Periodicals LLC on behalf of The American Geriatrics Society.

<31>
Accession Number
2035326993
Title
Innovative nitric oxide delivery technology for postoperative pulmonary
hypertension in congenital heart disease patients: a clinical trial.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
522. Date of Publication: 01 Dec 2025.
Author
Liu R.; Li Y.; Li B.; Liu S.; Tong M.; Ma Q.
Institution
(Liu, Li, Li, Liu, Tong, Ma) Department of Cardiac Surgery, Peking
University International Hospital, No.1 Life Garden Road, Zhongguancun
Life Science Park, Changping District, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background: Inhaled nitric oxide (iNO) is a selective pulmonary
vasodilator with therapeutic benefits for pulmonary hypertension patients.
Traditional cylinder-based iNO delivery systems are costly and complex,
creating unmet medical needs. This study evaluated the safety and efficacy
of a novel electrochemical nitric oxide generator (ENG) for administering
iNO to adult patients with congenital heart disease-associated pulmonary
arterial hypertension (CHD-PAH) in China following cardiac surgery.
 Method(s): Twenty patients with CHD-PAH, undergoing cardiac surgery,
were enrolled. Two hours post-surgery, when systemic circulation was
stable, iNO was delivered via the ENG at 20 ppm. Clinical data were
recorded, and iNO therapy was discontinued upon extubation. Safety, gas
exchange, and hemodynamic parameters were analyzed before and at 2, 4, and
6 h post-treatment. Result(s): All patients received iNO treatment
successfully and were discharged. The NO concentration remained stable,
unaffected by ventilator settings, and NO<inf>2</inf> levels stayed within
a safe range. iNO did not impact systemic blood pressure (P > 0.05). No
pulmonary hypertension crises or new complications occurred. INO was
associated with reductions in systolic pulmonary artery pressure at 2, 4,
and 6 h (P = 0.0053, P = 0.0218, P = 0.0002). In the hypoxemic subgroup
demonstrated significant improvements in both oxygenation and ventilation
parameters following iNO therapy, with PaO<inf>2</inf>/FiO<inf>2</inf>
increasing and PaCO<inf>2</inf> decreasing (P<0.05) at 6 h.
 Conclusion(s): The ENG provided stable NO delivery, ensuring safety
and efficacy in postoperative adult CHD-PAH patients. It was associated
with improvements of hemodynamics and gas exchange without systemic side
effects, offering a compact, efficient, and cost-effective alternative to
traditional iNO delivery systems. This research was registered with the
Clinical Trial Registry at http://www.chictr.org.cn, under the
registration number ChiCTR2400091214. The submission occurred on March 25,
2024, and the registration was made publicly available on October 23,
2024. Copyright © The Author(s) 2025.

<32>
Accession Number
2032095824
Title
The effect of spironolactone in reducing the risk of postoperative atrial
fibrillation in patients undergoing coronary artery bypass graft surgery:
randomized single-blind placebo-controlled study.
Source
General Thoracic and Cardiovascular Surgery. 73(8) (pp 579-584), 2025.
Date of Publication: 01 Aug 2025.
Author
Farzaneh A.; Moradi M.; Safarpoor G.; Karamian A.
Institution
(Farzaneh, Moradi) Department of Cardiology, School of Medicine, Hamadan
University of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Safarpoor) Department of Cardiac Surgery, Hamadan University of Medical
Sciences, Hamadan, Iran, Islamic Republic of
(Karamian) School of Medicine, Shahid Beheshti University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
Springer
Abstract
Background: Postoperative atrial fibrillation (POAF), one of the most
common cardiac arrhythmias following coronary artery bypass graft (CABG)
surgery is associated with unfavorable outcomes. Objective(s): This
study investigated the effect of spironolactone administered two weeks
before surgery on the incidence of POAF in patients undergoing CABG.
 Method(s): This randomized single-blind placebo-controlled study was
conducted on 130 CABG patients. All patients were randomly divided into
intervention and control groups including 65 cases for each group. In the
intervention group, patients received 50 mg of spironolactone orally daily
for 2 weeks before surgery, and in the control group patients received
placebo daily from 2 weeks before surgery. All patients were continuously
monitored for the occurrence of POAF for two weeks postoperatively.
 Result(s): The mean age of the patients in the intervention and
control groups was 61.7 +/- 5.4 and 60 +/- 6.7 years, respectively. The
incidence of POAF in the intervention and control groups was 7.7% and 20%,
respectively (Odds Ratio = 0.33, P = 0.042). All demographic and clinical
variables were similar in patients with and without POAF (all P > 0.05).
 Conclusion(s): Our findings revealed that in comparison to placebo,
the use of spironolactone is associated with reduced incidence of POAF in
CABG candidates. Copyright © The Author(s), under exclusive
licence to The Japanese Association for Thoracic Surgery 2024.

<33>
Accession Number
2035310142
Title
Resveratrol improves lipid profile and recovers heart function in
postoperative CABG patients.
Source
Molecular and Cellular Biochemistry. (no pagination), 2025. Date of
Publication: 2025.
Author
Ahmadi P.; Akbarzadeh S.; Alizadeh M.; Mohammadi N.; Mahmoodi M.; Amini
A.; Netticadan T.; Rezaei M.; Movahed A.
Institution
(Ahmadi, Mohammadi) Bushehr University of Medical Sciences, Bushehr, Iran,
Islamic Republic of
(Akbarzadeh, Alizadeh, Movahed) Department of Clinical Biochemistry,
Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr,
Iran, Islamic Republic of
(Mahmoodi) Department of Biostatistics and Epidemiology, Addiction and
Lifestyle Research Center, Bushehr University of Medical Sciences,
Bushehr, Iran, Islamic Republic of
(Amini) Department of Internal Medicine, Faculty of Medicine, Bushehr
University of Medical Sciences, Bushehr, Iran, Islamic Republic of
(Netticadan) Canadian Centre for Agri-Food Research in Health and
Medicine, Winnipeg, Canada
(Rezaei) Department of Cardiovascular Surgery, Faculty of Medicine,
Bushehr University of Medical Sciences, Bushehr, Iran, Islamic Republic of
Publisher
Springer
Abstract
Cardiovascular diseases (CVD), especially coronary artery disease (CAD),
are among the most important causes of mortality in the world. Coronary
artery bypass grafting (CABG) is a standard treatment for this disease,
but it may be associated with complications in the postoperative period.
This study investigated the effect of resveratrol (RES), a potent
antioxidant and anti-inflammatory molecule, on cardiovascular indices and
oxidative stress in patients after CABG surgery. This randomized,
double-blind, placebo-controlled trial was carried out at the Bushehr
Heart Center in Bushehr, Iran. A total of 60 patients undergoing CABG were
randomly assigned in equal numbers to either the intervention group or the
control group. The intervention group received RES capsules for 60 days,
and the control group received a placebo for the same duration.
Cardiovascular function and biochemical parameters, including lipid
profile, cardiac enzymes, and markers of oxidative stress and
inflammation, were measured at the beginning and end of the intervention.
Compared to the control group, RES intake significantly reduced systolic
blood pressure (SBP), triglyceride (TG), total cholesterol (TC),
low-density lipoprotein (LDL), and improved ejection fraction (EF).
Although decreases in cardiac enzymes, including creatine phosphokinase
(CPK) and lactate dehydrogenase (LDH), were observed in the RES group,
these changes were not statistically significant. Also, the two groups
showed no significant differences in diastolic blood pressure (DBP), HDL,
or oxidative stress markers. RES supplementation protects patients after
CABG by improving cardiovascular function and lipid profiles. Trial
registration: IRCT20111119008129N12, first trial registration date:
2022-06-18. Copyright © The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2025.

<34>
Accession Number
2039714521
Title
Transcatheter edge-to-edge repair in patients with mitral annular
calcification: A systematic review and meta-analysis.
Source
American Journal of the Medical Sciences. (no pagination), 2025. Date of
Publication: 2025.
Author
Idowu A.; Adebolu O.; Siraj B.; Wattanachayakul P.; Balogun O.; Lo K.B.;
Witzke C.; Akintoye E.; Bozorgnia B.; Pressman G.
Institution
(Idowu, Wattanachayakul) Department of Internal Medicine,
Jefferson-Einstein Hospital, Philadelphia, PA, United States
(Adebolu, Siraj) Division of Hospital Medicine, Jefferson-Einstein
Hospital, Philadelphia, PA, United States
(Balogun) Division of Hospital Medicine, Lankenau Medical Centre, PA,
United States
(Lo) Division of Cardiovascular Medicine, Brigham and Women's Hospital
Heart and Vascular Center, Boston, MA, United States
(Witzke, Bozorgnia, Pressman) Department of Cardiology, Jefferson-Einstein
Hospital, Philadelphia, PA, United States
(Akintoye) Cardiovascular Medicine, Department of Internal Medicine, Yale
University School of Medicine, New Haven, CT, United States
Publisher
Elsevier B.V.
Abstract
Background: Mitral annular calcification (MAC) is common in patients with
functional mitral regurgitation undergoing transcatheter edge-to-edge
mitral valve repair (TEER). However, the safety and effectiveness of TEER
systems in patients with MAC is poorly understood. Method(s): We
systematically reviewed multiple online databases to identify studies that
reported outcomes in patients undergoing TEER with underlying
moderate/severe MAC versus those with no/mild MAC. Random-effect model
meta-analysis at a 95 % confidence interval was done via Cochrane Review
Manager 5.4. Result(s): A total of 6 studies with a pooled 2808
patients (no/mild MAC: 84.5 % vs moderate/severe MAC: 15.5 %) were
included. Compared to those with no/mild MAC, patients undergoing TEER
with moderate/severe MAC have an insignificant trend towards a lower
immediate procedural success (OR: 0.62, 95 % CI: 0.37 - 1.04, p = 0.07).
After one year of TEER, the two groups had similar rates of repeat mitral
valve intervention or surgery (OR: 1.67, 95 %CI: 0.92 - 3.05, p = 0.09),
sustained clinical improvement (NYHA <= 2) (OR: 0.86, 95 %CI: 0.64 - 1.15,
p = 0.30), and heart failure re-admission (OR: 0.84, 95 %CI: 0.52 - 1.36,
p = 0.48). All-cause mortality was, however, higher in the moderate/severe
MAC patients (OR: 1.82, 95 %CI: 1.15 - 2.86, p = 0.01).
 Conclusion(s): TEER appears safe and effective in carefully selected
patients with significant MAC. A standardized selection algorithm is
needed to identify MAC patients that would benefit most from
TEER. Copyright © 2025

<35>
Accession Number
2037797955
Title
Efficacy and Safety of Distal Radial Artery Access versus Proximal Radial
Artery Access for Cardiac Procedures: A Systematic Review and
Meta-Analysis.
Source
Medical Principles and Practice. 34(4) (pp 328-337), 2025. Date of
Publication: 04 Feb 2025.
Author
Ur Rehman M.E.; Raja H.A.A.; Osama M.; Kakakhail A.; Waseem M.H.; Mukhlis
M.; Ali M.A.; Abideen Z.U.; Shoaib M.; Din Z.U.; Tahir A.; Hassan M.Z.U.;
Mazhar U.; Haider S.T.; Saeed S.; Nashwan A.J.
Institution
(Ur Rehman, Raja, Mazhar, Haider, Saeed) Department of Medicine,
Rawalpindi Medical University, Rawalpindi, Pakistan
(Osama, Ali, Shoaib, Din, Hassan) Khyber Medical College, Peshawar,
Pakistan
(Kakakhail) Khyber Girls Medical College, Peshawar, Pakistan
(Waseem) Allama Iqbal Medical College, Lahore, Pakistan
(Mukhlis) Ayub Medical College, Abbottabad, Pakistan
(Abideen) Department of Medicine, King Edward Medical University, Lahore,
Pakistan
(Tahir) Department of Medicine, Liaquat University of Medical and Health
Sciences, Jamshoro, Pakistan
(Nashwan) Hamad Medical Corporation, Doha, Qatar
Publisher
S. Karger AG
Abstract
Objective: Cardiac catheterization using the distal radial artery (DRA)
access, at the level of the anatomical snuff box post-radial artery
bifurcation, may be linked to a lower rate of arterial occlusion and
better hemostasis. In this meta-analysis, we compare DRA versus proximal
radial artery (PRA) access in cardiac catheterization or angiography.
 Method(s): A detailed literature search was performed on PubMed,
Cochrane, Em-base, and Clinicaltrials.gov from inception till June 2024.
Risk ratios (RRs) and mean differences (MDs) were pooled for categorical
and continuous outcomes, respectively. Random effects meta-analysis was
undertaken on RevMan. Result(s): Our meta-analyses include 21
randomized controlled trials with 9,539 patients (DRA 4,761, PRA 4,778).
DRA significantly reduced 24-h radial artery occlusion rates (RR 0.30, 95%
CI: 0.23 to 0.40, p <= 0.00001) and time to hemostasis (minutes) (MD
-44.46, 95% CI: -50.64 to -38.92, p < 0.00001), whereas PRA was
significantly superior in terms of the puncture success rate (RR 0.96, 95%
CI: 0.93 to 0.99, p < 0.01), the crossover rate (RR 2.89, 95% CI: 2.02 to
4.15, p < 0.00001), and puncture attempts (MD 0.69, 95% CI: 0.37 to 1.00,
p = 0.00001). Conclusion(s): DRA was associated with a lower risk of
occlusion and lower time to hemostasis, but required a greater number of
puncture attempts and had lower success rate. Further research is required
to elucidate the most optimal approach. Copyright © 2025 The
Author(s)

<36>
Accession Number
2035293100
Title
Effect of pulmonary hypertension on the prognosis of patients with severe
aortic stenosis after transcatheter aortic valve replacement: a systematic
review and meta-analysis.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
515. Date of Publication: 01 Dec 2025.
Author
Ruan Y.; Wei X.; Li Q.; Jin Z.
Institution
(Ruan, Wei, Li, Jin) Department of Cardiology, Beijing Tiantan Hospital,
Capital Medical University, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Objective: To systematically evaluate the impact of pulmonary hypertension
(PH) on the prognosis of patients with severe aortic stenosis (AS)
undergoing transcatheter aortic valve replacement (TAVR). Method(s):
We conducted a meta-analysis of cohort studies to evaluate the impact of
PH on the prognosis of patients with severe AS undergoing TAVR. A
comprehensive search was performed in PubMed, Embase, and the Cochrane
Library up to June 2024. Data extraction and quality assessment were
carried out independently by two researchers. Statistical analyses were
conducted using STATA 15.1. Result(s): A total of 7 cohort studies
were included. Meta-analysis results demonstrated that patients with PH
who underwent TAVR had significantly higher rates of all-cause mortality
at 30 days (OR = 2.52, 95% CI: 1.70-3.73, P < 0.001), 1 year (OR = 2.01,
95% CI: 1.52-2.66, P < 0.001) and 1-year cardiovascular mortality (OR =
2.56, 95% CI: 1.84-3.57, P < 0.001), compared to those without PH. There
was no statistical difference between the two groups in major bleeding
events, stroke, myocardial infarction and pacemaker implantation.
 Conclusion(s): PH is associated with higher short- and long-term
mortality in AS patients undergoing TAVR, suggesting it as a crucial
factor in patient prognosis post-procedure. Copyright © The
Author(s) 2025.

<37>
Accession Number
2039641610
Title
Global Research Trends and Hotspots in Anesthesia for Coronary Artery
Bypass Graft Surgery: A Bibliometric Analysis from 2004 to 2024.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Liu Y.; Li C.
Institution
(Liu, Li) Department of Anesthesiology, Second Hospital, Hebei Medical
University, Shijiazhuang, China
Publisher
W.B. Saunders
Abstract
Objectives: This study aimed to analyze global research trends and
hotspots in anesthesia for coronary artery bypass grafting (CABG) surgery
through a comprehensive bibliometric analysis. Design(s):
Observational bibliometric analysis. Setting(s): Data was collected
from the Web of Science Core Collection database, which encompasses a
broad array of international research publications. Participant(s):
There were 740 publications related to anesthesia for CABG surgery
published between 2004 and 2024. Intervention(s): No direct
interventions were performed. The study involved the collection and
analysis of published research data. Measurements and Main Results:
Key findings revealed that the United States, Turkey, and China are
leading in anesthesia for CABG surgery research output, with an average
international collaboration rate of 12.57%. The Cleveland Clinic
Foundation was the top contributor with 48 publications. The Journal of
Cardiothoracic and Vascular Anesthesia was noted for its high impact
(H-index of 33). Influential authors identified include Landoni Giovanni
and Zangrillo Alberto. Keyword analysis showed a shift in research focus
from ischemia and morphine to myocardial protection, complications, and
cardiac anesthesia from 2019 to 2024. Conclusion(s): This
bibliometric study provides a comprehensive overview of the evolving
research landscape in anesthesia for CABG surgery, highlighting trends,
collaborative efforts, and emerging research areas that may guide future
investigations and clinical practices in cardiac anesthesia
management. Copyright © 2025 Elsevier Inc.

<38>
Accession Number
2032466263
Title
Long-term outcomes with medical therapy, transcatheter repair, or surgery
for isolated tricuspid regurgitation: a systematic review and network
meta-analysis.
Source
Clinical Research in Cardiology. 114(2) (pp 272-280), 2025. Date of
Publication: 01 Feb 2025.
Author
Saito T.; Kuno T.; Aikawa T.; Ueyama H.A.; Kampaktsis P.N.; Kolte D.;
Misumida N.; Takagi H.; Ahmad Y.; Kaneko T.; Zajarias A.; Latib A.
Institution
(Saito) Department of Cardiology, Edogawa Hospital, Tokyo, Japan
(Kuno) Cardiology Division, Massachusetts General Hospital, Harvard
Medical School, 55 Fruit Street, GRB 800, Boston, MA, United States
(Kuno, Latib) Division of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, Bronx, NY, United States
(Aikawa) Department of Cardiovascular Biology and Medicine, Juntendo
University Graduate School of Medicine, Tokyo, Japan
(Ueyama) Division of Cardiology, Emory University School of Medicine,
Atlanta, GA, United States
(Kampaktsis) Structural and Congenital Center, Hackensack Medical Center,
Hackensack, NJ, United States
(Kolte) Cardiology Division, Massachusetts General Hospital, Harvard
Medical School, Boston, MA, United States
(Misumida) Division of Cardiovascular Medicine, Gill Heart and Vascular
Institute, University of Kentucky, Lexington, KY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Ahmad) Division of Cardiology, Department of Cardiology, University of
California San Francisco, San Francisco, CA, United States
(Kaneko) Cardiothoracic Surgery Division, Department of Surgery,
Washington University in St Louis School of Medicine, St Louis, MO, United
States
(Zajarias) Cardiovascular Division, Department of Medicine, Washington
University in St Louis School of Medicine, St Louis, MO, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Several transcatheter tricuspid valve (TV) repair devices for
tricuspid regurgitation (TR) have emerged. However, few studies have
compared transcatheter TV repair with medical therapy (MT) alone or
isolated TV surgery. Method(s): PubMed and EMBASE were searched in
February 2024. Studies comparing at least any of the following 2 were
included: MT, surgical TV repair, surgical TV replacement, or
transcatheter TV repair. The primary outcome was long-term mortality ( 1
year). The secondary outcomes were short-term mortality (30-day or
in-hospital mortality) and periprocedural complications. We performed a
network meta-analysis using a random effects model. Result(s): A
total of 25,831 patients from 22 studies (one randomized trial and 21
observational studies) were included. MT alone was associated with higher
long-term mortality compared to surgical TV repair (HR [95% CI] 1.72
[1.34-2.23]), surgical TV replacement (HR [95% CI] 1.49 [1.14-1.96]), and
transcatheter TV repair (HR [95% CI] 1.52 [1.30-1.78]). Long-term
mortality was comparable between transcatheter and surgical interventions.
Transcatheter TV repair had a lower risk of short-term mortality (versus
surgical TV repair; RR [95% CI] 0.40 [0.22-0.72], versus surgical TV
replacement; RR [95% CI] 0.35 [0.19-0.66]) and lower rates of
periprocedural complications, including new pacemaker implantation, renal
complications, cardiogenic shock than surgical interventions.
 Conclusion(s): MT alone for TR was associated with higher long-term
mortality compared to surgical or transcatheter TV interventions.
Transcatheter TV repair had better periprocedural outcomes compared to
surgical interventions with similar long-term mortality. Despite the
possibility of selection bias, transcatheter TV repair appears to be an
attractive option for TR treatment. Copyright © Springer-Verlag
GmbH Germany, part of Springer Nature 2024.

<39>
Accession Number
2039028589
Title
Patterns of prevention effectiveness in postoperative neurocognitive
disorder and delayed neurocognitive recovery research: a systematic review
with meta-regression of randomised trials.
Source
British Journal of Anaesthesia. 135(2) (pp 340-359), 2025. Date of
Publication: 01 Aug 2025.
Author
Lahiri N.K.; Vuckovic N.; Sidhu A.S.; Li J.; Sun Y.; Naiken S.; Curtis
S.J.; Bisch E.; Bolda R.; Nagra P.S.; Mann G.; Gonzales A.E.; Smith L.;
Anderson B.P.; Liu Z.; Adams D.C.; Meng L.
Institution
(Lahiri, Vuckovic, Sidhu, Sun, Naiken, Curtis, Bisch, Bolda, Nagra, Mann,
Gonzales, Smith, Anderson, Adams, Meng) Department of Anesthesia, Indiana
University School of Medicine, Indiana University, Indianapolis, IN,
United States
(Li, Liu) Department of Biostatistics & Health Data Science, Indiana
University School of Medicine, Indiana University, Indianapolis, IN,
United States
(Sun) Department of Anesthesiology, Nanjing Drum Tower Hospital, The
Affiliated Hospital of Nanjing University Medical School, Jiangsu
Province, Nanjing, China
Publisher
Elsevier Ltd
Abstract
Background: Postoperative neurocognitive disorder and delayed
neurocognitive recovery (pNCD/dNCR) are common yet unresolved
complications after surgery. Method(s): We conducted a systematic
literature search in resources of Ovid MEDLINE, EMBASE, Web of Science,
and ClinicalTrials.gov and multivariable meta-regression analyses of RCTs
to identify trial-level characteristics associated with prevention
effectiveness in pNCD/dNCR research. Trials investigating pNCD/dNCR
prevention in adult surgical patients were eligible. Trials performed in
paediatric patients or assessing cognitive changes on the same day of
surgery were excluded. Effectiveness associated with trial-level
characteristics was assessed using ratio of odds ratio (OR) and 95%
confidence interval (CI). Result(s): We analysed 187 eligible trials.
Trials originating from the USA/Canada (ratio of OR, 3.04; 95% CI,
1.62-5.73; P=0.001), Europe/Australia/New Zealand (1.58; 1.04-2.40;
P=0.033), and other regions (2.0; 1.19-3.36; P=0.009) were associated with
reduced effectiveness compared with trials from China. Higher pNCD/dNCR
incidence in control groups was associated with greater effectiveness
(0.98; 0.97-0.99; P<0.001). Trials involving volatile anaesthetics (2.12;
1.16-3.86; P=0.014) were associated with reduced effectiveness compared
with dexmedetomidine and abdominal surgery, respectively. Registered
trials exhibited enhanced effectiveness (0.69; 0.50-0.95; P=0.022),
whereas those with power analyses reported reduced effectiveness (1.43;
1.06-1.94; P=0.021). Trials with a high risk of bias in the selection of
the reported result were associated with reduced effectiveness (2.99;
1.04-8.59; P=0.041). Dexmedetomidine was the most studied intervention,
showing potential benefits, though evidence certainty was very low.
 Conclusion(s): Trial-level characteristics were significantly
associated with prevention effectiveness in pNCD/dNCR research.
Identifying and addressing the underlying causes of regional differences
might enhance the quality and consistency of future trials on a global
level. Systematic review protocol: PROSPERO
(CRD42024543584). Copyright © 2025 British Journal of Anaesthesia

<40>
Accession Number
2035306763
Title
Distal versus conventional radial artery catheterization for hemodynamic
monitoring in intensive care setting: a randomized, controlled,
non-inferiority trial.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 348. Date
of Publication: 01 Dec 2025.
Author
Peng C.; Wu W.; Zhang Y.; Han Z.; Deng X.; Tan J.; Xi Z.; Zhang R.
Institution
(Peng, Wu, Zhang, Han, Deng, Tan, Zhang) Department of Emergency and
Critical Care Medicine, Yichang Central People's Hospital, Hubei, Yichang,
China
(Peng, Xi) Department of Nursing, Yichang Central People's Hospital,
Hubei, Yichang, China
(Peng, Wu, Zhang, Han, Deng, Tan, Xi, Zhang) The First College of Clinical
Medical Science, China Three Gorges University, Hubei, Yichang, China
Publisher
BioMed Central Ltd
Abstract
Background: Arterial catheterization is fundamental for hemodynamic
monitoring in critically ill patients, yet instability and loss of
arterial pressure waveform remain clinically significant issues. The
distal radial artery (dRA) approach has been proposed as a potential
alternative to the conventional radial artery (RA) approach. This is the
first randomized clinical trial to assess the comparative efficacy and
reliability of dRA versus RA catheterization by examining first-attempt
success rates and the stability of arterial pressure waveforms in
critically ill ICU patients. Method(s): This randomized controlled
trial enrolled 200 critically ill patients requiring arterial
catheterization, assigning them to either dRA (n = 100) or conventional RA
(n = 100) groups. All procedures utilized a standard 20-gauge polyurethane
peripheral intravenous catheter. Co-primary outcomes included
first-attempt success rate and frequency of arterial pressure waveform
loss during the initial 72-h period. Secondary outcomes included
catheterization time, complications during insertion and management,
hemostasis time, and catheter duration. Bonferroni correction was applied
for multiple testing (alpha = 0.025). Result(s): First-attempt
success rates were comparable between dRA and RA groups (86% vs. 84%, P =
0.688). The dRA group experienced significantly fewer arterial pressure
waveform losses across all three days (Day 1: 1.0 [0.0, 2.0] vs. 2.0 [1.0,
2.0]; Day 2: 1.0 [0.0, 1.0] vs. 2.0 [1.0, 2.0]; Day 3: 0.0 [0.0, 1.0] vs.
1.0 [1.0, 2.0]; all P < 0.001). Both groups achieved 100% procedural
success with no site crossovers. Arterial catheterization time was longer
in the dRA group (P < 0.001). Complication rates during catheterization,
management, and after removal were similar between groups. Hemostasis time
was significantly shorter in the dRA group (2.6 +/- 1.5 min vs. 4.2 +/-
0.9 min, P < 0.001). Catheter duration was similar between groups (76.6
+/- 16.7 vs. 77.4 +/- 16.4 h, P = 0.724). Conclusion(s): While
first-attempt success rates were similar, the dRA approach offered greater
arterial pressure waveform stability and shorter hemostasis time than the
conventional RA approach, without increasing complications. Thus, dRA may
be a preferable option for arterial catheterization in critically ill
patients. Trial registration: This study is registered in the Chinese
Clinical Trials Registry (registration number: ChiCTR2400086284,
registration date: 27/06/2024). Copyright © The Author(s) 2025.

<41>
Accession Number
2039464789
Title
Outcomes of Lesions With Discordance Between FFR and Nonhyperemic Pressure
Ratios.
Source
JACC: Cardiovascular Interventions. 18(13) (pp 1631-1642), 2025. Date of
Publication: 14 Jul 2025.
Author
Ha E.T.; Nishi T.; Takahashi T.; Yamazaki T.; Saito Y.; Kuramitsu S.;
Kawase Y.; Parikh M.A.; Waksman R.; Kobayashi Y.
Institution
(Ha, Nishi, Parikh, Kobayashi) NewYork-Presbyterian Brooklyn Methodist
Hospital, Brooklyn, NY, United States
(Takahashi) Smidt Heart Institute, Cedars-Sinai Medical Center, CA, United
States
(Yamazaki, Saito) Department of Cardiovascular Medicine, Chiba University
Graduate School of Medicine, Chiba, Japan
(Kuramitsu) Sapporo Cardiovascular Clinic, Sapporo Heart Center, Sapporo,
Japan
(Kawase) Gifu Heart Center, Gifu, Japan
(Parikh, Kobayashi) Weill Cornell Medical College, New York, NY, United
States
(Waksman) Medstar Washington Hospital Center, Washington, DC, United
States
Publisher
Elsevier Inc.
Abstract
Background: Discordance between fractional flow reserve (FFR) and
nonhyperemic pressure ratios (NHPRs) can occur in about 20% of clinical
cases, creating treatment dilemmas in the cardiac catheterization
laboratory. Objective(s): The authors sought to perform a systematic
review and meta-analyses investigating the long-term outcome of deferral
strategy in patients found to have discordant physiology. Method(s):
The primary comparison tested the long-term prognosis of patients who were
deferred for discordant physiology vs those deferred for concordant
negative results. Various NHPRs were compared with FFR. The primary
endpoint was a composite of death (all-cause or cardiac) and myocardial
infarction/revascularization with several definitions. Secondary endpoint
consisted of death or myocardial infarction. The study is registered with
PROSPERO (CRD42024628393). Result(s): Six eligible trials with 9,854
intermediate lesions deferred for PCI were considered in the analysis.
Compared with concordant-negative physiology
(FFR-/NHPRs-), deferral of PCI for discordant
physiology was associated with an increase in the primary endpoints
(FFR-/NHPRs+: HR: 2.73 [1.95-3.80]; P < 0.00001 and
FFR+/NHPRs-: HR: 3.29[2.33-4.64]; P < 0.00001).
Secondary dichotomous analysis showed that deferral of PCI in both
discordant groups was associated with an increase in the hard endpoints
(death or myocardial infarction) compared with concordant-negative
physiology. Exploratory analysis comparing revascularization vs deferral
groups within discordant physiology demonstrated reduction in the primary
endpoint in the FFR+/NHPRs- group, but not in the
FFR-/NHPRs+ group. Conclusion(s): Deferral of
PCI in discordant-physiology was associated with worse long-term outcomes
compared with the concordant-negative physiology. There may be a benefit
of revascularization in FFR+/NHPRs- lesions, which
requires further investigation. Copyright © 2025 American College
of Cardiology Foundation

<42>
Accession Number
2035380535
Title
Impact of aortic angulation on outcomes in transcatheter aortic valve
replacement with balloon-expandable and self-expanding valves: a
systematic review and meta-analysis.
Source
Cardiovascular Intervention and Therapeutics. (no pagination), 2025. Date
of Publication: 2025.
Author
Khalefa B.B.; Gonnah A.R.; Yassin M.N.A.; Fayed H.; Arnaout M.; Elkholy
M.K.A.; Ramadan M.; Elettreby A.M.; Dway A.; Eldeeb H.; Abujabal A.S.;
Roberts D.H.
Institution
(Khalefa, Abujabal) Faculty of Medicine, Ain Shams University, Cairo,
Egypt
(Gonnah) Department of Medicine, Imperial College Healthcare NHS Trust,
London, United Kingdom
(Yassin) Faculty of Medicine, Cairo University, Cairo, Egypt
(Fayed, Eldeeb) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Arnaout) Faculty of Medicine, Aleppo University, Aleppo, Syrian Arab
Republic
(Elkholy) Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
(Ramadan) Faculty of Medicine, Suez University, Suez, Egypt
(Elettreby) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Dway) Faculty of Medicine, Al-Andalus University for Medical Sciences,
Tartus, Syrian Arab Republic
(Roberts) Lancashire Cardiac Centre, Blackpool, United Kingdom
(Roberts) School of Medicine, University of Liverpool, Liverpool, United
Kingdom
Publisher
Springer
Abstract
High aortic angulation (AA) can pose significant challenges during TAVR.
This meta-analysis determines the impact of a horizontal aorta on TAVR
outcomes with balloon-expandable (BEV) and self-expanding valves (SEVs). A
comprehensive search was conducted from inception to June 2024. Thirteen
observational studies assessing the impact of aortic angulation in
patients undergoing TAVR replacement were included. The pooled results
indicated that short-term mortality was significantly lower in patients
with a non-horizontal aorta (RR = 0.76; 95% CI 0.62-0.95, P = 0.01).
Subgroup analysis displayed that BEVs had a lower short-term mortality
with a horizontal aorta than SEVs. The incidence of stroke was not
significantly affected by aortic angulation with either valve type.
However, the overall risk of permanent pacemaker implantation was lower in
patients with a non-horizontal aorta for both valve types. Paravalvular
regurgitation was also reduced in the non-horizontal aorta group, with no
difference between aortic angulations in patients with BEVs. In contrast,
SEVs favored a non-horizontal aorta in reducing paravalvular leak (RR =
0.66; 95% CI 0.46-0.94, P = 0.02). Both BEVs and SEVs show better results
in patients with lower aortic root angulation. The increased incidence of
conduction abnormalities and PPI rates with both valve types in patients
with horizontal aorta is a concern. BEVs could be potentially used
preferentially to SEVs in patients with a horizontal aorta as there was no
difference between horizontal and non-horizontal aorta groups regarding
short-term mortality, moderate-to-severe paravalvular leak, and need for a
second valve. Copyright © The Author(s) 2025.

<43>
Accession Number
2033302686
Title
Reported Postoperative Surgical Site Infections in Tertiary Care
Hospitals, Systematic Review of Recent Literature.
Source
Current Drug Safety. 20(4) (pp 463-479), 2025. Date of Publication: 2025.
Author
Nadeem S.; Hameed A.A.; Gillani S.W.; Rathore H.A.
Institution
(Nadeem, Hameed, Gillani) College of Pharmacy, Pharmacy Practice, Gulf
Medical University, Ajman, United Arab Emirates
(Rathore) College of Pharmacy, Qatar University, QU Health, Doha, Qatar
Publisher
Bentham Science Publishers
Abstract
Purpose: The objective of this systematic review is to evaluate the
patterns of post-surgical site infections, pre-surgical antibiotics
prophylaxis, and related clinical outcomes in the recently published
literature. Method(s): This systematic review is registered with
PROSPERO registration number CRD42023398963. Several databases and
individual journal websites were used to collect data from PubMed/Medline,
TRIP, SCOPUS, Elsevier, Springer, ProQuest, and EMBASE. The established
criteria of inclusion were RCTs, retrospective, prospective, and
cross-sectional studies with patients who had a recent surgical procedure.
Excluded from the study designs were systematic reviews, prospective
studies, data on pediatrics, and data on disabilities. Quality assessment
analysis of the results for randomized controlled trials (RCT) used
CONSORT guidelines and STROBE guidelines for cross-sectional and cohort
studies. Result(s): A total of 328 articles were identified from
different databases. Among them, 15 studies were included for data
extraction and qualitative analysis. A total of 33,193 patients with an
average rate of 11.5% (surgical site infections- SSIs) were identified in
these studies during 2008-2022. The mean rate of SSIs among the total
number of immunocompromised patients/procedures was 10.2%. The SSI on
patients undergoing major surgical procedures with visible incisions was
26.0%. The majority of the studies reported the use of pre-surgical
antibiotic prophylaxis. Cefazolin was mostly prescribed antibiotics and
administered in 90% of patients. Other antibiotics included ceftriaxone
(4%), cloxacillin (3%), and vancomycin (4%). The mean reported rate of
SSIs with combination antibiotic prophylaxis therapy was 22.8%.
 Conclusion(s): This systematic review concluded the limited reported
data on surgical site infections (SSIs). The overuse of pre-surgical
antibiotic prophylaxis has been reported in several studies. This study
recommended developing standardized guidelines on the use of antibiotics
related to surgical cases rather than co-morbidities. Copyright ©
2025 Bentham Science Publishers.

<44>
Accession Number
2039746466
Title
Ultra-short-period perioperative pulmonary rehabilitation on short-term
outcomes after surgery in smoking patients with lung cancer: a randomized
clinical trial.
Source
International Journal of Surgery. 111(1) (pp 581-588), 2025. Date of
Publication: 01 Jan 2025.
Author
Han D.; Wang X.; Sun X.; Cao Y.; Li C.; Guo W.; Hu Y.; Hang J.; Li J.; Xie
Q.; Li H.
Institution
(Han, Wang, Cao, Li, Guo, Hu, Hang) Department of Thoracic Surgery, Ruijin
Hospital, Shanghai Jiao Tong University School of Medicine, China
(Sun, Xie) Department of Rehabilitation, Ruijin Hospital, Shanghai Jiao
Tong University School of Medicine, China
(Li) Clinical Research Center, Ruijin Hospital, Shanghai Jiao Tong
University School of Medicine, Shanghai, China
(Li) Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong
University School of Medicine, 197 Ruijin 2nd Road, Shanghai, China
Publisher
Wolters Kluwer Health Inc
Abstract
Background: Pulmonary rehabilitation (PR) is essential for airway
management after thoracic surgery. Most current PRs are composed of
2-4-week exercises, which require significant consumption of medical
resources and concerns about disease progression. Material(s) and
Method(s): This single-center, prospective, randomized controlled trial
enrolled smoking patients with pulmonary masses or nodules suitable for
lobectomy, aged 18-80, with a smoking history (>= 20 pack-years). Eligible
patients were randomized in a 1:1 ratio into two groups. Patients in the
intervention group underwent perioperative breathing exercises based on
positive pressure vibration expectoration and 3-day preoperative lower
limb endurance training. Patients in the control group received routine
perioperative care. The primary outcome was in-hospital incidence of
postoperative pulmonary complications. Secondary outcomes included
postoperative hospital stay, total hospitalization cost, postoperative
drainage time, drainage volume, semiquantitative cough strength score,
pain score, Borg scale-assessed fatigue, and walking distance on
postoperative days 1 and 2. Result(s): A total of 194 patients were
included in the study, with 94 in the intervention group and 100 in the
control group. Our ultrashort PR program potentially reduced pulmonary
complications incidence (24.5 vs. 33.0%), but without statistical
significance (P = 0.190). No significant differences were found in other
perioperative outcomes, except for postoperative semiquantitative cough
strength score (3 [interquartile range, 3-3.75] vs. 3 [interquartile
range, 2-3], P < 0.001) and change in walking distance from postoperative
days 1 to 2 (60 [interquartile range, 40-82.5] vs. 30 [interquartile
range, 10-60], P = 0.003). Conclusion(s): There were no significant
differences in postoperative complications and other hospitalizations, but
our ultrashort rehabilitation program improved patients' semiquantitative
cough strength score and walking distance, indicating the potential for
better outcomes. This treatment is a safe and effective means of airway
management for thoracic surgery in the era of enhanced recovery
(ClinicalTrials.gov Identifier: NCT03010033). Copyright © 2024
The Author(s).

<45>
Accession Number
2039662921
Title
Multimodal prehabilitation as a strategy to reduce postoperative
complications in cardiac surgery: A randomised controlled trial.
Source
European Journal of Anaesthesiology. (no pagination), 2025. Article
Number: 2236. Date of Publication: 2025.
Author
Lopez-Hernandez A.; Gimeno-Santos E.; Navarro-Ripoll R.; Arguis M.J.;
Lopez-Baamonde M.; Sanz-De La Garza M.; Sandoval E.; Castella M.;
Martinez-Palli G.
Institution
(Lopez-Hernandez) Universitat de Barcelona, Hospital Clinic de Barcelona,
Barcelona, Spain
(Lopez-Hernandez, Navarro-Ripoll, Arguis, Lopez-Baamonde, Martinez-Palli)
Anaesthesiology Department, Hospital Clinic de Barcelona, Barcelona, Spain
(Lopez-Hernandez, Gimeno-Santos, Navarro-Ripoll, Lopez-Baamonde)
Prehabilitation Unit, Hospital Clinic de Barcelona, Barcelona, Spain
(Gimeno-Santos, Arguis, Sanz-De La Garza, Sandoval, Castella,
Martinez-Palli) Fundacio de Recerca Clinic Barcelona-Institut
d'Investigacions Biomediques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona,
Spain
(Sanz-De La Garza) Cardiovascular Institute, Hospital Clinic de Barcelona,
Barcelona, Spain
(Sandoval, Castella) Cardiovascular Surgery Department, Hospital Clinic de
Barcelona, Barcelona, Spain
(Martinez-Palli) Centro de Investigacion Biomedica en Red Enfermedades
Respiratorias (CIBERES), Madrid, Spain
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND Prehabilitation has shown efficacy in improving postoperative
outcomes in abdominal surgery. Data on cardiac surgery are controversial.
OBJECTIVE To determine if a multimodal prehabilitation programme reduces
the rate of postoperative complications after elective cardiac surgery.
DESIGN Randomised controlled trial. SETTING Single-centre study in a
tertiary hospital with inclusion period spanned from March 2018 to June
2021. PATIENTS One hundred and fifty-one patients, with an expected
waiting time before surgery of 6 weeks or more, completed the study.
Excluded were those with functional, anatomical or cognitive impairment;
cardiac instability; dynamic left ventricle outflow tract obstruction or
proven exercise-induced arrhythmias. INTERVENTION Four to six weeks of a
multimodal prehabilitation programme, including exercise training,
psychological and nutritional support. MAIN OUTCOME Incidence of
postoperative complications. RESULTS No differences were found in the rate
of postoperative complications (80% in both groups, P = 0.968), most of
which were mild, with a Comprehensive Complication Index of 21 and more
than 70% with Clavien-Dindo grade I or II. Prehabilitated patients showed
a significant improvement in endurance time assessed by a constant-work
rate cycling exercise test: preintervention vs. postintervention (301 +/-
109 vs. 578 +/- 257 s, P = 0.001), and in 6-min walk test (6MWT) (487 +/-
77 vs. 504 +/- 74 min, P = 0.001). No patients experienced adverse events
attributable to the intervention. A sub-analysis restricted to
prehabilitated patients who showed a meaningful response to exercise
assessed by the 6MWT (increase >= 30 m) showed a reduction in the number
and severity of postoperative complications, compared to nonresponders
(1.1 +/- 0.9 vs. 2 +/- 2 complications per patient, P = 0.038); and the
Comprehensive Complication Index (16 +/- 15 vs. 25 +/- 19, P = 0.044).
CONCLUSION A multimodal prehabilitation programme before elective cardiac
surgery did not reduce the incidence of postoperative complications.
Nevertheless, when analysis was restricted to meaningful responders to
intervention, a significant reduction in postoperative complications and
their severity was observed. TRIAL REGISTRATION ClinicalTrials.gov
(NCT03466606). Copyright © 2025 European Society of
Anaesthesiology and Intensive Care.

<46>
Accession Number
2036895036
Title
Early remote rehabilitation to improve health of the elderly after cardiac
surgery - study protocol for a randomised trial.
Source
Danish Medical Journal. 72(7) (no pagination), 2025. Article Number:
A11240820. Date of Publication: 2025.
Author
Daugaard R.; Sorensen L.; Ingemann-Molden S.; Modrau I.S.
Institution
(Daugaard, Modrau) Department of Clinical Medicine, Aarhus University,
Denmark
(Daugaard, Modrau) Department of Cardiothoracic and Vascular Surgery,
Aarhus University Hospital, Denmark
(Sorensen, Ingemann-Molden) Department of Physiotherapy and Occupational
Therapy, Aarhus University Hospital, Denmark
(Ingemann-Molden) Center for Neuroplasticity and Pain (CNAP), Department
of Health Science and Technology, Aalborg University, Denmark
Publisher
Almindelige Danske Laegeforening
Abstract
INTRODUCTION. Early rehabilitation is recommended after cardiac surgery to
enhance recovery. However, due to precautions of sternum healing, the
initiation of cardiac rehabilitation is often postponed for 6-8 weeks
after surgery, leaving patients to face physical and emotional barriers on
their own. This study aims to investigate whether early remote cardiac
rehabilitation can enhance physical function and reduce the emotional
challenges that older patients face after discharge. METHODS. In this
bi-entre, randomised controlled trial, 120 patients older than 65 years of
age undergoing open heart surgery are assigned to individualised exercise
training and step counting supported by a mobile health app and weekly
calls with a physiotherapist as an adjunct to standard care (intervention
group), or standard care alone (control group) for six weeks after
discharge. Outcomes are assessed at baseline, a six-week follow-up and a
six-month follow-up. The primary outcome is change in the 30-second Chair
Stand Test. Secondary outcomes include health-related quality of life,
cost-effectiveness and prevalence of sarcopenia. CONCLUSIONS. This trial
will determine if early remote rehabilitation after cardiac surgery can
accelerate recovery and alleviate emotional distress, advocating for early
post-discharge interventions through digitally delivered
care. Copyright © 2025, Almindelige Danske Laegeforening. All
rights reserved.

<47>
Accession Number
2032714008
Title
Evaluating air leakage from staple line reinforcements in anatomical
pulmonary resection (AIRSTOP): a prospective randomized controlled trial
protocol.
Source
General Thoracic and Cardiovascular Surgery. 73(8) (pp 616-621), 2025.
Date of Publication: 01 Aug 2025.
Author
Yusa J.; Tanaka K.; Takahashi K.; Shiko Y.; Sugawara T.; Yoshino I.;
Suzuki H.
Institution
(Yusa, Tanaka, Yoshino, Suzuki) Department of General Thoracic Surgery,
Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chiba, Japan
(Takahashi, Shiko) Biostatistics Section, Clinical Research Center, Chiba
University Hospital, Chiba, Japan
(Shiko) Department of Biostatistics, Graduate School of Medicine, Saitama
Medical University, Saitama, Japan
(Sugawara) Clinical Research Center, Chiba University Graduate School of
Medicine, Chiba, Japan
(Yoshino) Department of Thoracic Surgery, International University Health
and Welfare School of Medicine, Narita, Japan
Publisher
Springer
Abstract
Background: Air leakage during pulmonary resection is a major complication
in thoracic surgery. It frequently occurs at sites of adhesion dissection,
due to lung manipulation, and along the staple lines of automatic suturing
devices, particularly in cases of pulmonary fragility such as those of
emphysema and interstitial pneumonia. Persistent postoperative air leakage
prolongs chest tube indwelling and extends hospitalization time. Staplers
with absorbable tissue reinforcements have been introduced for pulmonary
resection to prevent intraoperative stapler-related air leakage. This
phase II prospective, open-label, randomized, parallel-group trial aims to
validate the efficacy of staplers with or without absorbable tissue
reinforcements in controlling stapler-related air leakage during
anatomical pulmonary resections. Method(s): Overall, 120 patients
will be randomized into two groups: one that will undergo conventional
anatomical pulmonary resection and the other in which staplers with
absorbable tissue reinforcements will be used. The primary endpoint will
be intraoperative stapler-related air leakage. Data will be analyzed
between 2024 and 2025. Discussion(s): This trial will validate the
effectiveness and safety of staple line reinforcements in controlling
intraoperative air leakage during anatomical pulmonary resections,
potentially leading to optimized strategies for patients with conditions
such as emphysema and interstitial pneumonia. Trial registration: This
trial has been registered with the Japan Registry of Clinical Trials
1032220620
(https://jrct.niph.go.jp/latest-detail/jRCTs031230224). Copyright
© The Author(s) 2024.

<48>
Accession Number
2030486183
Title
Pulmonary Atresia with Intact Ventricular Septum, a National Comparison
Between Interventional and Surgical Approach, in Combination with a
Systemic Literature Review.
Source
Pediatric Cardiology. 46(6) (pp 1523-1536), 2025. Date of Publication: 01
Aug 2025.
Author
Manhem S.; Odermarsky M.; Wahlander H.; Ekman-Joelsson B.-M.
Institution
(Manhem, Wahlander, Ekman-Joelsson) Department of Pediatrics, Institution
for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Odermarsky) Department of Pediatric Cardiology, Skane University
Hospital, Lund, Sweden
(Odermarsky) Department of Clinical Sciences, Lund University, Lund,
Sweden
(Manhem, Wahlander, Ekman-Joelsson) Department of Cardiology, Queen Silvia
Children's Hospital, Behandlingsvagen 7, Gothenburg, Sweden
Publisher
Springer
Abstract
This study aimed to compare long-term morbidity in patients with pulmonary
atresia with intact ventricular septum (PA-IVS) treated with
catheter-based intervention (group A) versus those undergoing heart
surgery (group B) as initial intervention. Additionally, we conducted a
systematic literature review on PA-IVS treatment. All neonates born in
Sweden with PA-IVS between 2007 and 2019 were screened for inclusion. The
inclusion criterion was decompression of the right ventricle for initial
intervention. Medical records were reviewed, as well as the initial
preoperative angiogram, and the diagnostic echocardiogram. Comparisons
between groups were performed with Mann-Whitney U-test and Fisher's exact
test. A systematic literature review of original studies regarding
treatment of PA-IVS (2002 and onward) was conducted following the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines, to assess the outcomes of patients with PA-IVS. 34 (11
females) patients were included, 18 in group A and 16 in group B. There
was no mortality in either group. Follow-up time ranged from 2 to 15 years
(median 9). All attempted perforations in group A were successful, and 16
out of 18 patients reached biventricular circulation. In the surgical
group 15 out of 16 patients reached biventricular circulation. The
literature review presented heterogeneity in standards for treatment. This
retrospective population-based multicenter study demonstrates that both
catheter-based intervention and heart surgery are safe procedures. Our
results are comparable to, or exceed, those in the systematic literature
review. The systematic literature review displays a great heterogeneity in
study design, with no definitive golden standard treatment. Copyright
© The Author(s) 2024.

<49>
[Use Link to view the full text]
Accession Number
2039653795
Title
Comparison of the Incidence of Arterial Pressure Line Insufficiency
Between Polyethylene and Polyurethane Catheters in the ICU: A Randomized
Study.
Source
Critical Care Medicine. (no pagination), 2025. Article Number:
10.1097/CCM.0000000000006794. Date of Publication: 2025.
Author
Minami K.; Kazawa M.; Shimatani T.; Morinaga M.; Shimokawa A.; Maeda T.;
Takeuchi M.
Institution
(Minami, Kazawa, Shimatani, Takeuchi) Department of Critical Care
Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
(Morinaga, Shimokawa, Maeda) Department of Anesthesiology, National
Cerebral and Cardiovascular Center, Osaka, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: Continuous arterial pressure monitoring is crucial for
critically ill patients. However, the impact of catheter type on arterial
line insufficiency remains unexamined. DESIGN: Double-blinded,
superiority, randomized controlled trial. SETTING: A cardiovascular center
in Japan. PATIENTS: Adult patients scheduled for elective cardiovascular
surgery and postoperative admission to the ICU. INTERVENTIONS: Patients
were randomly assigned either polyethylene or polyurethane catheters.
MEASUREMENTS AND MAIN RESULTS: The outcome of interest was arterial line
insufficiency, defined by one or more of the following four criteria:
flattened or overdamped blood pressure waveform, sluggish free backflow of
blood (> 2 s) when the stopcock was opened to the atmosphere, inability to
draw blood from the arterial line, and inability to flush the catheter.
The frequency of arterial line insufficiency was observed at the first
noon after ICU admission. An interim analysis using the chi-square test
was performed after half of the participants were enrolled, with early
termination if p value of less than 0.005 based on the O'Brien-Fleming
method. Interim analysis of 132 patients revealed significant differences
in primary outcomes, leading to early termination of the trial. Arterial
line insufficiency occurred in four of 69 patients (5.8%) with
polyethylene catheters and 18 of 63 patients (28.6%) with polyurethane
catheters (relative risk, 0.15; 95% CI, 0.05-0.48; p = 0.001).
 CONCLUSION(S): This study demonstrated a lower occurrence rate of
arterial line insufficiency with polyethylene arterial catheters than
polyurethane catheters. Copyright © 2025 by the Society of
Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights
Reserved.

<50>
Accession Number
2039637087
Title
Centrifugation versus filtration-based cell salvage: Impact on
perioperative bleeding in cardiac surgery - The COLTRANE randomised
clinical trial - Study protocol.
Source
BMJ Open. 15(7) (no pagination), 2025. Article Number: e099423. Date of
Publication: 16 Jul 2025.
Author
Beurton A.; Mansour A.; Benard A.; Pernot M.; Brett V.-E.; Batsale C.;
Aitgougam A.; Cordon A.; Mouton C.; Fresselinat A.; Robert G.; Imbault J.;
Nesseler N.; Ouattara A.
Institution
(Beurton, Batsale, Imbault, Ouattara) Department of Cardiovascular
Anesthesia and Critical Care, CHU Bordeaux, Haut-Leveque Hospital,
Bordeaux, France
(Beurton, Imbault, Ouattara) INSERM, U1034, Biologie des Maladies
Cardiovasculaires, Univ. Bordeaux, Pessac, France
(Mansour, Nesseler) Department of Anesthesia and Critical Care
Pontchaillou, Rennes University Hospital, Rennes, France
(Benard, Cordon) Service d'Information Medicale, Clinical Epidemiology
Unit (USMR), CHU Bordeaux, Pole de Sante Publique, Bordeaux, France
(Pernot) Department of Cardiology and Cardio-Vascular Surgery, CHU
Bordeaux, Haut-Leveque Hospital, Bordeaux, France
(Brett, Mouton) Hematology Laboratory, Reference Center for Inherited
Platelet Disorders, CHU Bordeaux, Bordeaux, France
(Aitgougam, Fresselinat) Clinical Pharmacy of Medical Devices, CHU
Bordeaux, Bordeaux, France
(Robert) Clinical Research Manager, Internal Promotion, Clinical Research
and Innovation Department, CHU Bordeaux, Bordeaux, France
Publisher
BMJ Publishing Group
Abstract
Introduction Cardiac surgery remains a high-risk procedure for bleeding
despite advances in patient blood management. Conventional
centrifugation-based autotransfusion devices primarily recover red blood
cells, losing platelets and coagulation factors. The SAME autotransfusion
device (i-SEP, Nantes, France) introduces an innovative filtration-based
approach, recovering erythrocytes, leucocytes and platelets to enhance
perioperative haemostasis. The main objective is to determine whether the
filtration-based SAME device reduces significant perioperative bleeding
compared with the centrifugation-based system in high-risk cardiac surgery
patients. Methods and analysis The Centrifugation-based vs
filtration-based intraOperative cell saLvage on qualiTy of peRioperAtive
haemostasis iN cardiac surgEry (COLTRANE) trial is a multicentre,
parallel-group, single-blinded, superiority-randomised clinical trial.
Conducted over 19 months in 10 French hospitals, the study will target
patients at high risk of bleeding undergoing on-pump cardiac surgery via
sternotomy. A total of 570 patients (285 per group) are required to
achieve 80% statistical power for detecting clinically significant
differences. Eligible patients will be randomised to either a
centrifugation-based or filtration-based autotransfusion group. Both
groups will follow standardised perioperative and cardiopulmonary bypass
management, with the devices used only intraoperatively. The primary
outcome is the proportion of patients with clinically significant
perioperative bleeding defined as classes 2 to 4 of the Universal
Definition of Perioperative Bleeding. The secondary outcomes include
device efficiency and safety, perioperative haemostasis, lengths of
intensive care unit and hospital stays, early postoperative morbidity and
30-day all-cause mortality. Ancillary studies will be performed to
evaluate cell recovery and washing performance, the viscoelastic
properties of retransfused blood (Quantra Qplus; Stago,
Asnieres-sur-Seine, France), and the effect of salvaged leucocytes on
postoperative inflammation and immune function. Ethics and dissemination
This trial has received a favourable opinion from the Committee for the
Protection of Persons and authorisation from the French authorities
(Comite de protection des personnes Nord Ouest, IDRCB: 2023-A02566-39).
Protocol V.1.1 was approved on 22 January 2024. The trial is registered on
ClinicalTrials.gov (NCT06425614). The findings will be disseminated
through oral communications at national and international scientific
meetings and peer-reviewed journal publications. Individual participant
data will be made available on reasonable request to qualified
researchers, following review and approval by the study sponsor and ethics
committee. Copyright © 2025 Author(s) (or their employer(s)).

<51>
[Use Link to view the full text]
Accession Number
2033992011
Title
Effect of in Vivo Administration of Fibrinogen Concentrate Versus
Cryoprecipitate on Ex Vivo Clot Degradation in Neonates Undergoing Cardiac
Surgery.
Source
Anesthesia and Analgesia. 141(2) (pp 240-251), 2025. Date of Publication:
01 Aug 2025.
Author
Downey L.A.; Moiseiwitsch N.; Nellenbach K.; Xiang Y.; Brown A.C.;
Guzzetta N.A.
Institution
(Downey, Guzzetta) Department of Anesthesiology, Emory University School
of Medicine, Atlanta, GA, United States
(Downey, Guzzetta) Department of Anesthesiology, Children's Healthcare of
Atlanta, Atlanta, GA, United States
(Moiseiwitsch, Nellenbach, Brown) Department of Biomedical Engineering,
University of North Carolina-Chapel Hill and North Carolina State
University, Raleigh, NC, United States
(Moiseiwitsch, Nellenbach, Brown) Comparative Medicine Institute, North
Carolina State University, Raleigh, NC, United States
(Xiang) Department of Population and Public Health Sciences, Keck School
of Medicine of University of Southern California, Los Angeles, CA, United
States
(Brown) Department of Material Science and Engineering, North Carolina
State University, Raleigh, NC, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Neonates undergoing cardiac surgery require fibrinogen
replacement to restore hemostasis after cardiopulmonary bypass (CPB).
Cryoprecipitate is often the first-line treatment, but recent studies
demonstrate that fibrinogen concentrate (RiaSTAP; CSL Behring) may be
acceptable in this population. This investigator-initiated, randomized
trial compares cryoprecipitate to fibrinogen concentrate in neonates
undergoing cardiac surgery (ClinicalTrials.gov NCT03932240). The primary
end point was the percent change in ex vivo clot degradation from baseline
at 24 hours after surgery between groups. Secondary outcomes included
intraoperative blood transfusions, coagulation factor levels, and adverse
events. METHOD(S): Neonates were randomized to receive
cryoprecipitate (control group) or fibrinogen concentrate (study group) as
part of a post-CPB transfusion algorithm. Blood samples were drawn at 4
time points: presurgery (T1), after treatment (T2), arrival to the
intensive care unit (ICU) (T3), and 24 hours postsurgery (T4). Using the
mixed-effect models, we analyzed the percent change in ex vivo clot
degradation from a patient's presurgery baseline at each time point.
Intraoperative blood product transfusions, coagulation factor levels,
perioperative laboratory values, and adverse events were collected.
 RESULT(S): Thirty-six neonates were enrolled (intent to treat [ITT]).
Thirteen patients in the control group and seventeen patients in the study
group completed the study per protocol (PP). After normalizing to the
patient's own baseline (T1), no significant differences were observed in
clot degradation at T2 or T3. At T4, patients in the study group had
greater degradation when compared to those in the control group (826.5%,
95% confidence interval [CI], 291.1-1361.9 vs-545.9%, 95% CI,-1081.3
to-10.4; P <.001). Study group patients received significantly less median
post-CPB transfusions than control group patients (ITT, 27.2 mL/kg
[19.0-36.9] vs 41.6 [29.2-52.4]; P =.043; PP 26.7 mL/kg [18.8-32.2] vs
41.2 mL/kg [29.0-51.4]; P <.001). No differences were observed in bleeding
or thrombotic events. CONCLUSION(S): Neonates who received fibrinogen
concentrate, as compared to cryoprecipitate, have similar perioperative ex
vivo clot degradation with faster degradation at 24 hours postsurgery,
less post-CPB blood transfusions, and no increased bleeding or thrombotic
complications. Our findings suggest that fibrinogen concentrate adequately
restores hemostasis and reduces transfusions in neonates after CPB without
increased bleeding or thrombosis risk. Copyright © 2025
International Anesthesia Research Society.

<52>
Accession Number
2039154608
Title
Thin blood and thinner margins in anticoagulation with left ventricular
assist devices: Living on the Razor's Edge.
Source
Journal of Heart and Lung Transplantation. 44(8) (pp 1339-1342), 2025.
Date of Publication: 01 Aug 2025.
Author
Isath A.; Mehra M.R.
Institution
(Isath, Mehra) Center for Advanced Heart Disease, Brigham and Women's
Hospital and Harvard Medical School, Boston, MA, United States
Publisher
Elsevier Inc.

<53>
Accession Number
2034427448
Title
Perioperative interdisciplinary optimisation of patients with heart
failure undergoing non-cardiac surgery with intermediate or high surgical
risk: the rationale and study protocol for the multicentre, randomised
interventional PeriOP-CARE HF trial.
Source
Clinical Research in Cardiology. 114(5) (pp 523-531), 2025. Date of
Publication: 01 May 2025.
Author
Zitzmann A.; Willis F.; Welsch T.; Ukena C.; Stork S.; Sasko B.; Riese T.;
Oner A.; Neumann J.T.; Mardian S.; Lehmacher J.; Loser B.L.; Landmesser
U.; Kouz K.; Hecker A.; Hackert T.; Grundmann C.D.; Greiner A.; Germer
C.-T.; Flemming S.; Buchmann N.; Beyer K.; Aldarwish S.; Asgarpur G.;
Rucker V.; Widmann J.; Reese J.P.; Nuernberger C.; Heuschmann P.U.;
Treskatsch S.; Saugel B.; Reuter D.; Meybohm P.; Guder G.; Frey U.; Sander
M.; Assmus B.; Schneck E.; Markmann M.; Koch C.; Reichert M.; Kenz M.;
Herrmann E.J.; Habicher M.; Schmidt G.F.
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Aim: Chronic heart failure (HF) is a frequent comorbidity in elderly
patients undergoing major non-cardiac surgery with increasing prevalence.
This trial aims to evaluate a new interdisciplinary, multimodal and
individually optimised treatment strategy in patients with established or
at risk for HF throughout the entire perioperative period. Method(s):
The PeriOP-CARE HF trial is a prospective, multicentre, randomised,
controlled and interventional trial. The primary hypothesis is that an
interdisciplinary, intersectoral and standardised approach to the
preoperative evaluation, optimisation and perioperative management of
patients aged >= 65 years undergoing non-cardiac surgery with intermediate
or high surgical risk and preoperative N-terminal pro-brain natriuretic
peptide levels >= 450 pg/mL, will reduce postoperative morbidity. The
preoperative evaluation includes clinical evaluations by
anaesthesiologists and cardiologists, electrocardiography and
echocardiography, as well as a discussion of these findings by a
perioperative management team, where all involved specialities, including
the speciality surgeon, will decide the perioperative treatment strategy
for each patient. Intraoperative strategies include individualised
haemodynamic optimisation. The interdisciplinary team and specialised HF
nurses will screen patients for HF-related postoperative complications.
The primary end point will be a composite morbidity end point, comprising
any rehospitalisation, acute kidney injury, suspected or proven bacterial
infection requiring treatment and acute decompensated HF at postoperative
day 90. Conclusion(s): The new treatment form can potentially reduce
the morbidity burden after major non-cardiac surgery in patients with
known or unknown HF. If the PeriOP-CARE HF trial yields positive results,
the treatment of patients with HF undergoing major non-cardiac surgery
could be considerably improved. Trial Registration: clinicaltrials.gov:
NCT06381427, registered April 24, 2024. Copyright © The Author(s)
2025.

<54>
Accession Number
2039638064
Title
Rationale and design of randomized noninferiority clinical trial to
compare the safety and efficacy of ticagrelor monotherapy with dual
antiplatelet therapy in chronic coronary syndrome patients post
percutaneous coronary intervention (TICALONE-TAHA10 Protocol).
Source
PLOS ONE. 20(7 July) (no pagination), 2025. Article Number: e0325663. Date
of Publication: 01 Jul 2025.
Author
Mirhosseini S.A.; Akbari M.; Aldavood D.; Zarifkar H.; Attar A.; Kojuri J.
Institution
(Mirhosseini, Aldavood, Attar) Department of Cardiovascular Medicine, TAHA
Clinical Trial Group, Shiraz University of Medical Sciences, Shiraz, Iran,
Islamic Republic of
(Mirhosseini) MD-MPH Department, School of Medicine, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
(Akbari) Shiraz Nephro-Urology Research Center, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
(Zarifkar, Kojuri) Department of Cardiology, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
Publisher
Public Library of Science
Abstract
Background Despite the wide variety of antiplatelet regimens and
durations, the optimal treatment approach for chronic coronary syndrome
(CCS) patients remains a subject of ongoing debate. While current
guidelines recommend dual antiplatelet therapy (DAPT) with aspirin and
clopidogrel, the development of drug-eluting stents (DES) and more potent
agents has sparked interest in shorter DAPT regimens, followed by P2Y12
inhibitor monotherapy, as a potential alternative. Recent trials and
meta-analyses have shown that this approach may provide similar protection
against thrombotic events with reduced bleeding risk. Despite promising
data, the safety and efficacy of Ticagrelor monotherapy specifically in
CCS patients have not been rigorously tested in randomized trials. Methods
TICALONE is a non-inferiority, two-arm, double-blinded, randomized
controlled clinical trial designed to evaluate the safety and efficacy of
ticagrelor monotherapy compared to DAPT in CCS patients following PCI.
Eligible patients undergoing PCI with drug-eluting stents will be randomly
assigned to receive either conventional DAPT (aspirin and clopidogrel) or
ticagrelor monotherapy for six months. Follow-up visits will be conducted
at 1, 3, 6, and 12 months post-PCI to assess efficacy and safety
endpoints. The primary efficacy endpoint is a composite endpoint of
cardiac death, myocardial infarction, stroke, stent thrombosis, and the
need for revascularization. The primary safety endpoint is the occurrence
of Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding
events. The secondary endpoints include components of the primary efficacy
endpoint, any bleeding event (BARC type 1-5), and all-cause mortality.
Ancillary endpoints are other adverse events including dyspnea, drug
adherence, and reaction. All endpoints will be monitored by a Data Safety
Monitoring Board (DSMB) and Trial Management Committee (TMC). Statistical
analysis and reporting of trial results will follow the estimand
framework. Kaplan-Meier estimates will be used to assess event rates,
while the log-rank test and Cox regression analysis will be employed to
compare safety and efficacy outcomes between the groups. Discussion This
trial may serve as a crucial step toward eliminating aspirin from post-PCI
regimens, specifically in CCS patients. By comparing the safety and
efficacy of Ticagrelor monotherapy with the conventional DAPT regimen and
addressing potential risks of aspirin-free therapy and adverse events like
dyspnea, this study could offer valuable insights into the possibility of
P2Y12 monotherapy's safe adoption in this population. Copyright ©
2025 Mirhosseini 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.

<55>
[Use Link to view the full text]
Accession Number
2038728383
Title
Efficacy and Safety of Edoxaban in Anticoagulant Therapy Early After
Surgical Bioprosthetic Valve Replacement: A Randomized Clinical Trial.
Source
Circulation: Cardiovascular Interventions. 18(7) (pp e015108), 2025.
Article Number: e015108. Date of Publication: 01 Jul 2025.
Author
Izumi C.; Amano M.; Yoshikawa Y.; Fukushima S.; Yaku H.; Eishi K.;
Sakaguchi T.; Ohno N.; Hiraoka A.; Okada K.; Saiki Y.; Miura T.; Komiya
T.; Minami M.; Yamamoto H.; Omae K.
Institution
(Izumi, Amano) Department of Heart Failure and Transplantation, National
Cerebral and Cardiovascular Center, Suita, Japan
(Yoshikawa) Department of Bio-statistics, National Cerebral and
Cardiovascular Center, Suita, Japan
(Fukushima) Department of Cardiovascular Surgery, National Cerebral and
Cardiovascular Center, Suita, Japan
(Minami, Yamamoto, Omae) Department of Data Science, National Cerebral and
Cardiovascular Center, Suita, Japan
(Yaku) Department of Cardiovascular Surgery, Kyoto Prefectural University
of Medicine, Japan
(Eishi) Department of Cardiovascular Surgery, Hakujyuji Hospital, Fukuoka,
Japan
(Sakaguchi) Department of Cardiovascular Surgery, Hyogo Medical
University, Nishinomiya, Japan
(Ohno) Department of Cardiovascular Surgery, Kokura Memorial Hospital,
Kitakyushu, Japan
(Hiraoka) Department of Cardiovascular Surgery, Sakakibara Heart Institute
of Okayama, Japan
(Okada) Department of Cardiovascular Surgery, Kobe University Graduate
School of Medicine, Japan
(Saiki) Department of Cardiovascular Surgery, Tohoku University Graduate
School of Medicine, Sendai, Japan
(Miura) Department of Cardiovascular Surgery, Nagasaki University Graduate
School of Biomedical Sciences, Japan
(Komiya) Department of Cardiac Surgery, Kurashiki Central Hospital, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Anticoagulant therapy with vitamin K antagonists is
recommended in the current guidelines for 3 to 6 months following
bioprosthetic valve replacement. However, in the era of direct oral
anticoagulants, there is a paucity of evidence regarding the efficacy and
safety of direct oral anticoagulants in this patient group.
 METHOD(S): The ENBALV trial (Edoxaban in Anticoagulant Therapy After
Surgical Bioprosthetic Valve Replacement) was an investigator-initiated,
phase 3, randomized, open-label, multicenter study that aimed to evaluate
the efficacy and safety of edoxaban compared with warfarin within 3 months
following bioprosthetic valve replacement at the aortic or mitral position
or both. The primary outcome was stroke or systemic embolism. The
secondary outcomes included major bleeding, intracardiac thrombus, and a
composite of stroke, systemic embolism, or major bleeding. Given the
limited study period and the low event rate of the primary outcome, this
study assessed the difference in the point estimates of the event rate.
 RESULT(S): Of the 410 enrolled patients, 389 were included in the
final analysis (73+/-6 years, 56.8% male, 79.4% sinus rhythm; edoxaban
group: n=195, warfarin group: n=194). The primary outcome occurred in 0.5%
(n=1) in the edoxaban group, whereas in 1.5% (n=3) in the warfarin group
(risk difference, -1.03% [95% CI, -4.34 to 1.95%]). Major bleeding
occurred in 4.1% (n=8) in the edoxaban group and in 1.0% (n=2) in the
warfarin group (risk difference, 3.07% [95% CI, -0.67 to 7.27%]). No fatal
bleeding or intracranial hemorrhage was observed in patients treated with
edoxaban, whereas 1 fatal intracranial hemorrhage occurred in the warfarin
group. Intracardiac thrombus did not occur in any of the patients in the
edoxaban group, but did occur in 1.0% (n=2) in the warfarin group.
 CONCLUSION(S): Edoxaban is a potential alternative anticoagulant
therapy early after bioprosthetic valve replacement. Copyright ©
2025 American Heart Association, Inc.

<56>
Accession Number
2038898028
Title
Brugada Syndrome Ablation for the Prevention of Ventricular Fibrillation
Episodes (BRAVE).
Source
Heart Rhythm. 22(8) (pp 1975-1983), 2025. Date of Publication: 01 Aug
2025.
Author
Nademanee K.; Wongcharoen W.; Chimparlee N.; Chokesuwattanaskul R.;
Annueypol M.; Phusunti K.; Sahasatas D.; Prechawat S.; Prasertwitayakij
N.; Makarawate P.; Sutjaporn B.; Wilde A.; Drew C.; Postema P.G.;
Ngarmukos T.; Vardhanabhuti S.; Veerakul G.; Wandee P.; Mauleekoonphairoj
J.; Poovorawan Y.; Khongphatthanyaothin A.
Institution
(Nademanee, Chimparlee, Chokesuwattanaskul, Prechawat, Sutjaporn, Wandee,
Mauleekoonphairoj, Poovorawan, Khongphatthanyaothin) Center of Excellence
in Arrhythmia Research Chulalongkorn University, Department of Medicine,
Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
(Nademanee) Heart Institute, Bumrungrad Hospital, Bangkok, Thailand
(Nademanee, Drew, Vardhanabhuti) Pacific Rim Electrophysiology Research
Institute, Las Vegas, Nevada, United States
(Wongcharoen, Prasertwitayakij) Division of Cardiology, Department of
Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai,
Thailand
(Annueypol, Ngarmukos) Department of Medicine, Faculty of Medicine at
Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
(Phusunti) Department of Medicine, Maharat Nakhon Ratchasima Hospital,
Nakorn Ratchasima, Thailand
(Sahasatas, Makarawate) Department of Medicine, Faculty of Medicine, Khon
Kaen University, Khon Kaen, Thailand
(Wilde, Postema) Department of Cardiology, Amsterdam UMC location
University of Amsterdam, Amsterdam, Netherlands
(Wilde, Postema) Heart Failure and Arrhythmias, Amsterdam Cardiovascular
Sciences, Amsterdam, Netherlands
(Veerakul) Bangkok Heart Hospital, Bangkok General Hospital, Bangkok,
Thailand
(Poovorawan) Center of Excellence in Clinical Virology, Department of
Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok,
Thailand
Publisher
Elsevier B.V.
Abstract
Background: Catheter ablation has emerged as a promising treatment to
prevent ventricular fibrillation (VF) in Brugada syndrome (BrS). However,
evidence from a prospective, randomized clinical trial is lacking.
 Objective(s): The Brugada Syndrome Ablation for the Prevention of
Ventricular Fibrillation Episodes trial is a prospective, multicenter,
2-arm, randomized (1:1), open-label clinical study designed to evaluate
the efficacy and safety of ablation therapy in patients with symptomatic
BrS. Method(s): We enrolled patients with symptomatic BrS with an
implantable cardioverter-defibrillator. Patients were randomized to
ablation therapy or control groups. Ablation targeted arrhythmogenic areas
identified through electroanatomical mapping, predominantly at the right
ventricular epicardium. The primary outcome was the first occurrence of VF
or death. One interim analysis was planned after 50 patients were
randomized. Result(s): Of 67 patients screened, 52 were randomized
(25 to ablation, 25 to control, 2 withdrawals), and 15 declined
randomizations but remained in a registry (10 chose ablation, 5 opted
against ablation). After 3 years of follow-up, the ablation group had
significantly fewer VF events than the control group (hazard ratio, 0.288;
P = .0184). At the interim analysis, the Data Safety Monitoring Board
recommended early trial termination. Among all ablation recipients
(including crossovers and registry participants), 83% remained VF free
after a single procedure and 90% after a repeat ablation. Complications of
ablation included 1 hemopericardium without a long-term sequel.
 Conclusion(s): Epicardial substrate ablation significantly reduces VF
recurrence in patients with symptomatic BrS with implantable
cardioverter-defibrillators and seems safe, supporting its potential role
as a first-line therapy to prevent recurrent VF in patients with
symptomatic BrS. Copyright © 2025 Heart Rhythm Society

<57>
Accession Number
2038910576
Title
Custodiol-N versus Custodiol: Results from a prospective noninferiority
randomized single blind, multicenter phase 3 trial in patients undergoing
heart transplantation.
Source
Journal of Heart and Lung Transplantation. 44(8) (pp 1262-1272), 2025.
Date of Publication: 01 Aug 2025.
Author
Aliabadi-Zuckermann A.; Osorio-Jaramillo E.; Knosalla C.; Gummert J.;
Szabo G.; Wittmann F.; Yeter R.; Schramm R.; Goekler J.; Hennig F.;
Morshuis M.; Zuckermann A.
Institution
(Aliabadi-Zuckermann, Osorio-Jaramillo, Wittmann, Goekler, Zuckermann)
Department of Cardiac Surgery, Medical University of Vienna, Vienna,
Austria
(Knosalla, Yeter, Hennig) Department of Cardiothoracic and Vascular
Surgery, Deutsches Herzzentrum der Charite (DHZC), Berlin, Germany
(Knosalla, Yeter, Hennig) Charite-Universitatsmedizin Berlin, corporate
member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin,
Berlin, Germany
(Knosalla, Hennig) German Center for Cardiovascular Research (DZHK),
Partner Site Berlin, Berlin, Germany
(Gummert, Schramm, Morshuis) Department for Cardiac Surgery, Herz und
Diabeteszentrum NRW, Bad Oeynhausen, Germany
(Szabo) Department of Cardiac Surgery, University of Heidelberg,
Heidelberg, Germany
Publisher
Elsevier Inc.
Abstract
Background: Custodiol is a well-established preservation solution for
organ transplantation and was the basis for the development of Custodiol-N
to improve graft preservation. Previous results in coronary artery bypass
graft surgery have shown effective cardiac protection without safety
concerns. This study aimed to evaluate the safety and ability of
Custodiol-N to preserve cardiac grafts for heart transplantation.
 Method(s): This prospective, randomized, single-blind, multicenter,
noninferiority study was conducted at three centers in Austria and
Germany. The primary end-point was creatine kinase (CK-MB) peak value from
4 to 168 hours after opening of the aortic cross clamp, with a 30%
noninferiority margin. Key secondary efficacy end-points include patient
and graft survival, incidence of primary graft failure, or length of stay
in the intensive care unit. The primary and secondary end-points were
analyzed in both the treated and per protocol populations. Result(s):
A total of 105 randomized patients received Custodiol (n = 52) or
Custodiol-N (n = 53) preserved hearts. Average donor age and ischemic
times were comparable. Average CK-MB peak values were 176.94 +/- 189.61
U/L for the Custodiol versus 130.51 +/- 69.60 U/liter for the Custodiol-N
group (p-value for noninferiority of Custodiol-N by 30% <0.0001). Patient
survival was comparable 1-year post transplantation (90.4% for Custodiol
versus 88.7% for Custodiol-N). The incidence of primary graft failure and
median length of intensive care unit stay were higher for Custodiol group.
Safety assessment showed evenly distributed adverse events.
 Conclusion(s): This study shows that Custodiol-N is safe,
noninferior, and provides similar cardiac graft protection as the
established Custodiol solution. Copyright © 2025

<58>
Accession Number
2035293216
Title
Enhancing bleeding reporting in acute coronary syndrome clinical trials: a
systematic review of the ABC guidelines adherence.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
512. Date of Publication: 01 Dec 2025.
Author
Garcia-Campa M.; Medrano-Juarez S.; Castillo-Morales P.L.;
Montiel-Labastida J.A.; Vera-Pineda R.; Carrizales-Sepulveda E.F.;
Reyes-Araiza R.; Alvarez-Villalobos N.; Rodriguez-Gutierrez R.;
Azpiri-Lopez J.R.; Flores-Ramirez R.
Institution
(Garcia-Campa, Vera-Pineda, Carrizales-Sepulveda, Reyes-Araiza,
Azpiri-Lopez, Flores-Ramirez) Cardiology Service; "Dr. Jose E. Gonzalez"
University Hospital, Autonomous University of Nuevo Leon, Av. Francisco
Madero s/n, Monterrey, Mexico
(Garcia-Campa, Medrano-Juarez, Castillo-Morales, Montiel-Labastida,
Alvarez-Villalobos, Rodriguez-Gutierrez) Plataforma INVEST UANL-KER Unit
Mayo Clinic, School of Medicine and "Dr. Jose E. Gonzalez" University
Hospital, Autonomous University of Nuevo Leon, Monterrey, Mexico
(Garcia-Campa, Medrano-Juarez, Castillo-Morales, Montiel-Labastida,
Alvarez-Villalobos, Rodriguez-Gutierrez) Advanced Analysis Center of
Scientific Information, School of Medicine and "Dr. Jose E. Gonzalez"
University Hospital, Autonomous University of Nuevo Leon, Monterrey,
Mexico
Publisher
BioMed Central Ltd
Abstract
Background: Bleeding events in acute coronary syndromes (ACS)
significantly affect patient outcomes, yet consistent reporting remains a
challenge for clinicians. Although multiple standardized bleeding
definitions exist, the Academic Bleeding Consensus (ABC) provides the only
dedicated reporting guideline. This systematic review evaluates the
adoption of the ABC guidelines and adherence to bleeding definition
reporting in clinical research. Method(s): We systematically searched
Scopus, Web of Science, MEDLINE, EMBASE, and Cochrane Central for
randomized clinical trials (RCTs) published between 2012 and 2025
involving adult patients with ACS. Result(s): Of the 135 RCTs
included in the quantitative analysis, none fully adhered to the ABC
reporting guidelines. Most trials only partially reported elements in the
red and green domains, with only two RCTs fully reporting the orange
domain. The Bleeding Academic Research Consortium (BARC) definition was
the most frequently used (73.3%), though its reporting was often
incomplete (82.8%). Industry-funded RCTs (OR: 3.66; 95%CI: 1.55-2.90),
those prioritizing patient-important outcomes (OR: 13.22; 95%CI:
1.72-101.27), and trials with bleeding outcome reporting according to
definition (OR: 3.88; 95%CI 10.22) were more likely to fully report
bleeding definitions. Conversely, RCTs using the BARC definition showed
lower rates of complete reporting. Conclusion(s): The lack of
adherence to the ABC guidelines highlights the need for a universally
accepted reporting framework that integrates qualitative and quantitative
bleeding characteristics. Such a guideline would enhance the
interpretability of ACS interventions, supporting better patient-centered
decision-making. Copyright © The Author(s) 2025.

<59>
Accession Number
2034582372
Title
Prophylactic corticosteroids in neonatal cardiac surgeries using
cardiopulmonary bypass: a systematic review and meta-analysis.
Source
Journal of Anesthesia. 39(4) (pp 577-589), 2025. Date of Publication: 01
Aug 2025.
Author
Kataoka K.; Cheng S.; Sumie M.; Adam R.-I.; Niimi N.; Cunningham J.; Yang
A.; Ng W.C.K.; Hayes J.; Maynes J.T.; Aoyama K.
Institution
(Kataoka, Sumie, Niimi, Ng, Hayes, Maynes, Aoyama) Department of
Anesthesia and Pain Medicine, The Hospital for Sick Children, 555
University Ave, #2211, Toronto, ON, Canada
(Kataoka, Cheng, Sumie, Niimi, Cunningham, Hayes, Maynes, Aoyama) Temerty
Faculty of Medicine, University of Toronto, Toronto, ON, Canada
(Sumie, Yang, Aoyama) Program in Child Health Evaluative Sciences,
SickKids Research Institute, Toronto, ON, Canada
(Sumie) Department of Anesthesiology, St. Mary's Hospital, Fukuoka, Japan
(Sumie) Department of Anesthesiology and Critical Care Medicine, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan
(Adam) Department of Psychology, Queen's University, Kingston, ON, Canada
(Cunningham) The Hospital for Sick Children, Health Sciences Library, 555
University Avenue, Toronto, ON, Canada
(Ng) Department of Anesthesia and Perioperative Care, University of
California, San Francisco, CA, United States
(Maynes) Program in Molecular Medicine, SickKids Research Institute,
Toronto, ON, Canada
Publisher
Springer
Abstract
Purpose: Neonates undergoing cardiopulmonary bypass (CPB) are at a high
risk of a systemic inflammatory response leading to cardiac, respiratory,
and renal dysfunction due to their small body size and insufficient
adrenal stress response. We hypothesized that corticosteroids reduce
systemic inflammatory response and improve clinical outcomes in neonates
undergoing cardiac surgery with CPB. Method(s): A systematic search
was conducted on six databases including MEDLINE from their inceptions to
August 20, 2024. Inclusion criteria were randomized controlled trials
(RCTs) comparing corticosteroids and placebo in neonates undergoing
cardiac surgery with CPB. The primary outcomes were IL-6 and IL-10 serum
levels. The secondary outcomes were postoperative clinical outcomes such
as length of intensive care unit (ICU) stay, mortality, and incidence of
acute kidney injury. Pooled risk ratios or mean differences (MDs) and 95%
confidence intervals (CIs) were calculated using random-effects
meta-analysis. Certainty of evidence were assessed following GRADE. This
study was registered in PROSPERO (CRD42024548217). Result(s): Seven
RCTs met all inclusion criteria, consisting of 316 patients.
Administration of corticosteroids significantly decreased plasma IL-6 on
POD1 (MD -64.21 pg/mL, 95% CI -118.26 to -10.16) and plasma IL-10 on POD1
(MD - 4.60 pg/mL, 95% CI - 8.07 to - 1.12). We confirmed corticosteroids
administration did not improve clinical outcomes. Conclusion(s):
Corticosteroids significantly reduced inflammatory cytokines on POD1.
Routine prophylactic use of corticosteroids is not recommended even in
neonatal cardiac surgery, however, because of high incidence of adrenal
insufficiency in neonates after cardiac surgery with CPB, neonates with
clinically suspected adrenal insufficiency could benefit from
perioperative corticosteroids administration. Copyright © The
Author(s) under exclusive licence to Japanese Society of Anesthesiologists
2025.

<60>
[Use Link to view the full text]
Accession Number
2039637760
Title
Gabapentin for pain management following major surgery: a placebo
controlled, double blind, randomized clinical trial (The GAP Study).
Source
Anesthesiology. (no pagination), 2025. Article Number:
10.1097/ALN.0000000000005655. Date of Publication: 2025.
Author
Baos S.; Lui M.; Walker-Smith T.; Pufulete M.; Messenger D.; Abbadi R.;
Batchelor T.; Casali G.; Edwards M.; Goddard N.; Hilal M.A.; Alzetani A.;
Vaida M.; Martinovsky P.; Saravanan P.; Cook T.; Malhotra R.; Simpson A.;
Little R.; Wordsworth S.; Stokes E.; Eu J.J.; Reeves B.; Culliford L.;
Collett L.; Maishman R.; Chauhan N.; McCullagh L.; McKeon H.; Abbs S.;
Lamb J.; Gilbert A.; Hughes C.; Wynick D.; Angelini G.; Grocott M.;
Gibbison B.; Rogers C.A.
Institution
(Baos, Lui, Walker-Smith, Pufulete, Reeves, Culliford, Collett, Maishman,
McKeon, Abbs, Lamb, Gilbert, Hughes, Wynick, Angelini, Gibbison, Rogers)
University of Bristol, United Kingdom
(Messenger, Abbadi, Batchelor, Casali, Simpson, Chauhan, McCullagh,
Wynick) University Hospitals Bristol and Weston NHS Foundation Trust,
United Kingdom
(Edwards, Grocott) University of Southampton, United Kingdom
(Goddard, Hilal, Alzetani) University Hospital Southampton NHS Foundation
Trust, United Kingdom
(Vaida) Somerset Hospitals Foundation NHS Trust
(Martinovsky, Saravanan) University Hospitals Blackpool NHS Trust, United
Kingdom
(Cook) Royal United Hospitals, Bath NHS Trust, United Kingdom
(Malhotra, Little) University Hospitals Liverpool NHS Trust, United
Kingdom
(Wordsworth, Stokes, Eu) University of Oxford, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Gabapentin is an anticonvulsant medication with approval for
use in neuropathic pain and epileptic disorders. It is frequently added to
multimodal analgesic regimens during and after surgery to reduce opioid
use while controlling pain effectively. There is little evidence to show
its effectiveness in major surgery. Method(s): In this multicenter,
double blinded, randomized controlled trial, adults undergoing major
cardiac, thoracic or abdominal surgery were randomized to receive either
gabapentin (600mg before surgery, 300mg twice daily for 2 days after
surgery) or placebo. The primary outcome was length of hospital stay.
Secondary outcomes included acute and chronic pain, total opioid use,
adverse health events and health related quality of life. Patients were
followed up daily in-hospital until discharge and then at 4-weeks and 4
months after surgery. Result(s): 1196 participants were randomized
(500 underwent cardiac, 346 thoracic and 350 abdominal surgery); 596 were
allocated to placebo and 600 were allocated to gabapentin. Median length
of hospital stay was similar in the two groups (gabapentin 5.94 (IQR
4.08-8.04) days, placebo 6.15 (IQR 4.22 - 8.97) days; hazard ratio 1.07,
95%CI 0.95-1.20, p=0.26). Overall, 384 participants experienced one or
more serious adverse events (gabapentin 189/596, 31.7%; placebo 195/599,
32.6%), with some variation across surgical specialties.
 Conclusion(s): Among patients undergoing major cardiac, thoracic and
abdominal surgery, adding gabapentin to multimodal analgesic regimes did
not alter the length of hospital stay, or the number of serious adverse
events. Copyright © 2025 The Author(s). Published by Wolters
Kluwer Health, Inc., on behalf of the American Society of
Anesthesiologists.

<61>
Accession Number
2036885729
Title
Effectiveness of bispectral index on clinical outcomes of beating heart
off-pump coronary artery bypass grafting surgeries.
Source
JMS - Journal of Medical Society. 39(1) (pp 71-79), 2025. Date of
Publication: 01 Jan 2025.
Author
Singh L.C.; Singh S.; Deigheidy E.M.; Okyere I.; Boateng N.A.
Institution
(Singh) Department of Anaesthesia and Critical Care, RIMS, Manipur,
Imphal, India
(Singh) Department of Anaesthesiology and Intensive Care, Kwame Nkrumah
University of Science and Technology, Kumasi, Ghana
(Singh, Deigheidy) Collage of Medical Sciences, SAMSRI, Uttar Pradesh,
Lucknow, India
(Singh, Boateng) Directorate of Anaesthesia and Intensive Care, Komfo
Anokye Teaching Hospital, Kumasi, Ghana
(Deigheidy) Center of Surgery, Marie Lannelongue, University Paris-South,
Le Plessis-Robinson, France
(Okyere) Department of Surgery, Kwame Nkrumah University of Science and
Technology, Kumasi, Ghana
Publisher
Regional Institute of Medical Sciences
Abstract
Background: In high-risk patients with low hemodynamic reserve, it can be
challenging to get the optimal level of anesthesia without awareness
during off-pump coronary artery bypass grafting (OP-CABG) surgeries. This
study aimed to test whether the use of bispectral (BIS) Index monitoring
reduces the anesthetic requirements and improves the clinical outcomes
during beating heart CABG without awareness during general anesthesia
(ADGA). Material(s) and Method(s): This study was a single-center,
prospective, randomized clinical comparative study on the American Society
of Anesthesiologists (ASA) three patients booked for elective beating
heart OP-CABG surgeries under general anesthesia (GA). Patients received
sevoflurane anesthesia for the maintenance of anesthesia, and their
consumption was calculated and compared between study groups. The control
groups received conventional sevoflurane anesthesia, and hemodynamic
parameters (+/-20% of initial values) were considered for anesthesia. The
study groups received sevoflurane, and BIS (value 45 +/- 5) was used to
maintain anesthesia. In the study group, keeping the BIS monitor screen
open, and the anesthesia needs were set. However, in the control group,
the monitor screen was closed in such a way that the anesthetist could not
see the BIS value. In addition, hemodynamic parameters, awakening
conditions, length of intubation, inotropic requirements, cardiac care
unit (CCU), and hospital stay were recorded. To explicit ADGA, patients
were interviewed 24 h after extubation. Result(s): The sevoflurane
was used at 59.81 +/- 13.87 mL in the control group and 31.47 +/- 7.91 mL
in the study group, with a 47% reduction in requirement. This difference
was statistically significantly low with BIS-monitored anesthesia in the
study group compared to conventional anesthesia in the control group. The
number of cases in which adrenaline was used was 94.87% in the control
group and 53.65% in the study group. On calculating, there was a reduction
of 54.80% in adrenaline requirement with BIS-monitored anesthesia compared
to conventional anesthesia, and this difference was statistically
significant. In control and study groups, the lengths of endotracheal
intubation were 3.50 +/- 4.72 and 2.17 +/- 1.36 h, respectively. The
intubation time was reduced by 40% with BIS, which was statistically
significantly lower for the BIS groups (P < 0.05). Conclusion(s): BIS
monitoring reduces the anesthetic drug sevoflurane requirement by 47% in
patients undergoing OP-CABG surgeries without ADGA on a BIS level of 45
+/- 5. There was a reduction of 54.80% in adrenaline requirement and 40%
in intubation time with the BIS monitoring, which culminated in ultra-fast
track extubation in high-risk patients undergoing beating heart OP-CABG
surgeries. Copyright © 2025 Journal of Medical Society.

<62>
Accession Number
2019758502
Title
Intra-Arrest Therapeutic Hypothermia and Neurologic Outcome in Patients
Admitted after Out-of-Hospital Cardiac Arrest: A Post Hoc Analysis of the
Princess Trial.
Source
Brain Sciences. 12(10) (no pagination), 2022. Article Number: 1374. Date
of Publication: 01 Oct 2022.
Author
Macchini E.; Dillenbeck E.; Jonsson M.; Annoni F.; Forsberg S.; Hollenberg
J.; Truhlar A.; Svensson L.; Nordberg P.; Taccone F.S.
Institution
(Macchini, Annoni, Taccone) Department of Intensive Care, Hopital
Universitaire de Bruxelles (HUB), Brussels, Belgium
(Dillenbeck, Jonsson, Forsberg, Hollenberg, Nordberg) Department of
Clinical Science and Education, Sodersjukhuset, Centre for Resuscitation
Science, Karolinska Institutet, Stockholm, Sweden
(Truhlar) Emergency Medical Services of the Hradec Kralove Region,
Department of Anaesthesiology and Intensive Care Medicine, Charles
University in Prague, University Hospital Hradec Kralove, Hradec Kralove,
Czechia
(Svensson) Department of Medicine, Karolinska Institute, Stockholm, Sweden
(Nordberg) Function Perioperative Medicine and Intensive Care, Karolinska
University Hospital, Stockholm, Sweden
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Despite promising results, the role of intra-arrest
hypothermia in out-of-hospital cardiac arrest (OHCA) remains
controversial. The aim of this study was to assess the effects of
trans-nasal evaporative cooling (TNEC) during resuscitation on
neurological recovery in OHCA patients admitted alive to the hospital.
 Method(s): A post hoc analysis of the PRINCESS trial, including only
patients admitted alive to the hospital, either assigned to TNEC or
standard of care during resuscitation. The primary endpoint was favorable
neurological outcome (FO) defined as a Cerebral Performance Category (CPC)
of 1-2 at 90 days. The secondary outcomes were overall survival at 90 days
and CPC 1 at 90 days. Subgroup analyses were performed according to the
initial cardiac rhythm. Result(s): A total of 149 patients in the
TNEC and 142 in the control group were included. The number of patients
with CPC 1-2 at 90 days was 56/149 (37.6%) in the intervention group and
45/142 (31.7%) in the control group (p = 0.29). Survival and CPC 1 at 90
days was observed in 60/149 patients (40.3%) vs. 52/142 (36.6%; p = 0.09)
and 50/149 (33.6%) vs. 35/142 (24.6%; p = 0.11) in the two groups. In the
subgroup of patients with an initial shockable rhythm, the number of
patients with CPC 1 at 90 days was 45/83 (54.2%) in the intervention group
and 27/78 (34.6%) in the control group (p = 0.01). Conclusion(s): In
this post hoc analysis of admitted OHCA patients, no statistically
significant benefits of TNEC on neurological outcome at 90 days was found.
In patients with initial shockable rhythm, TNEC was associated with
increased full neurological recovery. Copyright © 2022 by the
authors.

<63>
Accession Number
2039725240
Title
Comparative efficacy and safety of no-touch versus conventional vein
harvesting techniques in coronary artery bypass grafting: a systematic
review and meta-analysis.
Source
Open Heart. 12(2) (no pagination), 2025. Article Number: e003391. Date of
Publication: 21 Jul 2025.
Author
Ali M.A.; Alam U.; Khattak F.; Bacha Z.; Sajjad F.; Khattak A.I.; Afridi
A.; Shahid S.; Sheraz M.; Khan N.A.; Sabir A.; Ahmed R.
Institution
(Ali, Alam, Khattak, Afridi) Khyber Medical College, N.W.F.P, Peshawar,
Pakistan
(Bacha, Sajjad, Khan) Department of Medicine, Khyber Medical College,
Peshawar, Pakistan
(Khattak) Bacha Khan Medical College, Mardan, Pakistan
(Shahid) Department of Medicine, Khawaja Muhammad Safdar Medical College,
Sialkot, Pakistan
(Sheraz) Department of Medicine, Continental Medical College, Lahore,
Pakistan
(Sabir) Department of Cardiac Surgery, Rawalpindi Institute of Cardiology,
Rawalpindi, Pakistan
(Ahmed) Department of Cardiology, Imperial College London, London, United
Kingdom
Publisher
BMJ Publishing Group
Abstract
Objective This meta-analysis aims to compare the clinical outcomes of the
no-touch (NT) and conventional (CON) vein harvesting techniques in
patients undergoing coronary artery bypass grafting (CABG). Methods We
conducted a systematic review and meta-analysis following the guidelines
of the Cochrane Handbook and PRISMA (Preferred Reporting Items for
Systematic Review and Meta-Analysis) statement. We searched PubMed, Embase
and Web of Science for randomised controlled trials (RCTs) comparing NT
and CON vein harvesting techniques in CABG patients. Data were extracted
on primary outcomes (graft failure incidence per patient, graft occlusion
incidence per patient and leg infection) and secondary outcomes
(revascularisation, all-cause death, myocardial infarction). Statistical
analysis was performed using Review Manager V.5.4, with risk ratios (RRs)
calculated for binary outcomes. Results Seven RCTs involving 4176 patients
were included. The NT group showed a significantly lower risk of graft
failure incidence per patient (RR=0.74, p=0.0001) and graft occlusion
incidence per patient (RR=0.62, p=0.0002) compared with the CON group.
However, the NT group had a higher risk of leg infection (RR=1.91,
p<0.00001). No significant differences were observed between groups for
revascularisation (p=0.46), all-cause death (p=0.87), or myocardial
infarction (p=0.95). Conclusions The no-touch vein harvesting technique is
associated with reduced graft failure incidence per patient and graft
occlusion incidence per patient compared with conventional harvesting
techniques in CABG, though it increases the risk of leg infection. These
findings suggest NT as a preferable technique for improving graft patency
but highlight the need for caution regarding leg infection. PROSPERO
registration number CRD42025646500. Copyright © World Health
Organization 2025. Licensee BMJ.

<64>
Accession Number
2035432105
Title
Neurally adjusted ventilatory assist in pediatric intensive care units: a
systematic review and meta-analysis.
Source
Frontiers in Pediatrics. 13 (no pagination), 2025. Article Number:
1597337. Date of Publication: 2025.
Author
Cai W.; Zuo Y.; Ma Y.; Li M.; Zhang L.
Institution
(Cai, Zuo, Li) Department of Nursing, Children's Hospital of Nanjing
Medical University, Nanjing, China
(Cai) Department of Nursing, Yancheng First Hospital, Affiliated Hospital
of Nanjing University Medical School, Yancheng, China
(Cai) Department of Nursing, The First People's Hospital of Yancheng,
Yancheng, China
(Zuo) Department of Nursing, Suzhou Municipal Hospital, The Affiliated
Suzhou Hospital of Nanjing Medical University, Suzhou, China
(Ma) Emergency Department, Children's Hospital of Nanjing Medical
University, Nanjing, China
(Li) Department of Rehabilitation Medicine, Children's Hospital of Nanjing
Medical University, Nanjing, China
(Zhang) Department of Nursing, Nanjing BenQ Medical Center, The Affiliated
BenQ Hospital of Nanjing Medical University, Nanjing, China
Publisher
Frontiers Media SA
Abstract
Background: Patient-ventilator asynchrony is a common problem in
mechanical ventilation, leading to an increase in MV complications.
Neurally adjusted ventilatory assist (NAVA) is a relatively new modality
of mechanical ventilation that can be used for both invasive and
non-invasive ventilation. There is evidence that NAVA reduces asynchronous
events, but the sample size is small and the effect on specific
physiological and clinical outcomes in children is controversial.
Therefore, we conducted a systematic review and meta-analysis to evaluate
the effect of NAVA on physiological parameters and clinical outcomes.
 Method(s): We searched electronic databases up to 26 September 2024.
Clinical trials comparing NAVA with conventional mechanical ventilation
modes were included. The primary outcomes were physiological parameters,
respiratory parameters, ventilator-related parameters, and other clinical
outcomes. Two review authors independently extracted data and assessed
study quality using the Cochrane Risk of Bias tool2. The certainty of the
evidence was assessed according to the scoring methodology. Apply
meta-analysis as much as possible, and use qualitative analysis when
conditions are not met. Result(s): Eleven studies involving 224
children met the inclusion criteria for this review. Four were randomized
cross-over trials, three were prospective cross-over trials, and four were
retrospective studies. There were significant differences in the methods
and quality of the included studies. Meta-analyses revealed significant
differences in PIP, RR, pO<inf>2</inf>, and the asynchronous index (AI)
when compared to traditional modes of mechanical ventilation. However, no
significant differences were observed in FiO<inf>2</inf>, PEEP, TV, pH,
pCO<inf>2</inf>, SpO<inf>2</inf>, EAdimax, and EAdimin.
 Conclusion(s): This systematic review and meta-analysis suggest that
while NAVA has advantages for certain short-term physiological outcomes,
the level of evidence remains low. Consequently, larger and higher-quality
studies are necessary to identify potential short- and long-term
differences between various ventilation patterns. Copyright 2025 Cai,
Zuo, Ma, Li, Li and Zhang.

<65>
Accession Number
2039417520
Title
Letter to the Editor: Quader M, Kiernan Z, Labate G, Chen Q. Hypothermic
myocardial preservation: the freezing debate. Transplant Proc.
2025;57(4):653-662. Fear of Freezing Fallacy: Storage in Melting Ice
Cannot Damage the Donor Heart.
Source
Transplantation Proceedings. 57(6) (pp 1205-1206), 2025. Date of
Publication: 01 Jul 2025.
Author
Rosenfeldt F.
Institution
(Rosenfeldt) Baker Heart and Diabetes Institute, Australia and Swinburne
University, Melbourne, Australia
Publisher
Elsevier Inc.
Abstract
The recent report by Quader et al (Quader M, Kiernan Z, Labate G, et al.
Hypothermic myocardial preservation: the freezing debate. Transplant Proc.
2025;57(4):653-662) addresses a critical question in donor heart
preservation: does storage at 0 degreeC cause myocardial injury? Their
findings show that hearts stored in melting water ice for 4 hours retain
structural and functional integrity, contradicting earlier assumptions
about freezing damage. This editorial places their findings in historical
context, evaluates prior conflicting evidence, and underscores important
implications for clinical practice. Copyright © 2025 Elsevier
Inc.

<66>
Accession Number
2039711760
Title
Impact of early high flow nasal oxygen on diaphragmatic function and
pulmonary complications after thoracic surgery: A randomized clinical
trial.
Source
Journal of Clinical Anesthesia. 106 (no pagination), 2025. Article Number:
111945. Date of Publication: 01 Sep 2025.
Author
Fogagnolo A.; Grasso S.; Dres M.; Azzolina D.; Dalla Corte F.; Dolci G.;
Tamburini N.I.; De Paoli G.; Murgolo F.; Pedarzani E.; Andalo A.; Volta
C.A.; Savino S.
Institution
(Fogagnolo, Volta, Savino) Emergency Department, Section of Anaesthesia
and Intensive Care, Azienda Ospedaliera-Universitaria Sant' Anna, Ferrara,
Italy
(Grasso, Murgolo) Department of Precision-Regenerative Medicine and Jonic
Area (DiMePRe-J), Section of Anesthesiology and Intensive Care Medicine,
University of Bari "Aldo Moro", Bari, Italy
(Dres) Service de Medecine Intensive - Reanimation-SRPR, APHP, Hopital
Pitie-Salpetriere, Sorbonne Universite, Paris, France
(Azzolina, Pedarzani) Department of Environmental and preventive science,
University of Ferrara, Italy
(Azzolina, Pedarzani) Research and Innovation Unit, Biostatistics and
Clinical Trial Area, University Hospital of Ferrara, Ferrara, Italy
(Dalla Corte) Department of Anaesthesia and intensive care medicine, IRCSS
Humanitas research Hospital, Rozzano, Milan, Italy
(Dolci, Tamburini) Department of Thoracic surgery, Azienda
Ospedaliera-Universitaria Sant'Anna, Ferrara, Italy
(De Paoli, Andalo, Volta, Savino) Department of translational medicine,
University of Ferrara. Ferrara, Italy
Publisher
Elsevier Inc.
Abstract
Background: Postoperative pulmonary complications (PPCs) are common after
thoracic surgery, particularly in patients that develop postoperative
diaphragmatic dysfunction. High-flow nasal cannula (HFNC) oxygen therapy
decreases postoperative work of breathing and provides a positive
end-expiratory pressure (PEEP) effect. As a result, it may decrease the
occurrence of diaphragmatic dysfunction and PPCs after thoracic surgery.
 Method(s): Single-centre, open-label, randomized controlled trial.
Patients undergoing video-assisted thoracoscopic lobectomy were randomized
to receive conventional oxygen therapy (COT) or high flow nasal cannula
oxygen therapy. In both groups, inspiratory oxygen fraction was titrated
to reach a peripheral oxygen saturation of >94 %. Diaphragmatic
displacement (DD) and diaphragmatic thickening fraction (TF%) were
measured 2 and 24 h after surgery. Diaphragmatic dysfunction was
identified by DD <10 mm. PPCs occurring within 7 days after study
enrollment were recorded. Result(s): We analyzed 116 patients in the
study. Postoperative diaphragmatic dysfunction occurred in 17/58 patients
(29 %) in the HFNC group compared to 21/58 (36 %) in the COT group (p =
0.55). The rate of PPCs was similar between the two groups: 32/58 (55 %)
in the HFNC group and 37/58 (64 %) in the COT group (p = 0.449). Patients
who developed postoperative diaphragmatic dysfunction experienced fewer
PPCs when treated with HFNC (20/37; 54 %) compared to COT (17/21; 81 %) (p
= 0.037). A post hoc mixed-model analysis confirmed that HFNC reduced the
risk of PPCs in patients with diaphragmatic dysfunction (OR 0.16, 95 % CI
0.02-0.83). Conclusion(s): Early HFNC support does not decrease the
rate of postoperative diaphragmatic dysfunction rate or respiratory
complications. In patients who develop postoperative diaphragmatic
dysfunction, HFNC may play a role in mitigating the risk of PPCs. Clinical
trial registration: NCT05532033 Copyright © 2025 The Authors

<67>
Accession Number
2034765502
Title
Synchronized diaphragmatic stimulation for the treatment of HFrEF-a
review.
Source
Heart Failure Reviews. 30(5) (pp 1035-1043), 2025. Date of Publication: 01
Sep 2025.
Author
Goldberg L.R.; Mirro M.; Becker G.; Shaburishvili T.; Fudim M.
Institution
(Goldberg) University of Pennsylvania Perelman School of Medicine,
Philadelphia, PA, United States
(Mirro) Indiana University School of Medicine and Parkview Mirro Center
for Innovation, Fort Wayne, IN, United States
(Becker) University of George and Tbilisi Heart and Vascular Clinic,
Tbilisi, Georgia
(Fudim) Duke Clinical Research Institute and Duke Cardiology, Durham, NC,
United States
(Shaburishvili) Ilia State University and Tbilisi Heart and Vascular
Clinic, Tbilisi, Georgia
Publisher
Springer
Abstract
The gap between maximally tolerated medical therapy and consideration for
permanent mechanical circulatory support and/or cardiac transplant or
palliative treatment of moderate to severe heart failure represents an
underserved patient population. New therapies are evolving which may not
only improve quality of life for these patients but also improve
hemodynamics and potentially reverse the progression of the disease. This
review is focused on one such therapy, synchronized diaphragmatic
stimulation. Current clinical results suggest that patients experience
improved exercise tolerance, quality of life, and hemodynamic function
over 6-12 months of therapy which can be safely implemented through a
minimally invasive laparoscopic procedure, often as an outpatient. This
technology has been granted breakthrough device designation and is being
evaluated for a double-blinded, randomized controlled trial by the US
FDA. Copyright © The Author(s) 2025.

<68>
Accession Number
2035263956
Title
Glucagon-like peptide-1 receptor agonist in myocardial infarction and
atherosclerotic cardiovascular disease risk reduction: a comprehensive
meta-analysis of number needed to treat, efficacy and safety.
Source
Cardiovascular Diabetology. 24(1) (no pagination), 2025. Article Number:
285. Date of Publication: 01 Dec 2025.
Author
Tang A.S.P.; Hsu J.T.Y.; Chong S.K.S.; Quek J.; Shek G.; Sulaimi F.; Chan
K.E.; Anand V.V.; Chong B.; Mehta A.; Toh S.-A.; Muthiah M.; Dimitriadis
G.K.; le Roux C.W.; Chan M.Y.-Y.; Mamas M.A.; Chin Y.H.; Chew N.W.S.
Institution
(Tang, Hsu, Chong, Quek, Chan, Chong, Toh, Chan, Chew) NUS Yong Loo Lin
School of Medicine, National University of Singapore, Singapore, Singapore
(Shek, Sulaimi) Wallace Wurth, University of New South Wales, Sydney, NSW,
Australia
(Anand) Lee Kong Chian School of Medicine, Nanyang Technological
University, Singapore, Singapore
(Mehta) Virginia Commonwealth University Health Pauley Heart Center,
Division of Cardiology (A.M.), Department of Internal Medicine, Virginia
Commonwealth University School of Medicine, Richmond, United States
(Toh) Department of Medicine, National University Hospital, Singapore,
Singapore
(Toh) NOVI Health, Singapore, Singapore
(Toh) Regional Health System Office, National University Health System,
Singapore, Singapore
(Muthiah) Division of Gastroenterology and Hepatology, Department of
Medicine, National University Hospital, Singapore, Singapore
(Muthiah) National University Centre for Organ Transplantation, National
University Health System, Singapore, Singapore
(Dimitriadis) Department of Endocrinology ASO/EASO COM, King's College
Hospital NHS Foundation Trust, London, United Kingdom
(Dimitriadis) Obesity, Type 2 Diabetes and Immunometabolism Research
Group, Department of Diabetes, Faculty of Cardiovascular Medicine &
Sciences, School of Life Course Sciences, King's College London, London,
United Kingdom
(le Roux) Diabetes Complications Research Centre, Conway Institute,
University College Dublin, Dublin, Ireland
(le Roux) Diabetes Research Centre, Ulster University, UK, United Kingdom
(Chan, Chew) Department of Cardiology, National University Heart Centre,
National University Health System, Singapore, Singapore
(Mamas) Keele Cardiac Research Group, Keele University, Stoke-on-Trent,
United Kingdom
(Chin) Ministry of Health Holdings, Ministry of Health, Singapore,
Singapore
Publisher
BioMed Central Ltd
Abstract
Background: Glucagon like peptide-1 receptor agonist (GLP-1RA) use in
individuals with high atherosclerotic cardiovascular disease (ASCVD) risk
reduces major adverse cardiovascular events (MACE). However, its clinical
impact, in terms of numbers needed to treat (NNT), efficacy and safety
profile in reducing the risk of myocardial infarction (MI) and the
individual ASCVD constituents remain unclear. Method(s): Electronic
databases, Medline and Embase were reviewed for randomized trials from
inception to 29 May 2025. Risk-reduction effect of GLP-1RA were pooled
using pairwise meta-analysis with random-effects model. The primary
outcome was MI, and secondary outcomes were the individual ASCVD
constituents. Result(s): 109,846 patients from 25 unique studies were
included. Over a follow-up duration of 3.48 +/- 1.51 (1.55 to 5.47) years,
GLP-1RA reduced the risk of total MI (RR: 0.86, p < 0.01), with numbers
needed to benefit (NNTB) of 207 to prevent one event of MI. Higher body
mass index was associated with greater MI risk reduction (beta: -0.09, p =
0.03) in GLP-1RA users. GLP-1RA reduced cardiovascular mortality (RR:
0.87, p < 0.01, NNTB 170), MACE (RR: 0.87, p < 0.01, NNTB 67) and stroke
(RR: 0.88, p < 0.01, NNTB 335) compared to placebo. GLP-1RA commonly
resulted in gastrointestinal side-effects amongst other systems (RR: 1.55,
p < 0.01, NNTH 9). Conclusion(s): GLP-1RA reduced the risk of MI,
stroke, cardiovascular mortality and MACE in a broad range of patients
with and without T2DM and/or prior ASCVD, supporting its role in ASCVD
prevention, especially in the cohort with high BMI. Trial registration:
Open Science Framework
(https://doi.org/10.17605/OSF.IO/7VXN5). Copyright © The
Author(s) 2025.

<69>
Accession Number
2036884632
Title
Exploring the Complementary Role of Traditional Chinese Medicine in
Enhancing Percutaneous Coronary Intervention Outcomes: Mechanisms,
Benefits, and Future Research Directions.
Source
Therapeutics and Clinical Risk Management. 21 (pp 1069-1083), 2025. Date
of Publication: 2025.
Author
Zheng S.; Guo J.; Wang Q.
Institution
(Zheng) Department of Cardiology, Beijing Hospital of Integrated
Traditional Chinese and Western Medicine, Beijing, China
(Guo, Wang) Department of Cardiology, The Sixth Medical Center of PLA
General Hospital, Beijing, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Percutaneous coronary intervention (PCI) is a cornerstone
treatment for coronary artery disease (CAD), yet opportunities remain to
improve clinical outcomes, symptom management, and long-term prognosis.
Traditional Chinese Medicine (TCM), with its multi-target and
multi-pathway mechanisms, offers a promising complementary approach to
enhance PCI efficacy. Method(s): A systematic search was conducted in
PubMed and Web of Science using the terms: ("Percutaneous Coronary
Intervention" AND "Traditional Chinese Medicine") and ("Percutaneous
Coronary Intervention" AND "Chinese Herbal Drugs"). Randomized controlled
trials (RCTs) with >=100 participants were included to evaluate TCM's
clinical efficacy in PCI. Pharmacological studies were also reviewed to
explore underlying mechanisms. Result(s): A review of 20 RCTs showed
that TCM plays multiple roles in CAD treatment during PCI. Specific
interventions such as Danhong Injection, Tongxinluo Capsule, and Shenzhu
Guanxin Granule were found to alleviate angina symptoms, restore cardiac
function, reduce cardiac biomarkers, prevent no-reflow/slow-flow
phenomena, inhibit in-stent restenosis, and improve prognosis while
reducing complications. Mechanistically, TCM exerts its effects through
antiplatelet action, anti-inflammation, inhibition of smooth muscle
proliferation, vasodilation, microcirculation improvement, and endothelial
protection. Conclusion(s): This systematic review highlights the
complementary benefits of TCM in PCI for CAD patients. Effective
interventions such as Danhong Injection and Tongxinluo Capsule contribute
to symptom relief, cardiac function restoration, restenosis inhibition,
and prognosis improvement. These benefits are linked to TCM's multi-target
mechanisms, including anti-inflammatory and antiplatelet effects. Future
high-quality studies are needed to further validate these findings and
refine clinical applications. Copyright © 2025 Zheng et al.

<70>
Accession Number
2039448982
Title
Association of Subclinical Liver Fibrosis With Death in Patients With
Coronary Artery Disease: A Post Hoc Analysis of the ISCHEMIA Trial.
Source
Journal of the American Heart Association. 14(13) (no pagination), 2025.
Article Number: e040848. Date of Publication: 27 Jun 2025.
Author
Caldonazo T.; Rahouma M.; Sandner S.; Redfors B.; Harik L.; Richter M.;
Kirov H.; Doenst T.; Gaudino M.F.L.
Institution
(Caldonazo, Rahouma, Kirov, Doenst) Department of Cardiothoracic Surgery,
Jena University Hospital, Friedrich- Schiller- University Jena, Germany
(Caldonazo, Rahouma, Sandner, Harik, Richter, Gaudino) Department of
Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United
States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Redfors) Department of Population Health Sciences, Weill Cornell
Medicine, New York, NY, United States
(Redfors) Department of Molecular and Clinical Medicine, Institute of
Medicine, Gothenburg University, Gothenburg, Sweden
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The fibrosis- 4 index (FIB- 4) score, a noninvasive marker of
subclinical liver fibrosis, has shown prognostic utility in general
surgical populations. Current risk assessment models for patients with
coronary artery disease undergoing percutaneous coronary intervention or
coronary artery bypass grafting do not account for liver dysfunction apart
from overt liver cirrhosis. We analyzed the distribution of the baseline
FIB- 4 score and its association with all- cause death in patients with
coronary artery disease using data from the International Study of
Comparative Health Effectiveness With Medical and Invasive Approaches
(ISCHEMIA) trial. METHOD(S): The baseline FIB- 4 score was calculated
for all ISCHEMIA randomized participants with laboratory data (platelet
count, aspartate aminotransferase, and alanine aminotransferase). The
primary outcome was the association between baseline FIB- 4 and all- cause
death. Secondary outcomes were cardiovascular death, heart failure,
myocardial infarction, and stroke. Multivariable Cox regression was
performed adjusting for key risk factors. RESULT(S): The FIB- 4 score
was calculated for 3735 participants. Baseline FIB- 4 score was
significantly associated with an increased risk of all- cause (hazard
ratio [HR], 1.19 [95% CI, 1.07-1.32]; P=0.001) and cardiovascular death
(HR, 1.19 [95% CI, 1.04-1.36]; P=0.011). This association was consistent
across the overall population and within subgroups of patients treated
with percutaneous coronary intervention, coronary artery bypass grafting,
and medical therapy. There was no significant association regarding heart
failure, myocardial infarction, and stroke. CONCLUSION(S): The FIB- 4
score may be a significant predictor of death in patients with coronary
artery disease. Preprocedural hepatic assessment should be considered to
stratify risk in patients undergoing invasive cardiac
procedures. 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.

<71>
Accession Number
2039651667
Title
Device-Related Complications in Transvenous Versus Subcutaneous
Defibrillator Therapy During Long-Term Follow-Up: The PRAETORIAN-XL Trial.
Source
Circulation. 152(3) (pp 172-182), 2025. Date of Publication: 22 Jul 2025.
Author
Olde Nordkamp L.R.A.; de Veld J.A.; Ghani A.; Kuschyk J.; Bonnemeier H.;
Bode K.; Boersma L.V.A.; de Weger A.; de Jong J.S.S.G.; Jansen W.P.J.;
Alings M.; Bijsterveld N.; El-Chami M.F.; Beukema R.J.; Vernooy K.;
Philbert B.T.; Neuzil P.; Nordbeck P.; van Opstal J.M.; Allaart C.P.;
Wright D.J.; Knaut M.; Betts T.R.; Whinnett Z.I.; Lambiase P.D.; de Groot
J.R.; Chicos A.B.; Nemirovksy D.; Kaab S.; Mittal S.; Borger van der Burg
A.E.; Dijkshoorn L.A.; Pepplinkhuizen S.; van der Stuijt W.; Dizon J.M.;
Miller M.A.; Behr E.R.; Burke M.C.; Kooiman K.M.; Quast A.-F.B.E.; Brouwer
T.F.; Wilde A.A.M.; Smeding L.; Knops R.E.; Bracke F.A.L.E.; Tijssen
J.G.P.; Demming T.; Oosterwerff F.J.; Leyva F.; Germans T.; Perdeck J.
Institution
(Olde Nordkamp, de Veld, Boersma, de Weger, de Groot, Dijkshoorn,
Pepplinkhuizen, van der Stuijt, Kooiman, Quast, Brouwer, Wilde, Smeding,
Knops) Department of Cardiology, University of Amsterdam, Amsterdam,
Netherlands
(Ghani) Department of Cardiology, Isala Heart Centre, Zwolle, Netherlands
(Kuschyk) First Department of Medicine, University Medical Center
Mannheim, Mannheim, Germany
(Kuschyk) German Center for Cardiovascular Research Partner Site
Heidelberg, Mannheim, Germany
(Bonnemeier) Christian Albrechts University, Kiel, Kiel, Germany
(Bode) Department of Electrophysiology, Heart Center, University of
Leipzig, Leipzig, Germany
(Boersma) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
Netherlands
(de Jong, Oosterwerff) Department of Cardiology, OLVG, Amsterdam,
Netherlands
(Jansen) Department of Cardiology, Tergooi MC, Blaricum, Netherlands
(Alings) Department of Cardiology, Amphia Hospital, Breda, Netherlands
(Alings) Werkgroep Cardiologische Centra Nederland, Utrecht, Netherlands
(Bijsterveld) Department of Cardiology, Flevoziekenhuis, Almere,
Netherlands
(El-Chami) Division of Cardiology, Section of Electrophysiology, Emory
University, Atlanta, GA, United States
(Beukema) Department of Cardiology, Radboud University Medical Center,
Nijmegen, Netherlands
(Vernooy) Department of Cardiology, Cardiovascular Research Institute
Maastricht, Maastricht University Medical Center, Maastricht, Netherlands
(Philbert) Department of Cardiology, The Heart Centre, Rigshospitalet,
University of Copenhagen, Copenhagen, Denmark
(Neuzil) Department of Cardiology, Homolka Hospital, Prague, Czechia
(Nordbeck) University, University Hospital Wurzburg, Wurzburg, Germany
(van Opstal) Medical Spectrum Twente, Enschede, Netherlands
(Allaart) Department of Cardiology and Amsterdam Cardiovascular Sciences
(ACS), Amsterdam UMC, Location VUMC, Amsterdam, Netherlands
(Wright) Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
(Knaut) Heart Surgery, Heart Center Dresden, Carl Gustav Carus Medical
Faculty, Dresden University of Technology, Dresden, Germany
(Betts) Oxford Biomedical Research Centre, Oxford University Hospitals NHS
Trust, Oxford, United Kingdom
(Whinnett) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Lambiase) Office of the Director of Clinical Electrophysiology Research,
Lead for Inherited Arrhythmia Specialist Services, University College
London, Barts Heart Centre, London, United Kingdom
(Chicos) Division of Cardiology, Northwestern Memorial Hospital,
Northwestern University, Chicago, IL, United States
(Nemirovksy) Department of Medicine, Englewood Hospital and Medical
Center, Englewood, NJ, United States
(Kaab) Department of Medicine I, Ludwig-Maximillians University Hospital,
Munchen, Germany
(Kaab) German Center for Cardiovascular Research, Munich Heart Alliance,
Munich, Germany
(Mittal) The Valley Health System, Ridgewood, NJ, United States
(Borger van der Burg) Medisch Centrum Leeuwarden, Leeuwarden, Netherlands
(Dizon) Department of Medicine - Cardiology, Columbia University Irving
Medical Center, New York, NY, United States
(Miller) Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital,
New York, NY, United States
(Behr) St George's University of London, London, United Kingdom
(Behr) St George's University Hospitals NHS Foundation Trust, London,
United Kingdom
(Burke) CorVita Science Foundation, Chicago, IL, United States
(Wilde) European Reference Network for Rare, Low Prevalence and Complex
Diseases of the Heart: ERN GUARD-Heart
(Bracke) Department of Electrophysiology, Catharina Hospital, Eindhoven,
Netherlands
(Tijssen, Perdeck) Amsterdam UMC, University of Amsterdam, Heart Center,
Department of Cardiology, Amsterdam Cardiovascular Sciences Heart Failure
& Arrhythmias, Amsterdam, Netherlands
(Demming) Department of Internal Medicine and Cardiology, University
Medical Center Schleswig-Holstein, Kiel, Germany
(Leyva) Department of Cardiology, Queen Elisabeth Hospital Liverpool,
Liverpool, United Kingdom
(Germans) Department of Cardiology, Medisch Centrum Alkmaar, Alkmaar,
Netherlands
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The PRAETORIAN trial (A Prospective, Randomized Comparison of
Subcutaneous and Transvenous Implantable Cardioverter Defibrillator
Therapy) investigated the efficacy and safety of the subcutaneous
implantable cardioverter defibrillator (S-ICD) compared with a transvenous
ICD (TV-ICD) and showed noninferiority of the S-ICD with regard to the
composite end point of device-related complications and inappropriate
shocks after 49.1 months. Complications associated with transvenous leads
are expected to occur after longer follow-up. The PRAETORIAN-XL trial aims
to investigate whether the S-ICD is superior to the TV-ICD with respect to
device-related complications at 8-year follow-up. METHOD(S): The
PRAETORIAN trial randomized patients with a class I or IIa indication for
ICD therapy without the need for pacing to either S-ICD or TV-ICD among 39
centers in the United States and Europe between March 2011 and January
2017. The follow-up was extended after 49.1 months by an additional 4
years for the PRAETORIAN-XL trial. The primary end point was the composite
of all device-related complications. Complications could be related or
unrelated to the lead and minor or major, with major complications being
those requiring an invasive intervention. End points were analyzed
according to the modified intention-to-treat principle using a Fine-Gray
subdistribution hazards model to account for competing risks. An
as-treated analysis was performed using a Cox proportional hazards model
with device type as time-dependent variable. RESULT(S): Patients were
randomized to S-ICD (n=426) and TV-ICD (n=423). Twenty-one percent of the
S-ICD group versus 18% of the TV-ICD group were women. The median age at
implantation was 63 (interquartile range, 54-69) years for the S-ICD and
64 (interquartile range, 56-69) years for the TV-ICD. After a median
follow-up of 87.5 months, all device-related complications (major and
minor combined) were not significantly different in the modified
intention-to-treat analysis (subdistribution hazard ratio, 0.73 [95% CI,
0.48-1.12]); P=0.15). However, TV-ICD patients more often had a major
complication or lead-related complication (P=0.03 and P<0.001,
respectively). Moreover, the as-treated analysis showed significantly more
complications in patients with a TV-ICD compared with an S-ICD (hazard
ratio, 0.64 [95% CI, 0.41-0.99]; P=0.047). CONCLUSION(S): The
PRAETORIAN-XL trial demonstrated that there was no significant difference
between the S-ICD and TV-ICD in all device-related complications during
long-term follow-up. However, the TV-ICD carries a higher risk of major
and lead-related complications compared with S-ICD therapy. The S-ICD
should therefore be considered for all patients without a pacing
indication who are evaluated for ICD therapy. Copyright © 2025
The Authors.

<72>
Accession Number
2030746677
Title
Ultrasound-Guided Versus Palpation-Guided Techniques to Achieve Vascular
Access in Children Undergoing Cardiac Surgery: A Systematic Review and
Meta-analysis of Randomized Controlled Trials.
Source
Pediatric Cardiology. 46(6) (pp 1426-1447), 2025. Date of Publication: 01
Aug 2025.
Author
Ibrahim A.A.; Allam A.R.; Amin A.M.; Rakab M.S.; Alhadeethi A.; Hageen
A.W.; Mahmoud A.; Abuelazm M.; Abdelazeem B.
Institution
(Ibrahim, Allam) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Amin, Rakab) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Alhadeethi) Department of General Medicine, Al-Salam Teaching Hospital,
Ninevah, Iraq
(Hageen, Abuelazm) Faculty of Medicine, Tanta University, Tanta, Egypt
(Mahmoud) Faculty of Medicine, Minia University, Minia, Egypt
(Abdelazeem) Department of Cardiology, West Virginia University,
Morgantown, WV, United States
Publisher
Springer
Abstract
Pediatric heart surgery is a vital therapeutic option for congenital heart
disease, which is one of the most prevalent causes of death in children.
Arterial cannulation (AC) and central venous catheter (CVC) are required
in pediatric cardiac surgery for continuous monitoring of the central
venous pressure (CVP), replacement of fluid or blood products, close
hemodynamic monitoring, and frequent sampling for arterial blood gases
(ABG). A systematic review and meta-analysis synthesizing evidence from
randomized controlled trials (RCTs) retrieved from PubMed, Embase
Cochrane, Scopus, and WOS until February 2024. Risk ratio (RR) was used to
report dichotomous outcomes, and mean difference (MD) was used to report
continuous outcomes, both with a 95% confidence interval (CI) using the
random-effects model. Thirteen RCTs with 1060 children were included.
Regarding arterial cannulation, the ultrasound-guided technique (US) was
associated with a statistically significant increase in successful
cannulation [RR: 1.31 with 95% CI (1.10, 1.56), P < 0.0001], and
first-attempt success [RR: 1.88 with 95% CI (1.35, 2.63), P < 0.0001].
However, US was not associated with any statistically significant
difference in venous cannulation in both outcomes with [RR: 1.13 with 95%
CI (0.98, 1.30), P = 0.10], [RR: 1.53 with 95% CI (0.86, 2.71), P = 0.15]
respectively. Moreover, US was associated with a statistically significant
decrease in the number of attempts either in arterial cannulation with
[MD: - 0.73 with 95% CI (- 1.00, - 0.46), P < 0.0001] or in venous
cannulation with [MD: - 1.34 with 95% CI (- 2.55, - 0.12), P = 0.03], and
the time of attempted cannulation also either in arterial cannulation with
[MD: - 2.27 with 95% CI (- 3.38, - 1.16), P < 0.0001] or in venous
cannulation with [MD: - 4.13 with 95% CI (- 7.06, - 1.19), P < 0.0001]. US
guidance improves successful cannulation rates and first-attempt success
in arterial access and reduces the number of attempts and procedural time
for arterial and venous access. It was also associated with a lower
incidence of complications and procedure failure, particularly in arterial
access. However, it was associated with a higher incidence of venous
puncture. Copyright © The Author(s) 2024.

<73>
[Use Link to view the full text]
Accession Number
2032090076
Title
Adjunctive Cilostazol in Patients with High Residual Platelet Reactivity
after Drug-Eluting Stent Implantation: A Randomized, Open-Label,
Single-Center, Prospective Study (ADJUST-HPR).
Source
American Journal of Therapeutics. 31(3) (pp E229-E236), 2024. Date of
Publication: 25 May 2024.
Author
Long Zhe G.; Hau Yu L.; Lee D.-H.; Kim M.H.; Serebruany V.
Institution
(Long Zhe, Hau Yu, Kim) Department of Cardiology, Dong-A University
Hospital, Busan, South Korea
(Long Zhe) Department of Cardiology, Affiliated Qiqihar Hospital, Southern
Medical University, China
(Hau Yu) Department of Cardiology, Guilin Medical University, China
(Lee) Department of Intensive Care Medicine, Dong-A University Hospital,
Busan, South Korea
(Serebruany) Division of Neurology, Department of Medicine, Johns Hopkins
University, Baltimore, MD, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Cilostazol as an adjunct to dual antiplatelet therapy (DAPT)
postcoronary stenting may further reduce vascular occlusion risks. The aim
of this study was to assess the impact of cilostazol on high residual
platelet reactivity (HRPR) in patients undergoing drug-eluting coronary
stent implantation. Method(s):In a randomized, open-label,
single-center, prospective study, the degree of platelet inhibition by
cilostazol 100 mg twice daily was assessed on top of conventional DAPT
compared with standard clopidogrel and low-dose aspirin combination in
poststent patients with HRPR. HRPR was defined as P2Y12 units (PRU) > 240
as measured by the VerifyNow P2Y12 assay. In addition, the platelet
activity was assessed by light transmittance aggregometry (LTA) and
Multiplate electrode analyzer (MEA). Result(s):The total of 148
patients were screened, and HRPR was observed in 64 (43.2%). Those were
randomized for DAPT versus triple therapy (TAPT). After 30 days, TAPT
group exhibited significantly lower rate of HRPR when assessed by all 3
devices (VerifyNow: 40.0 vs. 66.7% P = 0.04, LTA: 6.7 vs. 30.0% P = 0.02,
MEA: 10.0 vs. 30.0% P = 0.05 L all vs. DAPT). Also, higher absolute mean
difference in TAPT versus DAPT group after 30 days (VerifyNow: 71.3 +/-
38.2 vs. 24.6 +/- 40.2 P < 0.001, LTA: 23.9 +/- 15.1 vs. 9.4 +/- 11.8 P <
0.001, MEA: 9.3 +/- 12.9 vs. 2.4 +/- 17.3 P = 0.08) was observed.
 Conclusion(s):Cilostazol in addition to standard DAPT reduces the
incidence of HRPR and diminishes further platelet activity in poststent
patients. Whether this favorable laboratory finding will affect clinical
outcomes requires an adequately powered randomized trial. Copyright
© 2024 Lippincott Williams and Wilkins. All rights reserved.

<74>
Accession Number
2035274574
Title
Colchicine in patients with aortic stenosis undergoing transcatheter
aortic valve replacement: a double-blind randomized trial.
Source
Nature Communications. 16(1) (no pagination), 2025. Article Number: 6501.
Date of Publication: 01 Dec 2025.
Author
Ryffel C.; Lanz J.; Guntli N.; Samim D.; Furholz M.; Stortecky S.; Tomii
D.; Heg D.; Boscolo Berto M.; Peters A.A.; Reineke D.; Reichlin T.; Grani
C.; Windecker S.; Pilgrim T.
Institution
(Ryffel, Lanz, Guntli, Samim, Furholz, Stortecky, Tomii, Boscolo Berto,
Reichlin, Grani, Windecker, Pilgrim) Department of Cardiology,
Inselspital, Bern University Hospital, University of Bern, Bern,
Switzerland
(Ryffel) Department of Nuclear Medicine, Cardiac Imaging, University
Hospital Zurich, Zurich, Switzerland
(Samim) Clinical Trial Service Unit and Epidemiological Studies Unit
(CTSU), Nuffield Department of Population Health (NDPH), University of
Oxford (UK), Oxford, United Kingdom
(Heg) Department of Clinical Research, University of Bern, Bern,
Switzerland
(Peters) Department of Diagnostic, Interventional and Pediatric Radiology,
Inselspital, Bern University Hospital, Bern, Switzerland
(Reineke) Department of Cardiac Surgery, Inselspital, Bern University
Hospital, University of Bern, Bern, Switzerland
Publisher
Nature Research
Abstract
An inflammatory process may increase the risk of arrhythmias after
transcatheter aortic valve replacement (TAVR). In this single-centre,
double-blind, placebo-controlled, randomized trial we investigated the
efficacy of colchicine to reduce a composite of new-onset atrial
fibrillation or atrioventricular conduction disturbances requiring the
implantation of a permanent pacemaker at 30 days after TAVR. Between
September 21, 2021 and April 25, 2024, 120 patients with aortic stenosis
undergoing TAVR (mean age 80.6 +/- 5 years, 64% male) were randomly
allocated to treatment with colchicine (n = 60) or placebo (n = 60). The
trial was prematurely stopped due to a higher rate of stroke in the
experimental group in a pre-specified interim analysis (5 [8.3%] versus 0
at maximum available follow-up, p = 0.022). In the intention-to-treat
population, the primary endpoint occurred in 6 patients (10%) in the
colchicine group and in 15 patients (25%) in the placebo group
(risk-difference -15.0%, 95% CI -28.3 to -1.7, p = 0.031). The
prespecified imaging endpoint, subclinical leaflet thrombosis, was
detected in 13 of 48 patients (27%) in the colchicine group versus 26 of
48 patients (54%) in the placebo group (risk difference -27.1%. 95% CI
-46.0% to -8.2%, p = 0.007). Here, we show that periprocedural treatment
with colchicine may reduce the incidence of new-onset arrhythmias and
subclinical leaflet thrombosis after TAVR. However, given the premature
termination of the trial due to an unexpected increase in the stroke rate
among patients treated with colchicine, confirmatory trials are warranted
to corroborate the effect of anti-inflammatory treatment on the incidence
of arrhythmias and subclinical leaflet thrombosis after TAVR. The trial
was an investigator-initiated study supported by dedicated grants from the
Bangerter-Rhyner Foundation and the Swiss Life Foundation.
ClinicalTrials.gov Identifier: NCT04870424. Copyright © The
Author(s) 2025.

<75>
Accession Number
2025077315
Title
Assessment of Atherothrombotic Risk in Patients With Type 2 Diabetes
Mellitus.
Source
Journal of the American College of Cardiology. 81(25) (pp 2391-2402),
2023. Date of Publication: 27 Jun 2023.
Author
Berg D.D.; Moura F.A.; Bellavia A.; Scirica B.M.; Wiviott S.D.; Bhatt
D.L.; Raz I.; Bohula E.A.; Giugliano R.P.; Park J.-G.; Feinberg M.W.;
Braunwald E.; Morrow D.A.; Sabatine M.S.
Institution
(Berg, Moura, Bellavia, Scirica, Wiviott, Bohula, Giugliano, Park,
Braunwald, Morrow, Sabatine) TIMI Study Group, Division of Cardiovascular
Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston,
MA, United States
(Bhatt) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health
System, New York, NY, United States
(Raz) Faculty of Medicine, Hadassah Hebrew University Hospital, Jerusalem,
Israel
(Feinberg) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Risk of atherothrombotic events is not uniform in patients
with type 2 diabetes mellitus (T2DM). Tailored risk assessment may help
guide selection of pharmacotherapies for cardiovascular primary and
secondary prevention. Objective(s): The purpose of this study was to
develop a risk model for atherothrombosis in patients with T2DM.
 Method(s): We developed and validated a risk model for myocardial
infarction (MI) or ischemic stroke (IS) in a pooled cohort of 42,181
patients with T2DM from 4 TIMI (Thrombolysis In Myocardial Infarction)
clinical trial cohorts. Candidate variables were assessed with
multivariable Cox regression, and independent variables (P < 0.05) were
retained in the final model. Discrimination and calibration were assessed.
Treatment interactions with dapagliflozin (sodium-glucose cotransporter-2
inhibitor) and evolocumab (proprotein convertase subtilisin/kexin type 9
inhibitor) were explored in the DECLARE-TIMI 58 (Dapagliflozin Effect on
CardiovascuLAR Events-Thrombolysis In Myocardial Infarction 58) and
FOURIER (Further Cardiovascular Outcomes Research with PCSK9 Inhibition in
Subjects with Elevated Risk) trials, respectively. Result(s): Sixteen
variables were independent predictors of MI or IS. The model identified a
>8-fold gradient of MI or IS rates between the top vs bottom risk
quintiles in the validation cohort (3-year Kaplan-Meier rate: 14.9% vs
1.4%; P < 0.0001). C-indexes were 0.704 and 0.706 in the derivation and
validation cohorts, respectively. The model was well-calibrated in both
primary and secondary prevention. Absolute reduction in the rates of MI or
IS tended to be greater in patients with higher baseline predicted risk
for both dapagliflozin (absolute risk reduction: 2.1% vs 0.2%) and
evolocumab (absolute risk reduction: 3.2% vs 1.0%). Conclusion(s): We
developed and validated a risk score for atherothrombotic events,
leveraging 16 routinely assessed clinical variables in patients with T2DM.
The score has the potential to improve risk assessment and inform clinical
decision-making. Copyright © 2023 The Authors

<76>
Accession Number
2031154413
Title
Comparative Efficacy of Colchicine and Intensive Low-density Lipoprotein
Cholesterol Lowering in Patients with Atherosclerotic Diseases receiving
Statins: A Network Meta-analysis of Randomized Controlled Trials.
Source
Cardiovascular Drugs and Therapy. 39(4) (pp 811-822), 2025. Date of
Publication: 01 Aug 2025.
Author
Ou Z.; Wang F.; Chen Y.; Liu X.; Ran B.; Yin Y.; Cui K.
Institution
(Ou, Wang, Ran, Cui) Department of Cardiology, Chongqing General Hospital
of Chongqing University, Chongqing, China
(Ou, Wang, Ran, Cui) Department of Cardiology, Chongqing General Hospital,
No. 118 Xingguang Avenue, Liangjiang New Area, Chongqing, China
(Chen, Yin) Department of Cardiology, The Second Affiliated Hospital of
Chongqing Medical University, Chongqing, China
(Liu) Department of Cardiology, Graduate School of Medicine, Keio
University, Tokyo, Japan
Publisher
Springer
Abstract
Aims: Adding intensive low-density lipoprotein cholesterol
(LDL-C)-lowering agents or colchicine to statin has been shown to result
in additional cardiovascular benefits for patients with atherosclerotic
cardiovascular diseases (ASCVD). We aimed to compare the efficacy and
safety of these supplementary agents in patients with ASCVD receiving
statin. Method(s): We performed a systematic review and frequentist
network meta-analysis of randomized controlled trials. The primary
efficacy endpoint was the main adverse cardiovascular event (MACE), and
the secondary efficacy endpoints were myocardial infarct, stroke, coronary
revascularization, cardiovascular death, and all-cause mortality,
respectively. The safety endpoints were treatment discontinuation and
non-cardiovascular death. We obtained estimates for efficacy outcomes and
safety endpoints and presented these estimates as risk ratio (RR) with 95%
confidence intervals. We ranked the comparative efficacy and safety of all
drugs with P-scores. Result(s): Seventeen trials totaling 85,823
participants treated with colchicine (5926 participants), intensive LDL-C
lowering (37,854 participants) via proprotein convertase subtilisin/kexin
type 9 (PCSK9) inhibitor, Niemann-Pick C1-like 1 protein (NPC1L1)
inhibitor or ATP citrate lyase (ACL) inhibitor, or statin alone (42,043
participants) were included. Colchicine was associated with a greater
reduction in the risk of MACE (RR 0.72, 0.69-0.91), stroke (RR 0.55,
0.33-0.92), and coronary revascularization (RR 0.73, 0.60-0.90) compared
with NPC1L1 inhibitor, and it provided a larger reduction in the risk of
MACE (RR 0.79, 0.69-0.91) compared to PCSK9 inhibitor. However, colchicine
was associated with increased risk of non-cardiovascular death compared
with NPC1L1 inhibitor (RR 1.48, 1.04-2.10) and PCSK9 inhibitor (RR 1.57,
1.08-2.27). Although no regimen prolonged survival, colchicine had worse
performance on non-cardiovascular death and all-cause mortality.
 Conclusion(s): In patients with ASCVD receiving statin, colchicine
seems to be more effective than intensive LDL-C-lowering therapy with
PCSK9 inhibitor or NPC1L1 inhibitor for cardiovascular prevention.
However, using colchicine as an alternative to intensive LDL-C-lowering
therapy may need to be weighed against the cardiovascular benefits and the
potential harms of higher non-cardiovascular death. Trial Registration:
PROSPERO Identifier: CRD42023441385 Copyright © The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2024.

<77>
[Use Link to view the full text]
Accession Number
2034285560
Title
2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of
Hypertrophic Cardiomyopathy: A Report of the American Heart
Association/American College of Cardiology Joint Committee on Clinical
Practice Guidelines.
Source
Circulation. 149(23) (pp e1239-e1311), 2024. Date of Publication: 04 Jun
2024.
Author
Ommen S.R.; Ho C.Y.; Asif I.M.; Balaji S.; Burke M.A.; Day S.M.; Dearani
J.A.; Epps K.C.; Evanovich L.; Ferrari V.A.; Joglar J.A.; Khan S.S.; Kim
J.J.; Kittleson M.M.; Krittanawong C.; Martinez M.W.; Mital S.; Naidu
S.S.; Saberi S.; Semsarian C.; Times S.; Waldman C.B.
Institution
(Ommen, Ho, Martinez, Mital, Naidu, Saberi, Semsarian) AMSSM
Representative, United States
(Asif, Burke, Day, Dearani, Epps) HRS Representative, United States
(Balaji, Waldman) Lay Stakeholder Representative, United States
(Evanovich, Joglar) AHA/ACC Joint Committee on Clinical Practice
Guidelines Liaison, United States
(Evanovich, Kittleson) SCMR Representative, United States
(Ferrari) Joint Committee on Performance Measures Representative, United
States
(Khan) PACES Representative, United States
(Kim) ACC/AHA Joint Committee on Clinical Data Standards Representative,
United States
(Krittanawong) Joint ACC/AHA Staff Representative, United States
(Times) Former Joint Committee on Clinical Practice Guidelines Member,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
AIM: The "2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management
of Hypertrophic Cardiomyopathy"provides recommendations to guide
clinicians in the management of patients with hypertrophic cardiomyopathy.
 METHOD(S): A comprehensive literature search was conducted from
September 14, 2022, to November 22, 2022, encompassing studies, reviews,
and other evidence on human subjects that were published in English from
PubMed, EMBASE, the Cochrane Library, the Agency for Healthcare Research
and Quality, and other selected databases relevant to this guideline.
Additional relevant studies, published through May 23, 2023, during the
guideline writing process, were also considered by the writing committee
and added to the evidence tables, where appropriate. STRUCTURE:
Hypertrophic cardiomyopathy remains a common genetic heart disease
reported in populations globally. Recommendations from the "2020 AHA/ACC
Guideline for the Diagnosis and Treatment of Patients With Hypertrophic
Cardiomyopathy"have been updated with new evidence to guide
clinicians. Copyright © 2024 by the American Heart Association,
Inc.

<78>
Accession Number
2035274150
Title
Exploring mitochondrial health and transplantation strategies in DCD heart
transplantation: a systematic review.
Source
Journal of Translational Medicine. 23(1) (no pagination), 2025. Article
Number: 789. Date of Publication: 01 Dec 2025.
Author
Zhang X.; Yang Y.; Wang H.; Yan C.; Feng Y.; Ma X.; Hu M.; Li S.; Cheng C.
Institution
(Zhang, Yang, Yan, Ma, Hu, Li) Department of Cardiothoracic and Vascular
Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of
Science and Technology, 1095# Jiefang Ave, Hubei, Wuhan, China
(Feng, Cheng) Department of Cardiovascular Surgery, The Second Affiliated
Hospital, Zhejiang University School of Medicine, Zhejiang, Hangzhou,
China
(Wang) The Third Affiliated Hospital, Guangzhou Medical University,
Guangdong, Guangzhou, China
Publisher
BioMed Central Ltd
Abstract
This review explores the significant potential of mitochondrial
transplantation (MT) in enhancing outcomes for DCD heart transplantation,
particularly in mitigating ischemia-reperfusion injury (IRI). MT restores
mitochondrial function and ATP production, thereby improving myocardial
contractility and counteracting the energy depletion and oxidative stress
that jeopardize the viability of DCD grafts. Furthermore, the synergistic
application of MT with extracorporeal perfusion significantly enhances
graft viability by reducing metabolic waste accumulation and modulating
the inflammatory response during prolonged preservation. Studies show that
MT decreases reactive oxygen species (ROS) levels, enhances antioxidant
enzyme activity, and regulates immune activation, ultimately improving
graft survival. Notably, MT has shown promising results in maintaining
heart function during extended perfusion, delaying functional loss due to
energy depletion. Despite encouraging preclinical findings, additional
clinical validation is required, particularly in DCD heart
transplantation, to confirm its potential in improving long-term graft
function and expanding the donor pool in high-risk
scenarios. Copyright © The Author(s) 2025.

<79>
[Use Link to view the full text]
Accession Number
2038725169
Title
Impact of Natriuretic Peptide and Prior Hospitalization in Patients With
Severe Mitral Regurgitation: COAPT Trial.
Source
Circulation: Cardiovascular Interventions. 18(7) (no pagination), 2025.
Article Number: e015192. Date of Publication: 01 Jul 2025.
Author
Goel S.S.; Guha A.; Lindenfeld J.; Abraham W.T.; Kar S.; Kapadia S.R.;
Little S.H.; Lim D.S.; Reardon M.J.; Kleiman N.S.; Aiyer J.; Kotinkaduwa
L.N.; Mack M.J.; Stone G.W.
Institution
(Goel, Guha, Little, Reardon, Kleiman) Houston Methodist Hospital, TX,
United States
(Lindenfeld) Vanderbilt University Medical Center, Nashville, TN, United
States
(Abraham) The Ohio State University Wexner Medical Center, Columbus,
United States
(Kar) Los Robles Regional Hospital, Thousand Oaks, CA, United States
(Kapadia) Cleveland Clinic, OH, United States
(Lim) University of Virginia School of Medicine, Charlottesville, United
States
(Aiyer) Abbott Laboratories, Santa Clara, CA, United States
(Kotinkaduwa) Cardiovascular Research Foundation, New York, NY, United
States
(Mack) Baylor Scott and White Health, Plano, TX, United States
(Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The clinical significance of elevated baseline natriuretic
peptide level and prior heart failure hospitalization (HFH) within the
prior year in mitral transcatheter edge-to-edge repair outcomes is
unclear. This analysis examined the impact of BNP (B-type natriuretic
peptide) or NT-proBNP (N-terminal pro-B-type natriuretic peptide) and
prior HFH on outcomes in patients with severe secondary mitral
regurgitation. METHOD(S): The COAPT trial (Cardiovascular Outcomes
Assessment of the MitraClip Percutaneous Therapy for Heart Failure
Patients With Functional Mitral Regurgitation) was a randomized controlled
trial of subjects assigned to mitral valve transcatheter edge-to-edge
repair with the MitraClip device versus guideline-directed medical therapy
alone. COAPT patients were grouped by BNP/NT-proBNP levels and prior HFH
within 1 year: (1) Mild heart failure (HF): no prior HFH with
BNP/NT-proBNP<median; (2) Moderate HF: prior HFH with BNP/NT-proBNP<median
or no prior HFH with BNP/NT-proBNP>=median; and (3) Severe HF: prior HFH
and BNP/NT-proBNP>=median. The primary measures were 2-year rates of death
or HFH. RESULT(S): Of 572 patients, mild, moderate, and severe HF
were present in 125 (21.9%), 288 (50.3%), and 159 (27.8%) patients,
respectively. With guideline-directed medical therapy alone, the 2-year
rates of death or HFH in mild, moderate, and severe HF were 56.4%, 60.5%,
and 84.1%, respectively (Ptrend=0.001). These rates were 48.7% and 73.4%
among patients with moderate HF and a prior HFH only versus elevated
BNP/NT-proBNP>=median only (P=0.003). Mitral transcatheter edge-to-edge
repair reduced death/HFH compared with guideline-directed medical therapy
alone regardless of HF severity (Pinteraction=0.50). CONCLUSION(S):
In patients with HF with severe secondary mitral regurgitation enrolled in
the COAPT trial, 2-year rates of death/HFH were increased with an elevated
baseline BNP/NT-proBNP>=median, and more so if HFH within 1 year prior had
occurred. Treatment with mitral transcatheter edge-to-edge repair reduced
all-cause mortality and HFH consistently in mild, moderate, and severe HF.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier:
NCT01626079. Copyright © 2025 American Heart Association, Inc.

<80>
Accession Number
2039870159
Title
Comment on "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:
111954. Date of Publication: 01 Sep 2025.
Author
Cata J.P.; Nunez-Rodriguez E.
Institution
(Cata, Nunez-Rodriguez) Department of Anesthesiology and Perioperative
Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX,
United States
(Cata, Nunez-Rodriguez) Anesthesiology and Surgical Oncology Research
Group (ASORG), Houston, TX, United States
Publisher
Elsevier Inc.

<81>
Accession Number
2039846045
Title
Large Heart Transplant Meta-Analysis Reveals Several New Genetic
Associations with Post-Transplant Outcomes.
Source
American Journal of Transplantation. Conference: World Transplant Congress
2025. San Francisco United States. 25(8 Supplement 1) (pp S13), 2025. Date
of Publication: 01 Aug 2025.
Author
Mauduit V.; Van Setten J.; Chang B.; Holmes M.V.; de Jonge N.; Baan C.;
Manintveld O.; Peeters A.M.; Dominguez F.; Khush K.K.; Pablo G.; Rossano
J.W.; de Weger R.A.; Moore J.H.; Asselbergs F.W.; Keating B.
Institution
(Mauduit, Keating) New York University Langone Health, NY, United States
(Van Setten, de Jonge, de Weger, Asselbergs) UMC Utrecht, United States
(Chang, Holmes, Rossano, Moore) University of Pennsylvania, Palestine
(Baan, Manintveld, Peeters) Erasmus MC, Netherlands
(Dominguez, Pablo) Puerta de Hierro University Hospital, Spain
(Khush) Stanford University, United States
Publisher
Elsevier B.V.
Abstract
Purpose: Despite achieving satisfactory recipient survival rates at one
year, heart transplant failure occurs in approximately half of patients
within ten years post-transplant. Growing evidence suggests that both HLA
and non-HLA antibodies contribute to the pathogenesis of heart graft
dysfunction. To identify novel genetic variants associated with heart
graft failure, we conducted genome-wide association analyses across eight
heart transplant cohorts. Method(s): Eight cohorts comprised a total
of 1,630 recipients and 856 donors, including 851 donor-recipient (D-R)
pairs. After standard quality control steps and imputation with IMPUTE2,
we performed a genome-wide association studies (GWAS) for time to first
biopsy proven rejection and time to death or retransplant, in a two steps
process. First, Cox regression models were fitted using donor and
recipient age and sex and year of transplant. Residuals were then used as
a dependent variable in linear mixed models computed through the FastLMM
software. A GWAS was conducted for each cohort separately and
meta-analyzed using MANTEL. Additionally, we implemented a
loss-of-function (LoF) pipeline to compute D-R gene-level mismatches where
the donor presents at least one functional gene copy absent in the
recipient. Additionally, recipients and donors LoF genes were tested
separately. P-values below 5x10-8 and 8.3x10-5 were
considered significant for the GWAS and the LoF analysis, respectively.
 Result(s): Preliminary results identified four recipient-specific
(chromosomes 1, 7, 11, 13) and three donor-specific loci (chromsomes 7,9
and 18) associated with rejection, while a single donor-only variant was
linked to post-transplant death (chromosome 1). In the LoF analysis, four
genes were associated with rejection in the recipient-only study (AMPD1,
MED4 and NT5C1B) while a single gene was identified in donors (BID1). No
genetic association was found for D-R mismatches. Conclusion(s): Our
heart transplant meta-analysis, the largest ever conducted, revealed
several promising non-HLA associations with rejection and post-transplant
death. These findings will soon be expanded with the inclusion of
additional cohorts. CITATION INFORMATION: Mauduit V., Van Setten J., Chang
B., Holmes M., de Jonge N., Baan C., Manintveld O., Peeters A., Dominguez
F., Khush K., Pablo G., Rossano J., de Weger R., Moore J., Asselbergs F.,
Keating B. Large Heart Transplant Meta-Analysis Reveals Several New
Genetic Associations with Post-Transplant Outcomes AJT, Volume 25, Issue 8
Supplement 1 DISCLOSURES: V. Mauduit: None. Copyright © 2025

<82>
Accession Number
2036934949
Title
Cardiac function and mortality of stem cell therapy in patients with
coronary artery disease who underwent coronary artery bypass graft without
heart failure: A meta-analysis.
Source
Biomedical Reports. 23(3) (no pagination), 2025. Article Number: 147. Date
of Publication: 01 Sep 2025.
Author
Jansirirat T.; Khamsai S.; Sawanyawisuth K.
Institution
(Jansirirat, Khamsai, Sawanyawisuth) Department of Medicine, Faculty of
Medicine, Khon Kaen University, Khon Kaen, Thailand
Publisher
Spandidos Publications
Abstract
Coronary artery disease (CAD) is a common disease and can be treated with
coronary artery bypass grafting (CABG) in specific cases. Stem cell
therapy has been shown to be effective in patients with CAD who underwent
CABG in several settings but limited to those without heart failure. The
aim of the present study was to evaluate whether stem cell therapy is
effective in patients with CAD who underwent CABG and had no heart
failure. The present systematic review investigated wether there was any
improvement in cardiac function or reduction of mortality in patients with
CAD who received CABG and did not have heart failure. The types of studies
included in this systematic review were randomized controlled trials. In
total, four databases were used for a systematic search: PubMed, CENTRAL
database, Scopus, and CINAHL Plus. The results were reported as the mean
difference of left ventricular ejection fraction (LVEF) and risk ratio of
mortality rate between stem cell therapy vs. controls. There were 125
studies retrieved from a search in the four aforementioned databases; of
those, seven studies met the study criteria. Regarding the outcome of
cardiac function, the standardized mean difference of LVEF between the
experimental and the control groups was 0.17 (95% CI: -0.09, 0.44). The
risk ratio of mortality was also not statistically significant (1.59; 95%
CI: 0.68, 3.73). Stem cell therapy did not exert significant improvement
of the LVEF or the mortality rate compared with controls, in patients with
CAD who underwent CABG and had no heart failure. Further studies are
required to confirm the results of the present study. Copyright ©
2025 Jansirirat et al.

<83>
Accession Number
648107098
Title
Implementing Transitional Care Interventions for Surgical Patients: A
Scoping Review.
Source
Journal of advanced nursing. (no pagination), 2025. Date of Publication:
21 Jul 2025.
Author
Tobiano G.; Gillespie B.M.; Turner K.; Eskes A.M.; Patel B.; Colquhoun J.;
Ferronato L.; Chaboyer W.
Institution
(Tobiano, Gillespie, Chaboyer) NHMRC Centre of Research Excellence in
Wiser Wound Care, Griffith University, Southport, QLD, Australia
(Tobiano, Gillespie, Turner, Patel, Ferronato) Gold Coast University
Hospital, Gold Coast Hospital and Health Service, Southport, QLD,
Australia
(Gillespie, Eskes, Chaboyer) School of Nursing and Midwifery, Griffith
University, Gold Coast Campus, Southport, QLD, Australia
(Turner, Colquhoun) Griffith University, Gold Coast Campus, Southport,
QLD, Australia
(Eskes) Department of Surgery, Amsterdam, Netherlands
(Patel) Princess Alexandra Hospital, Brisbane, QLD, Australia
(Patel) Bond University, Robina, QLD, Australia
Abstract
AIMS: To synthesise the evidence on implementation strategies used to
implement transitional care interventions for adult surgical patients.
DESIGN: Scoping review. DATA SOURCES: Medline, CINAHL and EMBASE were
searched in August 2023 and updated June 2025, followed by citation
searches. Studies were screened independently by two researchers, and one
extracted data, another verified its accuracy. Studies about transitional
care interventions for adult surgical patients were coded according to the
'Five classes of implementation strategies' and the 'Patterns, Advances,
Gaps, Evidence for practice and Research recommendations' framework, to
illuminate the review findings. RESULT(S): Based on 27 studies
included in the scoping review, staff education, changes to staffing and
electronic systems, and change management techniques were frequently used
implementation strategies. Implementation strategies were mostly used with
patients undergoing colorectal and cardiac surgery in Asia and the United
States. Scale-up strategies and capacity-building initiatives for people
in charge of spearheading the change initiatives were less common.
 CONCLUSION(S): To further the field, future research could focus on
capacity-building and scale-up strategies, fidelity reporting, and
financial implications of implementation in a wider range of surgical
populations and settings. Work is needed to effectively implement surgical
transitional care interventions in real-world settings. IMPLICATION FOR
THE PROFESSION AND/OR PATIENT CARE: Our findings provide strategies for
hospital leaders to adopt when implementing transitional care
interventions for surgical patients. REPORTING METHOD: Scoping Reviews
(PRISMA-ScR) checklist. PATIENT OR PUBLIC CONTRIBUTION: Determined review
focus, interpreted findings, and contributed to manuscript. REVIEW
REGISTRATION: The Open Science Framework. Copyright © 2025 The
Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.

<84>
Accession Number
2036940653
Title
Comparative Hemodynamic Stability in Low-Dose versus Conventional-Dose
Bupivacaine for Spinal Anaesthesia in Elderly Patients.
Source
International Journal of Pharmacy Research and Technology. 15(2) (pp
633-638), 2025. Date of Publication: 16 Jun 2025.
Author
Patel A.; Yadav A.K.; Patel P.S.; Kumari R.; Deepesh
Institution
(Patel, Yadav) Department of Anaesthesia, UNS Autonomous State Medical
College, UP, Jaunpur, India
(Patel) RDMC, Banda, India
(Kumari) F.H. Medical college, Agra, Etmadpur, India
(Deepesh) CHC Cholapur, Varanasi, India
Publisher
Advanced Scientific Research
Abstract
Background: Spinal anaesthesia is favoured for lower-limb and
lower-abdominal surgery in the elderly, yet conventional doses of
hyperbaric bupivacaine frequently precipitate hypotension and bradycardia.
Reducing the intrathecal dose may mitigate these effects while preserving
surgical anaesthesia. Method(s): In this prospective, randomised,
double-blind trial we enrolled 120 patients aged >= 65 years (ASA II-III)
scheduled for elective hip or knee arthroplasty. Participants received
either low-dose (LD, 6 mg) or conventional-dose (CD, 12 mg) 0.5 %
hyperbaric bupivacaine with 25 microg fentanyl. Primary outcome was
incidence of clinically significant hypotension (>= 20 % fall in mean
arterial pressure or MAP < 65 mmHg) during the first 30 min after block.
Secondary outcomes included bradycardia (HR < 50 beats.min-1), vasopressor
usage, sensory-motor block characteristics, surgeon satisfaction, and
major adverse events. Result(s): Baseline characteristics were
comparable. Clinically significant hypotension occurred in 17 % of LD
versus 48 % of CD patients (relative risk 0.35; p < 0.001). Mean MAP at 5,
10, 20 and 30 min was consistently higher in LD (84 +/- 9, 82 +/- 8, 80
+/- 7, 79 +/- 6 mmHg) than CD (72 +/- 11, 70 +/- 10, 68 +/- 9, 67 +/- 8
mmHg; p < 0.01 at all points). Bradycardia was less frequent in LD (10 %
vs 28 %; p = 0.02). Ephedrine requirements (median 0 mg [IQR 0-6] vs 12 mg
[6-18]; p < 0.001) and atropine administration (2 % vs 12 %; p = 0.04)
were reduced in LD. Surgical anaesthesia was adequate in both groups; time
to two-segment regression was shorter in LD (78 +/- 14 min vs 103 +/- 18
min; p < 0.001) but did not prolong recovery room discharge. No patient
required conversion to general anaesthesia. Conclusion(s): In elderly
patients, intrathecal low-dose 0.5 % bupivacaine (6 mg) supplemented with
fentanyl provides satisfactory surgical conditions while significantly
improving haemodynamic stability compared with the conventional 12 mg
dose. Routine dose reduction should be considered to diminish
peri-operative cardiovascular morbidity in this population. Copyright
© 2025, Advanced Scientific Research. All rights reserved.

<85>
Accession Number
2039809498
Title
Efficacy of mitral valve repair in combination with coronary
revascularization for moderate ischaemic mitral regurgitation: a
systematic review and meta-analysis of randomized controlled trials.
Source
International Journal of Surgery. 110(6) (pp 3879-3887), 2024. Date of
Publication: 01 Jun 2024.
Author
Li X.; Hou B.; Hou S.; Jiang W.; Liu Y.; Zhang H.
Institution
(Li, Hou, Jiang, Zhang) Department of Cardiac Surgery Center, Beijing
Anzhen Hospital, Beijing Institute of Heart, Lung, and Blood Vascular
Diseases, Capital Medical University, Chaoyang district, Beijing, China
(Hou, Liu) Department of Cardiovascular Surgery, The First Affiliated
Hospital of Anhui Medical University, Shushan district, Hefei, China
Publisher
Wolters Kluwer Health Inc
Abstract
Background: The efficacy of mitral valve repair (MVR) in combination with
coronary artery bypass grafting (CABG) for moderate ischaemic mitral
regurgitation (IMR) remains unclear. To evaluate whether MVR + CABG is
superior to CABG alone, the authors conducted a systematic review and
meta-analysis of existing randomized controlled trials (RCTs).
 Method(s): The authors searched PubMed, Web of Science, and the
Cochrane Central Register of Controlled Trials for eligible RCTs from the
date of their inception to October 2023. The primary outcomes were
operative (in-hospital or within 30 days) and long-term (>= 1 year)
mortality. The secondary outcomes were postoperative stroke, worsening
renal function (WRF), and reoperation for bleeding or tamponade. The
authors performed random-effects meta-analyses and reported the results as
risk ratios (RRs) with 95% CIs. Result(s): Six RCTs were eligible for
inclusion. Compared with CABG alone, MVR + CABG did not increase the risk
of operative mortality (RR, 1.244; 95% CI, 0.514-3.014); however, it was
also not associated with a lower risk of long-term mortality (RR, 0.676;
95% CI, 0.417-1.097). Meanwhile, there was no difference between the two
groups in terms of postoperative stroke (RR, 2.425; 95% CI, 0.743-7.915),
WRF (RR, 1.257; 95% CI, 0.533-2.964), and reoperation for bleeding or
tamponade (RR, 1.667; 95% CI, 0.527-5.270). Conclusion(s): The
findings of this meta-analysis suggest that MVR + CABG fails to improve
the clinical outcomes of patients with moderate IMR compared to CABG
alone. Copyright © 2024 The Author(s). Published by Wolters
Kluwer Health, Inc.

<86>
Accession Number
2039751298
Title
Comparative Study on the Impact of Remifentanil vs. Fentanyl in General
Anesthesia for High-Risk Cardiac Patients.
Source
International Journal of Life Sciences Biotechnology and Pharma Research.
10(1) (pp 259-265), 2021. Date of Publication: 01 Jan 2021.
Author
Kasa R.S.R.; Gupta S.; Setu P.
Institution
(Kasa, Gupta, Setu) Department of Anaesthesia, N C Medical College &
Hospital, Israna, Panipat, India
Publisher
International Journal of Life Sciences Biotechnology and Pharma Research
Abstract
Aim: The aim of this study was to compare the impact of remifentanil
versus fentanyl in general anesthesia for high-risk cardiac patients
undergoing elective cardiac surgery, focusing on their effects on
hemodynamic stability, opioid consumption, recovery profiles, and
postoperative outcomes. Material(s) and Method(s): A prospective,
randomized, comparative study was conducted with 100 patients undergoing
elective cardiac surgery. Patients were randomly assigned to receive
either remifentanil (Group R) or fentanyl (Group F) for anesthesia
maintenance. The primary outcomes assessed included hemodynamic
parameters, opioid consumption, recovery times, postoperative pain,
nausea, vomiting, and patient satisfaction. Result(s): The baseline
characteristics of the two groups were comparable. Both remifentanil and
fentanyl provided similar hemodynamic stability, with no significant
differences in heart rate, blood pressure, or incidence of intraoperative
hypotension. Total opioid consumption was significantly higher in the
remifentanil group (380.2 +/- 45.3 microg) compared to the fentanyl group
(250.5 +/- 30.2 microg). The recovery profiles were similar between the
groups, with marginally faster extubation and recovery times in the
remifentanil group, but no significant differences in additional
postoperative analgesia needs. Postoperative pain control was
significantly better in the remifentanil group, as indicated by lower VAS
scores (2.5 +/- 1.1 vs. 3.2 +/- 1.4, p = 0.03). There were no significant
differences in nausea, vomiting, or overall patient satisfaction between
the groups. Conclusion(s): Both remifentanil and fentanyl provide
effective anesthesia for high-risk cardiac patients, with similar
hemodynamic stability and recovery profiles. Remifentanil, however,
provided superior postoperative pain control but required higher opioid
consumption. The choice between these two opioids should be based on the
patient's specific needs, including pain management and recovery time
considerations. Copyright ©2021Int. J.
LifeSci.Biotechnol.Pharma.Res.

<87>
Accession Number
648098953
Title
Rationale and design of the randomized 'early ventricular assist
device'-Trial (VAD-DZHK3).
Source
ESC heart failure. (no pagination), 2025. Date of Publication: 20 Jul
2025.
Author
Knosalla C.; Farber G.; Rieth A.J.; Wachter R.; Placzek M.; Albert W.;
Hasenfuss G.; Falk V.; Friede T.
Institution
(Knosalla, Albert, Falk) Department of Cardiothoracic and Vascular
Surgery, Berlin, Germany
(Knosalla, Albert, Falk) Charite - Universitatsmedizin Berlin, corporate
member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin,
Berlin, Germany
(Knosalla, Albert, Falk) German Center for Cardiovascular Research (DZHK),
partner site Berlin, Berlin, Germany
(Knosalla) Department of Thoracic and Cardiovascular Surgery Saarland,
University Medical Center and Saarland University, Homburg, Germany
(Farber) Department of Cardiothoracic Surgery, University Hospital Jena,
Friedrich Schiller University of Jena, Jena, Germany
(Rieth) Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad
Nauheim, Germany
(Rieth) German Center for Cardiovascular Research (DZHK), partner site
Rhine-Main, Frankfurt am Main, Germany
(Wachter) Department of Cardiology, University Hospital Leipzig, Leipzig,
Germany
(Wachter, Hasenfus) Clinic for Cardiology and Pneumology, Heart Research
Center, University Medical Center Gottingen, Gottingen, Germany
(Wachter, Hasenfus, Falk) Department of Health Science and Technology, ETH
Zurich, Zurich, Switzerland
(Placzek, Friede) German Center for Cardiovascular Research (DZHK),
partner site Gottingen ,Gottingen, Germany
(Placzek, Friede) Department of Medical Statistics, University Medical
Center Gottingen, Gottingen, Germany
Abstract
AIMS: Bridge to transplantation (BTT) with durable, continuous-flow left
ventricular assist devices (LVAD) of patients is a well-established
treatment concept in patients awaiting heart transplantation (HTx).
However, the role of elective LVAD implantation in patients with less
advanced HF, but increased risk of decompensation remains uncertain.
METHODS AND RESULTS: The VAD-DZHK3 trial is an investigator-initiated,
randomized controlled trial designed to assess whether an early strategy
of elective LVAD implantation improves outcomes compared with a
conventional approach involving optimal medical therapy and delayed device
implantation only after clinical deterioration. Eligible patients are
those with end-stage HF listed for cardiac transplantation. This is an
event-driven study, that is, the study is completed once 120 events of the
primary composite endpoint have been observed and all patients have at
least 1 year of follow-up unless they died earlier. Patients meeting
inclusion criteria who decline randomization are enrolled in a parallel
observational registry reflecting standard care. The primary efficacy
endpoint is survival free from high urgent cardiac transplantation,
disabling stroke and HF hospitalizations (including emergency room HF
visits >6 h). CONCLUSION(S): The VAD-DZHK3 trial will provide
guidance on the optimal timing and patient selection for LVAD implantation
in heart transplant candidates, potentially redefining current standards
of care. Copyright © 2025 The Author(s). ESC Heart Failure
published by John Wiley & Sons Ltd on behalf of European Society of
Cardiology.

<88>
Accession Number
648096988
Title
A prospective randomized clinical comparison of catheter ablation of
atrial fibrillation using the CENTAURI PEF system and standard
radiofrequency ablation.
Source
Europace. Conference: European Heart Rhythm Association Congress, EHRA
2025. Vienna Austria. 27(Supplement 1) (pp i311), 2025. Date of
Publication: 01 May 2025.
Author
Starek Z.; Soucek F.; Dolezalova K.; Pesl M.; Sebetovsky V.; Hejc J.;
Krejci J.
Institution
(Starek, Soucek, Dolezalova, Pesl, Sebetovsky, Hejc, Krejci) St. Anne
University Hospital Brno (FNUSA), Brno, Czechia
Publisher
Oxford University Press
Abstract
Introduction: Radiofrequency (RF) catheter ablation has been the standard
treatment for atrial fibrillation (AF) in recent years. However,
irreversible electroporation (pulse field ablation, PFA) is emerging as a
promising alternative. The aim of this study was to present one-year
results comparing the efficacy and safety of catheter ablation for AF
using the point-to-point CENTAURI PEF System (CardioFocus Inc.) and the
single-shot FARAPULSE System (Boston Scientific). Method(s): Patients
referred for ablation of paroxysmal and persistent AF were enrolled in
this study and randomly assigned to one of two groups. The CENTAURI PEF
group underwent ablation with the EnSite Precision 3D mapping system
(Abbott) for left atrial mapping and a TactiCath CF ablation catheter
(Abbott) for point-to-point ablation using PFA generated by the CENTAURI
generator. The FARAPULSE group underwent ablation with a specialized
single-shot multipolar basket catheter under fluoroscopy and intracardiac
ultrasound guidance. All procedures were performed under general
anesthesia. Periprocedural parameters and follow-up results were compared
between the two groups. Result(s): Between May 3, 2023, and November
1, 2024, a total of 201 patients underwent catheter ablation for AF (127
with paroxysmal AF and 74 with persistent AF). Of these, 106 patients were
treated with the CENTAURI system (CENTAURI group - CENT) and 95 with the
FARAPULSE system (FARAPULSE group - FARA). The baseline characteristics of
the two groups were similar: 27% of patients were women, the mean age was
61 years, and the mean left atrial size was 45 mm. The average total
procedure time was 110 min for the CENT and 70 min for the FARA. The X-ray
dose was 1500 mGy cm2 for the CENT and 2550 mGy cm2
for the FARA. The isolation time of the left pulmonary veins (LPVs) was 17
min for the CENT and 8 min for the FARA. The isolation time of the right
pulmonary veins (RPVs) was 19 min for the CENTand 8 min for the FARA.
Acute or subacute complications were not recorded in the CENT, while in
the FARA was one stroke and one pericardial effusion requiring
pericardiocentesis. A total of 29 patients from the CENT attended a
follow-up visit at 12 months, 72% of patients maintained sinus rhythm. No
patients in the FARA underwent a 12-month follow-up visit yet. The results
for ablation of both paroxysmal and persistent AF were similar for the two
groups. Conclusion(s): Catheter ablation with both PFA systems
appears to be comparably effective and safe. The complications observed in
the FARAPULSE group are typical of those associated with catheter ablation
of arrhythmias and may be attributed to the learning curve. Procedure
times were longer with the CENTAURI system, primarily due to 3D mapping
and point-by-point ablation, while the FARAPULSE system resulted in a
shorter procedure time but a significantly higher X-ray dose. The
assessment of long-term effectiveness is limited by the small number of
patients with follow-up data.

<89>
Accession Number
2039819409
Title
90degree versus 110degree rotation of left double lumen tube for
endobronchial intubation: a randomized controlled trial.
Source
Journal of Thoracic Disease. 17(7) (pp 4724-4731), 2025. Date of
Publication: 31 Jul 2025.
Author
Zhou H.; Zhao J.; Quan X.
Institution
(Zhou, Zhao, Quan) Department of Anaesthesiology, Peking Union Medical
College Hospital, Chinese Academy of Medical Sciences, Peking Union
Medical College, Beijing, China
Publisher
AME Publishing Company
Abstract
Background: It is conventional that anesthesiologist rotates the left
double lumen tube (DLT) 90degree counterclockwise when the DLT
endobronchial cuff crosses beyond the glottis, with which the success rate
of left endobronchial intubation on first attempt is 75.9%. However, the
true inclination angle of the left main bronchus is 108.4degree, so the
first attempt success rate of left bronchial intubation by 110degree left
DLT rotation would be higher than of 90degree left DLT rotation. This
study aimed to assess whether the first attempt success rate of left
bronchial intubation by 110degree left DLT rotation was higher than of
90degree left DLT rotation. Method(s): We conducted a randomized
controlled study to compare left DLT 90degree versus 110degree
counterclockwise rotation in adult patients intubated left DLT to undergo
elective thoracic surgery. We assessed the first attempt left
endobronchial intubation success rate and evaluated the airway injuries at
30 min after the starting of surgery by fiberoptic bronchoscopy and
intubation complications such as sore throat and hoarseness at the
postoperative 24 h. Result(s): A total of 556 patients (56.4+/-12.3
years of age; 322 women) were included: 275 patients in 90degree group and
281 patients in 110degree group. The first attempt success rate of left
bronchial intubation by left DLT was 87.9% in the 110degree group versus
80.7% in the 90degree group (P=0.02). The 110degree group had lower rate
of postoperative sore throat as well (33.9% versus 45.8%, P=0.005).
However, the two group had no statistical difference in carina mucosal
injury and postoperative hoarseness. Conclusion(s): When the
endobronchial cuff passed beyond the glottis, the left DLT 110degree
rotation increased the success rate of the first left bronchus intubation
and reduced the incidence of sore throat in adult patients during thoracic
surgery using left DLT. Copyright © AME Publishing Company.

<90>
Accession Number
648096821
Title
Biatrial ablation versus left atrial ablation for atrial fibrillation
treatment in patients with rheumatic heart disease undergoing valve
surgery: a systematic review and meta-analysis.
Source
Europace. Conference: European Heart Rhythm Association Congress, EHRA
2025. Vienna Austria. 27(Supplement 1) (pp i1508-i1509), 2025. Date of
Publication: 01 May 2025.
Author
Mazetto Silva Vieira R.; Bulhoes E.; Antunes V.L.J.; Farias V.A.G.;
Oliveira V.M.R.; Ximenes P.N.; Pinto M.V.; Guerreiro I.; Bastos E.; Sousa
P.A.M.G.; Guida C.; Bueno B.V.K.; Fernandes F.; Darrieux F.C.
Institution
(Mazetto Silva Vieira, Pinto, Guerreiro, Bastos) Amazonas State
University, Manaus, Brazil
(Bulhoes) FESAR - Amazon Higher Education College, Redencao, Brazil
(Antunes) Federal University of Health Sciences of Porto Alegre,
Department of Medicine, Porto Alegre, Brazil
(Farias) Uninove, Department of Medicine, Sao Paulo, Brazil
(Oliveira) Federal University of Goias, Department of Medicine, Goiania,
Brazil
(Ximenes) Portuguese Charity Hospital, Department of Medicine, Sao Paulo,
Brazil
(Sousa) Federal University of Uberlandia, Department of Medicine,
Uberlandia, Brazil
(Guida) Dante Pazzanese Institute of Cardiology, Department of Medicine,
Sao Paulo, Brazil
(Bueno, Fernandes, Darrieux) Heart Institute (InCor) HCFMUSP, Department
of Medicine, Sao Paulo, Brazil
Publisher
Oxford University Press
Abstract
Background: About 60% of patients with rheumatic heart disease have atrial
fibrillation (AF). The Maze procedure is effective for rhythm control in
these patients. However, there is limited data comparing biatrial ablation
to left atrial ablation during valve replacement surgery.
 Objective(s): This systematic review and single-arm meta-analysis
aims to compare the effectiveness of biatrial ablation versus left atrial
ablation in rhythm control for patients with rheumatic heart disease
undergoing valve replacement surgery. Method(s): PubMed, Embase, and
Cochrane Central were systematically searched for studies comparing
biatrial ablation to left atrial ablation in patients with rheumatic heart
disease undergoing valve replacement surgery. The outcomes reported
included (1) sinus rhythm and (2) recurrence of atrial fibrillation. We
calculated the Risk Ratio (RR) for binary outcomes and 95% confidence
intervals (CI). Statistical analysis was performed using R version 4.3.2.
A random-effects model was used for all outcomes. Heterogeneity was
examined with I2 statistics. Result(s): Three studies met the
inclusion criteria, comprising 417 patients with a mean age of 47.80
years, of whom 276 (66.2%) were women. Among these, 67 patients underwent
double valve replacement (DVR), 344 underwent mitral valve replacement
(MVR), and 91 underwent tricuspid valvuloplasty (TVP). The mean duration
of AF since diagnosis was approximately 32.25 months. The follow-up period
varied from 12 to 30 months. The biatrial ablation group showed superior
control of sinus rhythm compared to the left atrial ablation group (OR
0.62; 95% CI 0.393-0.992; p=0.046; Figure 1A) during a follow-up period of
12 months or more. However, there was no significant difference in atrial
fibrillation recurrence between the groups (OR 0.83; 95% CI 0.37-1.83;
p=0.6; Figure 1B) over the same follow-up period. Conclusion(s): This
systematic review and meta-analysis comparing biatrial ablation versus
left atrial ablation in patients with rheumatic heart disease undergoing
valve replacement surgery found that biatrial ablation demonstrated
superior control of sinus rhythm compared to left atrial ablation.
However, there was no significant difference in atrial fibrillation
recurrence between groups.

<91>
Accession Number
2039833138
Title
Cardiac CT and PET for Surveillance of Heart Transplant Recipients:
Systematic Review and Bayesian Meta-Analysis.
Source
JACC: Cardiovascular Imaging. (no pagination), 2025. Date of Publication:
2025.
Author
Sayed A.; Nayfeh M.; Alahdab F.; Al Rifai M.; Abramov D.; Fudim M.;
Moayedi Y.; Yousefzai R.; Al-Mallah M.H.
Institution
(Sayed, Alahdab, Al Rifai, Yousefzai, Al-Mallah) Houston Methodist DeBakey
Heart and Vascular Center, Houston, TX, United States
(Sayed) Ain Shams University, Faculty of Medicine, Cairo, Egypt
(Sayed) Rochester General Hospital, Rochester, NY, United States
(Nayfeh) Vanderbilt University School of Medicine, Nashville, TN, United
States
(Alahdab) University of Missouri, Columbia, MO, United States
(Abramov) Lomda Linda University Medical Center, Loma Linda, CA, United
States
(Fudim) Duke Clinical Research Institute, NC, United States
(Fudim) Duke University School of Medicine, Durham, NC, United States
(Moayedi) Ted Rogers Centre of Excellence in Heart Research, Peter Munk
Cardiac Centre, University Health Network, Toronto, ON, Canada
(Moayedi) Ajmera Transplant Centre, University Health Network, Toronto,
ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: For noninvasive surveillance of cardiac allograft vasculopathy
(CAV), cardiac computed tomography (cardiac computed tomography [CT]) and
positron emission tomography (PET) received a Class IIa recommendation by
the 2023 ISHLT (International Society for Heart and Lung Transplantation)
guidelines. However, implementation has lagged behind because of concerns
about their ability to rule out disease and stratify risk.
 Objective(s): The purpose of this study was to define the diagnostic
and prognostic ability of PET and cardiac CT in cardiac transplant
recipients. Method(s): Electronic databases were searched for studies
evaluating CT or PET for their diagnostic (for detecting angiographic CAV)
and prognostic (for predicting major adverse cardiovascular outcomes)
value. Sensitivity and specificity were pooled using Bayesian bivariate
binormal-normal models with random-effects. HRs were pooled using Bayesian
normal random-effects models. Result(s): In total, 44 studies (32 CT
and 12 PET) enrolling 3,049 patients were included. Coronary computed
tomography angiography (CTA) showed high sensitivity (97.6%; 95% credible
interval [CrI]: 93.7%-99.1%) and specificity (82.3%; 95% CrI: 75.3%-88.3%)
for detecting any CAV. Coronary CTA also showed high sensitivity (92.6%;
95% CrI: 86.2%-96.2%) and specificity (92.6%; 95% CrI: 89.8%-94.9%) for
significant CAV. The PET CAV algorithm for detecting significant CAV
showed good sensitivity (83.9%; 95% CrI: 69.1%-92.4%) and specificity
(89.6%; 95% CrI: 82.2%-94.2%). PET-derived parameters including myocardial
flow reserve, stress myocardial blood flow, PET CAV score, and summed
stress score, predicted future major adverse cardiovascular outcomes.
 Conclusion(s): Both coronary CTA and PET can rule out significant
CAV; however, at higher pretest probabilities, coronary CTA may be
preferrable. Multiple PET-derived parameters may have prognostic value,
whereas there is insufficient evidence for the long-term prognostic value
of CT. Copyright © 2025 American College of Cardiology Foundation

<92>
Accession Number
2035538348
Title
Efficacy and Safety of Transcatheter Therapy for Patients With Tricuspid
Regurgitation: A Systematic Review and Meta-Analysis of Randomized
Controlled Trials.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Mojica J.C.; Dandamudi M.; Rehman T.; Faizan M.A.; Giorgi J.
Institution
(Mojica) University of the East Ramon Magsaysay Medical Center, Quezon
City, Philippines
(Dandamudi) Montefiore Medical Center, Moses Campus, Bronx, NY, United
States
(Rehman, Faizan) Gomal Medical College, Dera Ismail Khan, Pakistan
(Rehman, Faizan) Khyber Medical University, Khyber, Pakistan
(Giorgi) Hospital Sirio Libanes, Sao Paulo, Brazil
(Giorgi) Hospital Albert Einstein, Sao Paulo, Brazil
Publisher
John Wiley and Sons Inc
Abstract
Severe tricuspid regurgitation (TR) is a prevalent valvular disorder
associated with significant morbidity, impaired quality of life, and
increased mortality. This meta-analysis evaluates the safety and efficacy
of transcatheter therapies (TCT) that have emerged as promising
alternatives to surgical intervention, especially in the high-risk
population. This study aimed to assess the safety and clinical outcomes of
TCT compared with optimal medical therapy (OMT) for severe TR. Multiple
databases, including MEDLINE, Embase, Scopus, and ClinicalTrials.gov were
searched from inception to March 2025. We assessed the clinical outcomes
of TCT compared with OMT using mean difference (MD) and risk ratio (RR)
with 95% confidence intervals (CI) and I2 for heterogeneity.
Outcomes included all-cause mortality (ACM), cardiovascular death (CV
death), heart failure hospitalizations (HFH), cardiac remodeling,
functional capacity, and quality of life score. We included four RCTs of
TCT on severe TR versus OMT, involving 1292 patients, of whom 710 (55%)
underwent TCT. In the pooled analysis, ACM was not affected by the
intervention therapy compared to OMT (RR = 1.12; 95% CI 0.65-1.93; p =
0.54), nor were CV death (RR = 0.87; 95% CI 0.50-1.51; p = 0.49), stroke
(RR = 1.54; 95% CI 0.27-8.76; p = 0.39), and HFH (RR = 0.86; 95% CI
0.61-1.22; p = 0.21). However, secondary outcomes were robustly affected
in the TCT group, as demonstrated by the six-minute walk distance test
(6MWD) (MD = 33.55 m; 95% CI 17.04-50.07; p < 0.01) and the Kansas City
cardiomyopathy questionnaire (KCCQ) (MD = 14.46; 95% CI 11.42-17.49; p <
0.01). In high-risk patients with severe TR, TCT effectively improves
functional status and enhances quality of life compared with OMT, while
survival benefits remain unproven. Copyright © 2025 Wiley
Periodicals LLC.

<93>
[Use Link to view the full text]
Accession Number
2039799912
Title
Effects of continuous pecto-intercostal fascial block for management of
post-sternotomy pain in patients undergoing cardiac surgery: a randomized
controlled trial.
Source
International Journal of Surgery. 111(2) (pp 2037-2045), 2025. Date of
Publication: 01 Feb 2025.
Author
Zhao Y.; He D.; Zhou W.; Chen C.; Liu Z.; Xia P.; Ye Z.; Li C.
Institution
(Zhao, He, Zhou, Chen, Liu, Xia, Ye, Li) Department of Anesthesiology,
Xiangya Hospital of Central South University, Hunan Province, Changsha,
China
(Liu, Xia, Ye, Li) National Clinical Research Center for Geriatric
Disorders, Central South University, Hunan Province, Changsha, China
Publisher
Wolters Kluwer Health Inc
Abstract
Background: Managing postoperative pain following median sternotomy has
long been a notable challenge for anesthesiologists. The administration of
postoperative analgesia traditionally relies on intravenous pumps for the
delivery of opioids. With the development of regional block techniques and
postoperative multimodal analgesia, pecto-intercostal fascial block (PIFB)
has gained widespread utilization due to its distinctive advantages.
However, its application is limited to a single block. This study aimed to
indicate whether continuous PIFB analgesia in cardiac surgery via
sternotomy could possess clinical advantages compared with intravenous
analgesia in terms of postoperative pain management. If continuous PIFB
analgesia was the priority, the secondary objective would involve
determining the most effective administration method, making it a critical
area of exploration. Method(s): Totally, 114 patients were randomly
allocated to three groups: the patient-controlled intravenous analgesia
(PCIA) group, receiving intravenous opioid infusion exclusively via pump,
and the constant infusion pecto-intercostal fascial block (C-PIFB) and
intermittent infusion pecto-intercostal fascial block (I-PIFB) groups,
where ultrasound-guided PIFB with a nerve-blocking pump was administered.
The C-PIFB group received a constant basal infusion, while programmed
intermittent boluses were administered in the I-PIFB group. The primary
end point was postoperative visual analog scale (VAS) scores, and
secondary outcomes included intraoperative sufentanil consumption, time to
extubation, mobilization, length of stay in the intensive care unit (ICU)
and hospital, and the incidence of postoperative complications.
 Result(s): The VAS scores at rest and during coughing were noticeably
diminished in the two block groups relative to the intravenous pump group
at 12, 24, 48, and 72 h postoperatively. Notably, intraoperative
sufentanil consumption was significantly reduced in the C-PIFB group [3.12
(0.93) microg kg-1] and the I-PIFB group [3.42 (0.77) microg
kg-1] compared with the PCIA group [4.66 (1.02) microg
kg-1, P < 0.001]. Time to extubation, mobilization, length of
stay in ICU and hospital, and use of rescue analgesics did not exhibit
statistically significant differences among the three groups. However, the
postoperative complication rates were markedly lower in the C-PIFB group
(42.11%) and I-PIFB group (36.84%) relative to the PCIA group (81.58%, P <
0.001). There were no significant differences between C-PIFB and I-PIFB
groups regarding VAS score, secondary outcomes, and postoperative
complications. Conclusion(s): Continuous PIFB can provide
satisfactory postoperative analgesia while reducing perioperative opioid
consumption, diminishing the risk of postoperative complications, and
accelerating postoperative recovery for patients undergoing median
sternotomy in cardiac surgery. The constant basal infusion method may be
the optimal approach for administering continuous PIFB. Copyright
© 2025 The Author(s)

<94>
Accession Number
2039820584
Title
The wound microbiome associated with deep sternal wound infection: a
scoping review.
Source
Journal of Thoracic Disease. 17(7) (pp 5330-5346), 2025. Date of
Publication: 31 Jul 2025.
Author
Bae J.; Woo W.; Gardner S.E.
Institution
(Bae, Gardner) College of Nursing, University of Iowa, Iowa City, IA,
United States
(Woo) Department of Internal Medicine, Dignity Health St. Joseph Medical
Center Stockton, Stockton, CA, United States
Publisher
AME Publishing Company
Abstract
Background: Deep sternal wound infection (DSWI) is a serious complication
following cardiovascular surgery, increasing patient mortality and
healthcare burden. Understanding the wound microbiome, including microbial
load, microbial diversity, presence/abundance of common wound
microorganisms, and biofilm formation, is crucial for improving infection
prevention, diagnosis, and management. This scoping review aims to: (I)
summarize DSWI definitions, specimen acquisition methods, and microbial
identification techniques; (II) synthesize current DSWI literature
regarding microbial load, microbial diversity, presence/ abundance of
common wound microorganisms, and biofilm formation. Method(s): A
scoping review was conducted using PubMed and EMBASE to identify studies
on the wound microbiome in DSWI. Studies were included if they were in
English, focused on adults, and published in journals. Exclusion included
secondary sources, case reports, transplant populations, and other
nosocomial infections. Data extraction followed a standardized approach,
and findings were synthesized narratively, with a table summarizing study
details. Seventy-one studies were included in this scoping review.
 Result(s): The Centers for Disease Control and Prevention (CDC)
criteria were most commonly used for DSWI. Specimen location was
unspecified in 60.6% of studies, while 14.1% specified the mediastinum.
Methods of specimen acquisition were reported in only 25.3% of studies.
Culture techniques were predominant (91.5%), while molecular or imaging
methods were used in only 8.5%. Among studies using culture,
Staphylococcus aureus was the most common microorganism, and 22.5%
investigated polymicrobial infections. Molecular studies identified
resistance genes such as blaZ in Staphylococci and blaKPC in
carbapenem-resistant Enterobacteriaceae (CRE). Biofilm formation was
examined in only 2.8% of studies, with findings linking staphylococci to
biofilm presence in DSWI. Conclusion(s): This review revealed
critical gaps in DSWI research, including poor reporting of specimen
acquisition, a narrow focus on common wound microorganisms, and an
overreliance on culture-based methods. The lack of standardized specimen
collection reporting reduces data reliability and comparability. Limited
use of molecular techniques restricts insights into microbial complexity.
Advanced molecular techniques, including polymerase chain reaction, 16S
ribosomal RNA (rRNA) sequencing, and metagenomic sequencing, are needed to
improve microbiome characterization. Addressing these gaps will improve
infection prevention and management for DSWI. Copyright © AME
Publishing Company.

<95>
Accession Number
2039599647
Title
Evaluating the effects of bempedoic acid on lipid profiles and
cardiovascular risk: An umbrella review of meta-analyses.
Source
Qatar Medical Journal. 2025(2) (no pagination), 2025. Article Number: 51.
Date of Publication: 2025.
Author
Ali A.; Bhimani S.; Karmani V.K.; Dhillon R.A.; Saeed S.; Amir A.; Patel
P.; Asif A.; Baig U.A.; Shamoon S.; Naseer A.; Ali O.
Institution
(Ali) Department of Internal Medicine, SRM Medicak College and Research
Center, Chennai, India
(Bhimani) Department of Internal Medicine, The Wright Center for Graduate
Medical Education, Scranton, PA, United States
(Karmani, Ali) Department of Internal Medicine, Jinnah Sindh Medical
University, Karachi, Pakistan
(Dhillon) Department of Internal Medicine, Riphah International
University, Rawalpindi, Pakistan
(Saeed) Department of Internal Medicine, Charleston Area Medical Center,
Charleston, WV, United States
(Amir) Department of Internal Medicine, Dow University of Health Sciences,
Karachi, Pakistan
(Patel) Department of Internal Medicine, New York Medical College, Saint
Michael's Medical Center, Newark, NJ, United States
(Asif) Department of Internal Medicine, Harlem Hospital Center, New York,
NY, United States
(Baig) Department of Cardiology, Orthopedic Medical and Institute,
Karachi, Pakistan
(Shamoon) Department of Internal Medicine, Rawalpindi Medical University,
Rawalpindi, Pakistan
(Naseer) Department of Cardiology, National Institute of Cardiovascular
Disorder, Karachi, Pakistan
Publisher
HBKU Press
Abstract
Background: This umbrella review aims to synthesize evidence from
previously conducted meta-analyses and review articles to assess the
effects of bempedoic acid on lipid profile and cardiovascular events.
 Method(s): While adhering to the Preferred Reporting Items for
Overviews of Reviews guidelines, PubMed, Google Scholar, Web of Science,
and Scopus were searched from the database inception to June 2024 to
identify relevant articles. The outcomes were total cholesterol,
low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein
cholesterol (HDL-C), non-HDL cholesterol, triglyceride (TAG),
apolipoprotein B (APOB), high-sensitivity CRP (hs-CRP), major
cardiovascular events (MACE), cardiovascular mortality, and myocardial
infarction (MI). A corrected covered area (CCA) assessment was performed
to determine overlap among reviews. Each included review was assessed for
its quality and rigor via the AMSTAR-2 tool. Result(s): From 18,297
articles identified during the literature search, 18 meta-analyses were
included. A significant overlap was noted across studies with a corrected
cover area of 44.4%. Bempedoic acid's effects on cardiovascular outcomes
and lipid levels have been extensively studied. For cardiovascular
mortality, the evidence is mixed: Goyal et al.21 reported a
risk ratio (RR) of 0.81 (95% CI 0.61-1.08) suggesting a potential benefit,
while other studies, such as De Filippo et al.26 and Zhang et
al.24, indicate no significant association. In terms of MACE,
11 reviews show a consistent trend toward reduced risk, with RRs between
0.75 and 0.88. Bempedoic acid also appears to significantly reduce the
risk of MI, with RRs and odds ratios (ORs) around 0.76. Evidence on
unstable angina suggests a lower risk, although some studies do not reach
statistical significance. For coronary revascularization, the data show a
reduced risk, with RRs ranging from 0.74 to 0.82. Studies on coronary
non-revascularization also indicate a significant risk reduction with RRs
and ORs of 0.41. Regarding lipid levels, bempedoic acid consistently
reduces LDL cholesterol (mean differences [MDs] from -17.5% to -33.91%),
total cholesterol (MDs from -12.69% to -34.41%), and non-HDL cholesterol
(MDs from -12.3% to -23.27%). The effects on HDL cholesterol are less
consistent (MDs from -1.29% to -5.18%), and triglyceride levels show
variable results (MDs from -8.35% to +5.23%). Conclusion(s): Our
findings show that bempedoic acid significantly reduces the risk of MACE,
nonfatal MI, coronary and noncoronary revascularization, and
hospitalizations for unstable angina. While results on cardiovascular
mortality are mixed, suggesting a need for further study, bempedoic acid
proves to be an effective treatment for improving lipid profiles and
reducing cardiovascular events, especially in patients who cannot tolerate
statins. It presents a valuable option for cardiovascular risk management,
potentially enhancing patient outcomes and quality of life. Further
research is needed to assess its long-term benefits and broader
applicability. Copyright © 2025 Ali, Bhimani, Karmani, Dhillon,
Saeed, Amir, et al., licensee HBKU Press.

<96>
Accession Number
2035541290
Title
Evaluating Zero-Contrast Transcatheter Aortic Valve Implantation (TAVI)
for Patients With Renal Impairment: A Pooled Meta-Analysis of 1505
Patients.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Badran A.S.; Gadelmawla A.F.; Khelifa H.; Hasanin E.H.; Gbreel M.I.
Institution
(Badran) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Khelifa) Faculty of Medicine, University of Oran 1, Ahmed Ben Bella,
Oran, Algeria
(Hasanin) Faculty of Medicine, University of Tripoli, Tripoli, Libyan Arab
Jamahiriya
(Gbreel) Faculty of Medicine, October 6 University, Giza, Egypt
(Gbreel) Department of Cardiology, Egyptian Railway Medical Educational
Centre, Cairo, Egypt
Publisher
John Wiley and Sons Inc
Abstract
Transcatheter Aortic Valve Implantation (TAVI) is a well-established
treatment for severe aortic stenosis (AS) but poses risks for chronic
kidney disease (CKD) patients due to contrast-induced nephropathy (CIN).
Zero-contrast TAVI offers a promising alternative, though evidence on its
safety and effectiveness is limited. We aim to evaluate the safety and
effectiveness of zero-contrast TAVI compared to standard TAVI in patients
with AS and CKD. We followed the Cochrane Handbook and PRISMA guidelines,
searching databases until September 2024. We conducted the meta-analysis
using the 'metafor' package with a random-effects model, calculating mean
differences (MDs) and risk ratios (RRs) along with their corresponding 95%
confidence intervals (CIs). We included 1505 patients from six papers. The
single-arm meta-analysis of zero-contrast TAVI showed a significant
implantation success rate (proportion = 0.97; 95% CI: [0.95, 0.99]; p <
0.01). Double-arm analysis revealed no significant difference in
implantation success between both groups (RR = 1.02; 95% CI: [0.97, 1.08];
p = 0.34). The postoperative mean transvalvular gradient was comparable
(MD = 0.19 mmHg; 95% CI: [-0.99, 1.39]; p = 0.75). The initial pooled
analysis found no significant difference in in-hospital AKI (RR = 0.66,
95% CI: 0.20-2.17), though this was confounded by significant
heterogeneity (I2 = 71.26%). Sensitivity analysis resolved this
heterogeneity and revealed a significant reduction in AKI with
Zero-contrast TAVI (RR = 0.47, 95% CI: [0.24, 0.92]; p = 0.03).
Post-procedural permanent pacemaker (PPM) implantation risk was higher in
the zero-contrast group, while Stroke rates were comparable. Zero-contrast
TAVI offers comparable success to contrast-based approaches and potential
renal benefits but carries a higher risk of PPM implantation. Trial
Registration: This meta-analysis was registered on PROSPERO. No.:
CRD42024597951. Copyright © 2025 Wiley Periodicals LLC.

<97>
Accession Number
2039820805
Title
Tailored single-lung ventilation approaches and postoperative pulmonary
outcomes in thoracic surgery.
Source
Journal of Thoracic Disease. 17(7) (pp 5371-5387), 2025. Date of
Publication: 31 Jul 2025.
Author
Sha Y.; Xu R.; Shao S.; Yang J.; Tang B.; Liang Q.; Wang Z.
Institution
(Sha, Shao, Yang, Tang, Liang, Wang) Department of Anesthesiology, The
Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer
Hospital, Peking University Cancer Hospital Yunnan, Kunming, China
(Xu) Department of Urology, The Second Affiliated Hospital of Kunming
Medical University, Kunming, China
Publisher
AME Publishing Company
Abstract
Traditional lung-protective ventilation [low tidal volume (VT) with fixed
positive end-expiratory pressure (PEEP)] reduces intraoperative lung
injury but exhibits limited efficacy in preventing postoperative pulmonary
complications (PPCs) following thoracic surgery requiring one-lung
ventilation (OLV). This review systematically examines the multifactorial
mechanisms of OLV-associated lung injury, encompassing hypoxemia [device
malposition, atelectasis, ventilation/perfusion (V/Q) mismatch, impaired
hypoxic pulmonary vasoconstriction (HPV)], oxidative stress,
ischemia-reperfusion injury (IRI) (glycocalyx degradation, mechanical
stress, inflammation), and ventilator-induced trauma (volutrauma,
biotrauma). To address these limitations, we propose an open-lung
protective ventilation strategy integrating alveolar recruitment maneuvers
(RMs) with individualized PEEP (iPEEP) titration based on optimal
respiratory compliance. Furthermore, we innovatively introduce oxygen
reserve index (ORI)-guided titration of fraction of inspired oxygen
(FiO<inf>2</inf>), enabling dynamic determination of the minimum effective
FiO<inf>2</inf> to mitigate hyperoxia-related toxicity. This synergistic
"RM-iPEEP-FiO<inf>2</inf> triad" facilitates personalized intraoperative
respiratory management by stabilizing alveoli, optimizing V/Q matching,
and minimizing oxidative stress, thereby significantly reducing PPCs risk
compared to conventional fixed-parameter approaches. Current limitations
include insufficient multicenter validation, technical dependency on
advanced monitoring/ ventilators, and lack of subgroup analyses for
high-risk populations. Future research should prioritize multicenter
randomized controlled trials to establish universal thresholds for
tailored parameters. Integration of artificial intelligence (AI) for
real-time respiratory mechanics analysis and multimodal imaging is
essential to refine precision thresholds. Ultimately, this strategy aims
to establish an evidence-based, precision perioperative ventilation
framework that optimizes clinical outcomes in thoracic surgical patients
by overcoming the constraints of standardized ventilation
protocols. Copyright © AME Publishing Company.

<98>
Accession Number
648097218
Title
Left bundle branch vs right ventricular pacing in AV-block and preserved
LVEF post-TAVI (Phys-TAVI randomized trial).
Source
Europace. Conference: European Heart Rhythm Association Congress, EHRA
2025. Vienna Austria. 27(Supplement 1) (pp i931-i933), 2025. Date of
Publication: 01 May 2025.
Author
Pujol-Lopez M.; Regueiro A.; Graterol F.R.; Garcia-Ribas C.; Uribe L.;
Borras R.; Guasch E.; Guichard J.B.; Regany-Closa M.; Arbelo E.;
Porta-Sanchez A.; Roca-Luque I.; Doltra A.; Tolosana J.M.; Mont L.
Institution
(Pujol-Lopez, Regueiro, Graterol, Uribe, Guasch, Guichard, Regany-Closa,
Arbelo, Porta-Sanchez, Roca-Luque, Doltra, Tolosana, Mont) Hospital Clinic
of Barcelona, Barcelona, Spain
(Garcia-Ribas, Borras) Institute of Biomedical Research August Pi Sunyer
(IDIBAPS), Barcelona, Spain
Publisher
Oxford University Press
Abstract
Background: There is currently no evidence of the best pacing mode for
high-degree atrioventricular (AV) block occurring after transcatheter
aortic valve implant (TAVI) in patients with preserved left ventricular
systolic ejection fraction (LVEF). Purpose(s): The purpose of the
trial was to compare a clinical combined endpoint achieved by left bundle
branch pacing (LBBP) vs right ventricular (RV) pacing in patients with
preserved LVEF post-TAVI at 12-month follow-up. Method(s):
Physiological vs right ventricular pacing in patients with normal
ventricular function post-TAVI (Phys-TAVI) was a pilot study designed as a
single-center, prospective, randomized, parallel-controlled clinical
trial. Adhered to CONSORT guidelines. Consecutive patients (n=24)
post-TAVI with high-degree AV block and LVEF>=50% were randomized to LBBP
or RV pacing. The primary endpoint was survival with an improvement
>=1point in NYHA class or >=25% increase in the distance covered in the
6-minute-walking-test (6MWT). Secondary endpoints were change in LVEF,
septal flash correction, mitral regurgitation, NTproBNP, heart failure
hospitalization, score on symptoms (KCCQ-12 Kansas City Cardiomyopathy
Questionnaire), and QRS duration. Result(s): Twenty-four patients
were included, 12 in each arm. Median stimulation 98.6% (75%-99%), no
differences between groups. Both groups showed a similar incidence of the
primary endpoint: 33.3% (n=4) in LBBP group vs 25% (n=3) in RV group
(p=1). One patient in each group had died at 1-year follow-up. In relation
to secondary endpoints, significant shortening in the QRS was observed in
LBBP patients, as compared to RV pacing (median -39ms vs 0ms), p<0.001.
Septal flash excursion was significantly lower for the LBBP group (median
0mm vs 2mm), p=0.03. None of the patients had LVEF<50% at 12-month
follow-up. Conclusion(s): Similar midterm outcomes were obtained with
LBBP and RV pacing in an elderly population with high-degree AV block and
preserved LVEF after TAVI. The pilot Phys-TAVI trial showed the
feasibility of LBBP in this population and set paves the way for larger
randomized clinical trials with extended follow-up to test for
differential clinical outcomes between pacing modalities.

<99>
Accession Number
648096654
Title
Optimizing first-pass isolation success in left pulmonary vein ablation: a
randomized study on radiofrequency ablation line design at the left atrial
ridge.
Source
Europace. Conference: European Heart Rhythm Association Congress, EHRA
2025. Vienna Austria. 27(Supplement 1) (pp i698-i700), 2025. Date of
Publication: 01 May 2025.
Author
Rauber M.; Robles A.G.; Antolic B.; Pernat A.
Institution
(Rauber, Robles, Antolic, Pernat) University Medical Centre of Ljubljana,
Ljubljana, Slovenia
Publisher
Oxford University Press
Abstract
Background/Introduction: Catheter ablation with pulmonary vein isolation
(PVI) is the standard treatment for atrial fibrillation (AF).
Radiofrequency ablation (RFA) remains the most effective modality, with
the CLOSE protocol used for successful PVI. However, anatomical challenges
at the left atrial (LA) ridge between the left pulmonary veins (LPV) and
left atrial appendage (LAA) can affect catheter stability and operator's
choice of ablation line construction, potentially lowering the isolation
rate. This study aims to optimize ablation line design in this region to
improve first attempt isolation of the LPV (FALPVI) and enhance AF
ablation outcomes. Purpose(s): The purpose of this randomised study
is to investigate ablation line design effect in this region on FALPVI.
 Method(s): In this single-center, prospective, randomized study, we
included patients treated for paroxysmal or persistent AF from August 2023
to August 2024. Patients were randomly assigned to undergo LPV ablation on
either the venous or LAA side of the LA ridge using the CLOSE protocol.
The primary outcome was FALPVI. The LA and pulmonary vein anatomy were
constructed using a multipolar mapping catheter, and intracardiac
echocardiography was used to ensure correct, group-specific positioning
and stable contact before each ablation. Result(s): Our study
included 40 patients, with 20 patients in each randomization group (Figure
1). Among them, 17 (43%) had persistent AF, and the remainder had
paroxysmal AF. The median CHA2DS2-VA score was 2 (IQR 1). Patient and
procedural characteristics are summarized in Figure 2. First-attempt
isolation of the left pulmonary veins was achieved in 16 (80%) patients in
the venous side group, compared to 7 (35%) in the LAA side group (p =
0.001). In cases of non-FALPVI, the LA ridge and/or carina were the
primary gap sites, with 1 patient in the venous side group (30%) and 7
patients in the LAA side group (100%) showing gaps (p < 0.001). The LAA
side group experienced significantly longer LPV ablation times (Figure 2).
One patient in the venous side group experienced tamponade, requiring
pericardiocentesis during right pulmonary vein ablation.
 Conclusion(s): Our study demonstrates that ablation on the venous
side of the LA ridge during circumferential LPV ablation significantly
improves FALPVI rates compared to the LAA side approach. These findings
suggest that optimizing ablation line design on the venous side may
enhance the efficacy and long-term success of PVI in AF ablation.

<100>
Accession Number
2039807189
Title
Comparisons of different new-generation transcatheter aortic valve
implantation devices for patients with severe aortic stenosis: a
systematic review and network meta-analysis.
Source
International Journal of Surgery. 109(8) (pp 2414-2426), 2023. Date of
Publication: 01 Aug 2023.
Author
Yang Y.-X.; Liu X.-M.; Fu Y.; Li C.; Wang H.-J.; Xu L.; Xia K.; Zhang
Z.-Y.; Zhong J.-C.; Chen M.-L.; Su P.-X.; Wang L.-F.
Institution
(Yang, Liu, Fu, Li, Wang, Xu, Xia, Zhang, Zhong, Chen, Su, Wang) Heart
Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang
Hospital, Capital Medical University, Chaoyang District, Beijing, China
Publisher
Wolters Kluwer Health Inc
Abstract
Background: Whether there are differences among the new-generation
transcatheter aortic valve implantation (TAVI) devices for patients with
aortic stenosis remains unclear. The aim of the study was to compare the
efficiency and safety of different new-generation TAVI devices for
patients with aortic stenosis. Material(s) and Method(s): A
comprehensive search of PubMed, Embase and Web of Science from their
inception to 1 February 2022. Randomized clinical trials and observational
studies that compared two or more different TAVI devices were enroled.
Pairwise meta-analysis and frequentist network meta-analysis were
conducted to pool the outcome estimates of interest. Result(s): A
total of 79 studies were finally included. According to the surface under
the cumulative ranking, the top two ranked valves for lower rates of
events were as follows: direct flow medical (DFM) (4.6%) and Lotus (48.8%)
for lower rate of device success; Sapien 3 (16.8%) and DFM (19.7%) for
lower mortality; DFM (8.6%) and Sapien 3 (25.5%) for lower rates of
stroke; Evolut (27.6%) and DFM (35.8%) for lower rates of major and
life-threatening bleeding; Portico (22.6%) and Sapien 3 (41.9%) for lower
rates of acute kidney injury; Acurate (8.6%) and DFM (13.2%) for lower
rates of permanent pacemaker implantation; Lotus (0.3%) and Sapien 3
(22.7%) for lower rates of paravalvular leak; Evolut (1.4%) and Portico
(29.1%) for lower rates of mean aortic valve gradients.
 Conclusion(s): The findings of the present study suggested that the
device success rates were comparable among these new-generation valves
except for DFM. After excluding DFM, Sapien 3 might be the best effective
for decreased mortality and stroke; Lotus might be the best effective for
decreased paravalvular leak; Evolut might be the best effective for
decreased major and life-threatening bleeding and mean aortic valve
gradients; Acurate and Portico might be the best effective for decreased
permanent pacemaker implantation and acute kidney injury,
respectively.2023 The Author(s). Copyright © 2023 Wolters Kluwer
Health Inc. All rights reserved.

<101>
Accession Number
2039799763
Title
The association between diabetes mellitus and postoperative cognitive
dysfunction: a systematic review and meta-analysis.
Source
International Journal of Surgery. 111(3) (pp 2633-2650), 2025. Date of
Publication: 01 Mar 2025.
Author
Liu H.; Chen J.; Ling J.; Wu Y.; Yang P.; Liu X.; Liu J.; Zhang D.; Yin
X.; Yu P.; Zhang J.
Institution
(Liu) Jiujiang Clinical Precision Medicine Research Center, Jiujiang,
China
(Liu) The First Clinical Medical College, Jiangxi Medical College,
Nanchang University, Nanchang, Jiangxi, China
(Chen) School of Stomatology, Jiangxi Medical College, Nanchang
University, Nanchang, Jiangxi, China
(Ling, Wu, Yang, Liu, Yu) Department of Endocrinology and Metabolism, The
Second Affiliated Hospital, Jiangxi Medical College, Nanchang University,
Nanchang, Jiangxi, China
(Liu) Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen
University, Guangzhou, China
(Zhang) Food and Nutritional Sciences, School of Biological Sciences, The
University of Hong Kong, Hong Kong
(Zhang, Yin) Department of Neurology, Clinical Medical School of Jiujiang
University, Jiangxi, Jiujiang, China
(Zhang, Yin, Zhang) Jiujiang Clinical Precision Medicine Research Center,
Jiangxi, Jiujiang, China
(Zhang) Department of Anesthesiology, The Second Affiliated Hospital,
Jiangxi Medical College, Nanchang University, Jiangxi, Nanchang, China
Publisher
Wolters Kluwer Health Inc
Abstract
Background: Postoperative cognitive dysfunction (POCD) is a typical
consequence following surgery, particularly in cardiac surgeries. Despite
its high incidence, the underlying etiology remains unclear. While
diabetes mellitus (DM) has been associated with cognitive impairment, its
specific function in POCD development remains unidentified. This study
aims to evaluate the connection between DM and the risk of POCD.
 Method(s): We conducted a comprehensive search of PubMed, Embase, Web
of Science, and the Cochrane Library databases for studies of DM and risk
with POCD, collecting data up to 14 September 2023. We assessed
publication bias, heterogeneity, and study quality, adhering to PRISMA and
AMSTAR guidelines. Result(s): Our study comprised 38 trials involving
8748 individuals, with 7734 patients undergoing follow-up. The pooled
results showed that individuals with DM had an increased incidence of POCD
compared to nondiabetic individuals (RR: 1.44, 95% CI: 1.26-1.65). The
incidence of POCD was significantly higher in the group of patients with
an average age older than 65 years (RR: 1.69, 95% CI: 1.30-2.20) compared
with diabetic patients with an average age younger than 65 years (RR:
1.29, 95% CI: 1.09-1.64). Compared with diabetic patients undergoing
cardiac surgery (RR: 1.33, 95% CI: 1.15-1.53), patients receiving
non-cardiac surgery showed a greater incidence of POCD (RR: 2.01, 95% CI:
1.43-2.84). Conclusion(s): Current evidence underscores that diabetic
patients face a significantly higher risk of POCD compared to their
nondiabetic counterparts. Further research is warranted to clarify the
precise mechanisms of this relationship and explore potential preventive
strategies for diabetic patients. Copyright © 2025 The Author(s)

<102>
Accession Number
648096828
Title
Flecainide vs Amiodarone for the cardioversion of Atrial Fibrillation in
the Emergency Department in patients with Coronary Artery Disease and
preserved ejection fraction. FLECA-ED study.
Source
Europace. Conference: European Heart Rhythm Association Congress, EHRA
2025. Vienna Austria. 27(Supplement 1) (pp i557), 2025. Date of
Publication: 01 May 2025.
Author
Tsioufis P.; Tsiachris D.; Argyriou N.; Doundoulakis I.; Kordalis A.;
Antoniou C.K.; Botis M.; Zamanis I.; Matthaiopoulos G.; Tsioufis K.
Institution
(Tsioufis, Tsiachris, Argyriou, Doundoulakis, Kordalis, Antoniou, Botis,
Tsioufis) Hippokration General Hospital, Athens, Greece
(Zamanis) Konstantopoulio General Hospital, Cardiology, Athens, Greece
(Matthaiopoulos) KAT General Hospital, Cardiology, Athens, Greece
Publisher
Oxford University Press
Abstract
Background: The increasing rates of AF-related ED visits and admissions
underscore the need for efficient strategies to safely restore sinus
rhythm [1,2]. Amiodarone remains the preferred choice for patients with
coronary artery disease (CAD) due to its established safety profile.
However, flecainide's efficacy and safety in CAD patients is an area
warranting further exploration, as recent analyses seem to suggest [3,4].
 Purpose(s): The primary objectives are to prove the superiority of
flecainide over amiodarone in the successful cardioversion of PAF within 6
hours and to demonstrate that the safety of flecainide is non-inferior to
amiodarone in patients with CAD without residual ischemia and an EF > 35%.
The secondary goals of the study are to prove the superiority of
flecainide over amiodarone in the reduction in hospitalizations from the
ED, in the time taken to achieve cardioversion, and in the reduction in
electrical cardioversion incidence. Method(s): The FLECA-ED trial
(NCT05549752) is a randomized, controlled, multi-center study, enrolling
patients with paroxysmal AF, CAD without residual ischemia and EF >35%
based on with recent PCI/CABG and/or negative cardiac stress imaging.
Continuous ECG monitoring is employed directly before randomization to IV
flecainide or amiodarone for 24 hours post-administration, with 30-day
follow-up. Study endpoints include SR restoration within 6 hours, time to
cardioversion, and incidence of adverse events. Result(s): To date, a
total of 25 patients have been enrolled; 10 in the flecainide group and 15
in the amiodarone group. Initial analysis indicates that median time to
cardioversion was 35 minutes (IQR 30.8) in the flecainide group and 679
minutes (IQR 1000) in the amiodarone group, p < 0.001. Ten out of 10
patients (100%) receiving flecainide were discharged safely from the ED in
SR within 6 hours. 11 out of 15 (73%) patients who received amiodarone
required hospitalization. One significant adverse event was reported in
the amiodarone group which required hospitalization prolongation with the
patient making full recovery. Conclusion(s): Preliminary data from
the FLECA-ED study suggest that flecainide may provide a faster and
effective alternative to amiodarone for pharmacologic cardioversion in CAD
patients with preserved EF. If these trends are confirmed, flecainide
could represent a valuable option for enhancing ED efficiency and
potentially reducing hospitalization rates.

<103>
Accession Number
648080424
Title
Letter to the editor: a commentary on "Exercise-based cardiac
rehabilitation for patients with coronary artery operation: a systematic
review and meta-analysis based on current randomized controlled trials".
Source
International journal of surgery (London, England). (no pagination),
2025. Date of Publication: 17 Jul 2025.
Author
Su Q.
Institution
(Su) Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou
People's Hospital, Quzhou, China

<104>
Accession Number
648077636
Title
A correspondence on impact of pecto-intercostal fascial block on
postoperative fatigue in elderly patients undergoing off-pump coronary
artery bypass grafting: a randomized clinical trial.
Source
International journal of surgery (London, England). (no pagination),
2025. Date of Publication: 17 Jul 2025.
Author
Dong W.; Li W.
Institution
(Dong) Department of Cardiovascular Surgery, Binzhou Medical University
Hospital, Binzhou, Shandong, China

<105>
Accession Number
648096567
Title
Randomized comparison of left atrial appendage closure and oral
anticoagulation after catheter ablation for atrial fibrillation:
subanalysis of AF type.
Source
Europace. Conference: European Heart Rhythm Association Congress, EHRA
2025. Vienna Austria. 27(Supplement 1) (pp i872), 2025. Date of
Publication: 01 May 2025.
Author
Tondo C.; De Potter T.; Pickett R.; Boersma L.V.A.; Razak E.; Tomassoni
G.; Khan A.; Wimmer A.; D'souza B.; Roy K.; Christen T.; Sutton B.; Wazni
O.
Institution
(Tondo) Surgical and Dentist Sciences, University of Milan, Heart Rhythm
Center at Monzino Cardiac Center, Milano, Italy
(De Potter) Onze Lieve Vrouw Ziekenhuis, Aalst, Belgium
(Pickett) Ascension St Thomas Research Institute, Nashville, United States
(Boersma) St. Antonius Hospital and Amsterdam UMC, Nieuwegein, Netherlands
(Razak) Virginia Mason Franciscan Health, Seattle, United States
(Tomassoni) Baptist Health Lexington, Lexington, United States
(Khan) Henry Ford Hospital, Detroit, United States
(Wimmer) Saint Luke's Hospital of Kansas City, Kansas City, United States
(D'souza) Penn Presbyterian Medical Center, Philadelphia, United States
(Roy, Christen, Sutton) Boston Scientific Corporation, Marlborough, United
States
(Wazni) Cleveland Clinic, Cleveland, United States
Publisher
Oxford University Press
Abstract
Background/Introduction: Cardiac ablation is effective at reducing the
symptoms associated with arrhythmia. If anticoagulation is ceased
postablation, contrary to clinical guidelines, patients are at increased
risk of stroke due to the potential for asymptomatic atrial fibrillation
(AF). Although left atrial appendage closure (LAAC) is an approved
treatment to decrease the risk of thromboembolism from the left atrial
appendage, it has not been well-studied following AF ablation.
 Purpose(s): OPTION compared the safety and efficacy of LAAC in a
contemporary postablation clinical AF patient population at risk of stroke
to contemporary oral anticoagulation (OAC). In this prespecified
subanalysis, treatment characteristics and outcomes by AF type (paroxysmal
and persistent) will be evaluated. Method(s): OPTION is a
multinational, multicenter, randomized, controlled trial. Catheter
ablation patients were eligible if the procedure occurred 90 to 180 days
prior to or was scheduled within 10 days of randomization. Patients were
randomized 1:1 to ablation+LAAC versus ablation +OAC (95% DOAC) stratified
by study site and ablation cohort (sequential or concomitant). The primary
safety endpoint was non-procedural bleeding through 36 months based on
International Society on Thrombosis and Haemostasis [ISTH] major bleeding
or clinically relevant non-major bleeding definitions. The primary
efficacy endpoint was the composite of all-cause death, stroke, or
systemic embolism at 36 months. The secondary endpoint was ISTH major
bleeding through 36 months. Additional endpoints include ablation and LAAC
procedural characteristics, arrythmia recurrence, and quality of life.
 Result(s): A total of 803 patients were randomized to catheter
ablation+LAAC and 797 to ablation+OAC. Overall, patients were 70+/-8 years
old, one-third were women, mean CHA2DS2-VASc score was 3.5+/-1.3, and mean
HAS-BLED was 1.2+/-0.8. Approximately 60% of patients had paroxysmal AF
and 40% had persistent AF in each treatment arm. OPTION met its primary
and secondary endpoints. In the subgroup of patients with paroxysmal AF,
the primary efficacy endpoint occurred in 3.5% of LAAC and 4.0% OAC
patients at 3 years. In patients with persistent AF, the rate was 8.0% in
the LAAC and 9.0% in the OAC cohort. The primary safety endpoint occurred
at a rate of 8.1% in LAAC and 18.1% in OAC-treated patients with
paroxysmal AF. The rates were 8.9% in LAAC and 16.9% in OAC-treated
patients with persistent AF. The rate of the secondary endpoint was 2.8%
in the LAAC and 4.6% in OAC patients with paroxysmal AF. In patients with
persistent AF, this rate was 5.5% in the LAAC and 5.8% in the OAC cohorts.
Conclusion(s): In OPTION, among patients undergoing AF ablation, LAAC
resulted in significantly less non-procedural bleeding than oral
anticoagulation, while preserving similarly low rates of stroke, systemic
embolism or death. Outcomes were consistent among patients with paroxysmal
and persistent AF.

<106>
Accession Number
648096631
Title
Comparison of outcomes between males and females treated with left atrial
appendage closure or oral anticoagulation after catheter ablation for
atrial fibrillation: an OPTION subanalysis.
Source
Europace. Conference: European Heart Rhythm Association Congress, EHRA
2025. Vienna Austria. 27(Supplement 1) (pp i877-i878), 2025. Date of
Publication: 01 May 2025.
Author
Wazni O.M.; Nair D.; Saliba W.I.; Marijon E.; Schmidt B.; Ebelt H.; Skurk
C.; Hounshell T.; Oza S.; Roy K.; Christen T.; Sutton B.; Phillips K.P.
Institution
(Wazni, Saliba) Cleveland Clinic, Cleveland, United States
(Nair) St. Bernards Medical Center and Arrhythmia Research Group,
Jonesboro, AR, United States
(Marijon) European Hospital Georges Pompidou, Paris, France
(Schmidt) Cardioangiologisches Centrum Bethanien, Agaplesion Markus
Krankenhaus, Frankfurt am Main, Germany
(Ebelt) Catholic Hospital 'St. Johann Nepomuk', Efurt, Germany
(Skurk) Deutsches Herzzentrum der Charite (DHZC), Campus Benjamin Franklin
DZHK Partner Site, Berlin, Germany
(Hounshell) Iowa Heart Center Inc, West Des Moines, United States
(Oza) Ascension St. Vincent's Medical Center, Jacksonville, FL, United
States
(Roy, Christen, Sutton) Boston Scientific Corporation, Marlborough, United
States
(Phillips) Brisbane AF Clinic, Greenslopes Private Hospital, Brisbane,
Australia
Publisher
Oxford University Press
Abstract
Background/Introduction: Female sex is an established, non-modifiable risk
factor for adverse outcomes in atrial fibrillation (AF) patients. Left
atrial appendage closure (LAAC) has been shown to be a generally safe and
effective alternative to oral anticoagulation (OAC) for stroke prevention
in patients with AF. However, there is limited data on sex-based outcomes
with LAAC associated with catheter ablation. Purpose(s): The OPTION
trial compared the strategy of LAAC to oral anticoagulation for reducing
the risk of thromboembolism in patients who had a catheter ablation for
atrial fibrillation. Evaluation of outcome in women vs men was
prespecified. Method(s): OPTION was a randomized controlled trial
enrolling catheter ablation patients. The ablation procedure could have
occurred 90 to 180 days prior to or within 10 days of randomization.
Groups were randomized 1:1 to either ablation+LAAC or ablation+OAC (~95%
DOAC). The primary safety endpoint was 36-month non-procedural bleeding
defined as International Society on Thrombosis and Haemostasis [ISTH]
major bleeding or clinically relevant non-major bleeding. The primary
efficacy endpoint was 36-month all-cause death, stroke, or systemic
embolism. The secondary endpoint was 36-month ISTH major bleeding,
including procedural bleeding. Additional endpoints included ablation and
LAAC procedural characteristics, medication adherence, and arrythmia
recurrence. Result(s): A total of 1600 patients were randomized in
OPTION (803 patients to catheter ablation+LAAC and 797 to ablation+OAC);
one-third were women. The rate of the primary efficacy endpoint was
similar in ablation+LAAC and ablation+OAC-treated men and women (Table).
The primary safety endpoint was significantly lower in the ablation+LAAC
treated men compared to ablation+OAC-treated men. The difference in
ablation+LAAC vs ablation+OAC-treated women was directionally similar. At
3 years, no differences in rates of mortality, ischemic stroke, and
systemic embolism were found between treatment arms in women or in men.
The reduction in post-operative bleeding was higher in men as compared to
women. Conclusion(s): OPTION demonstrated that LAAC reduced non-procedural
bleeding compared to OAC without increasing the risk of thromboembolic
events. Women exhibited higher rates of major bleeding compared to men;
however, a beneficial reduction in bleeding was still observed with LAAC
although conclusions may be impacted by the smaller sample size.

<107>
Accession Number
2039820073
Title
Sternal advancement surgery for pectus excavatum: a systematic review and
meta-analysis of cardiac and respiratory function outcomes.
Source
Journal of Thoracic Disease. 17(7) (pp 4897-4908), 2025. Date of
Publication: 31 Jul 2025.
Author
Belgacem A.; Abane C.; Tricard J.; Felix P.; Lavrand F.; Laloze J.; Lopez
P.; Bothorel P.; Auditeau E.; Fourcade L.; Ballouhey Q.
Institution
(Belgacem, Lopez, Fourcade, Ballouhey) Department of Pediatric Surgery,
Children Hospital, Limoges, France
(Abane) Department of Orthopedy and Traumatology, Hopital Dupuytren,
Limoges, France
(Tricard, Felix) Department of Thoracic Surgery, Hopital Dupuytren,
Limoges, France
(Lavrand) Department of Pediatric Surgery, Hospital Pellegrin Bordeaux,
Bordeaux, France
(Laloze) Department of Plastic Surgery, Hopital Dupuytren, Limoges, France
(Bothorel) Department of Pediatric Cardiology, Children Hospital, Limoges,
France
(Auditeau) Department of Epidemiology, Hopital Dupuytren, Limoges, France
Publisher
AME Publishing Company
Abstract
Background: Pectus excavatum (PE) is the most common malformation of the
anterior chest wall, affecting around 1 in 400 births, with a male/female
sex ratio of 5:1. Even if the functional repercussions and management of
PE are still the subject of many debates, the cardiorespiratory function
improvement after surgical correction of PE with sternal advancement seem
to be confirmed in the recent literature. This study aims to assess the
impact of sternal advancement surgery-specifically minimally invasive
repair of PE (MIRPE) and sternochondroplasty-on cardiorespiratory function
at rest and during exercise in patients with PE. Method(s): A
meta-analysis was conducted on 21 studies reporting pre- and
post-operative cardiac and/or respiratory function at rest and during
exercise. Result(s): A total of 1,087 patients (mean age, 18.93
years) were included. Significant improvements were found in resting
cardiac function, including cardiac output (P=0.04), cardiac index
(P=0.03), left ventricular systolic ejection volume (LVSEV, P=0.001), and
ejection fraction (P=0.03). Exercise capacity also improved significantly,
with increases in VO<inf>2</inf>max and O<inf>2</inf> pulse (both
P<0.001). No significant changes were observed in respiratory parameters.
 Conclusion(s): Cardiac output assessment should be central to
surgical decision-making in PE. Techniques involving sternal mobilization
can yield meaningful improvements in cardiopulmonary function, unlike
procedures that do not remodel the osteocartilaginous
deformity. Copyright © AME Publishing Company.

<108>
Accession Number
2039825869
Title
Sentinel Cerebral Embolic Protection During Transcatheter Aortic Valve
Replacement: An Updated Meta-Analysis.
Source
JACC: Cardiovascular Interventions. 18(15) (pp 1948-1950), 2025. Date of
Publication: 11 Aug 2025.
Author
Goel S.; Khera S.; Krishnamoorthy P.; Hooda A.; Lerakis S.; Safi L.M.;
Kini A.S.; Sharma S.K.; Dangas G.D.; Tang G.H.L.
Publisher
Elsevier Inc.

<109>
Accession Number
648097019
Title
Use of Colchicine in the Prevention of Perioperative Atrial Fibrillation
after Non-cardiac Thoracic Surgery.
Source
Europace. Conference: European Heart Rhythm Association Congress, EHRA
2025. Vienna Austria. 27(Supplement 1) (pp i148), 2025. Date of
Publication: 01 May 2025.
Author
Divinagracia R.; Sadian A.D.; Cabalquinto M.C.
Institution
(Divinagracia, Sadian, Cabalquinto) St. Luke's Medical Center, Cardiology,
Quezon, Philippines
Publisher
Oxford University Press
Abstract
Background: Post operative atrial fibrillation (AF) is one of the most
frequent arrhythmias after noncardiac thoracic surgeries and is associated
with markedly higher risk of stroke, myocardial infarction, and all-cause
mortality. Colchicine, an anti-inflammatory drug may prevent post
operative AF in patients who will undergo non-cardiac surgeries.
 Method(s): A systematic search of Cochrane, PubMed, ClinicalKey and
Google Scholar was conducted for randomized controlled trials (RCTs) from
inception until November 2023. The primary outcome was the incidence of
peri-operative AF after any non-cardiac thoracic surgery. Risk ratios (RR)
were reported using the Mantel Haenszel method. Result(s): A total of
3 RCTs with 3515 patients were eventually included in this meta-analysis,
where 1760 patients received colchicine and 1755 patients received placebo
or usual care. Perioperative colchicine treatment was related to a
decreased incidence of post-operative AF (RR: 0.65; 95% confidence
interval [CI]: 0.56 to 0.75, p<0.001). Conclusion(s): In conclusion,
the result of our meta-analysis suggests that colchicine treatment could
lower the incidence of postoperative AF. Further studies are needed to
determine the optimal colchicine treatment regimen to minimize the
incidence of adverse events.

<110>
Accession Number
2039818925
Title
Comparison of Two Activated Clotting Time Targets During Cardiac Surgery
With Cardiopulmonary Bypass: A Prospective Multicenter Randomized
Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Gorter K.A.M.; Stehouwer M.C.; de Vroege R.; Zuthof D.; Meesters M.I.;
Noordzij P.G.; Niesten E.D.; Suyker W.J.L.
Institution
(Gorter) Department of Perfusion, University Medical Center, Utrecht,
Netherlands
(Stehouwer) Department of Perfusion, Sint Antonius Hospital, Nieuwegein,
Netherlands
(de Vroege) Department of Perfusion, Haga Hospital, Den Haag, Netherlands
(Zuthof) Department of Perfusion, Medisch Spectrum Twente, Enschede,
Netherlands
(Meesters) Department of Anesthesiology, Catharina Hospital, Eindhoven,
Netherlands
(Noordzij) Department of Anesthesiology, Intensive Care and Pain
Management, Sint Antonius Hospital, Nieuwegein, Netherlands
(Noordzij) Department of Intensive Care, University Medical Center,
Utrecht, Netherlands
(Niesten) Department of Anesthesiology, Medisch Spectrum Twente, Enschede,
Netherlands
(Suyker) Department of Cardiothoracic Surgery, University Medical Center,
Utrecht, Netherlands
Publisher
W.B. Saunders
Abstract
Objectives: The present study was designed to investigate the equivalence
of two target activated clotting time (ACT) values with regard to packed
red blood cell (PRBC) transfusion in patients undergoing cardiac surgery
with cardiopulmonary bypass (CPB). Secondary endpoints include
postoperative blood loss, transfusion of other blood products, and
postoperative laboratory parameters, including renal function, intensive
care unit length of stay, postoperative thrombotic events, and other
adverse events. Design(s): Multicenter, randomized, single-blind,
controlled equivalence trial. Patients were randomized to a lower target
ACT of >=400 seconds or a higher target ACT of >=480 seconds.
 Setting(s): Three tertiary and one university medical center in the
Netherlands. Participant(s): 1,021 patients >=18 years of age
scheduled for first-time elective cardiac surgery with CPB between
November 2019 and December 2023. Measurements and Main Results: PRBC
transfusion was equivalent in both ACT groups (19.1% v 17.2% risk
difference -0.029; 0.066). In the low ACT group, blood loss at 6 and 24
hours postoperative was significantly lower (median [interquartile range],
260 [245] v 300 [250] mL, p = 0.003 and 480 [363] v 550 [410] mL, p =
0.007) and the hemoglobin level at 6 hours and 1 day after surgery
significantly higher (mean [95% confidence interval], 11.8 [11.6-11.9] v
11.6 [11.3-11.8] g/dL, p = 0.017 and 11.4 [11.1-11.6] v 11.1 [11.0-11.4]
g/dL, p = 0.045) compared with the high ACT group, but lacking clinical
relevance. The frequency of thromboembolic events was similar in both
groups. Conclusion(s): This study showed that a target ACT of >=400
seconds is equivalent to a target ACT of >=480 seconds in terms of
intraoperative and postoperative PRBC transfusion rates in the modern
cardiac surgery setting. This target range is considered comparable
regarding the outcomes of patients undergoing cardiac surgery with
CPB. Copyright © 2025 The Author(s)

<111>
Accession Number
648092850
Title
Vitamin K Antagonists vs. Direct Oral Anticoagulation After Transcatheter
Mitral Valve Replacement.
Source
The American journal of cardiology. (no pagination), 2025. Date of
Publication: 17 Jul 2025.
Author
Donzo M.W.; Hebbo E.; Ueyama H.A.; Zahid A.; Greenbaum A.B.; Xie J.X.;
Murphy A.; Garg S.; Camaj A.; Fratti J.D.D.C.; Noman A.; Devireddy C.M.;
Hanzel G.; Shekiladze N.; Lisko J.C.; Byku I.; Babaliaros V.; Gleason P.T.
Institution
(Donzo, Hebbo, Ueyama, Zahid, Greenbaum, Xie, Murphy, Garg, Camaj, Fratti,
Noman, Devireddy, Hanzel, Shekiladze, Lisko, Byku, Babaliaros, Gleason)
Structural Heart and Valve Center, Emory University Hospital, Atlanta, GA,
United States
Abstract
Optimal anticoagulation strategies after TMVR remain unknown with no
randomized trial data. Current practices for anticoagulation after TMVR
vary widely as a result. We aimed to compare clinical outcomes between
vitamin K antagonists (VKA) and direct oral anticoagulation (DOAC) after
transcatheter mitral valve replacement (TMVR) at our institution. We
included consecutive patients who underwent valve in valve (ViV) or valve
in ring (ViR) TMVR between 2012 and 2022. Clinical outcomes and valve
hemodynamics were compared between VKA and DOAC. Primary outcome was major
adverse cardiovascular (MACE), defined as composite of all-cause death,
stroke, or valve thrombosis. A total of 148 patients (84 VKA and 64 DOAC)
were included. The VKA group had a higher prevalence of myocardial
infarction, atrial fibrillation/flutter, and pacemakers. Survival analysis
showed no significant difference in cumulative survival free of MACE over
1 year (p = 0.68). Mitral valve mean gradient significantly reduced after
intervention (12.9 mmHg to 7.8 mmHg in VKA patients and 10.7 mmHg to 7.5
mmHg in DOAC patients) and was maintained over 1 year without difference
between groups (7.6 mmHg and 7.6 mmHg). In conclusion, there was no
difference in outcomes between DOAC and VKA after TMVR. Data from
randomized clinical trials is still needed to assess efficacy and safety
in a larger population. Copyright © 2025. Published by Elsevier
Inc.

<112>
Accession Number
2032959619
Title
Mesenchymal stem cells and thermal annular procedures for discogenic pain:
a systematic review with pooled analysis.
Source
Pain Management. 14(2) (pp 101-114), 2024. Date of Publication: 2024.
Author
DesRochers J.; DesRochers R.; Patel D.; Andruszka C.; Manchanda S.;
Ernazarov A.; Mobley A.
Institution
(DesRochers, DesRochers, Patel, Andruszka, Manchanda, Ernazarov)
Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, United States
(Mobley) Rowan Medicine NeuroMusculoskeletal Institute, Stratford, NJ,
United States
Publisher
Taylor and Francis Ltd.
Abstract
Aim: Compare the effectiveness of mesenchymal stem cell injection
therapies (MSC) and thermal annular procedures for the treatment of
discogenic lower back pain. Material(s) and Method(s): A systematic
review was performed following PRISMA 2020 guidelines. Pooled analysis was
performed using patients' pain scores at baseline and at 12 months
post-intervention. Result(s): Effect sizes based on change in pain
score from baseline to 12 month follow-up revealed clinically significant
improvement in pain score across all interventions. Conclusion(s):
Minimally invasive interventions provide meaningful relief in discogenic
back pain, with results suggesting promise for MSC injection therapies as
a treatment model. Copyright © 2024 Expert Publishing Medicine
Ltd trading as Taylor & Francis.

<113>
Accession Number
648098766
Title
Antithrombotic Treatment After Valve-in-Valve, Valve-in-Ring, and
Valve-in-MAC Procedures: A Systematic Review and Meta-Analysis.
Source
Acta medica portuguesa. (no pagination), 2025. Date of Publication: 21
Jul 2025.
Author
Terleira Batista G.; Costa G.; Delgado Silva J.; Goncalves L.
Institution
(Terleira Batista) Servico de Cardiologia. Centro Hospitalar e
Universitario de Coimbra. Coimbra. Portugal, Portugal
(Costa, Delgado Silva, Goncalves) Servico de Cardiologia. Centro
Hospitalar e Universitario de Coimbra. Coimbra. & Faculdade de Medicina.
Universidade de Coimbra. Coimbra. & Coimbra Institute for Clinical and
Biomedical Research (iCBR). Coimbra. Portugal, Portugal
Abstract
INTRODUCTION: While antithrombotic therapy following transcatheter valve
implantation has been extensively studied in various clinical trials,
there remains a notable gap in evidence regarding the optimal approach
following valve-in-valve (ViV), valve-in-ring (ViR) and valve-in-mitral
annular calcification (ViMAC) procedures, warranting further assessment.
This gap is particularly concerning due to the apparent increased risk of
thrombosis associated with ViV interventions. The aim of this systematic
review was to explore the potential benefits of anticoagulation in ViV,
ViR, and ViMAC procedures. METHOD(S): We searched PubMed, Embase, and
the Cochrane Central Register of Controlled Trials, as well as the grey
literature, for observational and interventional studies published until
December 2023. Trials were included if a comparative analysis between the
two antithrombotic strategies was feasible and excluded if patients under
18 years old were analysed. The primary efficacy endpoints were incidence
of clinical and total valve thrombosis (VT), major bleeding was the sole
safety primary endpoint. Additional analyses were performed regarding
valves in the mitral position and valve type. The risk of bias was
evaluated using the Newcastle-Ottawa scale. Data was assessed using the
Review Manager 5.4 software. RESULT(S): A total of five observational
and one case series were included (n = 614 on anticoagulation and n = 468
on antiplatelets), comprising a total of 1082 participants. Clinical VT
rates were 4.2% for all procedures, and patients on anticoagulants were
associated with a a lower risk of clinical VT (1.1% vs 8.3%; OR: 0.18; 95%
CI: 0.07 - 0.42, I2: 0%) and total VT (1.3% vs 8.5%; OR: 0.16; 95% CI:
0.07 - 0.37, I2: 0%). Regarding bleeding events, the existing literature
did not provide adequate information to enable a thorough analysis.
 CONCLUSION(S): Our study suggests a potential benefit of
anticoagulation regimens to decrease the high rates of VT following
valve-in-valve, valve-in-ring and valve-in-mitral annular calcification
procedures. However, the lack of randomized controlled trials and data on
bleeding and mortality emphasises the necessity for further research.

<114>
Accession Number
648099563
Title
Response to "Comment on Hypotension after induction of anesthesia with
remimazolam or etomidate: a non-inferiority randomized controlled trial in
patients undergoing coronary artery bypass grafting".
Source
Korean journal of anesthesiology. (no pagination), 2025. Date of
Publication: 18 Jul 2025.
Author
Min J.-J.; Oh E.J.; Cho H.; Kim C.; Lee J.-H.
Institution
(Min, Cho, Kim, Lee) Department of Anesthesiology and Pain Medicine,
Samsung Medical Center, Sungkyukwan University School of Medicine,
Gangnam-Gu, Seoul, South Korea
(Oh) Department of Anesthesiology and Pain Medicine, Kangbuk Samsung
Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea

<115>
Accession Number
2039807649
Title
Transversus thoracic muscle plane block for pain during cardiac surgery: a
systematic review and meta-analysis.
Source
International Journal of Surgery. 109(8) (pp 2500-2508), 2023. Date of
Publication: 01 Aug 2023.
Author
Xue J.-J.; Cui Y.-Y.; Busse J.W.; Ge L.; Zhou T.; Huang W.-H.; Ding S.-S.;
Zhang J.; Yang K.-H.
Institution
(Xue, Yang) Evidence-based Medicine Center, School of Basic Medical
Science, Lanzhou University, Gansu, Lanzhou, China
(Xue) Department of Anesthesiology, Gansu Province Hospital of Traditional
Chinese Medicine, Gansu, Lanzhou, China
(Xue) Gansu Clinical Research Center of Integrative Anesthesiology, Gansu,
Lanzhou, China
(Cui, Zhou, Huang, Ding, Zhang) First School of Clinical Medicine, Gansu
University of Chinese Medicine, Chengguan District, Gansu, Lanzhou, China
(Ge) Key Laboratory of Evidence Based Medicine and Knowledge Translation
of Gansu Province, Gansu, Lanzhou, China
(Ge, Yang) Evidence-Based Social Science Research Center, School of Public
Health, Lanzhou University, Gansu, Lanzhou, China
(Busse) Department of Anesthesia, Hamilton, ON, Canada
(Busse) The Michael G. DeGroote National Pain Centre, McMaster University,
Hamilton, ON, Canada
Publisher
Wolters Kluwer Health Inc
Abstract
Study Objective: The role of transversus thoracic muscle plane blocks
(TTMPBs) during cardiac surgery is controversial. We conducted a
systematic review to establish the effectiveness of this procedure.
 Design(s): Systematic review. We searched PubMed, Embase, Web of
Science, CENTRAL, WanFang Data, and the China National Knowledge
Infrastructure to June 2022, and followed the GRADE approach to evaluate
the certainty of evidence. Study Eligibility Criteria: Eligible studies
enrolled adult patients scheduled to undergo cardiac surgery and
randomized them to receive a TTMPB or no block/sham block. Main
Result(s): Nine trials that enrolled 454 participants were included.
Compared to no block/sham block, moderate certainty evidence found that
TTMPB probably reduces postoperative pain at rest at 12 h [weighted mean
difference (WMD) -1.51 cm on a 10 cm visual analogue scale for pain, 95%
CI -2.02 to -1.00; risk difference (RD) for achieving mild pain or less
(<=3 cm), 41%, 95% CI 17-65) and 24 h (WMD -1.07 cm, 95% CI -1.83 to
-0.32; RD 26%, 95% CI 9-37). Moderate certainty evidence also supported
that TTMPB probably reduces pain during movement at 12 h (WMD -3.42 cm,
95% CI -4.47 to -2.37; RD 46%, 95% CI 12-80) and at 24 h (WMD -1.73 cm,
95% CI -3.24 to -0.21; RD 32%, 95% CI 5-59), intraoperative opioid use
[WMD -28 milligram morphine equivalent (MME), 95% CI -42 to -15],
postoperative opioid consumption (WMD -17 MME, 95% CI -29 to -5),
postoperative nausea and vomiting (absolute risk difference 255 less per
1000 persons, 95% CI 140-314), and intensive care unit (ICU) length of
stay (WMD -13 h, 95% CI -21 to -6). Conclusion(s): Moderate certainty
evidence showed TTMPB during cardiac surgery probably reduces
postoperative pain at rest and with movement, opioid consumption, ICU
length of stay, and the incidence of nausea and vomiting. Copyright
© 2023 The Author(s).

<116>
Accession Number
2035554933
Title
Incidence and Influencing Factors for Steam Pops in Cardiac Ablations: A
Systematic Review.
Source
PACE - Pacing and Clinical Electrophysiology. (no pagination), 2025. Date
of Publication: 2025.
Author
Elenizi K.; Alharthi R.
Institution
(Elenizi) Department of Internal Medicine, Colleges of Medicine, Prince
Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
(Alharthi) Department of Cardiology, Dr. Sulaiman Al-Habib Hospital,
Riyadh, Saudi Arabia
Publisher
John Wiley and Sons Inc
Abstract
Background: Steam pops (SPs) during cardiac ablations have emerged as a
notable phenomenon with potential implications for procedural safety and
efficacy. This is the first review of SPs, which aims to explore the
current understanding of SPs. The review investigates their incidence,
associations, predictors, clinical significance, and management
strategies. Presently, the factors that give rise to SPs have not been
completely understood, and the root cause of SPs remains elusive. To
achieve this goal, the study conducted a comprehensive review of existing
research on SPs in cardiac ablation procedures to ascertain the prevalence
and predictors of SPs. Method(s): The research involved an extensive
search of databases from their inception until April 2024 to investigate
the prevalence of SPs during cardiac ablation procedures in humans. The
primary objective of this study was to gather patient demographics,
incidence rates, and potential risk factors and predictors that could
contribute to the occurrence of SPs and determine any significant
correlations between them. The data collected were thoroughly reviewed to
identify any significant associations between the various risk factors,
predictors, and the incidence of SPs. Result(s): A comprehensive
review of literature sourced from EMBASE and PubMed identified 25 relevant
studies focused on the incidence and clinical significance of steam pops
(SPs) during catheter ablation procedures. The studies reported varying
rates of SPs, ranging from 0% to 26%, with the highest incidence observed
in atrial fibrillation (AFib) and ventricular ablation cases. The
association between SPs and factors such as catheter type, irrigation
methods, and monitoring parameters was assessed. Notably, advanced
catheter technologies, such as the QDOT MICRO and THERMOCOOL SMARTTOUCH,
demonstrated a significant reduction in SP occurrences. Additionally, the
analysis highlighted the role of temperature control and contact force in
minimizing the risk of SPs, with temperature-controlled ablation (TCA)
generally leading to fewer SPs compared to power-controlled ablation
(PCA). Despite the low incidence of severe complications, the review
underscores the importance of careful monitoring of impedance and
real-time feedback during ablation to ensure patient safety.
 Conclusion(s): SPs are not uncommon during ablation procedures with
irrigated catheters. Caution is required to avoid temperature feedback
issues. Advanced catheters are associated with a reduced incidence of
steam pops. The risks can be minimized by decreasing energy settings and
monitoring impedance changes. Copyright © 2025 Wiley Periodicals
LLC.

<117>
Accession Number
2039820568
Title
State-of-the-art artificial intelligence methods for pre-operative
planning of cardiothoracic surgery and interventions: a narrative review.
Source
Journal of Thoracic Disease. 17(7) (pp 5282-5297), 2025. Date of
Publication: 31 Jul 2025.
Author
Mank Q.J.; Thabit A.; Maat A.P.W.M.; Siregar S.; Mahtab E.A.F.; van Walsum
T.; Sadeghi A.H.; Kluin J.
Institution
(Mank, Maat, Siregar, Sadeghi, Kluin) Department of Cardiothoracic
Surgery, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam,
Rotterdam, Netherlands
(Thabit, van Walsum) Biomedical Imaging Group Rotterdam, Department of
Radiology & Nuclear Medicine, Erasmus MC, University Medical Center
Rotterdam, Rotterdam, Netherlands
(Mahtab) Department of Cardiothoracic surgery, Leiden University Medical
Center, Leiden, Netherlands
(Sadeghi) Department of Cardiothoracic Surgery, Heart and Lung Division,
University Medical Center Utrecht, Utrecht, Netherlands
(Sadeghi) Department of Cardiothoracic Surgery, Thoraxcenter, Erasmus MC,
University Medical Center Rotterdam, Dr. Watermolenplein 40, Rotterdam,
Netherlands
Publisher
AME Publishing Company
Abstract
Background and Objective: Artificial intelligence (AI) has been
increasingly explored as a tool to enhance clinical decision-making and
optimize and speed up preoperative planning in cardiothoracic surgery. By
improving precision and efficiency, AI has the potential to streamline
workflows and improve outcomes. This study aimed to examine the current
applications of AI in preoperative planning for cardiothoracic procedures.
 Method(s): We systematically reviewed the literature in PubMed. Two
search strings were employed to identify research articles related to AI
applications in preoperative cardiothoracic surgery planning published up
to August 2024. Studies were screened, and articles were included based on
predefined criteria. Key Content and Findings: A total of 525 articles
were extracted from the PubMed database. After applying exclusion criteria
and analyzing the articles, 32 articles were included. These articles were
categorized into and described according to their application: aortic
(valve) surgery/intervention, mitral valve surgery/intervention, other
cardiac surgeries, and lung, thoracic wall, and mediastinal surgeries. Key
AI applications included segmentation of anatomical structures, tumor
detection, prosthesis sizing for transcatheter aortic valve implantation
(TAVI), and automated measurement of surgical parameters. The reviewed
studies demonstrated that AI could increase segmentation accuracy, reduce
preoperative planning time, and automate critical steps in surgical
preparation. Conclusion(s): AI has been introduced in preoperative
planning for cardiothoracic procedures to support clinicians by increasing
segmentation accuracy, reducing preoperative planning time, and automating
several preoperative planning steps such as tumor detection, TAVI
prosthesis sizing and other planning measurements. However, the widespread
adoption faces several challenges, including the need for robust
validation, regulatory approval, and integration into clinical workflows.
Additionally, the implementation of AI involves substantial costs,
including investments in software development, computational
infrastructure, and training of clinical staff. Future research should
focus not only on advancing AI technology but also on evaluating the
cost-effectiveness to ensure it delivers measurable benefits while
remaining accessible and sustainable for healthcare systems. Addressing
these issues is essential to realize the full potential of AI in
cardiothoracic surgery. Copyright © AME Publishing Company.

<118>
Accession Number
648097040
Title
Efficacy of the aldosterone antagonists in reducing the risk of
postoperative atrial fibrillation in patients undergoing cardiac surgery:
a meta-analysis.
Source
Europace. Conference: European Heart Rhythm Association Congress, EHRA
2025. Vienna Austria. 27(Supplement 1) (pp i403), 2025. Date of
Publication: 01 May 2025.
Author
Bulhoes E.; Farias C.A.G.; Souza P.A.M.G.; Mazetto R.; Antunes V.L.J.;
Oliveira V.M.R.; Guida C.; Ximenes P.N.; Darrieux F.C.
Institution
(Bulhoes) FESAR - Amazon Higher Education College, Redencao, Brazil
(Farias) Uninove, Medicine Department, Sao Paulo, Brazil
(Souza) Federal University of Uberlandia, Medicine Department, Uberlandia,
Brazil
(Mazetto) Amazonas State University, Medicine Department, Manaus, Brazil
(Antunes) Federal University of Health Sciences of Porto Alegre, Medicine
Department, Porto Alegre, Brazil
(Oliveira) Federal University of Goias, Medicine Department, Goiania,
Brazil
(Guida) Dante Pazzanese Institute of Cardiology, Medicine Department, Sao
Paulo, Brazil
(Ximenes) Portuguese Charity Hospital, Cardiology Department, Sao Paulo,
Brazil
(Darrieux) Instituto do Coracao FMUSP, Cardiology Department, Sao Paulo,
Brazil
Publisher
Oxford University Press
Abstract
Background: Postoperative atrial fibrillation (PAOF) is a prevalent
cardiac arrhythmia following heart surgeries, resulting in increased
complications and prolonged hospital stays. Aldosterone antagonists (AA)
demonstrate potential in managing PAF, but their effectiveness in
significantly reducing the condition remains unclear in the existing
literature. Purpose(s): We conducted a meta-analysis to evaluate the
efficacy of the AA in reducing the risk of PAOF in patients undergoing
cardiac surgery. Method(s): PubMed, Embase, and Cochrane database
were analyzed. Outcome analyzed was PAOF. A random effects model was used
to calculate the risk ratios (RRs) with 95% confidence intervals.
Statistical analysis was performed using the R program (version 4.3.2).
Heterogeneity was assessed with I2 statistics. Result(s): We included
756 patients from 3 studies. Of those, 2 were derived from RCTs.
Spironolactone was administered to 338 patients out of the 409 patients
who received AA. The remaining 71 patients received eplerenone as an
intervention. The cardiac surgeries were: valvular surgery and coronary
artery bypass graft (CABG). The use of AA was associated with a
significant reduction in the risk of PAOF compared to non-use (RR 0.73;
95% CI 0.58-0.92; P = 0.007; I2 = 47%). Conclusion(s): In this
meta-analysis, AAs were associated with a lower risk of PAOF in patients
undergoing cardiac surgery.

<119>
Accession Number
2039808917
Title
Comparative Study of 20 ml of Injection Levobupivacaine 0.25% vs 20 ml of
Injection Bupivacaine 0.25% both with Fentanyl for Pecto-Intercostal
Fascial Block for Acute Pain Management in Cardiac Surgery Patients - A
Prospective Randomized Double-Blind Study.
Source
European Journal of Cardiovascular Medicine. 15(7) (pp 690-696), 2025.
Date of Publication: 01 Jul 2025.
Author
Mohod V.; Gautam S.; Arathi C.V.; Devasree D.L.
Institution
(Mohod) Dept - Anesthesiology and Critical Care, Grant Government Medical
College, Sir JJ group of Hospitals, Mumbai, India
(Gautam) Dept - Anesthesiology and Critical Care, Vardhman Mahavir Medical
College, Delhi, India
(Arathi) Dept - Anesthesiology and Critical Care, Lokmanya Tilak Municipal
Medical College and General Hospital, Sion, Mumbai, India
(Devasree) Dept - Anesthesiology and Critical Care, Grant Government
Medical College, Sir JJ Group of Hospitals, Mumbai, India
Publisher
Healthcare Bulletin
Abstract
Background: Effective postoperative analgesia in cardiac surgery is
essential for recovery. Pecto-intercostal fascial block (PIFB) offers an
opioid-sparing regional technique. This study compared levobupivacaine and
bupivacaine (both with fentanyl) for PIFB in cardiac surgery patients.
 Method(s): In this prospective, randomized, double-blind study, 110
adult patients undergoing elective cardiac surgery via median sternotomy
were randomized to receive bilateral ultrasound-guided PIFB using either
0.25% levobupivacaine + fentanyl (n = 56) or 0.25% bupivacaine + fentanyl
(n = 54). The block was administered twice: once after induction
(preoperative) and again at the end of surgery before shifting patients to
ICU. VAS pain scores, fentanyl requirements, extubation time, ICU stay,
and complications were recorded. Result(s): No statistically
significant difference was found between the groups in postoperative VAS
scores (both <= 3 till 16 hrs), total fentanyl consumption
(Levobupivacaine: 161.6 +/- 21.3 mcg; Bupivacaine: 165.74 +/- 27.17 mcg; P
= 0.376), extubation time (P = 0.227), or ICU stay (P = 0.479). No
block-related complications were observed. Conclusion(s): Both
levobupivacaine and bupivacaine are equally effective and safe when used
twice for PIFB during cardiac surgery. The technique provides reliable
analgesia and supports fast-tracking without complications. Copyright
© 2025 Healthcare Bulletin. All rights reserved.

<120>
Accession Number
648097096
Title
A Bayesian meta-analysis on recurrence of atrial arrhythmia between Hybrid
AF ablation and endocardial AF ablation.
Source
Europace. Conference: European Heart Rhythm Association Congress, EHRA
2025. Vienna Austria. 27(Supplement 1) (pp i830-i831), 2025. Date of
Publication: 01 May 2025.
Author
Khanra D.; Dutta A.; Rashid W.; Deshpande S.; Gupta A.; Mukherjee A.;
Choudhury M.
Institution
(Khanra) Countess Of Chester Hospital NHS Foundation Trust, CHESTER,
United Kingdom
(Dutta) University of Delhi, Ministry of Ayush, New Delhi, India
(Rashid) Government Medical College, Srinagar, India
(Deshpande) Jaslok Hospital, Mumbai, India
(Gupta) Safdarjung Hospital, New Delhi, India
(Mukherjee) Castle Hill Hospital, East Yorkshire, United Kingdom
(Choudhury) University Hospitals of North Midlands NHS Trust, Stoke on
Trent, United Kingdom
Publisher
Oxford University Press
Abstract
Background: The outcome of ablation in persistent atrial fibrillation (AF)
has been modest despite adding linear ablation or substrate modification.
Hybrid AF ablation consisting of surgical epicardial ablation concomitant
or staged endocardial left atrial ablation being emerged as an alternative
to. Comparative studies are characterised by limited sample size, diverse
results and variations in lesions set. Objective(s): This is the
first meta-analysis of studies comparing the outcome of Hybrid ablation to
endocardial ablation for persistent AF patients with Bayesian
meta-regression analysis [PROSPERO ID CRD42024601042]. Method(s): A
systematic literature search was performed to include both randomized and
observational studies comparing Hybrid ablation to endocardial ablation
for persistent AF. The selected studies underwent formal critical
appraisal. Baseline and outcome data were extracted. Primary outcome was
recurrence of atrial arrhythmia. Meta-regression analysis was performed
for range of covariates. Secondary outcomes were procedural complications
and hospital stay. Statistical analysis was performed in R platform using
random effect model. Result(s): 15 studies (4 RCT; 2 multi-centric; 3
Asian; 10 thoracoscopic; 7 staged hybrid) were selected for the
meta-analysis including a total of 1671 patients of persistent and
long-standing persistent AF[SD6] . The inclusion criteria of the patients
as well as lesion sets in the surgical and endocardial ablation across the
studies were diverse . The frequentist model showed significantly lower
recurrence of atrial arrhythmia in the hybrid ablation group [log RR
-0.27; 95%CI (-0.53, -0.02)] (Fig 1A), and the effect was maintained even
after the Bayesian adjustment [log RR -0.29; 95%CI (-0.57, -0.03)] (Fig
1B) and the effect strengthened [log RR -0.36; 95%CI (-0.59, -0.14)] after
adjusting for significant (p = 0.04) small study-bias (Fig 1C). In the
meta-regression analysis none of the variables (viz. age, LA size,
follow-up duration, lesions sets, LAA occlusion, previous AF ablations,
and duration of AF, design of the study or even use of non-thoracoscopic
approach) had any significant effect on the recurrence of atrial
arrhythmia. Short-term complications were significantly higher [log RR
0.60; 95%CI (0.05, 1.14)] (Fig 2), and the duration of hospital stay was
longer in the hybrid group [MD 3.54; 95%CI (1.62, 5.46) days] (Fig 2).
 Conclusion(s): Hybrid AF ablation was found to be superior to
catheter ablation even after Bayesian and small study-bias adjustments,
however complications were more and hospital stays were longer implicating
further need for cost-effectivity analysis.

<121>
Accession Number
2039799504
Title
Comparison of thoracoscopic-guided intercostal nerve block and
ultrasound-guided intercostal nerve block in postoperative analgesia of
uniportal video-assisted lobectomy: a pilot randomized controlled trial.
Source
International Journal of Surgery. 111(2) (pp 1995-2001), 2025. Date of
Publication: 01 Feb 2025.
Author
Li Y.; Wei L.; Du J.-H.; He J.-X.; Xu X.; Hu L.-H.
Institution
(Li, Wei, Du, Xu, Hu) Department of Anesthesiology, China
(He) Department of Thoracic Surgery, The affiliated Lihuili Hospital of
Ningbo University, Ningbo, China
Publisher
Wolters Kluwer Health Inc
Abstract
Background: Ultrasound-guided intercostal nerve block (UINB) and
thoracoscopic-guided intercostal nerve block (TINB) are often used for
analgesia after thoracic surgery. Herein, we compared the application of
TINB and UINB for analgesia after uniportal video-assisted lobectomy.
 Method(s): Sixty patients were randomly allocated into two groups:
UINB and TINB. The surgical time of intercostal nerve block (INB), the
success rate of the first needle, visual analog scale (VAS) scores, the
time of the first patient-controlled intravenous analgesia (PCIA) press,
the time for removing the thoracic drainage tube, consumption of
sufentanil and the number of PCIA presses within 24 hours postoperatively,
and adverse reactions (ARs) were compared between the two groups.
 Result(s): The surgical time of INB was significantly shorter in the
TINB group than in the UINB group (P < 0.001). The time of the first press
of PCIA was significantly earlier in the TINB group than in the UINB group
(P < 0.001). The success rate of the first needle was significantly higher
in the TINB group than in the UINB group (P < 0.001). No significant
differences were observed between the two groups regarding VAS scores,
time for removing the thoracic drainage tube, the consumption of
sufentanil, the number of PCIA presses within 24 hours postoperatively,
and ARs. Conclusion(s): TINB and UINB have similar analgesic effects
after uniportal video-assisted lobectomy. However, TINB demonstrates
shorter surgical time and a higher success rate than UINB. Copyright
© 2025 The Author(s).

<122>
Accession Number
648096652
Title
Comparison of left atrial appendage closure and oral anticoagulation after
catheter ablation for atrial fibrillation: concomitant and sequential
cohorts of the OPTION randomized controlled trial.
Source
Europace. Conference: European Heart Rhythm Association Congress, EHRA
2025. Vienna Austria. 27(Supplement 1) (pp i879), 2025. Date of
Publication: 01 May 2025.
Author
Wazni O.M.; Nair D.; Iyer V.; Calle Perez G.; Weiner S.; Islam N.H.;
Grygier M.; Ibanez Criado J.L.; Duthoit G.; Reddy Y.M.; Roy K.; Christen
T.; Sutton B.; Saliba W.I.
Institution
(Wazni, Saliba) Cleveland Clinic, Cleveland, United States
(Nair) St. Bernards Medical Center and Arrhythmia Research Group,
Jonesboro, AR, United States
(Iyer) MarinHealth Medical Center, Greenbrae, United States
(Calle Perez) Hospital Puerta del Mar, Cadiz, Spain
(Weiner) Christus Trinity Mother Frances Health System, Tyler, United
States
(Islam) University of Maryland St. Joseph Medical Group, Towson, United
States
(Grygier) Uniwersytecki Szpital Kliniczny w Poznaniu, Poznan, Poland
(Ibanez Criado) Hospital Universitario Doctor Balmis;Instituto de
Investigacion Sanitaria y Biomedica de Alicante, Alicante, Spain
(Duthoit) Hopital Pitie-Salp triere, APHP, Paris, France
(Reddy) University of Kansas Hospital, Kansas City, United States
(Roy, Christen, Sutton) Boston Scientific Corporation, Marlborough, United
States
Publisher
Oxford University Press
Abstract
Introduction/Objectives: Guidelines recommend continuation of
anticoagulation following atrial fibrillation (AF) ablation in patients at
high risk for stroke. Left atrial appendage closure (LAAC) has not been
well-studied for routine use post ablation. LAAC can be performed in
separate procedures with cardiac ablation (sequentially) or concomitantly
in the same operative session. In this prespecified subanalysis of the
OPTION trial, timing of ablation relative to LAAC will be evaluated.
 Method(s): OPTION is a multicenter, prospective randomized clinical
trial. Patients with AF and an elevated CHA2DS2-VASc score undergoing
catheter ablation were randomly assigned (1:1) to catheter-based LAAC
versus oral anticoagulation. Patients underwent an AF catheter ablation
procedure between 90 and 180 days prior to randomization (sequential) or
were planning to have catheter ablation within 10 days of randomization
(concomitant). The primary safety endpoint was non-procedural major or
clinically-relevant non-major bleeding. The primary efficacy endpoint was
the composite of all-cause death, stroke, or systemic embolism at 36
months. The secondary endpoint was major bleeding through 36 months,
including procedural bleeding. Result(s): A total of 1600 patients
with a mean age (+/-SD) of 70+/-8 years, and a CHA2DS2-VASc score of
3.5+/-1.3 were randomized to anticoagulation. LAAC (n=803) was performed
concomitantly with (n=328; 41%) or sequentially after (n=475; 59%) AF
ablation. In the control arm (n=797), AF ablation was concomitant with
randomization in 41% of patients (n=326) or sequential in 59% (n=471).
Generally, patients in the sequential cohort had more clinical
comorbidities. Clinical outcomes at 3 years will be available at the time
of the presentation. Conclusion(s): This subanalysis of OPTION will
examine whether LAAC is a reasonable alternative to contemporary OAC after
sequential or concomitant AF ablation in patients currently guideline
recommended to stay on oral anticoagulation.

<123>
Accession Number
2035517603
Title
Gender Disparity in the Treatment of Aortic Stenosis.
Source
Current Treatment Options in Cardiovascular Medicine. 27(1) (no
pagination), 2025. Article Number: 47. Date of Publication: 01 Dec 2025.
Author
Aggarwal A.; Kumar M.; Abid S.; Khlidj Y.; Davila C.D.
Institution
(Aggarwal) Section of Cardiovascular Medicine, Department of Internal
Medicine, Yale New Haven Health, Bridgeport Hospital, Bridgeport, CT,
United States
(Kumar) John H. Stroger Jr. Hospital of Cook County, Chicago, IL, United
States
(Abid) Department of Internal Medicine, Yale New Haven Health, Bridgeport
Hospital, Bridgeport, CT, United States
(Khlidj) Department of Medicine, University of Algiers 1, Algiers, Algeria
(Davila) Section of Cardiovascular Medicine, Department of Internal
Medicine, Yale University School of Medicine, New Haven, CT, United States
Publisher
Springer
Abstract
Purpose of Review: Aortic stenosis (AS) demonstrates marked sex-related
differences in its pathophysiology, clinical presentation, and outcomes
following intervention. This review aims to examine recent evidence
concerning sex-based differences in the pathophysiology, clinical
presentation, and outcomes of AS. We specifically address the implications
of these differences for diagnostic pathways, procedural planning, and
management strategies, focusing on the comparative outcomes of
transcatheter (TAVR) and surgical aortic valve replacement (SAVR) in men
and women. Recent Findings: Emerging studies highlight significant
sex-related disparities in AS. Compared with men, women typically present
later in the disease course, often at an older age, but with fewer
comorbidities, less valvular calcification, and greater fibrotic changes.
Women exhibit distinct myocardial responses, characterized by concentric
left ventricular remodeling and smaller ventricular cavities, and
increasing procedural complexity. Short-term outcomes after TAVR are less
favourable in women, marked by higher vascular complication and bleeding
rates; however, long-term survival is consistently superior in women
compared to men. Recent clinical trials, such as RHEIA and SMART, along
with population-level registry data, have reinforced the importance of
valve type selection and procedural planning in women, particularly those
with small aortic annuli. These studies also underscore persistent gaps in
diagnosis, referral, and treatment access for women with AS. Summary:
Gender-specific differences significantly influence the clinical
trajectory and outcomes of AS treatment. Despite encountering greater
procedural complexity and short-term complications, women benefit from
improved long-term survival following TAVR. These observations emphasize
the necessity of individualized, gender-based management strategies to
optimize patient outcomes. Further research is needed to elucidate the
underlying biological mechanisms driving these disparities and to refine
guidelines for tailored, sex-specific therapeutic approaches in
AS. Copyright © The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2025.

<124>
Accession Number
648063732
Title
Impact of active cancer on mortality and complications after TAVR: A
systematic review and meta-analysis.
Source
Journal of Clinical Oncology. Conference: 2025 ASCO Annual Meeting I.
Chicago, IL United States. 43(16 Supplement) (no pagination), 2025. Date
of Publication: 01 Jun 2025.
Author
Aiman W.; Khawar M.; Qadeer A.; Ali U.; Khawar M.M.H.; Saeed H.; Tayyab
M.; Shah S.A.; Ali M.A.; Khan S.M.I.; Haider M.Z.; Kirchoff R.W.
Institution
(Aiman, Khawar, Qadeer, Ali, Khawar, Saeed, Tayyab, Shah, Ali, Khan,
Haider, Kirchoff) New York Medical College - Saint Michael's Medical
Center, Newark, NJ; King Edward Medical University, Lahore, Pakistan; Mayo
Clinic Hospital, Phoenix, AZ; Services Institute of Medical Sciences
Lahore, Lahore, Pakistan; KEMU, Lahore, Pakistan; Saint Mary's and Saint
Clare's Hospital, New York Medical College, Denville, NJ; National
University of Medical Sciences, Rawalpindi, Pakistan; West Virginia
University, Morgantown, WV; Mayo Clinic Hospital, Pheonix, AZ
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Patients with active cancer undergoing trans catheter aortic
valvular replacement (TAVR) face a higher risk of adverse outcomes due to
the interplay between cancer and cardiovascular disease. Although TAVR is
increasingly used in high-risk populations, data on outcomes for these
patients remain limited. This systematic review and meta-analysis aim to
evaluate the clinical outcomes associated with TAVR in patients with
active cancer compared to non-cancer controls, providing insights to
inform clinical decision-making in this unique group. Method(s): A
systematic search of major databases (PubMed, Embase, OVID, Web of
Science, Scopus) was conducted to identify studies comparing clinical
outcomes of TAVR between patients with active cancer and those without
cancer. Key outcomes included measures of mortality, procedural
complications, and post-procedure adverse events. The Mantel- Haenszel
method was used for pooled analysis, applying random-effects or
fixed-effects modeling based on heterogeneity assessed by Higgins I2.
Statistical significance was set at a p-value , 0.05. Result(s):
Twelve studies involving 5,73,192 patients (67,684 active cancer, 505508
control) were included. Patients with active cancer undergoing TAVR have
significantly higher risks of short-term mortality (OR 1.31, 95% CI [1.15,
1.49], p < 0.0001), long-term mortality (OR 2.24, 95% CI [1.85, 2.70],
p,0.0001), and major bleeding complications (OR 1.80, 95% CI [1.68, 1.92],
p < 0.0001). There were no statistically significant differences in
cardiovascular mortality (OR 1.33, 95% CI [0.94, 1.89], p = 0.11),
myocardial infarction (OR 1.60, 95% CI [0.82, 3.11], p = 0.17), stroke (OR
0.61, 95% CI [0.28, 1.35], p = 0.22), AKI (OR 0.92, 95% CI [0.49, 1.73], p
= 0.80), or the need for permanent pacemaker implantation (OR 1.12, 95% CI
[0.85, 1.48], p = 0.42). Conclusion(s): Patients with active cancer
undergoing TAVR face significantly higher risks of mortality and major
bleeding compared to non-cancer controls. However, the risks of
cardiovascular mortality, MI, stroke, AKI, and the need for permanent
pacemaker implantation are comparable to those of non-cancer controls.
Careful risk assessment and management are crucial for optimizing outcomes
in this vulnerable population, and further studies are needed to refine
treatment strategies.

<125>
Accession Number
648064703
Title
Left atrial appendage closure (LAAC) in cancer patients: A systematic
review and meta-analysis.
Source
Journal of Clinical Oncology. Conference: 2025 ASCO Annual Meeting I.
Chicago, IL United States. 43(16 Supplement) (no pagination), 2025. Date
of Publication: 01 Jun 2025.
Author
Devkota A.; Shrestha A.B.; Anil K.C.; Mohamed S.; Jaiswal V.; Shrestha S.;
Rohita D.
Institution
(Devkota, Shrestha, Anil, Mohamed, Jaiswal, Shrestha, Rohita) Medstar
Union Memorial Hospital, Baltimore, MD; Medical Research Hub, Kathmandu,
Nepal; Mayo Clinic, Jacksonville, FL; Wayne State University/ DMC Sinai
Grace, Detroit, MI; JCCR, Varanasi, India; Kist Medical College and
Teaching Hospital, Lalitpur, Nepal; Wyckoff Heights Medical Center,
Brooklyn, NY
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Cancer increases the risk of atrial fibrillation (AF),
particularly in patients over 65 or those with pre-existing cardiovascular
disease. Patients with active cancer are at a higher risk of arterial and
venous thrombosis. Oral anticoagulation (OAC) is recommended in most
patients with comorbidities, based on the CHA2DS2-VASc score. However,
because OAC raises the risk of bleeding, it might not be appropriate for
patients who have significant or frequent bleeding episodes, vascular
malformations, or other contraindications. Anticoagulation in cancer
patients is challenging due to thrombocytopenia, bleeding risks, and
interactions with chemotherapy. Left atrial appendage Closure (LAAC)
offers an alternative to anticoagulation for mitigating stroke risk in
nonvalvular AF patients. However, this procedure has been offered less
frequently as concerns regarding its prognosis among cancer patients
remain unclear. This article aims to find the prognosis of cancer patients
with LAAC. Method(s): A systematic search was conducted in electronic
databases from inception until June 2024 using appropriate Mesh terms.
Pooled risk ratios (RR) with their corresponding 95% confidence intervals
(CI) were calculated using random effects models. A p-value of ,0.05 was
considered statistically significant. Result(s): A total of 5 studies
with a population of 1,20,502 (Cancer Patients: 3803 and Non- Cancer
patients: 116699) were included which met all the inclusion criteria. An
increased risk of in-hospital mortality among cancer patients with LAAC
(RR=1.90; 95% CI=1.05-3.45, P=0.03) with statistically significant was
observed. However, other parameters were comparable including, 30 days
readmission (RR=1.12; 95% CI=0.95-1.032), all-cause mortality (RR=1.33;
95% CI=0.72-1.95), any bleeding complication (RR=1.04; 95% CI=0.37-1.70),
Cardiovascular complication (RR=1.44; 95% CI=0.51-4.06), thromboembolism
(RR= 2.28; 95% CI=0.57-9.06), and neurological complication (RR=0.81; 95%
CI=0.17-1.46). Conclusion(s): There were increased chances of
in-hospital mortality among cancer patients than in noncancer patients
with LAAC procedures. However, other parameters like cardiovascular
complications, any bleeding complications, thromboembolism, and
neurological complications were not significantly associated. Further
studies are warranted to validate these findings.

<126>
Accession Number
648063718
Title
Transcatheter aortic valve replacement in cancer patients with chest
radiation therapy: Risks and outcomes.
Source
Journal of Clinical Oncology. Conference: 2025 ASCO Annual Meeting I.
Chicago, IL United States. 43(16 Supplement) (no pagination), 2025. Date
of Publication: 01 Jun 2025.
Author
Farooq S.; Khawar M.; Ali U.; Shah S.A.; Khawar M.M.H.; Muhammad A.; Saeed
H.; Khan S.M.I.; Qadeer A.; Haider M.Z.; Hamza M.; Kirchoff R.W.
Institution
(Farooq, Khawar, Ali, Shah, Khawar, Muhammad, Saeed, Khan, Qadeer, Haider,
Hamza, Kirchoff) Montefiore Saint Luke's Cornwall Hospital, Newburgh, NY;
King Edward Medical University, Lahore, Pakistan; Services Institute of
Medical Sciences Lahore, Lahore, Pakistan; KEMU, Lahore, Pakistan;
National University of Medical Sciences, Rawalpindi, Pakistan; Mayo Clinic
Hospital, Phoenix, AZ; West Virginia University, Morgantown, WV; Albany
Medical Center Hospital, Albany, NY; Mayo Clinic Hospital, Pheonix, AZ
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is a widely
adopted treatment for severe aortic stenosis, but outcomes in cancer
survivors with prior chest radiation therapy (CXRT) remain uncertain. This
study compares the clinical outcomes of TAVR between patients with a
history of C-XRT and those without prior radiation exposure (control
group). Method(s): Patients with prior chest radiation therapy
(C-XRT) were compared to a control group without radiation exposure to
evaluate key clinical endpoints. For each endpoint, odds ratios (OR) and
95% confidence intervals (CI) were determined, and heterogeneity was
analyzed using the I2 statistic. A p-value of ,0.05 was considered
statistically significant. Result(s): Nine studies were included in
the meta-analysis, encompassing 3083 C-XRT and 8891 control patients.
Patients with prior C-XRT showed significantly higher long-term mortality
(OR 1.84,95%CI [1.08, 3.13], p=0.02) compared to controls. Other outcomes,
including access-related vascular complications, Acute Kidney Injury,
Congestive heart failure, major bleeding, need for pacemaker, short-term
mortality, and stroke, did not demonstrate significant differences between
the groups. Conclusion(s): Cancer survivors with prior chest
radiation therapy undergoing TAVRmay experience higher long-term mortality
compared to patients without radiation exposure. However, no significant
differences were observed in other major outcomes. These findings suggest
that while TAVR is a viable treatment for C-XRT patients, long-term risks
require further investigation to optimize patient selection and management
strategies.

<127>
Accession Number
2035442335
Title
The effect of repetitive transcranial magnetic stimulation (rTMS) on
perioperative neurocognitive disorders in patients after cardiac surgery:
study protocol for a randomized controlled trial.
Source
Trials. 26(1) (no pagination), 2025. Article Number: 253. Date of
Publication: 01 Dec 2025.
Author
Wang J.; Wang X.; Li S.; Yang J.; Yan X.; Gao J.; Jia X.; Zuo L.; Wu A.;
Wei C.
Institution
(Wang, Wang, Li, Yang, Yan, Wu, Wei) Department of Anesthesiology, Beijing
Chao-Yang Hospital, Capital Medical University, No.8 Gongti Nanlu,
Chao-Yang District, Beijing, China
(Gao) Department of Cardiac Surgery, Beijing Chao-Yang Hospital, Capital
Medical University, No.8 Gongti Nanlu, Chao-Yang District, Beijing, China
(Jia, Zuo) Department of Radiology, Beijing Chao-Yang Hospital, Capital
Medical University, No.8 Gongti Nanlu, Chao-Yang District, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Introduction: Perioperative neurocognitive disorders (PND) is one of the
most common postoperative complications among elderly patients (above 65
years old) undergoing cardiac surgery. However, thus far, there have not
been any effective therapies for managing PND. Recent research has shown
that repetitive transcranial magnetic stimulation (rTMS) alters brain
plasticity and improves cognitive function in several neurodegenerative
disorders and psychiatric disorders. However, the potential benefits of
rTMS in reducing PND in patients undergoing cardiac surgery have not been
investigated. Therefore, the current protocol is designed to determine
whether rTMS can reduce the incidence of PND in patients undergoing
cardiac surgery. Methods and analysis: The study will be a single-blinded,
randomized controlled trial. Participants undergoing elective cardiac
surgery will be randomized to receive either rTMS or sham stimulation with
focal figure-of-eight coils over the right dorsolateral prefrontal cortex.
A series of neuropsychological tests will be completed to evaluate
cognitive function in surgery patients before, on day 7, and on day 30
after cardiac surgery. The primary outcome is the prevalence of PND in
cardiac surgery patients. The secondary outcomes will be the incidence of
postoperative delirium, pain, sleep quality, depressive symptoms,
activities of daily living, length of hospital stay and ICU length of
stay, and rate of complication and mortality during the hospital stay.
Ethics and dissemination: Beijing Chaoyang Hospital Ethics Committee
approved this study and has the number 2022-ke-487. It is registered with
Clinical Trials (trial number NCT 05668559). Informed consent must be
provided by all participants. The study result will be published in a
peer-reviewed journal. Trial registration: NCT05668559. Registered on June
6, 2022. Copyright © The Author(s) 2025.

<128>
Accession Number
648026093
Title
Effects of Oxygen on Perioperative Vascular Function: A Randomized
Clinical Trial.
Source
Journal of the American Heart Association. (pp e041778), 2025. Date of
Publication: 17 Jul 2025.
Author
Lopez M.G.; Pandey A.K.; Hennessy C.; Hughes C.G.; Absi T.S.; Shah A.S.;
Shotwell M.S.; Harrison D.G.; Billings F.T.
Institution
(Lopez, Hughes, Billings) Division of Anesthesiology Critical Care
Medicine, Department of Anesthesiology Vanderbilt University Medical
Center Nashville TN USA
(Pandey) Division of Cardiovascular Medicine, Department of Medicine
Brigham and Women's Hospital Boston MA USA
(Hennessy, Shotwell) Department of Biostatistics Vanderbilt University
Medical Center Nashville TN USA
(Absi, Shah) Department of Cardiac Surgery Vanderbilt University Medical
Center Nashville TN USA
(Harrison, Billings) Division of Clinical Pharmacology, Department of
Medicine Vanderbilt University Medical Center Nashville TN USA
Abstract
BACKGROUND: Vascular dysfunction contributes to postoperative organ
injury. Exposure to high concentrations of oxygen during surgery is common
and may impair vascular function. We tested the hypothesis that hyperoxia
during cardiac surgery impairs vascular function compared with normoxia.
 METHOD(S): We recruited and randomly assigned patients having
elective cardiac surgery to hyperoxia or normoxia during surgery, measured
endothelium-mediated vasodilation via brachial artery flow-mediated
dilation and fingertip pulse amplitude tonometry (reactive hyperemia
index), assessed endothelium-dependent, endothelium-independent, and
heme-independent soluble guanylyl cyclase activator-induced vasodilation
ex vivo in mediastinal fat arterioles using wire myography, and quantified
plasma markers of vascular function and oxidative stress. RESULT(S):
Two hundred participants completed the study. Oxygen treatment did not
affect flow-mediated dilation (primary outcome, P=0.377) or reactive
hyperemia index (P=0.898). In isolated mediastinal fat arterioles,
however, hyperoxia impaired endothelium-independent relaxation (P<0.001)
but not endothelium-dependent relaxation (P=0.759) or heme-independent
soluble guanylyl cyclase activation (P=0.650). Hyperoxia also increased
plasma plasminogen activator inhibitor-1 postoperatively but not
e-selectin or syndecan-1. Hyperoxia increased intraoperative
concentrations of F2-isoprostanes and isofurans, which were associated
with plasminogen activator inhibitor-1 but not other measurements of
vascular function. CONCLUSION(S): Among adults receiving cardiac
surgery, intraoperative hyperoxia did not affect endothelium-dependent
vasodilation but impaired endothelium-independent vasodilation, likely via
soluble guanylyl cyclase heme oxidation. Soluble guanylyl cyclase is a
potential therapeutic target to enhance vascular function. REGISTRATION:
URL: https://www.clinicaltrials.gov; Unique identifier: NCT02361944.

<129>
Accession Number
2035431800
Title
Transcatheter Structural Heart Interventions in Women.
Source
Current Cardiology Reports. 27(1) (no pagination), 2025. Article Number:
118. Date of Publication: 01 Dec 2025.
Author
Chung J.; Yang K.; Nozadze N.; Kukarni A.; Ashwath M.; Bui Q.; Co-Vu J.;
Jone P.-N.; Lyubarova R.; Andrade-Bucknor S.
Institution
(Chung, Yang, Bui) Division of Cardiology, Department of Medicine, Harbor
UCLA Medical Center, 1000 W Carson St. Box 405, Torrance, CA, United
States
(Nozadze, Lyubarova) Division of Cardiology, Department of Medicine,
Albany Medical College, Albany, NY, United States
(Kukarni) Division of Pediatric Cardiology, Department of Pediatrics,
Heart Center at Cohen Children's Medical Center at Northwell Health, New
Hyde Park, NY, United States
(Ashwath) Division of Cardiology, Department of Internal Medicine, UHS/UT
Health San Antonio, San Antonio, TX, United States
(Co-Vu) Department of Pediatrics, Congenital Heart Center, University of
Florida College of Medicine, Gainesville, FL, United States
(Jone) Division of Cardiology, Department of Pediatrics, Ann & Robert H.
Lurie Children's Hospital, Northwestern University Feinberg School of
Medicine, Chicago, IL, United States
(Andrade-Bucknor) Division of Cardiology, Department of Medicine,
University of Miami, Miami, FL, United States
Publisher
Springer
Abstract
Purpose of Review: To provide a review of current transcatheter structural
heart interventions in women, with a focus on sex-specific considerations
in diagnosis, treatment and outcomes. Recent Findings: Transcatheter
interventions have transformed structural heart disease treatment,
including valvular heart disease and left atrial appendage closure.
Historically, low female enrollment in cardiovascular trials has limited
sex-specific data integration into clinical guidelines. Recently, the
changing landscape of female representation has provided insight into
distinct pathophysiology, high-risk features, clinical characteristics,
disease surveillance, referral barriers, and treatment responses.
 Summary: The success of transcatheter structural heart interventions
relies on judicious patient selection and timely intervention. This review
evaluates contemporary female representation in transcatheter studies,
highlighting sex-specific prevalence, anatomic and physiologic variations,
clinical presentations and both short- and long-term outcomes. Knowledge
gaps and future research directions are identified to address diagnostic
and therapeutic disparities, ultimately improving individualized lifetime
care in women with structural heart disease. Copyright © The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2025.

<130>
Accession Number
2039811056
Title
Surgical consensus for screening, diagnosis, staging, multimodal
management and surveillance of early-stage resectable non-small cell lung
cancer (NSCLC) in Malaysia.
Source
Translational Lung Cancer Research. 14(7) (pp 2403-2426), 2025. Date of
Publication: 31 Jul 2025.
Author
Sachithanandan A.; Razi A.A.M.; Krishnasamy S.; Chan K.M.J.; Lam H.Y.;
Diong N.C.; Sathiamurthy N.; Ooi A.S.W.; Soon S.Y.
Institution
(Sachithanandan) Division of Cardiothoracic Surgery, Sunway Medical
Centre, Selangor, Malaysia
(Sachithanandan) School of Medical & Life Sciences, Sunway University,
Selangor, Malaysia
(Razi) Department of Cardiovascular and Thoracic Surgery, Faculty of
Medicine, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
(Razi) Department of Cardiothoracic Surgery, Gleneagles Hospital Johor,
Johor, Malaysia
(Krishnasamy) Cardiothoracic Division, University Malaya, Kuala Lumpur,
Malaysia
(Chan) Department of Cardiothoracic Surgery, CVSKL Hospital Kuala Lumpur,
Kuala Lumpur, Malaysia
(Lam) Lam Wah Ee Hospital, Pulau Pinang, Malaysia
(Diong) Department of Surgery, Hospital Sultan Ismail, Johor, Malaysia
(Sathiamurthy) Thoracic Unit, Department of Surgery, Hospital Kuala
Lumpur, Kuala Lumpur, Malaysia
(Ooi) Department of Cardiothoracic Surgery, Oriental Melaka Straits
Medical Centre, Melaka, Malaysia
(Soon) Department of Cardiothoracic Surgery, Sarawak Heart Centre,
Sarawak, Malaysia
Publisher
AME Publishing Company
Abstract
Background: Lung cancer is the most frequently diagnosed cancer globally.
In Malaysia, it ranks as the second most common cancer among men and third
among women. Presently, no local clinical practice guidelines exist for
lung cancer care in Malaysia. Given the lack of consensus regarding the
perioperative management of early-stage non-small cell lung cancer
(NSCLC), this article seeks to harmonise surgical practices among thoracic
physicians and surgeons in Malaysia by recommending best practices for
screening, diagnosis and staging, as well as multimodal management and
surveillance in early-stage disease (stages I to IIIB-N2). Method(s):
A local expert committee comprising nine high-volume actively practicing
cardiothoracic or general thoracic surgeons gathered between February to
July 2024 to deliberate existing evidence and formulate recommendations. A
modified Delphi method comprising systematic review of published evidence
and expert opinion based on local experience was utilised. The document
was subsequently independently reviewed by two senior oncologists and two
senior respiratory physicians, before incorporating their feedback into
the final version. Result(s): This document comprises a surgical
consensus of evidence-based guidelines to provide local recommendations on
contemporary real-world best practices. The consensus statements were
grouped into five domains of early-stage resectable NSCLC: (I) screening
(3 statements); (II) diagnosis and staging (6 statements); (III)
neoadjuvant/perioperative immunotherapy (3 statements); (IV) adjuvant
therapy with tyrosine kinase inhibitors (TKIs) or immunotherapy (4
statements); and (V) operative metrics and postoperative surveillance (5
statements). Conclusion(s): These consensus statement guidelines will
elevate and standardise the perioperative management of early-stage NSCLC
in Malaysia, serve as a valuable educational and training tool for
relevant medical professionals, and promote an inclusive, comprehensive
multidisciplinary approach to integrated holistic patient care, aimed at
improving both clinical outcomes and patients' quality of life with the
best available evidence. Copyright © AME Publishing Company.

<131>
Accession Number
2035514350
Title
Effects of Esketamine Combined With Remimazolam Tosylate on Hemodynamics
During Cardiovascular Anesthesia.
Source
Clinical and Translational Science. 18(8) (no pagination), 2025. Article
Number: e70232. Date of Publication: 01 Aug 2025.
Author
Xi L.; Liu H.; Tang X.; Jiang Z.
Institution
(Xi, Liu, Jiang) Department of Anesthesiology, Renmin Hospital, Hubei
University of Medicine, Hubei, Shiyan, China
(Tang) Department of Radiology, Renmin Hospital, Hubei University of
Medicine, Hubei, Shiyan, China
Publisher
John Wiley and Sons Inc
Abstract
This study aimed to evaluate the effects of esketamine combined with
remimazolam tosylate on hemodynamic stability, cerebral oxygen metabolism,
and cognitive outcomes in patients undergoing heart valve replacement.
Seventy-eight patients were randomized to Group C (dexmedetomidine
hydrochloride) or Group R (esketamine + remimazolam tosylate). The
following parameters were measured: multiple time points, including mean
arterial pressure (MAP), heart rate (HR), respiratory rate (RR),
arterial-jugular vein oxygen content difference (Da-jvO<inf>2</inf>),
cerebral oxygen uptake rate (CERO<inf>2</inf>), and biomarkers of
myocardial injury (cTnI, CK-MB, FABP) at baseline (T0), incision (T1),
sternotomy (T2), pre-cardiopulmonary bypass (T3), and post-surgery (T4).
Cognitive function was assessed using the Mini-Mental State Examination
(MMSE) and Confusion Assessment Method (CAM). Group R showed prolonged
values of lower RR in T1 to T4 than Group C (p < 0.05). The
Da-jvO<inf>2</inf> and CERO<inf>2</inf> were found to be much higher in
Group R in T2, T3, and T4 (p < 0.05). This is an indication of improved
cerebral oxygen metabolism. MMSE scores were elevated in Group R: the
incidence of delirium and CAM Scores were lower compared with Group C (p <
0.05). This indicates better cognitive outcomes. Also, cTnI, CK-MB, and
FABP, myocardial injury markers, were significantly reduced in Group R at
postoperative 24 and 72 h (p < 0.05), indicating reduced myocardial
injury. The combination of esketamine and remimazolam tosylate offers
hemodynamic stability, enhances cerebral oxygen metabolism, improves
cognitive function, and reduces myocardial injury in patients undergoing
heart valve replacement surgery. This approach might provide significant
benefits in cardiovascular anesthesia. Copyright © 2025 The
Author(s). Clinical and Translational Science published by Wiley
Periodicals LLC on behalf of American Society for Clinical Pharmacology
and Therapeutics.

<132>
Accession Number
648038619
Title
Effects of high-intensity interval training on cardiopulmonary function
and quality of life in post-PCI or CABG patients with coronary heart
disease: a meta-analysis.
Source
Journal of cardiothoracic surgery. 20(1) (pp 303), 2025. Date of
Publication: 16 Jul 2025.
Author
Hong G.; Liu F.
Institution
(Hong) Nutriology Department, Guilin Rehabilitation and Rehabilitation
Center of Joint Logistics Support Force, Guilin, China
(Liu) Sanatorium Department, Guilin Rehabilitation and Rehabilitation
Center of Joint Logistics Support Force, Wanfu Road ,Xiangshan District,
Guilin, China
Abstract
BACKGROUND: High-intensity interval training (HIIT) has emerged as a
potential cardiac rehabilitation strategy for coronary heart disease (CHD)
post-surgery, but its efficacy compared to moderate-intensity continuous
training (MICT) remains uncertain. AIM: This meta-analysis aimed to
evaluate the effects of HIIT on cardiopulmonary function and quality of
life in CHD patients post-PCI or CABG in comparison with MICT.
 METHOD(S): We systematically reviewed randomized controlled trials
from PMID, Cochrane, Embase, Wanfang, and China National Knowledge
Infrastructure (CNKI) databases comparing HIIT with MICT in CHD patients.
Data on peak oxygen uptake (VO2peak), left ventricular ejection function
(LVEF), heart rates, and quality of life were extracted and analyzed using
random-or fixed-effects models based on heterogeneity. RESULT(S):
HIIT significantly improved VO2peak by 1.678 mL/kg/min (95%CI =
1.082-2.275), increased LVEF by 2.831% (95%CI = 1.124-4.538), enhanced
peak HR by 6.717 beats/min (95%CI = 5.111-8.323) compared to MICT. Resting
HR did not differ significantly between groups. Quality of life (SMD =
0.132, 95%CI = 0.051-0.213, P = 0.001) was significantly elevated by HIIT,
particularly in the physical domain. Subgroup analyses showed consistent
benefits of HIIT across exercise durations and times. CONCLUSION(S):
HIIT effectively enhances cardiopulmonary function and quality of life in
CHD post-surgery. HIIT may be a time-efficient alternative to MICT in
cardiac rehabilitation programs. However, publication bias and high
heterogeneity warrant caution in interpreting these results, indicating a
need for further research. Copyright © 2025. The Author(s).

<133>
Accession Number
648018442
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 (Basel, Switzerland). (pp 1-10), 2025. Date of
Publication: 15 Jul 2025.
Author
Wang K.; Shi L.; Ruan Z.; Jin C.; Li M.; Liu H.; Chen H.; Ju W.; Chen M.
Abstract
INTRODUCTION: Patients with atrial fibrillation (AF) continue to face
thrombotic risks even after the left atrial appendages (LAA) 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 appendages
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 aims 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. TRIAL
REGISTRATION: ClinicalTrials.gov: NCT05671276. Copyright S. Karger AG,
Basel.

<134>
Accession Number
2039790947
Title
Natural Killer Cells as Critical Modulators of Heart Disease: Exploring
Pathophysiological Mechanisms and Therapeutic Perspectives.
Source
Iranian Journal of Allergy, Asthma and Immunology. 24(2) (pp 119-131),
2025. Date of Publication: 2025.
Author
Shamlou S.; Kiani J.; Hasanpoor Z.; Tollabi M.; Norooznezhad F.; Goudarzi
S.T.; Verdi J.; Vousooghi N.
Institution
(Shamlou, Norooznezhad, Goudarzi, Verdi, Vousooghi) Department of Applied
Cell Sciences, School of Advanced Technologies in Medicine, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Kiani) Department of Molecular Medicine, Faculty of Advanced Technologies
in Medicine, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Hasanpoor) Department of Immunology, School of Medical Science, Tarbiat
Modares University, Tehran, Iran, Islamic Republic of
(Tollabi) Cellular and Molecular Research Center, Iran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Tollabi) Department of Tissue Engineering and Regenerative Medicine,
Faculty of Advanced Technologies in Medicine, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
Tehran University of Medical Sciences
Abstract
Natural killer (NK) cells are crucial components of the innate immune
system and have emerged as significant players in the pathogenesis of
heart diseases. This review discusses recent findings regarding the
multifaceted roles of NK cells in various cardiac conditions, including
coronary artery disease, myocardial infarction, heart failure,
myocarditis, and heart transplantation. It outlines the NK cell subsets,
particularly CD56-bright and CD56-dim variations, their functional
characteristics, cytokine profiles, and the inflammatory pathways they are
involved. The review discusses both the beneficial and detrimental effects
of NK cell activity on cardiac pathology by underlining their
participation in immune regulation, tissue repair, and graft rejection
dynamics. Additionally, we have addressed the impact of NK-cell-oriented
environmental signals and discussed potential therapeutic approaches, such
as immunomodulatory and anti-inflammatory strategies targeting NK cells.
This review was therefore geared towards integrating available studies in
understanding NK cell dynamics in heart disease and offering insights for
future clinical interventions. Copyright © 2025 shamlou et al.

<135>
Accession Number
2039808610
Title
Prospective Randomized Study Comparing Indigenous Tas Scope and
Conventional Macintosh Laryngoscope for Cormack Lehane Grading and
Intubation in Patients Undergoing Elective Coronary Bypass Surgery.
Source
European Journal of Cardiovascular Medicine. 15(7) (pp 728-732), 2025.
Date of Publication: 01 Jul 2025.
Author
Patel M.D.; Manjunatha K.R.; Nanjappa S.N.; Bharathi K.S.
Institution
(Patel, Manjunatha, Bharathi) Department of Anaesthesiology, Sri Jayadeva
Institute of Cardiovascular Sciences and Research, Karnataka, Mysore,
India
(Nanjappa) Department of Anaesthesiology, Sri Jayadeva Institute of
Cardiovascular Sciences and Research, Karnataka, Mysore, India
Publisher
Healthcare Bulletin
Abstract
Background: General anaesthesia (GA) with endotracheal intubation is the
mainstay of anaesthesia for elective coronary bypass surgeries. The study
was aimed to compare a new indigenous TAS (The anaesthesia society) scope
with conventional Macintosh laryngoscope in Cormack Lehane grading (CLG)
of larynx and ease of intubation along with hemodynamic response.
Materials and Methods 120 patients undergoing coronary artery bypass
surgery with GA were randomized into two groups and named after A device
which was used for both laryngoscope and intubation. In Group TAS,
patients were intubated with TAS Scope after initial laryngoscopy with
Macintosh. In Group MAC, Intubated with Macintosh after initial
laryngoscope /CLG with TAS scope. CLG, Time to intubate, number of
attempts, hemodynamic parameters were noted. Result(s): Patients
having Cormack Lehane grading of gr 3 and 4 (11.6%) in MAC group changed
gr 1 and 2 when laryngoscopy was performed with TAS scope and none had gr
3 and 4 when TAS scope was performed. Mean time to intubate were 23.73
+/-3.48 and 12.50 +/-2.50 (p=0.006) seconds in TAS and MAC groups
respectively. Conclusion(s): Indigenous TAS can be used to get better
visualization of larynx with improved Cormack Lehane gradings with
acceptable hemodynamic changes. Copyright © 2025 Healthcare
Bulletin. All rights reserved.

<136>
Accession Number
2039816210
Title
Superficial vs. deep serratus anterior plane block for analgesia in
patients undergoing single-port video-assisted thoracoscopic surgery: A
randomized prospective trial.
Source
Journal of Clinical Anesthesia. 106 (no pagination), 2025. Article Number:
111950. Date of Publication: 01 Sep 2025.
Author
Meng G.; Chen W.; Shi D.; Mei B.; Liu X.
Institution
(Meng, Chen, Shi, Mei, Liu) Department of Anesthesiology, The First
Affiliated Hospital of Anhui Medical University, Hefei, China
Publisher
Elsevier Inc.
Abstract
Study objective: Postoperative pain following thoracic surgery is often
severe, and serratus anterior plane block (SAPB) is widely used for
perioperative analgesia in such patients. Local anesthetics injected on
the surface of the serratus anterior muscle are called superficial SAPB
(SSAPB), while those injected on the deep surface are called deep SAPB
(DSAPB). We observed the differences in analgesic effects of two variants
of SAPB (superficial and deep) on patients receiving single-port
video-assisted thoracoscopic surgery (VATS). Design(s): A randomized
prospective trial. Setting(s): Single university teaching hospital.
 Patient(s): Eighty patients who underwent single-port VATS under
general anesthesia. Intervention(s): Eighty patients who received
single-port VATS were randomly assigned to Group S (patients who received
SSAPB) and Group D (patients who received DSAPB). Measurements: The
primary outcome was opioid consumption within 24 h after surgery.
Secondary outcomes were pain scores at rest and on coughing before
surgery, immediately after surgery, 6, 12, and 24 h after surgery.
 Main Result(s): Within 24 h after surgery, the total opioid
consumption of patients in Group S was lower than that of patients in
Group D (P = 0.001). The pain scores of patients in Group S were lower
than those in Group D at rest or coughing 6 h after surgery (P = 0.000, P
= 0.000). The pain score on coughing in Group S was lower than that in
Group D at 12 h after surgery (P = 0.000), and there was no difference in
postoperative pain scores between the two groups at other time points.
 Conclusion(s): For patients undergoing single-port VATS lobectomy,
SSAPB was associated with reduced opioid consumption and lower pain scores
compared to DSAPB. Copyright © 2025

<137>
Accession Number
648024037
Title
Preoperative nutrition status in children with congenital heart disease
and its impact on postoperative outcomes: a systematic review and
meta-analysis.
Source
Scientific reports. 15(1) (pp 25738), 2025. Date of Publication: 16 Jul
2025.
Author
Abbas Q.; Ali H.; Ahuja A.K.; Bhatti O.A.; Ladak S.; Khan I.; Rehman A.;
Mohsin S.; Shah I.; Ilyas A.; Ladak L.A.
Institution
(Abbas, Ali, Ladak) Department of Pediatrics and Child Health, Aga Khan
University Hospital, Karachi, Pakistan
(Ahuja, Bhatti, Ladak, Khan) Medical College, Aga Khan University,
Karachi, Pakistan
(Rehman) Department of Biological and Biomedical Sciences, Aga Khan
University, Karachi, Pakistan
(Mohsin) Department of Cardiovascular Sciences, Sindh Institute of Urology
and Transplantation, Karachi, Pakistan
(Shah, Ilyas, Ladak) School of Nursing and Midwifery, Aga Khan University,
Karachi, Pakistan
(Ladak) Honorary Faculty, Susan Wakil School of Nursing and Midwifery,
Sydney Nursing School, University of Sydney, Sydney, Australia
Abstract
Despite the significant advancement in congenital heart disease (CHD)
surgery over the years, the mortality and morbidity rate in children
undergoing CHD surgery is substantial, especially in lower-middle-income
countries. Evidence shows that malnutrition contributes to morbidity and
mortality in these children, with a negative impact on their surgical
outcomes. The aim of this systematic review and meta-analysis was to
assess the impact of preoperative nutritional status on postoperative
outcomes among patients with CHD. PubMed, Embase, Scopus, CINAHL,
ProQuest, and the Cochrane Library were searched from January 1, 2000, to
Mar 1, 2024. Twenty-one studies were included in the review with 22,621
malnourished and 60,402 well-nourished children undergoing CHD surgery.
Malnourished children had a significantly longer LOS in the hospital, with
a standard mean difference (SMD) of 0.49 [95% confidence interval (CI)
0.09-0.88] days, a longer ICU stay (SMD 0.51 [95% CI 0.16-0.86] days), a
higher RACHS-1/STAT score (SMD 1.72 [95% CI 1.32-2.25]), and a higher
mechanical ventilation time (SMD 0.46 [95% CI 0.18-0.74] hours). However,
there was no significant difference in mortality, with an odds ratio (OR)
of 1.82 [95% CI 0.94-3.5], and postoperative infection rates (OR 1.27 [95%
CI 0.05-35.02]) between the malnourished and well-nourished groups.
Malnourished children undergoing CHD surgery experience significantly
worse postoperative outcomes in terms of hospital and ICU stay, and
mechanical ventilation time. Efforts to improve preoperative nutritional
status could potentially enhance these outcomes. Copyright ©
2025. The Author(s).

<138>
[Use Link to view the full text]
Accession Number
2039762965
Title
Randomized Controlled Trial of New Oral Anticoagulants Versus Warfarin for
Post Cardiac Surgery Atrial Fibrillation: The NEWAF Trial.
Source
Annals of Surgery. (no pagination), 2025. Article Number:
10.1097/SLA.0000000000006853. Date of Publication: 2025.
Author
Moonsamy P.; Zhao Y.; Makarem A.; Paneitz D.C.; Wolfe S.; Turco I.; Colon
K.M.; Ethridge B.R.; Li S.S.; Leya G.; Verma S.; D'Alessandro D.A.; Jassar
A.S.; Langer N.B.; Tolis G.; Villavicencio M.A.; Melnitchouk S.I.; Bloom
J.P.; Michel E.; Kreso A.; Alireza Rabi S.; Akeju O.; Sundt T.M.; Osho
A.A.
Publisher
Wolters Kluwer Health
Abstract
Objective To determine whether anticoagulation for new onset atrial
fibrillation (AF) with rivaroxaban decreases length of stay compared to
warfarin. Summary of Background Data Direct Oral Anticoagulants (DOACs)
have been shown to be noninferior to warfarin for stroke prevention in
nonsurgical patients with atrial fibrillation. There are no published
randomized trials comparing DOACs to warfarin in cardiac surgery patients,
and DOACs are yet to be widely adopted in this population. Methods In a
pragmatic, prospective, clinical trial, 100 patients with new-onset AF
after cardiac surgery were randomized to receive rivaroxaban (n=50) or
warfarin (n=50). Patients were followed for 30 days post-discharge, with
patient-reported outcomes assessed two weeks after discharge using the
Perception of Anticoagulant Treatment Questionnaire and the EuroQol-5D-3L
survey. Results The primary endpoint, length of stay (LOS) from day of
surgery to discharge (days, IQR), was 7 (6-9) for rivaroxaban and 8 (6-9)
for warfarin (p=0.460). LOS from initiation of anticoagulation to
discharge was 2 (1-4) days for rivaroxaban and 2 (1-3) days for warfarin
(p=0.738). The mean INR at discharge in the warfarin group was 1.68 (SD
0.5). No major bleeding events, strokes, or other arterial thromboembolism
events occurred in either group. Minor bleeding events were reported in
3/50 (6%) patients in the rivaroxaban group versus 1/50 (2%) in the
warfarin group (p=0.617), none of which required blood transfusion. One
patient (2%) in the rivaroxaban group developed a pericardial effusion
requiring drainage, compared to none in the warfarin group (p=1.000).
Patients taking rivaroxaban reported significantly higher scores for
convenience (p<0.001) and better overall perception of their
anticoagulation experience (p=0.006), though both groups reported similar
treatment satisfaction (p=0.494). Mobility issues were reported by 42.2%
of patients taking rivaroxaban compared to 18.6% of those taking warfarin
(p=0.021). All outcomes were consistent in both the intention-to-treat and
as-treated populations. Conclusions Treatment with rivaroxaban in
new-onset atrial fibrillation after cardiac surgery did not decrease
length of stay compared to warfarin. However, patients treated with
rivaroxaban reported significantly better convenience and a more favorable
overall perception of their anticoagulation experience compared to
warfarin. Given similar safety profiles, these findings support
incorporating rivaroxaban as an option for shared-decision-making when
selecting anticoagulation therapy for this patient
population. Copyright © 2025 Wolters Kluwer Health. All rights
reserved.

<139>
[Use Link to view the full text]
Accession Number
2039745787
Title
Bilateral External Oblique Intercostal Plane Block Versus Intravenous
Morphine for Rescue Pain Relief in Patients with Epidurals Following Upper
Abdominal Surgeries: A Randomized Controlled Trial.
Source
A and A Practice. 19(7) (pp e02019), 2025. Date of Publication: 01 Jul
2025.
Author
Srinivasaraghavan N.; Seshadri R.A.; Ramasamy Y.; Raj P.; Chockalingam P.;
Sankar P R P.; Modh V.; Ramakrishnan B.
Institution
(Srinivasaraghavan, Ramasamy, Raj, Chockalingam, Sankar P R, Modh)
Department of Anesthesia and Critical Care, Cancer Institute (WIA), Tamil
Nadu, Chennai, India
(Seshadri) Integrated Cancer Care Group, Tamil Nadu, Chennai, India
(Ramakrishnan) Department of Clinical Trials Services Unit, Clinical
Trials Services Unit, Cancer Institute (WIA), Tamil Nadu, Chennai, India
Publisher
Wolters Kluwer Health
Abstract
BACKGROUND: The management of postoperative pain after upper abdominal
surgery is challenging. Thoracic epidural analgesia, though effective, has
limitations, while intravenous (IV) morphine is associated with side
effects. Ultrasound-guided external oblique intercostal block (EOIB) is an
emerging regional technique for upper abdominal pain relief. We
hypothesized that EOIB would provide superior pain relief to IV morphine
in patients undergoing upper abdominal surgery. The main objective of the
study was to compare pain relief from EOIB versus IV morphine as rescue
analgesia in patients with moderate to severe pain despite an epidural
after upper abdominal surgeries. METHOD(S): This double-blinded,
randomized controlled trial was conducted at a tertiary cancer hospital
from January to November 2024. Patients aged >=18 years undergoing upper
abdominal surgery with pain on the numerical rating scale >=4 despite
epidural and IV paracetamol were randomized (1:1) to IV morphine (0.05
mg/kg, Arm A) or bilateral EOIB (0.1% bupivacaine 1 mL/kg and 4 mg
dexamethasone, Arm B). The primary outcome was the total 24-hour morphine
rescue requirement. Secondary outcomes included pain intensity difference
(PID) at 0.5, 1, 4, 8, 12, 16, 20, and 24 hours, summated pain intensity
difference at 8 and 24 hours (SPID), percentage PID in the first four
hours, pain-free hours (PFH), and adverse events. Participants and outcome
assessor nurses were blinded in the trial. RESULT(S): Of 101 screened
patients, 66 were randomized with 33 in each group. The EOIB arm had
significantly lower 24-hour morphine requirements compared to the morphine
arm median (interquartile range) 0 mg (0-1.5) vs 2.5 mg (1-6.1),
respectively; median difference (95% confidence interval [CI], 1.5
[0.00-3.40]; P =.006). Repeated measures analysis of variance with
Greenhouse-Geisser correction determined that the mean PID did not differ
among the two groups across different time points over 24 hours; F (7,434)
= 1.08, P =.37. SPID at 8 and 24 hours favored EOIB (P =.038 and P =.048,
respectively). The percentage PID in the first four hours was higher in
the EOIB arm than morphine arm, 66.6% [58.5%-100%] vs 50% [34.9%-74%]; P
=.002. PFH was significantly higher in the EOIB arm than morphine arm 4.00
[0.00-8.00] hours vs 0.00[0.00-0.37] hours; P =.015, with two patients
achieving complete pain relief (NRS = 0) for 24 hours, compared to none in
the IV morphine group. No significant adverse events were observed.
 CONCLUSION(S): EOIB provided superior and prolonged analgesia
compared to IV morphine as a supplement to epidural analgesia, reducing
opioid consumption and increasing the pain-free period in patients
undergoing upper abdominal surgery. Copyright © 2025
International Anesthesia Research Society. Unauthorized reproduction of
this article is prohibited.

<140>
Accession Number
648026673
Title
Early mobilisation to enhance recovery following cardiac valvular surgery
in atrial fibrillation patients: a randomised controlled trial.
Source
Scientific reports. 15(1) (pp 25701), 2025. Date of Publication: 16 Jul
2025.
Author
Gao Z.; Fan C.; Zeng B.; Song L.; Tian L.
Institution
(Gao, Zeng) Clinical Nursing Teaching and Research Section, Second Xiangya
Hospital, Central South University, Changsha, Hunan, China
(Gao, Fan, Zeng, Song) Department of Cardiovascular Surgery, Second
Xiangya Hospital, Central South University, 139 Renmin Middle Road,
Changsha, Hunan, China
(Tian) Clinical Nursing Teaching and Research Section, Second Xiangya
Hospital, Central South University, Changsha, Hunan, China
(Tian) Department of Cardiovascular Surgery, Second Xiangya Hospital,
Central South University, 139 Renmin Middle Road, Changsha, Hunan, China
Abstract
This study aimed to assess the feasibility and safety of early
mobilisation in promoting enhanced recovery among patients with concurrent
atrial fibrillation undergoing cardiac valve surgery. A total of 190
patients who underwent cardiac valve surgery with concurrent atrial
fibrillation at a tertiary-grade A hospital in Changsha City between
January and December 2022 were randomly allocated to either an
intervention (n = 95) or a control group (n = 95). The control group
received standard perioperative care, while the intervention group
followed a care programme that integrated conventional and Enhanced
Recovery After Surgery (ERAS) protocols. The study compared recovery
progress, incidence of complications, and various other metrics between
the two groups. The intervention group demonstrated statistically.
significant differences (p < 0.01) compared to the control group in terms
of time to first mobilisation, duration of intensive care unit (ICU) stay,
mechanical ventilation duration, pain scores, 6-minute walking distances,
occurrence of arrhythmias, ICU re-admission, pulmonary infection rates,
sternal incision infection rates, length of hospital stay, hospitalisation
expenses, and adverse event rates. Summarily, patients in the intervention
group exhibited more favourable outcomes across these metrics than those
in the control group. Implementing an ERAS protocol-based early
mobilisation strategy is a safe and viable approach for patients
undergoing cardiac valve surgery with concurrent atrial fibrillation,
facilitating their expedited recovery. Copyright © 2025. The
Author(s).

<141>
Accession Number
645166114
Title
Association between Ranolazine, Ischaemic Preconditioning and
Cardioprotection in Patients Undergoing Scheduled Percutaneous Coronary
Intervention.
Source
European Cardiology Review. Conference: EuroCVP 2023: Advances in
Cardiovascular Pharmacotherapy. Florence Italy. 19(Supplement 1) (pp
22-23), 2024. Date of Publication: 01 May 2024.
Author
Bourazana A.; Kourtis K.; Xanthopoulos A.; Skoularigki E.; Papadakis E.;
Patsilinakos S.; Skoularigkis J.
Institution
(Bourazana, Xanthopoulos, Skoularigki, Skoularigkis) Department of
Cardiology, University Hospital of Larissa, Larissa, Greece
(Kourtis, Papadakis, Patsilinakos) Department of Cardiology,
Konstantopouleio General Hospital, Athens, Greece
Publisher
Radcliffe Medical Media
Abstract
Background: Remote ischaemic preconditioning (RIPC) has been shown to
confer protection against myocardial ischaemia-reperfusion injury when
performed prior to percutaneous coronary revascularisation. In addition,
ranolazine has been used as an anti-ischaemic drug to reduce ischaemic
events in patients with chronic angina. However, to date, no trials have
investigated the associations of ranolazine pretreatment with RIPC in
patients scheduled for percutaneous coronary interventions.
 Material(s) and Method(s): A retrospective, observational study was
performed of 150 patients who were scheduled for coronary
revascularisation. Of these, 50 patients were assigned to the control
group in which, except for the coronary intervention, no further treatment
was practiced; 50 patients were assigned to the RIPC group, in which RIPC
was applied to either of the upper limbs for 5 minutes with a cuff
pressure of 200 mmHg and followed by a 60-second period of reperfusion;
and 50 patients were submitted to RIPC before PCI, already treated with
500 mg ranolazine twice daily with the indication of stable angina.
Analysis of variance (ANOVA) and Kruskal-Wallis test were computed for the
comparison of mean values. Statistical significance was defined as p<0.05.
 Result(s): Ranolazine administration along with RIPC resulted in (A)
a significantly lower increase of TNI levels in comparison to the RIPC or
control group (Figure 1); (B) significantly lower levels of CPK at 4, 10
and 24 hours compared to the RIPC group (p=0.020, p=0.020 and p=0.019,
respectively) and significantly lower levels of CPK compared to the
control group at 10 hours (p=0.050); and (C) significantly lower levels of
CK-MB at 10 hours compared to the control group (p=0.050).
 Conclusion(s): RIPC applied before a scheduled coronary procedure
when combined with ranolazine pretreatment may be associated with reduced
ischaemia induction, as reflected by myocardial enzyme levels.

<142>
Accession Number
2039774247
Title
The Cusp Overlap Technique Reduces Pacemaker Implantation in TAVR: A
Systematic Review and Meta-analysis.
Source
American Journal of Cardiology. 254 (pp 75-84), 2025. Date of Publication:
01 Nov 2025.
Author
Hazique M.; Jafar Z.; Lohana S.; Reyaz I.; Burhan M.; Narayan R.; Alraies
M.C.
Institution
(Hazique, Lohana) Department of Internal Medicine, Nuvance Health/Vassar
Brothers Medical Center, Poughkeepsie, NY, United States
(Jafar, Narayan) Department of Cardiology, Nuvance Health/Vassar Brothers
Medical Center, Poughkeepsie, NY, United States
(Reyaz) Department of Internal Medicine, Christian Medical College,
Ludhiana, India
(Burhan) Department of Internal Medicine, Rawalpindi Medical University,
Rawalpindi, Pakistan
(Alraies) Department of Cardiology, Detroit Medical Center, Michigan,
United States
Publisher
Elsevier Inc.
Abstract
Transcatheter aortic valve replacement (TAVR) has become the preferred
treatment for symptomatic aortic stenosis, yet conduction disturbances
leading to permanent pacemaker implantation (PPI) remain a significant
complication, particularly with self-expanding valves (SEVs). The cusp
overlap view (COV) technique has been introduced to achieve a higher, more
controlled valve implantation compared to the conventional coplanar view
(CPV). We performed a systematic review and meta-analysis (14 studies;
5,266 TAVR patients) comparing the COV to the CPV. Data were pooled using
the DerSimonian-Laird random-effects model with I2 for heterogeneity. The
analysis demonstrated that the COV technique was associated with
significantly lower PPI rates (11.2% vs 17.7%; OR = 0.63; p <0.0001).
Additionally, patients in the COV group experienced a significantly
shorter hospital stay (SMD = -0.56; p = 0.016) and a modestly lower mean
transvalvular gradient (SMD = -0.10; p = 0.049). Although the depth
measured from the non-coronary cusp did not differ significantly between
groups, the arithmetic mean distance from the non-coronary and left
coronary cusps was significantly lower in the COV group (SMD = -0.21; p
<0.001), indicating a higher valve position. Our meta-analysis suggests
that the cusp overlap technique significantly reduces PPI rates and
improves procedural outcomes in TAVR with SEVs. In conclusion, these
findings suggest that COV not only enhances patient outcomes by reducing
conduction disturbances and shortening hospital stays but also optimizes
healthcare resource utilization. Future randomized controlled trials are
needed to confirm these benefits and further standardize TAVR protocols in
clinical practice. Copyright © 2025 Elsevier Inc.

<143>
Accession Number
645181607
Title
Study protocol of a short psychosomatic intervention to prevent depression
and anxiety disorder in patients with atrial fibrillation undergoing
pulmonary vein isolation.
Source
Psychotherapy and Psychosomatics. Conference: 27th World Congress of the
International College of Psychosomatic Medicine, ICPM 2024. Tubingen
Germany. 93(Supplement 1) (pp 92), 2024. Date of Publication: 01 Aug 2024.
Author
Rometsch C.; Weyand S.
Institution
(Rometsch) Department of Experimental and Clinical Medicine, University of
Florence, Florence, Italy
(Weyand) Medizinische Klinik II-Kardiologie und Angiologie,
Ostalb-Klinikum Aalen, Aalen, Germany
Publisher
S. Karger AG
Abstract
Background: Atrial fibrillation (AF) is a prevalent cardiac arrhythmia
affecting approximately 2% of the population. AF is associated with an
increased risk of comorbid psychological disorders, notably depression and
anxiety. Pulmonary Vein Isolation (PVI) is a common ablation treatment for
AF and leads to a reduction in depressive and anxious symptoms. However,
the diagnostic procedure of cardiac patients is often does not encompass
mental aspects. This randomized-controlled trial (RCT) aims at
investigating the efficacy of an enhanced psychodiagnostic procedure in a
cardiac department to prevent depression and anxiety disorders in patients
undergoing PVI. Method(s): This study proposes an RCT with an
intervention and control group (receiving treatment as usual) with 50
patients per arm. Participants in the intervention group will receive a
short psychosomatic intervention by a psychosomatic physician, identified
through psychometric instruments such as the Hospital Anxiety and
Depression Scale (HADS) and the Patient Health Questionnaire (PHQ), aiming
to mitigate symptoms of depression and anxiety. Assessments will occur
before and after the PVI procedure, with follow-ups at 6 and 12 months to
evaluate the intervention's effectiveness over time. Result(s): Based
on a systematic review and meta-analysis on prevalence of depression and
anxiety disorder in patients with AF undergoing PVI, an interventional
study is being designed. The study protocol and first pilot data will be
presented at the conference. It is anticipated that the intervention group
will exhibit a significant reduction in symptoms of depression and anxiety
post-PVI, compared to the control group. Discussion(s): Depression
and anxiety disorders are notably prevalent among AF patients and can
detrimentally affect their prognosis and quality of life. The proposed RCT
aims to fill the existing gap by integrating a psychosomatic approach into
the treatment pathway of AF patients undergoing PVI. By addressing the
psychological aspects of AF, the study expects to not only improve mental
health outcomes but also enhance overall treatment efficacy. This could
pave the way for the inclusion of psychosomatic care in national and
international guidelines, promoting a more holistic, patient-centered
approach to AF management.

<144>
Accession Number
647989135
Title
Transcatheter versus Surgical Aortic Valve Replacement in Low-Risk
Patients: Updated Meta-Analysis.
Source
The American journal of cardiology. (no pagination), 2025. Date of
Publication: 12 Jul 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, Graduate School of Medicine,
University of Tokyo, Tokyo, Japan
(Fukuhara, Yokoyama) Department of Cardiac Surgery, University of
Michigan, Ann Arbor, United States
(Ueyama) Division of Cardiology, Emory University School of Medicine,
Atlanta, United States
(Sakurai) Department of Surgery, Marshall University Joan Edwards School
of Medicine, Huntington, United States
(Sa) Division of Cardiac Surgery, Massachusetts General Hospital, Harvard
Medical School, Boston, United States
(Latib) Division of Cardiology, Montefiore Medical Center, Albert Einstein
College of Medicine, NY, United States
(Laham) Division of Cardiology, Beth Israel Deaconess Medical Center,
Harvard Medical School, Boston, 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, United States
(Kuno) Division of Cardiology, Beth Israel Deaconess Medical Center,
Harvard Medical School, Boston, USA; Cardiology Division, Massachusetts
General Hospital, Harvard Medical School, Boston, USA
Abstract
Background 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. Methods 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. Results Seven 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 0.75; 95% CI 0.61-0.93), but not thereafter. The RMST analysis at 5
years favored TAVR by 1.01 months (p=0.011). Conclusions 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. Published by Elsevier Inc.

<145>
Accession Number
645066617
Title
HEART IN FOCUS: PERICARDIAL EFFUSION DIAGNOSIS AND MANAGEMENT WITH POCUS.
Source
European Journal of Case Reports in Internal Medicine. Conference:
European Congress of Internal Medicine, ECIM 2024. Istambul Turkey.
11(Supplement 1) (pp 34-35), 2024. Date of Publication: 2024.
Author
Krowicki J.; De Azevedo S.M.; Duarte R.; Paracana B.; Arroja S.P.F.;
Vazquez D.; Mariz J.
Institution
(Krowicki, Paracana) Internal Medicine Department, Centro Hospitalar do
Baixo Vouga, Aveiro, Portugal
(De Azevedo) Internal Medicine Department, Centro Hospitalar Universitario
de Santo Antonio, Porto, Portugal
(Duarte) Internal Medicine Department, Centro Hospitalar Lisboa Ocidental,
Lisboa, Portugal
(Arroja, Vazquez) Emergency Department, Hospital de Braga, Portugal
(Mariz) School of Medicine, University of Minho, Braga, Portugal
Publisher
SMC Media Srl
Abstract
Summary: Pericardial effusion (PEF) refers to the accumulation of fluid
within the pericardial sac. It can be caused by various medical conditions
and may lead to serious complications if not diagnosed and managed
promptly. Point-of-care ultrasound (POCUS) has emerged as a valuable tool
in the clinical evaluation of pericardial effusions, offering real-time
visualization and aiding in the assessment of its size, characteristics,
and potential hemodynamic impact. Purpose(s): This qualitative review
explores the utility of POCUS and proposes a practical approach for the
diagnosis and management of PEFs. Method(s): A comprehensive search
was conducted on PubMed. The search strategy involved using the keywords
"POCUS" and "pericardial" as MeSH terms, and reference mining.
Publications of the last ten years (August 2013-2023) were included, and
thirteen out of sixteen articles were selected. Animal and paediatric
studies were excluded. Results and Discussion: Characterization and
quantification of PEF may provide the clinician with clues regarding the
etiologic diagnosis that, in addition to other hemodynamic parameters, can
guide subsequent management. By establishing a clinical correlation
between the patient's symptoms and the sonographic findings, we propose a
diagnostic and management algorithm to exclude the need of an urgent
pericardiocentesis, while improving mortality and morbidity of cardiac
tamponade. Conclusion(s): POCUS has revolutionized the clinical
evaluation of PEFs, providing clinicians with a rapid and accurate bedside
tool for diagnosis and management. Its ability to assess and continuously
monitor effusion size, signs of cardiac tamponade and guide
pericardiocentesis procedures has proven invaluable in improving patient
outcomes.

<146>
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Accession Number
647989232
Title
Cardiothoracic Wound Management in Pediatrics: A Scoping Review.
Source
The Journal of cardiovascular nursing. (no pagination), 2025. Date of
Publication: 10 Jul 2025.
Author
Cunninghame J.; Takashima M.; Orchard J.; Grewel H.; Venugopal P.; Ullman
A.
Abstract
BACKGROUND: Congenital heart defects represent the most prominent cause of
mortality in a child's first year of life. Management of cardiothoracic
wounds in pediatric populations is complex, attributed to the fragility of
soft tissue, with healing progressing differently in adults. Understanding
the breadth of wound care management is essential in establishing its
applicability to clinical practice, especially in the prevention of
complications. OBJECTIVE(S): The aim of this study was to expansively
explore preoperative, intraoperative, and postoperative cardiothoracic
wound care in pediatrics. METHOD(S): In this scoping review, a
systematic search of MEDLINE, EMBASE, and Cumulative Index to Nursing and
Allied Health Literature was conducted to retrieve interventional studies
on pediatric cardiothoracic surgical patients (younger than 21 years) with
wounds requiring intervention published in the preceding 10 years.
 RESULT(S): A total of 2379 studies were retrieved, with 23 studies
included. This review predominantly consisted of observational studies (n
= 13, 57%), with 2 randomized clinical trials (8.7%). Most studies focused
on procedural interventions (n = 14, 41.2%), with an equal distribution of
management-focused (n = 10, 29.4%) and bundle-focused (n = 10, 29.4%)
interventions. Interventions were most used in the postoperative period (n
= 68, 49.6%). Study authors typically assessed the association of
pharmaceutical, dressing, mechanical, and decontamination interventions
with the incidence of sternal wound infections, healing, other infections,
nutrition, parental outcomes, and postoperative complications. Frequency
of wound surveillance and dressing changes were heterogeneous and rarely
reported among studies. CONCLUSION(S): This review demonstrated the
limited availability of high-level evidence evaluating the effectiveness
of wound care interventions associated with pediatric cardiothoracic
surgery. It is paramount that researchers leverage existing clinical
networks to establish clinical trials. Copyright © 2025 Wolters
Kluwer Health, Inc. All rights reserved.

<147>
Accession Number
645166130
Title
Empaglifozin in Hypertrophic Cardiomyopathies: Effects on Disease
Progression (EFCARISTO): Design of a Randomised, Open-label, Multicentric
Study.
Source
European Cardiology Review. Conference: EuroCVP 2023: Advances in
Cardiovascular Pharmacotherapy. Florence Italy. 19(Supplement 1) (pp
27-28), 2024. Date of Publication: 01 May 2024.
Author
Morelli C.; Coppini R.; Ferrantini C.; Petrucci G.; Rocca B.; Olivotto I.;
Cerbai E.
Institution
(Morelli) Department of Life Science and Public Health, Catholic
University School of Medicine, Rome, Italy
(Morelli, Coppini, Cerbai) Department of Neurofarba, University of
Florence, Florence, Italy
(Ferrantini, Olivotto) Department of Experimental and Clinical Medicine,
University of Florence, Florence, Italy
(Ferrantini) European Laboratory for Nonlinear Spectroscopy, University of
Florence, Florence, Italy
(Petrucci, Rocca) Section of Pharmacology, Department of Safety and
Bioethics, Catholic University School of Medicine, Rome, Italy
(Olivotto) Meyer University Children Hospital and Care, Florence, Italy
Publisher
Radcliffe Medical Media
Abstract
Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have
demonstrated benefit in heart failure with preserved ejection fraction
(HFpEF) patients. Hypertrophic cardiomyopathy (HCM) was an exclusion
criterion in all phase III trials, so the SGLT2i therapeutic potential in
HCM patients is unknown. Material(s) and Method(s): A multicentre,
randomised, open-label, intervention study was designed to evaluate the
effect of SGT2is in HCM patients, focusing on biomarkers surrogate of HF
severity. Adult patients with obstructive (oHCM) and non-obstructive HCM
(noHCM) and a documented left ventricular ejection fraction (LVEF) .55%,
symptomatic (New York Heart Association [NYHA] class II or III) despite
best medical therapy (BMT), will be randomised to continuing BMT alone or
with empaglifozin 10 mg once daily. The exclusion criteria will be severe
HF symptoms (NYHA class IV), recipients of heart transplant or being a
candidate for heart transplantation, AF, clear indication for antiplatelet
and/or anticoagulant drugs, severe renal dysfunction (an estimated
glomerular filtration rate [GFR] <20 ml/min per 1.73 m2 of surface area),
symptomatic hypotension, hypersensitivity to empaglifozin, and history of
recurrent urinary or genital tract infections. The primary endpoint will
be the change from baseline in NT-proBNP after 6 months. Exploratory
secondary endpoints will investigate symptoms as well as biomarkers of
inflammation ex vivo, oxidative status in vivo and cardiac fibrosis. The
study will have a power of at least 80% with a type I error of 0.05 and
type II error of 0.20 to detect a relative reduction of N-terminal
pro-B-type natriuretic peptide (NT-proBNP) between the intervention versus
standard of- care arms of at least 40% of ln(NT-proBNP) after 6 months.
Thus, assuming a dropout of 10%, the total sample size will recruit 136
patients. Result(s): Figure 1 shows a summary of the study timetable.
 Conclusion(s): The EF-CARISTO study is designed to provide
exploratory data on the effects of SGLT2i on biomarkers of cardiac
function, and exercise capacity in obstructive and non-obstructive HCM.

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