EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
2033204427
Title
Prognostic Value of Perioperative Near-Infrared Spectroscopy Monitoring
for Postoperative Acute Kidney Injury in Pediatric Cardiac Surgery: A
Systematic Review.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 29(3) (pp 209-218),
2025. Date of Publication: 01 Sep 2025.
Author
Niezen C.K.; Modestini M.; Massari D.; Bos A.F.; Scheeren T.W.L.; Struys
M.M.R.F.; Vos J.J.
Institution
(Niezen, Modestini, Massari, Scheeren, Struys, Vos) Department of
Anesthesiology, University Medical Center Groningen, University of
Groningen, Groningen, Netherlands
(Niezen) Department of Anesthesiology, Isala Hospital, Zwolle, Netherlands
(Bos) Department of Neonatology, Beatrix Children's Hospital, University
Medical Center Groningen, University of Groningen, Groningen, Netherlands
(Struys) Department of Basic and Applied Medical Sciences, Ghent
University, Gent, Belgium
Publisher
SAGE Publications Inc.
Abstract
Introduction: Postoperative acute kidney injury (AKI) is a common
postoperative complication in cardiac surgery, with varying reported
incidences and prognostic factors. Renal hypoperfusion is believed to be a
key factor contributing to postoperative AKI. Near-infrared spectroscopy
(NIRS) monitoring, which assesses regional tissue saturation
(RSO<inf>2</inf>), has been suggested as a tool to predict postoperative
AKI. The aim of this systematic review was to examine the prognostic value
of perioperative NIRS monitoring in predicting postoperative AKI in
pediatric patients. <br/>Methods and Results: After a systematic search in
PubMed, EMBASE, and Cochrane library, twenty studies (1517 patients) were
included. The inter-rater agreement on study quality was strong, yet a
high risk of bias was identified. <br/>Conclusion(s): The heterogeneity of
the results-in part attributable to several potential confounding factors
regarding study population, monitoring technique and the definition of
AKI-together with the lack of a clear and consistent association between
RSO<inf>2</inf> values and AKI, currently preclude recommending NIRS
monitoring as a reliable and valid clinical tool to "predict" AKI in the
individual patient.<br/>Copyright &#xa9; The Author(s) 2025. This article
is distributed under the terms of the Creative Commons Attribution 4.0
License (https://creativecommons.org/licenses/by/4.0/) which permits any
use, reproduction and distribution of the work without further permission
provided the original work is attributed as specified on the SAGE and Open
Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).

<2>
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Accession Number
2040105816
Title
Anticoagulant interruption in transcatheter aortic valve implantation
(TAVI): a strategy to lower bleeding risks.
Source
Annals of Medicine and Surgery. 87(6) (pp 3057-3059), 2025. Date of
Publication: 01 Jun 2025.
Author
Rasheed S.; Anas M.; Salomon I.
Institution
(Rasheed) Department of Medicine, Jinnah Sindh Medical University,
Karachi, Pakistan
(Anas) Bacha Khan College of Dentistry, Mardan, Pakistan
(Salomon) Department of General Medicine and Surgery, University of Rwanda
College of Medicine and Health Sciences, Kigali, Rwanda
Publisher
Lippincott Williams and Wilkins

<3>
Accession Number
2035776603
Title
Depression and health outcomes: An umbrella review of systematic reviews
and meta-analyses of observational studies.
Source
Translational Psychiatry. 15(1) (no pagination), 2025. Article Number:
298. Date of Publication: 01 Dec 2025.
Author
Chen X.; Liu X.; Li F.; He H.; Li X.; Qin T.; Jiang B.; Chen Y.; Wang Y.;
Su Y.; Wang X.; Liang L.; Hua H.; Wu J.; Ma J.; Hu F.; Qin P.
Institution
(Chen, Li, Li, Wang, Su) School of Public Health, Shantou University,
Guangdong, Shantou, China
(Liu, Hua) Department of Respiratory and Critical Care Medicine, the
Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
(He) Department of Urology, Shenzhen Qianhai Shekou Free Trade Zone
Hospital, Shenzhen, China
(Qin) Institute of Software Chinese Academy of Sciences, Guangdong,
Beijing, China
(Jiang, Wang, Wu, Ma) Department of Neurology, Shenzhen Qianhai Shekou
Free Trade Zone Hospital, Guangdong, Shenzhen, China
(Chen, Liang) Department of Gynecology and Obstetrics, Shenzhen Qianhai
Shekou Free Trade Zone Hospital, Guangdong, Shenzhen, China
(Hu) Department of Biostatistics and Epidemiology, School of Public
Health, Shenzhen University Medical School, Shenzhen, China
(Qin) Department of Behavioural Science and Health, University College
London, London, United Kingdom
Publisher
Springer Nature
Abstract
Background: Currently, most studies of depression are limited to a single
disease endpoint. <br/>Aim(s): This study aimed to conduct an umbrella
review to comprehensively assess the association between depression and
health outcomes. <br/>Method(s): Until December 17, 2024, we conducted a
systematic search of systematic reviews and meta-analyses in PubMed,
Embase, and Web of Science. We reanalyzed the summary effects and 95%
confidence intervals for each study using random models. We assessed the
methodological quality and evidence quality of the research with A
Measurement Tool to Assess Systematic Reviews 2 and Grade of
Recommendations, Assessment, Development and Evaluation, classifying
studies into four categories based on evidence classification criteria.
<br/>Result(s): We selected a total of 72 articles from 27,150 resulting
in 114 meta-analyses and 109 health outcomes. Depression exposure was
associated with 23 mortality, 21 cardiovascular outcomes, 15 offspring
outcomes, 9cancer outcomes, 9 neurological outcomes, 5 endocrine outcomes,
5 dental outcomes, 3 digestive outcomes, and 19 other health outcomes.
Moderate-quality evidence linked depression to specific mortality in
bladder cancer (Class IV), all-cause mortality in myocardial infarction
(Class III), mortality within 2 years of initial assessment in coronary
artery disease (Class IV), major adverse cardiovascular events after
percutaneous coronary intervention (Class III), irritable bowel syndrome
(insignificant), fear of falling (Class III), and frailty (Class III).
<br/>Conclusion(s): Depression has a significant impact on health
outcomes, primarily mortality and cardiovascular outcomes. However, more
definitive conclusions still require randomized controlled trials or
prospective studies for validation.<br/>Copyright &#xa9; The Author(s)
2025.

<4>
Accession Number
2035801517
Title
Unveiling the Future of Infective Endocarditis Diagnosis: The
Transformative Role of Metagenomic Next-Generation Sequencing in
Culture-Negative Cases.
Source
Journal of Epidemiology and Global Health. 15(1) (no pagination), 2025.
Article Number: 108. Date of Publication: 01 Dec 2025.
Author
Shinge S.A.U.; Zhang B.; Zheng B.; Qiang Y.; Ali H.M.; Melchiade Y.T.V.;
Zhang L.; Gao M.; Feng G.; Zeng K.; Yang Y.
Institution
(Shinge, Zhang, Zheng, Qiang, Zhang, Gao, Feng, Zeng, Yang) Department of
Cardiovascular Surgery, The Eighth Affiliated Hospital of Sun Yat-sen
University, Futian, Shenzhen, China
(Yang) Department of Cardiothoracic and Vascular Surgery, University
Hospital, Linkoping University, Linkoping, Sweden
(Melchiade) Department of Cardiovascular Surgery, Sun Yat-sen Memorial
Hospital, Sun Yat-sen University, Guangzhou, China
(Ali) Department of Pediatric, The First Affiliated Hospital of Sun
Yat-sen University, Guangzhou, China
Publisher
Springer Science and Business Media B.V.
Abstract
Culture-negative infective endocarditis (CNE) remains a significant
diagnostic challenge in cardiology and infectious disease, often leading
to delayed or empirical treatment. Metagenomic next-generation sequencing
(mNGS) has emerged as a complementary diagnostic tool capable of
identifying fastidious, unexpected, or novel pathogens without prior
assumptions. This narrative review synthesizes evidence from 152 studies
(2015-2024), evaluating mNGS within existing diagnostic frameworks for
culture-negative IE. Compared to conventional diagnostics (blood cultures,
PCR, 16 S rRNA sequencing), mNGS demonstrates enhanced detection
capabilities for polymicrobial infections and rare pathogens, though
methodological heterogeneity across studies precludes definitive
performance comparisons. Performance varies substantially based on sample
type, sequencing platform, and bioinformatic pipelines. Real-world
applications reveal persistent challenges, including cost barriers,
interpretive complexities in low-biomass samples, and contamination risks.
Integration with host-response biomarkers and AI-driven interpretation
platforms shows promise for advancing clinical utility. For mNGS to be
effectively integrated into routine CNE care, standardization, regulatory
clarity, and equitable implementation will be essential.<br/>Copyright
&#xa9; The Author(s) 2025.

<5>
Accession Number
2037022290
Title
Continuing versus Withholding renin angiotensin aldosterone system
antagonists before non-cardiac surgery: A protocol of a systematic review
and meta-analysis.
Source
Tunisie Medicale. 103(8) (pp 978-981), 2025. Date of Publication: 01 Aug
2025.
Author
Chaouch M.A.; Haddad F.; Kammoun E.; Clautiaux H.; Daghmouri M.A.
Institution
(Chaouch) Department of Visceral and Digestive Surgery, Monastir
University Hospital, Monastir, Tunisia
(Haddad, Kammoun) University Tunis El Manar, Faculty of medicine of Tunis,
Mongi Slim Hospital, Department of anesthesia and intensive care, Tunis,
Tunisia
(Clautiaux, Daghmouri) Department of Anesthesiology, Montreuil
Intercommunal Hospital Center, France
Publisher
Societe Tunisienne des Sciences Medicales
Abstract
Introduction: Perioperative use of ACE inhibitors (ACEIs) and angiotensin
II receptor blockers (ARBs) has been linked to early postinduction
hypotension requiring vasopressor use under general anesthesia,
potentially leading to complications like acute renal injury, myocardial
injury, or stroke. However, the relationship between perioperative
ACEI/ARB use and major morbidity remains uncertain. <br/>Aim(s): This
meta-analysis assessed the differences between the continuation or
discontinuation of ACE inhibitor (ACE-I) or angiotensin II receptor
blocker (ARB) therapy during the perioperative period and hemodynamical
instability, mortality, and major morbidity outcomes. <br/>Method(s): The
protocol was registered in the PROSPERO database (ID: CRD42024519162).
Literature searches of electronic databases and manual searches on the
Medline, Embase, Scopus, and Web of Science databases up to August 30,
2024, will be performed. Case-control studies, cohort studies,
non-randomized controlled trials, and randomized controlled trials (RCTs)
involving adult patients aged over 18 years, who were chronically using
ACEIs or ARBs due to chronic hypertension, undergoing non-cardiac surgery,
where ACEIs or ARB therapy was either withheld or continued less than 10
hours before surgery will be included. The primary outcome will be the
incidence of intraoperative hypotension. Secondary outcomes will be the
intraoperative use of vasoactive agent (incidence, dose of ephedrine (mg)
and dose of phenylephrine (ng)), the incidence of severe hypotension,
hospital length of stay, intraoperative and postoperative hypertension,
the incidence of acute kidney injury, 30-day postoperative all-cause
mortality and incidence of major cardio-cerebral events.
<br/>Conclusion(s): The results of this systematic review and
meta-analysis should provide evidence for withholding or continuing
perioperative ACE-I or ARB in noncardiac surgery.<br/>Copyright &#xa9;
2025, Societe Tunisienne des Sciences Medicales. All rights reserved.

<6>
Accession Number
2040112653
Title
Clinical Presentation, Biomarker Trajectories, and Outcomes in Women and
Men Hospitalized for Acute Heart Failure.
Source
JACC: Heart Failure. 13(10) (no pagination), 2025. Article Number: 102524.
Date of Publication: 01 Oct 2025.
Author
Ravera A.; Qin H.; ter Maaten J.M.; Santema B.T.; Adamo M.; Ponikowski P.;
Cotter G.; Davison B.A.; Felker G.M.; Filippatos G.S.; Pang P.S.;
Greenberg B.H.; Gimpelewicz C.; Severin T.; Teerkink J.R.; Voors A.A.;
Metra M.
Institution
(Ravera, Adamo, Metra) Institute of Cardiology, ASST Spedali Civili di
Brescia and Department of Medical and Surgical Specialties, Radiologic
Sciences and Public Health, University of Brescia, Brescia, Italy
(Ravera, Qin, ter Maaten, Santema, Voors) Department of Cardiology,
University of Groningen, Groningen, Netherlands
(Ponikowski) Department of Heart Diseases, Medical University, Wroclaw,
Poland
(Ponikowski) Department of Cardiology, Center for Heart Diseases, Clinical
Military Hospital, Wroclaw, Poland
(Cotter, Davison) Momentum Research, Durham, NC, United States
(Felker) Division of Cardiology and Duke Clinical Research Institute, Duke
University School of Medicine, Durham, NC, United States
(Filippatos) Department of Cardiology, Athens University Hospital Attikon,
School of Medicine, National and Kapodistrian University of Athens,
Athens, Greece
(Pang) Department of Emergency Medicine, Indiana University School of
Medicine, Indianapolis, IN, United States
(Greenberg) University of California San Diego Health, Cardiovascular
Institute, La Jolla, CA, United States
(Gimpelewicz, Severin) Novartis Pharma, Basel, Switzerland
(Teerkink) Section of Cardiology, San Francisco Veterans Affairs Medical
Center and School of Medicine, University of California, San Francisco,
CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Previous studies have shown important but sometimes
heterogeneous differences between women and men with heart failure (HF).
<br/>Objective(s): This study aims to investigate sex differences in the
phenotype and journey of men and women in a large contemporary acute heart
failure (AHF) cohort. <br/>Method(s): The authors analyzed 6,545 AHF
patients (40% women) enrolled in RELAX-AHF-2 (Efficacy, Safety and
Tolerability of Serelaxin When Added to Standard Therapy in AHF).
<br/>Result(s): Women were older (78 vs 72 years; P < 0.001) and had
higher ejection fraction (45% vs 35%; P < 0.001). During hospitalization,
women received lower diuretic doses (furosemide equivalent through day 5:
200 vs 240 mg intravenous; P < 0.001) and achieved lower weight loss
(relative; P = 0.026), with slightly lower diuretic response (-0.33 vs
-0.36 kg/40 mg furosemide at day 5; P = 0.011) and similar sign and
symptom improvement by day 5 compared with men (all adjusted P > 0.05).
More women experienced worsening renal function by day 5 (WRF; adjusted
HR: 1.24 [95% CI: 1.06-1.46]; P = 0.009). Women experiencing WRF had
increased risk of 180-day cardiovascular death and rehospitalizations for
HF or renal failure (RF) and of rehospitalizations for HF/RF compared with
men and women without WRF (adjusted P for interaction: P < 0.001).
Incidence of other outcomes was similar in women and men (all P > 0.2).
<br/>Conclusion(s): During an AHF hospitalization, women received lower
doses of loop diuretic agents and achieved less weight loss with slightly
lower diuretic response compared with men, despite similar symptom relief
and postdischarge outcomes. Early incident WRF was more frequent in women
and was associated with worse 180-day outcomes. (Efficacy, Safety and
Tolerability of Serelaxin When Added to Standard Therapy in AHF
[RELAX-AHF-2]; NCT01870778)<br/>Copyright &#xa9; 2025

<7>
Accession Number
2037023679
Title
Cardiovascular risk and JAK inhibitor for the treatment of
spondyloarthritis: A systematic review protocol.
Source
Tunisie Medicale. 103(8) (pp 975-977), 2025. Date of Publication: 01 Aug
2025.
Author
Dhahri R.; Bellakhal S.; Boussaid S.; Ammar L.B.; Bettaieb H.; Gharsallah
I.; Sahli H.; Douggui M.H.
Institution
(Dhahri, Bellakhal, Boussaid, Ammar, Bettaieb, Gharsallah, Sahli, Douggui)
University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
(Dhahri, Ammar, Gharsallah) Department of Rheumatology, Military Hospital,
Tunis, Tunisia
(Bellakhal, Bettaieb, Douggui) Internal Medicine department, Internal
Forces Security Hospital, Rue Taher Ben Achour, La Marsa, Tunisia
(Boussaid, Sahli) Department of Rheumatology, La Rabta Universitary
Hospital, Tunisia
Publisher
Societe Tunisienne des Sciences Medicales
Abstract
Introduction: JAK inhibitors, a newer class of medications, work by
blocking specific enzymes (Janus kinases) that play a key role in
inflammation. By inhibiting these enzymes, JAK inhibitors help alleviate
inflammation and symptoms, providing an alternative treatment option to
conventional therapies like NSAIDs and biologics. Considering the lack of
updated findings on cardiovascular effects in SpA patients treated with
JAK inhibitors, we will perform a systematic review of the literature to
investigate the safety of JAK inhibitors in SpA patients. The aim of this
review is to evaluate cardiovascular safety of JAK inhibitors.
<br/>Method(s): We will search multiple databases, including PubMed,
Embase, and the Cochrane Library, using specific keywords such as "Janus
kinase inhibitors," "JAK inhibitors," "spondyloarthritis," and "cardiac
risk." Our inclusion criteria will focus on randomized controlled trials,
that reports Major Adverse Cardiovascular Events (MACE), in patients
treated with JAK inhibitors for spondyloarthritis. We will exclude cohort
studies, and those without relevant cardiac data, as well as animal
studies or those outside the scope of JAK inhibitor treatment. After
screening titles and abstracts, we performed a full-text review of the
selected articles to ensure the inclusion of studies with high
methodological quality and relevant data on cardiac risk factors. The
various stages of this literature search will be summarized using the
Preferred Reporting of Systematic Reviews and Meta-Analysis (PRISMA) flow
chart format to visualize the processes and findings of the review.
<br/>Result(s): The preliminary results demonstrated that the existing
data indicated no significant change in cardiovascular risk for JAK
inhibitors-treated patients with SpA. Data analyze find no notable
difference in the occurrence of MACE between the interventions and the
placebo groups. These finding are to interpret with caution, given the
limitations of the study numbers and duration. However, these findings
provide a foundation for further investigation in this area.
<br/>Conclusion(s): This systemic review highlights the safety of JAK
inhibitors according to MACE occurrence in patients with SpA when compared
to placebo. These results needs to be interpreted with caution regarding
the limited long-term data and small sample sizes in clinical trials.
Long-term studies are needed to clarify these risks.<br/>Copyright &#xa9;
2025, Societe Tunisienne des Sciences Medicales. All rights reserved.

<8>
Accession Number
2035761557
Title
Dexmedetomidine for the prevention of postoperative delirium in patients
undergoing cardiac surgery: a systematic review and meta-analysis with
trial sequential analysis.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 408. Date
of Publication: 01 Dec 2025.
Author
Zhong Y.; Ren Z.; Gao J.; He X.; Li Q.
Institution
(Zhong, Ren, Gao, Li) West China School of Medicine and West China
Hospital, Sichuan University, Chengdu, China
(He) School of Medicine, The Chinese University of Hong Kong, Shenzhen,
China
Publisher
BioMed Central Ltd
Abstract
Background: The efficacy of dexmedetomidine in preventing postoperative
delirium (POD) following cardiac surgery remains controversial. This
systematic review aimed to evaluate whether dexmedetomidine could prevent
POD in patients undergoing cardiac surgery. <br/>Method(s): PubMed,
CENTRAL, and Embase were searched up to 1 November 2024. Randomized
controlled trials (RCTs) concerning dexmedetomidine for preventing POD in
patients undergoing cardiac surgery were included. The primary outcome was
the incidence of POD, and the secondary outcome was the incidence of
postoperative atrial fibrillation (POAF). The analyses were performed
using RevMan 5.3 and R 4.4.2 to calculate risk ratio (RR) with 95%
confidence interval (CI). Trial sequential analysis (TSA) was conducted
using TSA 0.9.5.10 Beta. <br/>Result(s): Thirty-two studies with 6046
participants were included. Dexmedetomidine notably reduced the incidence
of POD (RR = 0.67, 95% CI 0.59-0.76, P < 0.00001), with sufficient
evidence and conclusive result from TSA. Dexmedetomidine was more
effective in preventing POD compared with both positive control (RR =
0.47, 95% CI 0.38-0.59, P < 0.00001) and placebo control (RR = 0.83, 95%
CI 0.70-0.98, P = 0.02). It reduced the incidence of POD not only in
elderly patients (RR = 0.66, 95% CI 0.54-0.81, P < 0.0001) but also in
normal age patients (RR = 0.68, 95% CI 0.57-0.80, P < 0.00001). Moreover,
dexmedetomidine decreased the incidence of POAF (RR = 0.82, 95% CI
0.74-0.92, P = 0.0005). <br/>Conclusion(s): Dexmedetomidine could reduce
the incidence of POD in patients undergoing cardiac surgery and was
associated with a decreased incidence of POAF. The findings should be
interpreted with caution because of the low to moderate quality of
evidence. Further trials are still needed to explore the optimal regimen
of dexmedetomidine. Registration number: INPLASY2024110008.<br/>Copyright
&#xa9; The Author(s) 2025.

<9>
Accession Number
2034676760
Title
Using a Markov Model and Real-World Evidence to Identify the Most
Cost-Effective Cholesterol Treatment Escalation Threshold for the
Secondary Prevention of Cardiovascular Disease.
Source
Applied Health Economics and Health Policy. 23(5) (pp 869-883), 2025. Date
of Publication: 01 Sep 2025.
Author
Mariani A.; Mohiuddin S.; Muller P.; Samarasekera E.; Swain S.A.; Mills
J.; Patel R.; Preiss D.; Shantsila E.; Downing B.C.; Lonergan M.; Rowark
S.; Welton N.J.; Williams R.; Wonderling D.
Institution
(Mariani, Mohiuddin, Muller, Rowark, Wonderling) Science, Evidence and
Analytics Directorate, National Institute for Health and Care Excellence,
2 Redman Place (2nd Floor), London, United Kingdom
(Samarasekera, Swain) Centre for Guidelines, National Institute for Health
and Care Excellence, London, United Kingdom
(Mills) Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
(Patel) Barts Health NHS Trust, University College London Hospitals NHS
Foundation Trust, London, United Kingdom
(Preiss) Nuffield Department of Population Health, University of Oxford,
Oxford, United Kingdom
(Shantsila) Institute of Population Health, University of Liverpool,
Liverpool, United Kingdom
(Downing, Welton) Population Health Science, Bristol Medical School,
University of Bristol, Bristol, United Kingdom
(Lonergan, Williams) Clinical Practice Research Datalink (CPRD), Safety
and Surveillance Group, Medicines and Healthcare Products Regulatory
Agency, London, United Kingdom
Publisher
Adis
Abstract
Background: Despite the decreased risk of cardiovascular disease (CVD)
with statins, there remains an unfulfilled clinical need to prevent CVD
events and premature mortality through further cholesterol-modifying
interventions. In people with established CVD taking a statin, lipid
therapy escalation to reduce low-density lipoprotein cholesterol (LDL-C)
or non-high-density lipoprotein cholesterol (non-HDL-C) levels may lower
the risk of CVD hospital admissions and improve survival. However, the
cost-effectiveness of different cholesterol treatment escalation
thresholds is uncertain. <br/>Objective(s): This study aimed to identify
the most cost-effective cholesterol threshold for escalating lipid therapy
in people with established CVD who are taking a statin, to support the
2023 update of the NICE guideline on CVD in England. <br/>Method(s): A
cohort Markov model with a yearly cycle length was developed to compare
the lifetime costs and quality-adjusted life years (QALYs) of various
LDL-C treatment escalation thresholds (0-4.0 mmol/L), using a combination
of treatment effects from an original network meta-analysis of randomised
controlled trials (RCTs), real-world data for estimating baseline
cholesterol levels and CVD event rates from a published meta-analysis of
statin RCTs. The model used the following CVD events: ischaemic stroke;
transient ischaemic attack; peripheral artery disease; myocardial
infarction; unstable angina; coronary revascularisation; and mortality.
The model also used evidence-based estimates of resource use and costs,
and published quality of life data. Baseline LDL-C levels and CVD hospital
admission rates were estimated through a bespoke analysis of the English
primary care data from Clinical Practice Research Datalink (CPRD), linked
to Hospital Episode Statistics Admitted Patient Care (HES) and Office for
National Statistics (ONS) death registrations. <br/>Result(s): Data from
590,917 adult individuals (61.7% men) with CVD on a statin in primary care
between 1 January 2013 and 28 February 2020 were included in the
CPRD-HES-ONS analysis. The most cost-effective threshold for lipid therapy
escalation was an LDL-C of 2.2 mmol/L (or equivalent non-HDL-C of 2.9
mmol/L) at NICE's lower cost per QALY of 20,000. An LDL-C of 2.0 mmol/L
(or equivalent non-HDL-C of 2.6 mmol/L) was the most cost-effective
treatment escalation threshold in a significant proportion (38%) of
probabilistic simulations and produced more health. At this threshold, the
model predicted that 42% of people with CVD would require combination
therapy with ezetimibe while 19% would require an injectable drug such as
inclisiran. At NICE's upper cost per QALY of 30,000, the most
cost-effective LDL-C treatment escalation threshold was 1.7 mmol/L (or
equivalent non-HDL-C of 2.2 mmol/L). <br/>Conclusion(s): The results
demonstrate the importance of establishing evidence of cost-effectiveness
for cholesterol treatment escalation thresholds. The study's findings
support the updated NICE guideline recommending a threshold of 2.0 mmol/L
LDL-C (or equivalent non-HDL-C of 2.6 mmol/L) for secondary prevention of
CVD.<br/>Copyright &#xa9; Crown 2025.

<10>
Accession Number
2035811503
Title
Outcomes of transcatheter aortic valve replacement in younger low-risk
patients: a comprehensive meta-analysis of efficacy and safety.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1586477. Date of Publication: 2025.
Author
Rocha de Almeida A.; Lima M.R.; Gomes D.A.; Fernandes R.; Oliveira E.I.;
Goncalves P.A.; Teles R.C.; de Sousa Almeida M.; Patricio L.
Institution
(Rocha de Almeida, Fernandes, Patricio) Unidade Local de Saude Alentejo
Central, Hospital Espirito Santo de Evora, Evora, Portugal
(Rocha de Almeida) Catolica Biomedical Research Centre, Faculty of
Medicine, Catholic University of Portugal, Oeiras, Portugal
(Rocha de Almeida, Oliveira) Centro de Cardiologia, Hospital Lusiadas
Lisboa, Lusiadas Saude, Lisboa, Portugal
(Lima, Gomes, Oliveira, Goncalves, Teles, de Sousa Almeida) Unidade Local
de Saude de Lisboa Ocidental, Hospital de Santa Cruz, Lisbon, Portugal
(Lima) Centro Clinico Academico de Lisboa, Lisboa, Portugal
(Goncalves, Teles, de Sousa Almeida) Comprehensive Health Research Center
(CHRC), Nova Medical School, Lisbon, Portugal
Publisher
Frontiers Media SA
Abstract
Background and aims: Severe aortic stenosis (AS) was traditionally managed
with surgical aortic valve replacement (SAVR). Transcatheter aortic valve
implantation (TAVI) emerged as a less invasive alternative, initially for
high-risk patients. This meta-analysis evaluates the outcomes of TAVI in
younger, low-risk patients, in whom SAVR is currently the gold standard.
<br/>Method(s): Following PRISMA guidelines, we systematically searched
randomized controlled trials (RCTs) comparing TAVI with SAVR in younger
(mean age <75 years) low-risk patients (STS score <4%) with severe AS. The
primary endpoint was a composite of death or disabling stroke. Secondary
endpoints included all-cause mortality, disabling stroke, atrial
fibrillation (AF), permanent pacemaker implantation (PPI), bleeding,
functional class (NYHA), and quality-of-life (KCCQ score) improvements.
<br/>Result(s): Four RCTs were included with 4,252 patients (2,125 TAVI
and 2,127 SAVR). At a mean follow-up of 16 +/- 5 months, TAVI showed a
non-significant reduction in the composite of death or disabling stroke
[2.8% vs. 5.1% risk ratio (RR) 0.98, 95% confidence interval (CI)
(0.96-1.00), p = 0.11] and all-cause mortality [2.1% vs. 3.7%, RR 0.99,
95% CI (0.97-1.00), p = 0.15]. The incidence of disabling stroke was
significantly lower in TAVI [0.9 vs. 2.1 RR 0.99, 95% CI (0.98-1.00), p <
0.01]. Hospital readmission [7.1% vs. 9.5% RR 0.97, 95% CI (0.96-0.99), p
< 0.01] and bleeding rates [4.7% vs. 16%, RR 0.87, 95% CI (0.82-0.93), p <
0.01] were significantly lower in the TAVI group. Conversely, TAVI had a
higher PPI rate [14% vs. 6%, RR 1.08, 95% CI (1.02-1.14), p < 0.01].
Faster symptomatic and quality-of-life improvements were sustained in the
TAVI group. <br/>Conclusion(s): TAVI is a viable option for younger
low-risk patients with severe AS, being non-inferior to SAVR in short-term
outcomes. The benefits of TAVI include a lower risk of disabling stroke,
hospital readmission, and bleeding, as well as quicker improvements in
symptoms and quality of life. However, higher PPI rates require careful
patient selection. The results support a tailored approach to TAVI in
younger patients, with ongoing evaluation of long-term outcomes.
Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024559473, PROSPERO
(CRD42024559473).<br/>Copyright 2025 Rocha de Almeida, Lima, Gomes,
Fernandes, Oliveira, Goncalves, Teles, de Sousa Almeida and Patricio.

<11>
Accession Number
647492428
Title
Postoperative stellate ganglion block reduces high-sensitivity troponin T
release in patients undergoing off-pump coronary artery bypass surgery: a
randomized controlled trial.
Source
Minerva anestesiologica. 91(7-8) (pp 658-665), 2025. Date of Publication:
01 Jul 2025.
Author
Zhu Y.; Zhu X.; Wang L.; Shen L.; Qi D.
Institution
(Zhu, Zhu, Wang, Shen) Key Laboratory of Anesthesiology, Xuzhou Medical
University, Xuzhou, China
(Zhu, Zhu, Wang, Shen, Qi) Department of Anesthesiology, Affiliated
Hospital of Xuzhou Medical University, Xuzhou, China
(Qi) Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou,
China
Abstract
BACKGROUND: The non-analgesic applications of stellate ganglion block
(SGB) are increasingly garnering scholarly and clinical interest. This
study aimed to investigate the myocardial protective effects of
postoperative SGB in patients undergoing off-pump coronary artery bypass
grafting (OPCABG). <br/>METHOD(S): In this double-blind, randomized
controlled trial, 62 adults scheduled for OPCABG were randomized to one of
two groups: the right stellate ganglion block group (RSGB group) and the
control group. Postoperation, participants had a right SGB. However,
controls were not blocked. The primary outcome was serum high-sensitivity
troponin T concentration measured within seven days after surgery.
Secondary outcomes included postoperative hemodynamics, postoperative pain
scores, postoperative incidence of atrial fibrillation, postoperative
dosage of vasoactive drugs, postoperative opioid consumption, incidence of
myocardial infarction, 30-day postoperative mortality, and length of
hospital stay. <br/>RESULT(S): At some point after the operation, the RSGB
group patients' serum high-sensitivity troponin levels were noticeably
lower than the control group, with means (standard deviation [SD]) of
146.1 (49.7) vs. 207.8 (50.6) at 12 hours; 132.7 (35.6) vs. 202.6 (43.8)
at 24 hours; 19.7 (9.2) vs. 41.7 (24.7) at seven days; all P<0.001.
Moreover, the RSGB group showed significantly lower pain scores, a
significantly reduced postoperative rate-pressure product (RPP) value, and
a substantially lower incidence of atrial fibrillation.
<br/>CONCLUSION(S): In patients undergoing OPCABG, it was observed that
postoperative right SGB can reduce postoperative high-sensitivity cardiac
troponin T levels.

<12>
Accession Number
2035822122
Title
Effect of SGLT2 inhibitors on cardiac structure and function assessed by
cardiac magnetic resonance: a systematic review and meta-analysis.
Source
Cardiovascular Diabetology. 24(1) (no pagination), 2025. Article Number:
345. Date of Publication: 01 Dec 2025.
Author
Leo I.; Salerno N.; Figliozzi S.; Cersosimo A.; Ielapi J.; Stankowski K.;
Bisaccia G.; Dellegrottaglie S.; Canino G.; De Rosa S.; Sorrentino S.;
Bucciarelli-Ducci C.; Torella D.
Institution
(Leo, Salerno, Cersosimo, Ielapi, Canino, Torella) Department of
Experimental and Clinical Medicine, Magna Graecia University, Catanzaro,
Italy
(Leo, Bucciarelli-Ducci) CMR department, Royal Brompton and Harefield
Hospitals, Guy's and St Thomas' NHS foundation Trust, London, United
Kingdom
(Leo, Salerno, De Rosa, Sorrentino, Torella) Research Center for
Cardiovascular Science, Magna Graecia University, Catanzaro, Italy
(Figliozzi) IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano,
Milan, Italy
(Figliozzi) Department of Biomedical Sciences, Humanitas university, Pieve
Emanuele, Milan, Italy
(Stankowski) Department of Peri-operative Cardiology and Cardiovascular
Imaging, Centro Cardiologico Monzino IRCSS, Milan, Italy
(Bisaccia) Department of Neuroscience, Imaging and Clinical Sciences,
Institute for Advanced Biomedical Technologies "G. d'Annunzio", University
of Chieti- Pescara, Chieti, Italy
(Dellegrottaglie) Advanced Cardiovascular Imaging Unit, Ospedale
Medico-Chirurgico Accreditato Villa dei Fiori, Naples, Italy
(De Rosa, Sorrentino) Department of Medical and Surgical Sciences, Magna
Graecia University, Catanzaro, Italy
(Bucciarelli-Ducci) School of Biomedical Engineering and Imaging Sciences,
Faculty of Life Sciences and Medicine, King's College University, London,
United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background and aim: Sodium-glucose cotransporter-2 inhibitors (SGLT2i)
improve outcomes in patients with heart failure (HF) but underlying
mechanisms remain incompletely understood. Cardiac magnetic resonance
(CMR) is key in evaluating cardiac structure and function, enabling
accurate assessment of reverse remodeling. Aim of this systematic review
and meta-analysis was to assess the effects of SGLT2i on cardiac
remodeling evaluated by CMR changes. <br/>Method(s): We conducted a
systematic review and meta-analysis of studies assessing changes in CMR
parameters in patients treated with SGLT2i (PROSPERO registration:
CRD42024574302). Databases were searched through April 30, 2025.
Random-effects models were used to pool mean changes in left and right
ventricular volumes, mass, function, stroke volume, global longitudinal
strain, left atrial volume, and tissue characterization indices.
Meta-regression and sensitivity analyses were performed to evaluate
potential sources of heterogeneity. <br/>Result(s): Twenty-three studies
and 1008 patients were included. Treatment with SGLT2i was associated with
significant reductions in left ventricular (LV) end-diastolic volume (-
7.10 mL; 95% CI: -13.01 to - 1.19, p = 0.023), left ventricular mass (-
4.24 g; 95% CI: -7.88 to - 0.60, p = 0.027) and epicardial adipose tissue
(-4.94 ml; 95% CI: -9.06, -0.82, p = 0.019). A subgroup analysis in
patients with reduced LV ejection fraction showed improvement in LV stroke
volume. Meta-regression revealed no significant effect of age, male sex or
diabetes prevalence on pooled estimates. <br/>Conclusion(s): SGLT2i are
associated with reductions in LV volumes and mass in line with an overall
favorable reverse remodeling effects as assessed by CMR.<br/>Copyright
&#xa9; The Author(s) 2025.

<13>
Accession Number
2039203698
Title
Link Between Cardiac Allograft Vasculopathy and Metabolic Syndrome: A
Systematic Review and Meta-Analysis.
Source
Metabolic Syndrome and Related Disorders. 23(7) (pp 338-348), 2025. Date
of Publication: 01 Aug 2025.
Author
Pajareya P.; Chuanchai W.; Siranart N.; Phutinart S.; Jansem P.; Basch N.;
Techasatian W.; Tokavanich N.; Prasitlumkum N.; Chokesuwattanaskul R.
Institution
(Pajareya, Chuanchai, Siranart, Phutinart, Chokesuwattanaskul) Division of
Cardiovascular Medicine, Center of Excellence in Arrhythmia Research,
Cardiac Center, Faculty of Medicine, King Chulalongkorn Memorial Hospital,
Chulalongkorn University, Bangkok, Thailand
(Jansem) Department of Psychiatry, Faculty of Medicine, Prince of Songkla
University, Songkhla, Thailand
(Basch) Faculty of Medicine, King Chulalongkorn Memorial Hospital,
Chulalongkorn University, Bangkok, Thailand
(Techasatian) Division of Cardiovascular Medicine, Louisiana State
University, Shreveport, LA, United States
(Tokavanich) Division of Cardiovascular Medicine, University of Michigan
Health, Ann Arbor, MI, United States
(Prasitlumkum) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
Publisher
Mary Ann Liebert Inc.
Abstract
Background: Metabolic syndrome (MetS) is increasingly prevalent globally
and is linked to inflammation in cardiac tissues. Cardiac allograft
vasculopathy (CAV) is a significant inflammatory condition and a leading
cause of graft failure after orthotopic heart transplantation (OHT). The
relationship between MetS and CAV remains poorly understood.
<br/>Method(s): A literature search was conducted from inception to
September 2024, including studies that reported associations between MetS
or its components (obesity, hypertension, dyslipidemia, and diabetes
mellitus) and CAV. The primary endpoint was the development of CAV after
OHT. Results were presented as odds ratios (OR) or hazard ratios (HR) with
95% confidence intervals (CI), employing both random and fixed-effect
models based on heterogeneity. <br/>Result(s): A total of 16 studies
involving 3,366 patients were included. The prevalence of MetS was high
before OHT (32%, 95% CI: 24-41%, I² = 75%) and increased after
OHT (37%, 95% CI: 18-61%, I² = 83%). MetS was significantly
associated with CAV (OR = 1.99, 95% CI: 1.28-3.09, I² = 36%).
Key components of MetS linked to CAV included obesity (OR = 1.54, 95% CI:
1.11-2.13, I² = 0%) and dyslipidemia (OR = 1.87, 95% CI:
1.49-2.36, I² = 0%). New-onset diabetes mellitus after
transplantation increases the risk of CAV with an HR of 1.71 (95% CI:
1.56-1.88, I² = 0%). <br/>Conclusion(s): The high prevalence of
MetS both before and after OHT is associated with an increased risk of
CAV, highlighting the need for targeted interventions to manage MetS in
heart transplant recipients.<br/>Copyright 2025, Mary Ann Liebert, Inc.,
publishers.

<14>
Accession Number
2040164828
Title
Radiation exposure risk for various personnel in the catheterization
laboratory: A systematic review and meta-analysis.
Source
Physica Medica. 137 (no pagination), 2025. Article Number: 105096. Date of
Publication: 01 Sep 2025.
Author
Balazs B.B.; Laczko D.; Gergo D.; Szabo B.; Duray G.; Molnar Z.; Horvathy
D.B.; Papp J.; Hegyi P.; Merkely B.; Edes I.F.
Institution
(Balazs, Laczko, Duray, Merkely, Edes) Heart and Vascular Center,
Semmelweis University, Budapest, Hungary
(Balazs, Laczko, Gergo, Szabo, Duray, Molnar, Horvathy, Papp, Hegyi, Edes)
Center for Translational Medicine, Semmelweis University, Budapest,
Hungary
(Gergo) Faculty of Pharmacy, Department of Pharmacognosy, Semmelweis
University, Budapest, Hungary
(Szabo, Hegyi) Institute for Translational Medicine, Medical School,
University of Pecs, Pecs, Hungary
(Duray, Papp) Department of Cardiology, Central Hospital of Northern Pest
- Military Hospital Budapest, Hungary
(Molnar) Department of Anesthesiology and Intensive Therapy, Semmelweis
University, Budapest, Hungary
(Molnar) Department of Anesthesiology and Intensive Therapy, Poznan
University of Medical Sciences, Poznan, Poland
(Horvathy) Department of Interventional Radiology, Heart and Vascular
Center, Semmelweis University, Budapest, Hungary
(Hegyi) Institute of Pancreatic Diseases, Semmelweis University, Budapest,
Hungary
Publisher
Associazione Italiana di Fisica Medica
Abstract
Purpose: Radiation exposure is a well-recognized occupational hazard for
catheterization lab personnel. However, the extent of exposure disparities
among different staff roles remains unclear. Existing research primarily
focuses on primary operators, leaving a gap in understanding radiation
risks for ancillary staff. This study aims to evaluate how staff
positioning and shielding affect radiation exposure, focusing on
disparities between primary operators and ancillary staff during
fluoroscopy-guided cardiovascular procedures. <br/>Method(s): After a
systematic search across five databases on November 20, 2023, we included
studies reporting radiation data for coronary angiographies, structural
heart interventions, electrophysiological procedures, or endovascular
aorta interventions, with at least one ancillary staff member in
prespecified positions. Radiation exposures were compared relative to the
primary operator using the Ratio of Means (ROM) during meta-analysis. Risk
of Bias was assessed using RoB-2 or ROBINS-E. The review protocol was
registered as CRD42023484491. <br/>Result(s): Our meta-analysis, based on
8116 measurements from 3091 procedures across 23 studies, suggests that
personnel at the patient's head without shielding may experience higher
radiation exposure than primary operators (ROM 1.77, 95% CI: 0.75-4.18),
although this difference didn't reach statistical significance. Shielded
workers at the head or in secondary/assistant positions received
significantly lower radiation than primary operators (ROM 0.26, 95% CI:
0.12-0.57; ROM 0.33, 95% CI: 0.25-0.43). <br/>Conclusion(s): Our results
suggest a potential disparity in radiation exposure among catheterization
laboratory personnel, with unshielded workers at the patient's head
tending to receive the highest levels of exposure. Dedicated shielding
solutions and attention to all personnel are imperative.<br/>Copyright
&#xa9; 2025 Associazione Italiana di Fisica Medica e Sanitaria

<15>
Accession Number
2039570708
Title
Impact of superficial and deep parasternal blocks on recovery after
cardiac surgery with sternotomy: a randomised controlled trial.
Source
British Journal of Anaesthesia. 135(3) (pp 764-771), 2025. Date of
Publication: 01 Sep 2025.
Author
Demarquette A.; Jeanneteau A.; Blanchard-Daguet A.; Fouquet O.;
Parot-Schinkel E.; Lasocki S.; Rineau E.; Leger M.
Institution
(Demarquette, Jeanneteau, Blanchard-Daguet, Lasocki, Rineau, Leger)
Departement d'Anesthesie Reanimation, Centre Hospitalier Universitaire
d'Angers, Angers, France
(Fouquet) Service de Chirurgie Cardiaque, Centre Hospitalier Universitaire
d'Angers, Angers, France
(Fouquet, Lasocki, Rineau) Univ Angers, INSERM, CNRS, MITOVASC, Equipe
CARME, SFR ICAT, Angers, France
(Parot-Schinkel) Departement de Biostatistique et Methodologie, Centre
Hospitalier Universitaire d'Angers, Angers, France
(Leger) INSERM UMR 1246 - SPHERE, Nantes University, Tours University,
Nantes, Centre Hospitalier Universitaire d'Angers, Angers, France
(Leger) UCSF Medical Center, Department of Anesthesia and Perioperative
Care, San Francisco, CA, United States
Publisher
Elsevier Ltd
Abstract
Background: Pain is common after cardiac surgery and can impair recovery.
Regional anaesthesia has been proposed to limit pain, but its impact on
recovery is unknown. This study compared the impact of superficial or deep
parasternal intercostal plane blocks (SPIP or DPIP) in addition to
standard care vs standard care alone on postoperative quality of recovery
(QoR) after cardiac surgery with sternotomy. <br/>Method(s): In this
single-centre, randomised, single-blind, controlled trial, adult patients
undergoing cardiac surgery with sternotomy were randomly assigned to one
of three groups (with a 1:1:1 allocation ratio): control group (standard
care without regional anaesthesia), SPIP group, or DPIP group. The primary
endpoint was QoR assessed using a French validated version of the Quality
of Recovery-15 questionnaire at 24 h after surgery. Secondary outcomes
included postoperative pain scores, analgesic consumption, ICU and
hospital length of stay, and adverse events. <br/>Result(s): Between July
1, 2022, and August 30, 2023, we randomised 254 patients (81.1% men, 65.5
[27-85] yr). The French validated version of the Quality of Recovery-15
scores did not significantly differ between any parasternal block group
(SPIP or DPIP) and the standard care group (P=0.248). Postoperative pain
and analgesic consumption were similar across groups, with low pain scores
(median [interquartile range] 24-h numerical rating scale: 2.0 [3.0-0.0]).
There were more pneumothoraces in the DPIP group (P=0.032). No significant
differences were observed for other complications. <br/>Conclusion(s):
Regional anaesthesia by parasternal intercostal plane blocks after
sternotomy did not improve QoR at 24 h compared with standard care.
Clinical trial registration: NCT05345639.<br/>Copyright &#xa9; 2025
British Journal of Anaesthesia

<16>
Accession Number
2035822154
Title
Cusp-overlap view versus three cusp coplanar view during transcatheter
aortic valve replacement using self-expandable valves: a systematic
review, meta-analysis and meta-regression.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
619. Date of Publication: 01 Dec 2025.
Author
Khalefa B.B.; Awad A.K.; Gonnah A.R.; Yassin M.N.A.; Hamam N.G.; Eldeeb
H.; Ramadan M.; Dway A.; Alsalhi K.; Osman M.T.; Alqeeq B.F.; Al-Tawil M.;
Sicouri S.; Baudo M.; Yamashita Y.; Ramlawi B.
Institution
(Khalefa, Awad, Osman) Faculty of Medicine, Ain Shams University, Cairo,
Egypt
(Awad) Department of Cardiothoracic Surgery, Ain-shams University
Hospitals, Cairo, Egypt
(Gonnah) Imperial College Healthcare NHS Trust, London, United Kingdom
(Yassin, Hamam) Faculty of Medicine, Cairo University, Cairo, Egypt
(Eldeeb) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Ramadan) Faculty of Medicine, Suez University, Suez, Egypt
(Dway) Faculty of Medicine, Al-Andalus University for Medical Sciences,
Tartus, Syrian Arab Republic
(Alsalhi) Faculty of Medicine, Batterjee Medical College, Jeddah, Saudi
Arabia
(Alqeeq) Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
(Al-Tawil) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
(Sicouri, Baudo, Yamashita, Ramlawi) Department of Cardiothoracic Surgery
Research, Lankenau Institute for Medical Research, Wynnewood, PA, United
States
(Baudo, Yamashita, Ramlawi) Department of Cardiothoracic Surgery, Lankenau
Heart Institute, Wynnewood, PA, United States
Publisher
BioMed Central Ltd
Abstract
Transcatheter aortic valve replacement (TAVR) is currently the treatment
of choice for most patients with severe aortic stenosis. We conducted this
meta-analysis to compare the outcomes of the cusp overlap technique (COT)
versus the standard three-cusp technique during self-expandable valves
implantation. We systematically searched PubMed, Scopus, Embase, Cochrane,
and Web of Science (WOS) from inception to March 5, 2024. To estimate the
effect size, dichotomous outcomes were pooled as RR, and continuous
outcome was pooled as MD with their respective 95% CI. We included
seventeen studies with a total of 3,129 patients in cusp-overlap technique
(COT) arm and 2,818 patients in standard technique (ST) arm. The rate of
30-day mortality was borderline reduced in COT compared with ST, however,
with no significant difference (RR = 0.61; 95% CI: [0.37-1.00], P = 0.05).
Regarding conduction abnormalities, COT was related to lower risk of
complete atrioventricular (AV) block (RR = 0.51; 95% CI: [0.37-0.69], P <
0.01), and permanent pacemaker implantation (PPM) (RR = 0.56; 95% CI:
[0.46-0.70], P < 0.01). Mild to severe paravalvular leak (PVL) (RR = 1.00;
95% CI: [0.66-1.51], P = 1.00, I2 = 62%; P = 0.02) were comparable between
COT and ST. Our study findings suggest that COT offers several advantages
over ST, including reduced 30-day mortality, bleeding complications, and
shorter procedural duration. The COT most importantly lowers the risk of
conduction abnormalities, and hence the incidence PPM.<br/>Copyright
&#xa9; The Author(s) 2025.

<17>
Accession Number
2040121123
Title
Predictors of short-term mortality in patients undergoing emergency
coronary artery bypass grafting: a systematic review and meta-analysis.
Source
Vessel Plus. 8 (no pagination), 2024. Article Number: 32. Date of
Publication: 2024.
Author
Comanici M.; Nadia B.; Raja S.G.
Institution
(Comanici, Nadia, Raja) Department of Cardiac Surgery, Harefield Hospital,
London, United Kingdom
Publisher
OAE Publishing Inc.
Abstract
Aim: Emergency coronary artery bypass grafting (CABG) is a critical
intervention for patients with acute coronary syndrome (ACS), particularly
in high-risk cases where rapid revascularization is necessary. Despite
advancements in surgical techniques, early mortality rates remain high.
This study aims to identify predictors of short-term mortality in patients
undergoing emergency CABG for ACS through a comprehensive systematic
review and meta-analysis. <br/>Method(s): A PRISMA-based systematic review
was performed using major databases up to May 2024. Inclusion criteria
focused on studies reporting short-term mortality outcomes and associated
predictors in patients undergoing emergency CABG for ACS. Data extraction
and quality assessment were performed independently by multiple reviewers.
Statistical analysis included pooled odds ratios (OR) and confidence
intervals (CI) for identified predictors using random-effects models.
<br/>Result(s): A total of 20 studies encompassing 4,777 patients met the
inclusion criteria. Key predictors of short-term mortality include
advanced age (OR 1.40, 95%CI: 1.07-1.82), cardiogenic shock (OR 5.35,
95%CI: 3.27-8.74), chronic kidney disease (OR 3.55, 95%CI: 1.30-9.71), and
preoperative use of an intra-aortic balloon pump (OR 2.46, 95%CI:
1.00-6.04). Timing of surgery within the first 48 h post-ACS was also
associated with higher mortality rates. <br/>Conclusion(s): This
systematic review and meta-analysis highlight important predictors of
short-term mortality in patients undergoing emergency CABG for ACS. These
findings underscore the importance of tailored perioperative management
strategies to improve outcomes in this high-risk patient
population.<br/>Copyright &#xa9; The Author(s) 2024.

<18>
Accession Number
2039683734
Title
Evolution and Clinical Relevance of Left Atrial Appendage Residual Patency
After Percutaneous Closure: A Prespecified Analysis of the SWISS-APERO
Trial.
Source
JACC: Cardiovascular Imaging. 18(9) (pp 1059-1061), 2025. Date of
Publication: 01 Sep 2025.
Author
Galea R.; Krsnik J.P.; Peters A.A.; de Marco F.; Aminian A.; Meneveau N.;
Chalkou K.; Grani C.; Anselme F.; Franzone A.; Vranckx P.; Fischer U.;
Bedogni F.; Raber L.; Valgimigli M.
Publisher
Elsevier Inc.

<19>
[Use Link to view the full text]
Accession Number
2039982849
Title
A Randomized Trial of Acute Normovolemic Hemodilution in Cardiac Surgery.
Source
New England Journal of Medicine. 393(5) (pp 450-460), 2025. Date of
Publication: 31 Jul 2025.
Author
Monaco F.; Lei C.; Bonizzoni M.A.; Efremov S.; Morselli F.; Guarracino F.;
Giardina G.; Arangino C.; Pontillo D.; Vitiello M.; Belletti A.; Ajello
V.; Licheri M.; Nigro Neto C.; Barucco G.; Bukamal N.A.; Faustini C.;
Mantovani L.F.; Oriani A.; Santonocito C.; Mucchetti M.; Federici F.;
Gerli C.; Porta S.; Scandroglio A.M.; Zhang H.; Pieri M.; Osinsky R.;
Lazzari S.; Leonova E.; Calabro M.G.; Amitrano D.; Turi S.; Prati P.;
Fresilli S.; D'Amico F.; D'Andria Ursoleo J.; Labanca R.; Marmiere M.;
Pruna A.; Scquizzato T.; Klrali K.; Monti G.; Carmona M.J.C.; Tanaka K.;
Likhvantsev V.; Ti L.K.; Bove T.; Paternoster G.; Singh K.; Gurcu M.E.;
Lomivorotov V.; Landoni G.; Bellomo R.; Zangrillo A.
Institution
(Monaco, Bonizzoni, Morselli, Giardina, Pontillo, Belletti, Licheri,
Barucco, Faustini, Oriani, Mucchetti, Gerli, Scandroglio, Pieri, Lazzari,
Calabro, Turi, Fresilli, D'Amico, D'Andria Ursoleo, Labanca, Marmiere,
Pruna, Scquizzato, Monti, Landoni, Zangrillo) Department of Anesthesia and
Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
(Lei) Anesthesia Clinical Research Center, Department of Anesthesiology
and Perioperative Medicine, Xijing Hospital, Xi'an, China
(Efremov, Leonova) Saint-Petersburg State University Hospital, St.
Petersburg, Russian Federation
(Guarracino, Amitrano) Department of Cardiothoracic and Vascular
Anesthesia and Intensive Care, Azienda Ospedaliero Universitaria Pisana,
Pisa, Italy
(Arangino) Department of Cardiothoracic Anesthesia and Intensive Care,
IRCCS Centro Cardiologico Monzino, Milan, Italy
(Vitiello) San Carlo Hospital, Cardiovascular Anesthesia and Intensive
Care, Potenza, Italy
(Ajello, Prati) Department of Cardiac Anesthesia, Tor Vergata University
Hospital, Rome, Italy
(Nigro Neto) Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil
(Bukamal) Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Bahrain
(Mantovani) Department of Anesthesia and Intensive Care, Maria Cecilia
Hospital, GVM International, Cotignola, Italy
(Santonocito) Department of Anesthesia and Intensive Care Medicine III,
Centro di Alte Specialita E Trapianti, Azienda Ospedaliero Universitaria
Policlinico G. Rodolico-San Marco, Catania, Italy
(Federici) Unita Operativa Complessa Anestesia E Rianimazione, Azienda
Ospedaliero-Universitaria Sant'Andrea, Rome, Italy
(Porta) S.C. Anestesia e Rianimazione Cardiovascolare, Azienda Ospedaliera
Ordine Mauriziano Umberto I di Torino, Turin, Italy
(Zhang) Department of Anesthesiology and Perioperative Medicine, Xijing
Hospital, Xi'an, China
(Pieri, Monti, Landoni, Zangrillo) School of Medicine, Vita-Salute San
Raffaele University, Milan, Italy
(Osinsky) E. Meshalkin National Medical Research Center, Department of
Anesthesiology and Intensive Care, Novosibirsk, Russian Federation
(Klrali) Kosuyolu High Specialization Education and Research Hospital,
Department of Cardiovascular Surgery, Istanbul, Turkey
(Carmona, Lomivorotov) Hospital Das Clinicas da Faculdade de Medicina da
Universidade de Sao Paulo, Instituto do Coracao, InCor, Sao Paulo, Brazil
(Tanaka) Department of Anesthesiology, University of Oklahoma Health,
Oklahoma, United States
(Likhvantsev) Federal Clinical and Research Center of Intensive Care and
Rehabilitation, Moscow, Russian Federation
(Likhvantsev) Loginov Moscow Clinical Scientific Center, Moscow, Russian
Federation
(Ti) Department of Anaesthesia, National University Hospital, Singapore
(Bove) Department of Emergency, University Hospital of Udine, Azienda
Sanitaria Universitaria Friuli Centrale Santa Maria della Misericordia,
Udine, Italy
(Bove) Department of Medicine, University of Udine, Udine, Italy
(Paternoster) Department of Health Science, Anesthesia and Intensive Care,
School of Medicine, University of Basilicata San Carlo Hospital, Potenza,
Italy
(Singh) University of Virginia Health, Charlottesville, United States
(Gurcu) Kosuyolu High Specialization Education and Research Hospital,
Department of Anesthesiology, Istanbul, Turkey
(Lomivorotov) Department of Anesthesiology and Perioperative Medicine,
Penn State Milton S. Hershey Medical Center, Hershey, PA, United States
(Bellomo) Department of Critical Care, University of Melbourne, Melbourne,
VIC, Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, VIC, Australia
Publisher
Massachussetts Medical Society
Abstract
Background Patients undergoing cardiac surgery often receive red-cell
transfusions, along with the associated risks and costs. Early
intraoperative normovolemic hemodilution (i.e., acute normovolemic
hemodilution [ANH]) is a blood-conservation technique that entails
autologous blood collection before initiation of cardiopulmonary bypass
and reinfusion of the collected blood after bypass weaning. More data are
needed on whether ANH reduces the number of patients receiving allogeneic
red-cell transfusion. Methods In a multinational, single-blind trial, we
randomly assigned adults from 32 centers and 11 countries who were
undergoing cardiac surgery with cardiopulmonary bypass to receive ANH
(withdrawal of >=650 ml of whole blood with crystalloids replacement if
needed) or usual care. The primary outcome was the transfusion of at least
one unit of allogeneic red cells during the hospital stay. Secondary
outcomes were death from any cause within 30 days after surgery or during
the hospitalization for surgery, bleeding complications, ischemic
complications, and acute kidney injury. Results A total of 2010 patients
underwent randomization; 1010 were assigned to ANH and 1000 to usual care.
Among patients with available data, 274 of 1005 (27.3%) in the ANH group
and 291 of 997 (29.2%) in the usual-care group received at least one
allogeneic red-cell transfusion (relative risk, 0.93; 95% confidence
interval, 0.81 to 1.07; P=0.34). Surgery for postoperative bleeding was
performed in 38 of 1004 patients (3.8%) in the ANH group and 26 of 995
patients (2.6%) in the usual-care group. Death within 30 days or during
hospitalization occurred in 14 of 1008 patients (1.4%) in the ANH group
and 16 of 997 patients (1.6%) in the usual-care group. Safety outcomes
were similar in the two groups. Conclusions Among adults undergoing
cardiac surgery, ANH did not reduce the number of patients receiving
allogeneic red-cell transfusion.<br/>Copyright &#xa9; 2025 Massachusetts
Medical Society.

<20>
Accession Number
2032706462
Title
LANDMARK comparison of early outcomes of newer-generation Myval
transcatheter heart valve series with contemporary valves (Sapien and
Evolut) in real-world individuals with severe symptomatic native aortic
stenosis: a randomised non-inferiority trial.
Source
The Lancet. 403(10445) (pp 2695-2708), 2024. Date of Publication: 22 Jun
2024.
Author
Baumbach A.; van Royen N.; Amat-Santos I.J.; Hudec M.; Bunc M.;
Ijsselmuiden A.; Laanmets P.; Unic D.; Merkely B.; Hermanides R.S.; Ninios
V.; Protasiewicz M.; Rensing B.J.W.M.; Martin P.L.; Feres F.; De Sousa
Almeida M.; van Belle E.; Linke A.; Ielasi A.; Montorfano M.; Webster M.;
Toutouzas K.; Teiger E.; Bedogni F.; Voskuil M.; Pan M.; Angeras O.; Kim
W.-K.; Rothe J.; Kristic I.; Peral V.; Garg S.; Elzomor H.; Tobe A.;
Morice M.-C.; Onuma Y.; Soliman O.; Serruys P.W.
Institution
(Baumbach) Centre for Cardiovascular Medicine and Devices, William Harvey
Research Institute, Queen Mary University of London and Barts Heart
Centre, London, United Kingdom
(Baumbach) Cleveland Clinic, London, United Kingdom
(van Royen) Department of Cardiology, Radboud University Hospital,
Nijmegen, Netherlands
(Amat-Santos) CIVERCV, Centro de Investigacion Biomedica en red -
Enfermedades Cardiovasculares, University Clinical Hospital of Valladolid,
Valladolid, Spain
(Amat-Santos) Department of Cardiology, University Clinical Hospital of
Valladolid, Valladolid, Spain
(Hudec) Department of Acute Cardiology, Middle-Slovak Institute Of
Cardiovascular Diseases, Banska Bystrica, Slovakia
(Bunc) Department of Cardiology, University Medical Centre Ljubljana,
Ljubljana, Slovenia
(Ijsselmuiden) Department of Cardiology, Amphia Hospital, Breda,
Netherlands
(Ijsselmuiden) Department of Interventional Cardiology, Maastricht
University Medical Center, Maastricht, Netherlands
(Ijsselmuiden) Zuyderland Hospital, Limburg, Netherlands
(Laanmets) Department of Invasive Cardiology, North Estonia Medical
Centre, Tallinn, Estonia
(Unic) Department of Cardiac and Transplant Surgery, University Hospital
Dubrava, Zagreb, Croatia
(Merkely) Heart and Vascular Centre, Semmelweis University Heart and
Vascular Centre, Budapest, Hungary
(Hermanides) Department of Cardiology, Isala Hospital, Zwolle, Netherlands
(Ninios) Department of Cardiology, European Interbalkan Medical Center,
Thessaloniki, Greece
(Protasiewicz) Department of Cardiology, Institute of Heart Diseases,
Wroclaw Medical University, Wroclaw, Poland
(Rensing) Department of Cardiology, St Antonius Hospital, Nieuwegein,
Netherlands
(Martin) Department of Interventional Cardiology, University Hospital of
Gran Canaria Dr Negrin, Las Palmas, Spain
(Feres) Department of Invasive Cardiology, Instituto Dante Pazzanese, Sao
Paulo, Brazil
(De Sousa Almeida) CHRC, NOVA Medical School, NOVA University Lisbon,
Lisbon, Portugal
(van Belle) Department of Interventional Cardiology, Lille University,
Lille, France
(Linke) Department of Internal Medicine and Cardiology, University Clinic,
Heart Center Dresden, University of Technology Dresden, Dresden, Germany
(Ielasi) Department of Interventional Cardiology, IRCCS Galeazzi
Sant'Ambrogio Hospital, Milan, Italy
(Montorfano) School of Medicine, Vita-Salute San Raffaele University,
Milan, Italy
(Montorfano) Interventional Cardiology Unit IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Webster) Department of Cardiology, Auckland City Hospital, Auckland, New
Zealand
(Toutouzas) Department of Cardiology, Hippokration Hospital, Athens,
Greece
(Teiger) Department of Medico-surgical Cardiovascular and Anaesthesiology,
Henri-Mondor University Hospital, Creteil, France
(Bedogni) Department of Clinical Cardiology, San Donato Hospital, Milan,
Italy
(Voskuil) Department of Interventional Cardiology, University Medical
Center Utrecht, Utrecht, Netherlands
(Pan) Department of Cardiology, University Hospital Reina Sofia,
University of Cordoba, Cordoba, Spain
(Angeras) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Angeras) Department of Clinical and Molecular Medicine, Gothenburg
University, Gothenburg, Sweden
(Kim) Department of Cardiology and Angiology, University of Giessen and
Marburg, Giessen, Germany
(Kim) Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim,
Germany
(Rothe) Department of Cardiology and Angiology, University Heart Center
Freiburg Bad Krozingen, University Medical Center Freiburg, Freiburg,
Germany
(Rothe) Department of Cardiology and Angiology, Faculty of Medicine,
University of Freiburg, Freiburg, Germany
(Kristic) Department of Cardiology, University Hospital of Split, Split,
Croatia
(Peral) Department of Cardiology, Son Espases University Hospital, Palma,
Spain
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Elzomor, Tobe, Onuma, Soliman, Serruys) Department of Cardiology, School
of Medicine, University of Galway, Galway, Ireland
(Morice) Cardiovascular European Research Center, Paris, France
Publisher
Elsevier B.V.
Abstract
Background: Transcatheter aortic valve implantation is an established,
guideline-endorsed treatment for severe aortic stenosis. Precise sizing of
the balloon-expandable Myval transcatheter heart valve (THV) series with
the aortic annulus is facilitated by increasing its diameter in 1.5 mm
increments, compared with the usual 3 mm increments in valve size. The
LANDMARK trial aimed to show non-inferiority of the Myval THV series
compared with the contemporary THVs Sapien Series (Edwards Lifesciences,
Irvine, CA, USA) or Evolut Series (Medtronic, Minneapolis, MN, USA).
<br/>Method(s): In this prospective, multinational, randomised,
open-label, non-inferiority trial across 31 hospitals in 16 countries
(Germany, France, Sweden, the Netherlands, Italy, Spain, New Zealand,
Portugal, Greece, Hungary, Poland, Slovakia, Slovenia, Croatia, Estonia,
and Brazil), 768 participants with severe symptomatic native aortic
stenosis were randomly assigned (1:1) to the Myval THV or a contemporary
THV. Eligibility was primarily decided by the heart team in accordance
with 2021 European Society of Cardiology guidelines. As per the criteria
of the third Valve Academic Research Consortium, the primary endpoint at
30 days was a composite of all-cause mortality, all stroke, bleeding
(types 3 and 4), acute kidney injury (stages 2-4), major vascular
complications, moderate or severe prosthetic valve regurgitation, and
conduction system disturbances resulting in a permanent pacemaker
implantation. Non-inferiority of the study device was tested in the
intention-to-treat population using a non-inferiority margin of 10.44% and
assuming an event rate of 26.10%. This trial is registered with
ClinicalTrials.gov, NCT04275726, and EudraCT, 2020-000137-40, and is
closed to new participants. <br/>Finding(s): Between Jan 6, 2021, and Dec
5, 2023, 768 participants with severe symptomatic native aortic stenosis
were randomly assigned, 384 to the Myval THV and 384 to a contemporary
THV. 369 (48%) participants had their sex recorded as female, and 399
(52%) as male. The mean age of participants was 80.0 years (SD 5.7) for
those treated with the Myval THV and 80.4 years (5.4) for those treated
with a contemporary THV. Median Society of Thoracic Surgeons scores were
the same in both groups (Myval 2.6% [IQR 1.7-4.0] vs contemporary 2.6%
[1.7-4.0]). The primary endpoint showed non-inferiority of the Myval (25%)
compared with contemporary THV (27%), with a risk difference of -2.3%
(one-sided upper 95% CI 3.8, p<inf>non-inferiority</inf><0.0001). No
significant difference was seen in individual components of the primary
composite endpoint. <br/>Interpretation(s): In individuals with severe
symptomatic native aortic stenosis, the Myval THV met its primary endpoint
at 30 days. <br/>Funding(s): Meril Life Sciences.<br/>Copyright &#xa9;
2024 Elsevier Ltd

<21>
Accession Number
2035204138
Title
Long-Term Outcomes in Sleeve Gastrectomy versus Roux-en-Y Gastric Bypass:
A Systematic Review and Meta-Analysis of Randomized Trials.
Source
Obesity Surgery. 35(8) (pp 3246-3257), 2025. Date of Publication: 01 Aug
2025.
Author
Monteiro Delgado L.; Fabretina de Souza V.; Fontel Pompeu B.; de Moraes
Ogawa T.; Pereira Oliveira H.; Sacksida Valladao V.D.C.; Lima Castelo
Branco Marques F.I.
Institution
(Monteiro Delgado, Fabretina de Souza, de Moraes Ogawa, Pereira Oliveira)
Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
(Fontel Pompeu, Lima Castelo Branco Marques) Department of General
Surgery, Hospital Heliopolis, Sao Paulo, Brazil
(Sacksida Valladao) Universidade Federal de Santa Catarina, Florianopolis,
Brazil
Publisher
Springer
Abstract
Obesity is a global health concern linked to metabolic and cardiovascular
complications. Bariatric surgery is an effective treatment, with sleeve
gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) being the most
studied procedures. This systematic review and meta-analysis compare the
long-term efficacy and safety of SG and RYGB. We searched PubMed, Embase,
and the Cochrane Library until May 20, 2024, for randomized trials with >=
5 years of follow-up comparing SG and RYGB. Primary outcomes included
excess weight loss (EWL), total weight loss (TWL), and excess BMI loss
(EBL). Secondary outcomes included diabetes remission, HbA1c levels,
obesity-related comorbidities, complications, and mortality. Risk ratios
(RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were
pooled using a random-effects model. We included 9 randomized trials
encompassing 1,489 patients. RYGB resulted in significantly greater EWL
(MD -14.00%; 95% CI -20.65 to -7.35), TWL (MD -5.67%; 95% CI -8.81 to
-2.52), and EBL (MD -7.44%; 95% CI -10.54 to -4.34) compared to SG. T2DM
remission was higher in the RYGB group (RR 0.72; 95% CI 0.54-0.97),
although HbA1c levels were similar between groups. RYGB also led to
greater improvement in GERD symptoms (RR 0.48; 95% CI 0.31-0.74). No
significant differences were observed between SG and RYGB in dyslipidemia,
hypertension, obstructive sleep apnea syndrome (OSAS), or joint pain.
Regarding safety, SG was associated with significantly lower late major
complications (RR 0.41; 95% CI 0.20-0.85), while early minor (RR 0.55; 95%
CI 0.17-1.83), early major (RR 0.99; 95% CI 0.45-2.20), and late minor
complications (RR 0.77; 95% CI 0.39-1.54) did not differ significantly
between procedures. Only one surgery-related death was reported, occurring
in the early postoperative period in the SM-BOSS trial. RYGB is associated
with greater long-term weight loss, improved T2DM remission, and superior
GERD control compared to SG. However, SG showed a lower incidence of late
major complications. Both procedures were comparable for the remaining
outcomes. These findings highlight the importance of considering both
efficacy and safety in the context of individual patient characteristics,
rather than focusing solely on weight loss.<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2025.

<22>
Accession Number
2040111255
Title
The Use of Perceval Valves in Older Patients: A Systematic Review.
Source
Reviews in Cardiovascular Medicine. 26(7) (no pagination), 2025. Article
Number: 39463. Date of Publication: 01 Jul 2025.
Author
Deblier I.; De Bock D.; Rodrigus I.; Mistiaen W.
Institution
(Deblier) Department of Cardiovascular Surgery, ZAS Middelheim Hospital,
Antwerp, Belgium
(De Bock, Rodrigus) Department of Cardiovascular Surgery, UZA - University
Hospital Antwerp, Edegem, Belgium
(Rodrigus, Mistiaen) Faculty of Medicine & Health Sciences, University of
Antwerp, Antwerp, Belgium
Publisher
IMR Press Limited
Abstract
Background: The Perceval device is a sutureless, rapid-deployment valve
designed to shorten aortic cross-clamp (ACC) and cardiopulmonary bypass
(CPB) times, with the aim of improving postoperative outcomes in older,
high-risk patients. <br/>Method(s): A systematic review was conducted for
full articles published between 2020 and 2024, comparing the Perceval
valve with conventionally sutured valves, with a focus on preoperative and
operative data, as well as postoperative outcomes. Single-arm series were
retained for the same purpose. Articles with at least 100 valves were
included. <br/>Result(s): A total of six propensity score-matched series
and four randomized controlled trials were identified after removing
articles with data from the same patient population. Consequently, age and
risk scores were comparable. The use of a minimally invasive approach and
the association of other procedures, such as coronary artery bypass
grafting (CABG), varied depending on the research design. Adverse
postoperative events were comparable for both valve types, except for the
development of conduction defects, which required the implantation of a
permanent pacemaker (PPM). The initial PPM implantation rate was higher
for the Perceval valve, as shown in 5 of the 14 comparative series
however, this rate decreased after the adaptation of surgical techniques.
A meta-analysis showed that the CPB and ACC times were significantly
shorter using the Perceval valve, at 14.9 (8.2-21.5) minutes and 16.6
(12.1-21.2) minutes, respectively. Platelet counts after implantation were
lower with no clinical consequences, and the hemodynamic performance of
the Perceval device was acceptable and stable over time. The survival and
durability of the Perceval valve were also acceptable, with a reoperation
rate of 1% at the 5-year follow-up. <br/>Conclusion(s): The Perceval valve
appears to be a suitable alternative for older, high-risk patients
undergoing aortic valve replacement. Notably, the Perceval valve is
associated with shorter surgical times and could facilitate the advantage
of minimally invasive surgery. The need for postoperative PPM implantation
remains an issue.<br/>Copyright &#xa9; 2025 The Author(s).

<23>
[Use Link to view the full text]
Accession Number
2039983983
Title
Sex-Specific Differences in Clinical Outcomes in Patients With Coronary
Bifurcation Lesions.
Source
Cardiology in Review. 33(5) (pp 419-422), 2025. Date of Publication: 01
Sep 2025.
Author
Hosseinpour A.; Attar A.; Agrawal A.; Malik A.H.; Sood A.; Patel N.C.;
Aronow W.S.; Frishman W.H.; Gupta R.
Institution
(Hosseinpour) Department of Cardiology, School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Attar) Department of Cardiovascular Medicine, School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Agrawal) Department of Internal Medicine, Crozer Chester Medical Center,
Upland, PA, United States
(Malik, Aronow, Frishman) Department of Cardiology, Westchester Medical
Center, New York Medical College, Valhalla, NY, United States
(Sood) Department of Medicine, Navjivan General and Maternity Hospital,
Punjab, Jalandhar, India
(Patel, Gupta) Department of Cardiology, Lehigh Valley Heart Institute,
Lehigh Valley Health Network, Allentown, PA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Coronary bifurcation lesions are frequent challenging findings during
percutaneous coronary intervention (PCI). Contemporary evidence has
explored the potential sex-specific differences in patients undergoing
PCI. In the present meta-analysis, we compared clinical outcomes of
patients undergoing bifurcation PCI between women and men. Using the
random-effects method, we compared the clinical outcomes of patients with
a coronary bifurcation lesion following PCI between women and men. The
results were reported using relative risk (RR) and 95% confidence interval
(CI). Baseline comorbidities and mean age were compared between the 2
studied groups. Four observational studies comprising 30,684 patients
(8898 women and 21,786 men) were included in the meta-analysis. Women were
significantly older than men with a relatively higher prevalence of
baseline comorbidities. After using adjusted data from 2 out of 4
available studies, performing PCI for bifurcation lesions in women was not
associated with an increased risk of mortality (RR 1.33, 95% CI,
0.78-2.29), myocardial infarction (RR 1.22, 95% CI, 0.41-3.61), target
lesion revascularization (RR 1.06, 95% CI, 0.40-2.81), stent thrombosis
(RR 0.99, 95% CI, 0.09-10.52), and stroke (RR 1.19, 95% CI, 0.64-2.22).
Women were at higher risk of major bleeding compared to male counterparts
(RR 2.23, 95% CI, 1.73-2.89). The present study showed no difference in
the risk of adverse clinical outcomes except the risk of bleeding between
genders with coronary bifurcation lesions. Future studies with adjustment
of age and baseline comorbidities are needed to confirm these
findings.<br/>Copyright &#xa9; 2023 Wolters Kluwer Health, Inc. All rights
reserved.

<24>
Accession Number
2039521097
Title
Effects of ketamine on postoperative cognition: a scoping review.
Source
British Journal of Anaesthesia. 135(3) (pp 642-659), 2025. Date of
Publication: 01 Sep 2025.
Author
Brenna C.T.A.; He X.W.; Liu D.; Kaustov L.; Choi S.; Orser B.A.
Institution
(Brenna, Choi, Orser) Department of Anesthesiology & Pain Medicine,
University of Toronto, Toronto, ON, Canada
(Brenna, He, Liu, Orser) Department of Physiology, University of Toronto,
Toronto, ON, Canada
(Brenna, Kaustov, Choi, Orser) Perioperative Brain Health Centre,
Sunnybrook Health Sciences Centre, Toronto, ON, Canada
(Kaustov, Choi, Orser) Department of Anesthesia, Sunnybrook Health
Sciences Centre, Toronto, ON, Canada
Publisher
Elsevier Ltd
Abstract
Postoperative delirium and other forms of perioperative neurocognitive
deficits occur commonly in older adult patients. Ketamine, administered
either before or during general anaesthesia, may have cognitive-sparing
properties owing to its ability to reduce neuroinflammation, increase
neurotrophin levels, or allow reductions in the doses of other general
anaesthetic drugs. However, the efficacy of ketamine in preventing
perioperative neurocognitive disorders remains highly controversial. This
scoping review summarises clinical studies that examined the
cognitive-sparing properties of ketamine in adult surgical patients.
Clinical trials and retrospective cohort analyses that assessed cognition
in adult patients after treatment with racemic (R,S) ketamine, esketamine,
or arketamine were identified through a systematic search of the Embase
and Embase Classic databases (from 1947 to 2025). Overall, we identified
58 studies involving 6830 patients. Most studies (n=31) evaluated
postoperative delirium and, of these, most used a derivative of the
Confusion Assessment Method as the primary measurement tool (81%).
Thirty-nine studies evaluated other types of perioperative neurocognitive
disorders; of these, 24 (62%) used the Mini Mental State Examination and
six (15%) used the Montreal Cognitive Assessment. Ketamine produced no
cognitive benefits in 35 of the 58 studies (60%), whereas 23 studies (40%)
reported a reduced incidence or duration of perioperative neurocognitive
disorders, or both. There were no clear trends in terms of the doses,
enantiomeric formulations, or timing of ketamine administration associated
with favourable cognitive outcomes. However, ketamine studies that
evaluated cognition at only early postoperative timepoints were more
likely to report no cognitive benefit. Most trials were underpowered to
detect changes in cognitive endpoints, and study populations and methods
were too heterogeneous to support meaningful meta-analyses. Although the
current results summarised in this extensive review are inconsistent, the
data nevertheless support the need for larger, well-designed trials to
determine whether subgroups of patients that undergo specific types of
surgeries might benefit from ketamine. Recommendations regarding the
direction of future research are proposed.<br/>Copyright &#xa9; 2025
British Journal of Anaesthesia

<25>
Accession Number
2022332615
Title
Rationale and design for the myocardial ischemia and transfusion (MINT)
randomized clinical trial.
Source
American Heart Journal. 257 (pp 120-129), 2023. Date of Publication: 01
Mar 2023.
Author
Carson J.L.; Brooks M.M.; Chaitman B.R.; Alexander J.H.; Goodman S.G.;
Bertolet M.; Abbott J.D.; Cooper H.A.; Rao S.V.; Triulzi D.J.; Fergusson
D.A.; Kostis W.J.; Noveck H.; Simon T.; Steg P.G.; DeFilippis A.P.;
Goldsweig A.M.; Lopes R.D.; White H.; Alsweiler C.; Morton E.; Hebert P.C.
Institution
(Carson, Kostis, Noveck) Rutgers Robert Wood Johnson Medical School, New
Brunswick, NJ
(Brooks, Bertolet) University of Pittsburgh School of Public Health,
Pittsburgh, Panama
(Chaitman) St Louis University School of Medicine, St Louis, Macao
(Alexander, Lopes) Duke Clinical Research Institute, Durham, New Caledonia
(Goodman) St. Michael's Hospital, University of Toronto, Toronto, Canada
(Goodman) Canadian VIGOUR Centre, University of Alberta, Edmonton, AB,
Canada
(Abbott) Warren Alpert Medical School. Brown University, Providence, RI
(Cooper) Westchester Medical Center, Valhalla, NY
(Rao) Durham VA Medical Center, Durham, New Caledonia
(Rao) NYU Langone Health, New York, NY
(Triulzi) University of Pittsburgh School of Medicine, Pittsburgh, Panama
(Fergusson) Ottawa Hospital Research Institute Ottawa, ON, Canada
(Simon) Hopital Saint Antoine, Paris, France
(Steg) Universite Paris-Cite, Paris, France
(DeFilippis) Vanderbilt University, Nashville, Tunisia
(Goldsweig) University of Nebraska Medical Center, Omaha, Niger
(Lopes) Brazilian Clinical Research Institute, Sao Paulo, Brazil
(White, Alsweiler) Green Lane Clinical Coordinating Centre Ltd, Auckland,
New Zealand
(Morton) Finders University, Adelaide, Australia
(Hebert) Centre de Recherche du Centre Hosp. Universitaire de Montreal,
Montreal, Quebec, Canada
Rutgers Robert Wood Johnson Medical School (A01), United States
Louisville - University of Louisville (A02), Jewish Hospital (A14), Norton
Hospital (A65), United States
Westchester Medical Center (A03), United States
WakeMed Health & Hospitals (A04), United States
Montefiore - Weiler Hospital (A06), Moses Hospital (A23), United States
University of Arkansas Medical Sciences - Central Arkansas Veterans (A07),
United States
University of Arkansas Medical Sciences -University of Arkansas Medical
(A49), United States
Northwell Hospital System - Staten Island University (A09), United States
Northwell Hospital System - Southside Hospital (A53), United States
Northwell Hospital System - Lenox Hill Hospital (A62), United States
UNC Hospitals (A10), United States
Rochester General Hospital (A11), United States
AdventHealth - Adventist Hinsdale Hospital (A12), Adventist La Grange
Hospital (A21), Adventist Bolingbrook (A22), United States
Mayo Clinic (A13), United States
Lifespan - Rhode Island Hospital (A15), United States
Lifespan - The Miriam Hospital (A16), United States
Memphis VA Medical Center (A18), United States
UPMC Presbyterian (A20), United States
University of Vermont Medical (A27), United States
Jersey Shore University Medical (A29), United States
Virginia Commonwealth (A31), United States
St. Joseph Mercy Hospital (A32), United States
University of New Mexico (A33), United States
University of Chicago (A34), United States
University of Toledo (A36), United States
Beth Israel Deaconess (A37), United States
Memorial Hospital at Gulfport (A38), United States
Baylor St Luke's (A39), United States
PENN Presbyterian (A40), United States
Massachusetts General Hospital (A44), United States
Thomas Jefferson University (A45), United States
Cooper University Hospital (A47), United States
Stony Brook University (A48), United States
NYU Langone Medical Center (A51), United States
University of Michigan (A54), United States
Boston Medical Center (A56), United States
Albany Medical College (A57), United States
Medical College of Wisconsin (A59), United States
NYP Queens (A60), United States
Minneapolis Heart Institute (Foundation) (A61), United States
Lancaster General (A63), United States
Durham VA Medical Center (A64), United States
University of Nebraska Medical Center (A67), United States
Vanderbilt (A69), United States
Saint Luke's Mid America Heart (A05), United States Sites - Inactive
Hackensack University Medical (A17), United States Sites - Inactive
University of Minnesota (A25), United States Sites - Inactive
UCLA / Veterans Affairs Greater LA (A30), United States Sites - Inactive
Washington University St Louis (A35), United States Sites - Inactive
University of Rochester (A43), United States Sites - Inactive
Rush University Medical Center (A46), United States Sites - Inactive
NYP Brooklyn Methodist (A50), United States Sites - Inactive
Lankenau Medical Center (A66), United States Sites - Inactive
Hospital Sao Paulo (B01), Brazilian Sites
Sociedade Hospitalar Angelina Caron (B02), Brazilian Sites
Hospital Maternidade e Pronto Socorro Santa Lucia (B04), Brazilian Sites
Santa Casa de Marilia (B05), Brazilian Sites
Hospital da Bahia (B06), Brazilian Sites
Hospital de Base de Rio Preto (B07), Brazilian Sites
Hospital Cardio Pulmonar (B10), Brazilian Sites
Instituto de Cardiologia do RS (B13), Brazilian Sites
Pronto Socorro Cardiologico de Prof. Luiz Tavares (B14), Brazilian Sites
Hospital de Clinicas UFTM (B16), Brazilian Sites
Montreal General Hospital (C01), Canadian Sites
Foothills Medical Centre (C02), Canadian Sites
Grey Nuns Community Hospital (C03), Canadian Sites
Hamilton Health Sciences/St. Joseph's Healthcare Hamilton - Hamilton
General Hospital (C04), Canadian Sites
Hamilton Health Sciences/St. Joseph's Healthcare Hamilton - Juravinski
Hospital (C29), Canadian Sites
Hamilton Health Sciences/St. Joseph's Healthcare Hamilton - St. Joseph's
Healthcare Hamilton (C30), Canadian Sites
Hopital Charles Lemoyne (C05), Canadian Sites
Quebec Heart and Lung Institute (C06), Canadian Sites
University Of Alberta Hospital (C07), Canadian Sites
Royal Victoria Hospital (C08), Canadian Sites
Regina General Hospital (C09), Canadian Sites
QE II Health Sciences Center (C10), Canadian Sites
Centre Hosp. Universitaire de Montreal (C12), Canadian Sites
Jewish General Hospital (C14), Canadian Sites
Vancouver General Hospital (C15), Canadian Sites
Centre integre universitaire de sante et de services sociaux de la
Mauricie-et-du-Centre-du-Quebec (C17), Canadian Sites
Centre Hospitalier Sherbrooke (C21), Canadian Sites
Sunnybrook Health Sciences Centre (C22), Canadian Sites
London Health Sciences Centre - Victoria Hospital - LHSC (C11), University
Hospital (C23), Canadian Sites
St. Boniface General Hospital (C24), Canadian Sites
St. Boniface General Hospital (C24), Canadian Sites
Royal Alexandra Hospital (C25), Canadian Sites
St. Michael's Hospital (C27), Canadian Sites
Victoria Heart Institute (C28), Canadian Sites
UHN (C31), Canadian Sites
Royal Columbian Hospital (C13), Canadian Sites - Inactive
Hotel Dieu de Levis (C19), Canadian Sites - Inactive
Hopital BICHAT - APHP (E01), European Union Sites
HEGP - APHP (E02), European Union Sites
CHRU Lille (E03), European Union Sites
CHU Nice - Hopital Pasteur (E04), European Union Sites
CHU Caremeau - Nimes (E05), European Union Sites
Hopital Pitie Salpetriere - APHP (E06), European Union Sites
Hopital Michalon - Grenoble (E07), European Union Sites
Hopital Haut Leveque - Pessac (E08), European Union Sites
CHU Rangueil - Toulouse (E09), European Union Sites
CHU le Bocage - Dijon (E10), European Union Sites
Centre Hospitalier sud francilien (E11), European Union Sites
CHRU Tours - Hopital Trousseau (E12), European Union Sites
Hopital Lariboisiere - APHP (E13), European Union Sites
CH Louis Pasteur, Chartres (E14), European Union Sites
CHU Nancy (E15), European Union Sites
CHU de Rouen (E16), European Union Sites
CHU Poitiers (E18), European Union Sites
CHU Arnaud de Villeneuve - Montpellier (E19), European Union Sites
Clinique du pont de chaume - Montauban (E20), European Union Sites
Christchurch Hospital (N01), New Zealand Sites
Auckland Hospital (N02), New Zealand Sites
Whangarei Hospital (N04), New Zealand Sites
Taranaki Hospital (N05), New Zealand Sites
Nelson Hospital (N06), New Zealand Sites
Concord Repatriation General Hospital (V03), Australian Sites
Royal Perth Hospital (V04), Australian Sites
Publisher
Elsevier Inc.
Abstract
Background: Accumulating evidence from clinical trials suggests that a
lower (restrictive) hemoglobin threshold (<8% g/dL) for red blood cell
(RBC) transfusion, compared with a higher (liberal) threshold (>=10 g/dL)
is safe. However, in anemic patients with acute myocardial infarction
(MI), maintaining a higher hemoglobin level may increase oxygen delivery
to vulnerable myocardium resulting in improved clinical outcomes.
Conversely, RBC transfusion may result in increased blood viscosity,
vascular inflammation, and reduction in available nitric oxide resulting
in worse clinical outcomes. We hypothesize that a liberal transfusion
strategy would improve clinical outcomes as compared to a more restrictive
strategy. <br/>Method(s): We will enroll 3500 patients with acute MI (type
1, 2, 4b or 4c) as defined by the Third Universal Definition of MI and a
hemoglobin <10 g/dL at 144 centers in the United States, Canada, France,
Brazil, New Zealand, and Australia. We randomly assign trial participants
to a liberal or restrictive transfusion strategy. Participants assigned to
the liberal strategy receive transfusion of RBCs sufficient to raise their
hemoglobin to at least 10 g/dL. Participants assigned to the restrictive
strategy are permitted to receive transfusion of RBCs if the hemoglobin
falls below 8 g/dL or for persistent angina despite medical therapy. We
will contact each participant at 30 days to assess clinical outcomes and
at 180 days to ascertain vital status. The primary end point is a
composite of all-cause death or recurrent MI through 30 days following
randomization. Secondary end points include all-cause mortality at 30
days, recurrent adjudicated MI, and the composite outcome of all-cause
mortality, nonfatal recurrent MI, ischemia driven unscheduled coronary
revascularization (percutaneous coronary intervention or coronary artery
bypass grafting), or readmission to the hospital for ischemic cardiac
diagnosis within 30 days. The trial will assess multiple tertiary end
points. <br/>Conclusion(s): The MINT trial will inform RBC transfusion
practice in patients with acute MI.<br/>Copyright &#xa9; 2022 Elsevier
Inc.

<26>
Accession Number
2040152425
Title
Response to letter to the editor: "Prevalence of postoperative
neurocognitive disorders in older non-cardiac surgical patients: A
systematic review and meta-analysis".
Source
Journal of Clinical Anesthesia. 106 (no pagination), 2025. Article Number:
111973. Date of Publication: 01 Sep 2025.
Author
Huang W.W.Y.; Fan S.; Li W.-Y.; Thangavelu V.; Saripella A.; Englesakis
M.; Yan E.; Chung F.
Institution
(Huang) School of Medicine, University of Limerick, Limerick, Ireland
(Fan) Schulich School of Medicine and Dentistry, Western University,
London, ON, Canada
(Li, Saripella, Yan, Chung) Department of Anesthesia and Pain Management,
Toronto Western Hospital, University Health Network, University of
Toronto, ON, Canada
(Thangavelu, Yan, Chung) Institute of Medical Science, Temerty Faculty of
Medicine, University of Toronto, ON, Canada
(Englesakis) Library & Information Services, University Health Network,
Toronto, ON, Canada
Publisher
Elsevier Inc.

<27>
Accession Number
2040132667
Title
Optical coherence tomography- vs angiography-guided coronary stent
implantation in calcified lesions: The ILUMIEN IV trial.
Source
European Heart Journal. 46(32) (pp 3201-3210), 2025. Date of Publication:
21 Aug 2025.
Author
Ali Z.A.; Shin D.; Vijayvergiya R.; Gawalkar A.A.; Shlofmitz R.A.; Alfonso
F.; Calligaris G.; Canova P.; Sakai K.; Price M.J.; Leistner D.; Prati F.;
Mintz G.; Matsumura M.; McGreevy R.J.; McNutt R.W.; Nie H.; Buccola J.;
Landmesser U.; Maehara A.; Stone G.W.
Institution
(Ali, Shin, Shlofmitz, Sakai) Department of Cardiology, St. Francis
Hospital and Heart Center, Roslyn, NY, United States
(Ali) New York Institute of Technology, Old Westbury, NY, United States
(Vijayvergiya, Gawalkar) Department of Cardiology, Post Graduate Institute
of Medical Education and Research, Chandigarh, India
(Alfonso) Cardiology Department, Hospital Universitario de la Princesa,
CIBERCV, IIS-IP, Madrid, Spain
(Calligaris) Centro Cardiologico Monzino IRCCS, Milano, Italy
(Canova) Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo,
Italy
(Price) Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, CA,
United States
(Leistner, Landmesser) Department of Cardiology, Angiology and Intensive
Care Medicine, Deutsches Herzzentrum Charite;, Charite -
Universitatsmedizin Berlin, Berlin, Germany
(Leistner) Department of Medicine, Cardiology, Goethe University Hospital,
Frankfurt, Germany
(Prati) Cardiology, Saint Camillus International University of Health
Sciences, CLI Foundation, Rome, Italy
(Mintz, Matsumura, Maehara) Clinical Trial Center, Cardiovascular Research
Foundation, New York, NY, United States
(McGreevy, McNutt, Nie, Buccola) Abbott Vascular, Santa Clara, CA, United
States
(Landmesser) Berlin Institute of Health, Berlin, Germany
(Landmesser) German Centre for Cardiovascular Research, Berlin, Germany
(Maehara) Center for Interventional Cardiovascular Care, Columbia
University Medical Center, New York, NY, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, The ILUMIEN IV Investigators, New York,
NY, United States
Publisher
Oxford University Press
Abstract
Background and Aims The large-scale, randomized ILUMIEN IV trial was
examined to determine whether procedural guidance with optical coherence
tomography (OCT) during percutaneous coronary intervention (PCI) of
angiographically calcified lesions improves outcomes. Methods Patients
with a single PCI target lesion were included in the present analysis. The
presence of none, mild, moderate or severe lesion calcification was
determined by an angiographic core laboratory. The primary imaging
endpoint was the post-PCI minimal stent area (MSA) assessed by OCT. The
primary clinical endpoint was 2-year target-vessel failure (TVF), a
composite of cardiac death, target-vessel myocardial infarction (TV-MI),
or ischaemia-driven target-vessel revascularization. Results In the
overall population (n = 2114), there was a significant interaction between
the effect of randomization to OCT guidance vs angiography guidance in
lesions with moderate/severe calcification (n = 1082) vs no/mild
calcification (n = 1032) on the 2-year rate of TVF (Pinteraction =. 01).
The post-PCI MSA in moderately and severely calcified lesions was larger
with OCT guidance (n = 544) compared with angiography guidance (n = 538)
(5.57 +/- 1.86 mm² vs 5.33 +/- 1.78 mm²; P =. 03).
In the moderate/severe calcified lesion cohort, TVF within 2 years
occurred in 35 patients with OCT guidance and in 51 patients with
angiography guidance (6.8% vs 9.7%; adjusted hazard ratio [aHR] 0.62; 95%
confidence interval [CI] 0.40-0.96), whereas there was no significant
difference in TVF in the no/mild calcified lesion cohort (7.7% vs 5.2%;
aHR 1.48; 95% CI 0.90-2.44) (Pinteraction =. 01). In moderately/severely
calcified lesions, OCT-guided PCI also reduced the 2-year rates of serious
major adverse cardiac events (2.8% vs 4.7%; aHR 0.49; 95% CI 0.25-0.95; P
=. 03), TV-MI (1.9% vs 4.0%; aHR 0.36; 95% CI 0.17-0.79; P =. 01), and
stent thrombosis (0.2% vs 1.5%; aHR 0.11; 95% CI 0.01-0.89; P =. 04)
compared with angiography-guided PCI. Conclusions In the ILUMIEN IV trial,
OCT-guided PCI in patients with angiographically determined moderately or
severely calcified lesions reduced the 2-year rate of TVF compared with
angiography-guided PCI, an effect that was not seen in patients with
lesions with no or mild angiographic calcium.<br/>Copyright &#xa9; 2025
The Author(s). Published by Oxford University Press on behalf of the
European Society of Cardiology.

<28>
Accession Number
2035811200
Title
Randomized, controlled trial comparing the efficacy of intercostal nerve
block in thoracoscopic surgery by timing: study protocol for a randomized
clinical trial.
Source
Trials. 26(1) (no pagination), 2025. Article Number: 301. Date of
Publication: 01 Dec 2025.
Author
Sekine Y.; Ichimura H.; Ueda S.; Kitazawa S.; Kobayashi N.; Murata Y.;
Yamada K.; Inomata S.; Maruo K.; Sato Y.
Institution
(Sekine, Ichimura, Ueda, Kitazawa, Kobayashi, Sato) Department of Thoracic
Surgery, University of Tsukuba Hospital, Tsukuba, Japan
(Murata, Yamada, Inomata) Department of Anesthesiology, University of
Tsukuba Hospital, Tsukuba, Japan
(Maruo) Department of Biostatistics, Institute of Medicine, University of
Tsukuba, Tsukuba, Japan
(Ichimura) Department of Thoracic Surgery, Institute of Medicine,
University of Tsukuba, 1-1-1 Tennodai, Ibaraki, Tsukuba, Japan
Publisher
BioMed Central Ltd
Abstract
Background: Even minimally invasive thoracic surgeries carry a
postoperative cost in pain. While regional anesthesia may alleviate this
anticipated pain, especially intercostal nerve blocks (ICNB), the timing
of block administration for optimal effect (at the beginning of surgery
vs. before wound closure) remains controversial. Here, we plan (1) to test
the hypothesis that performing ICNB at the beginning of surgery provides
superior postoperative analgesic effects compared to before wound closure
and (2) to observe perioperative outcomes to determine whether the timing
affects acute and chronic postoperative pain, or intraoperative patient
management. <br/>Method(s): This single-blinded, single-center,
randomized, controlled trial will be conducted at the Department of
Thoracic Surgery, University of Tsukuba Hospital from Sep 29, 2024, to
June 30, 2026. Patients 16-79 years old within the regular population of
patients undergoing lung wedge resection via video-assisted thoracoscopic
surgery (VATS) without a utility window approach and who are ASA-PS
classes 1-3 will be enrolled to receive ICNB either pre-operatively or
before wound closure. Groups will be single-blinded (patient only) at
random, and the primary outcome will be assessment by Numerical Rating
Scale (NRS) pain scores during movement, measured 4 h after returning to
the ward. Secondary outcomes will be (1) any additional analgesic use
within the 4-h return window, (2) intraoperative measurements (including
amounts of remifentanil used, time from surgery completion to extubation,
occurrence of shivering or nausea after extubation, use of antiemetics,
and maximum blood pressure/heart rate), (3) acute pain during
hospitalization (using routinely administered NRS), (4) postoperative
analgesic use, and (5) quality of life (QOL) scores on EQ-5D and SF-36
questionnaires at preoperative and 3-month postoperative timepoints.
Chronic pain at 3 months post-surgery will also be determined by NRS.
<br/>Discussion(s): A complete evaluation of ICNB efficacy as a preemptive
analgesic approach will contribute to the development of improved
perioperative pain management techniques. A reduction in the duration of
surgery-related symptoms and an improvement in postoperative QOL will be
the result. Trial registration: Japan Registry of Clinical Trials:
identifier jRCT1031240358. Registered on 29 Sep 2024.
https://jrct.niph.go.jp/latest-detail/jRCT1031240358.<br/>Copyright &#xa9;
The Author(s) 2025.

<29>
Accession Number
2037753661
Title
Multivitamins After Myocardial Infarction in Patients With Diabetes A
Randomized Clinical Trial.
Source
JAMA Internal Medicine. 185(5) (pp 540-548), 2025. Date of Publication: 05
May 2025.
Author
Ujueta F.; Lamas G.A.; Anstrom K.J.; Navas-Acien A.; Boineau R.; Rosenberg
Y.; Stylianou M.; Jones T.L.Z.; Joubert B.R.; Yu Q.; Wen J.; Nemeth H.;
Huang Z.; Fonseca V.; Nathan D.M.; Uwaifo G.; Arenas I.A.; Luo L.; Baker
J.; Visentin D.; Paixao A.; Schmedtje J.F.; Mark D.B.
Institution
(Ujueta) Brigham and Women's Hospital Division of Cardiovascular Medicine,
Boston, MA, United States
(Lamas) Columbia University Division of Cardiology, Mount Sinai Medical
Center, Miami Beach, FL, United States
(Anstrom) Gillings School of Global Public Health, University of North
Carolina, Chapel Hill, United States
(Navas-Acien) Department of Environmental Health Sciences, Columbia
University Mailman School of Public Health, New York, NY, United States
(Boineau) National Center for Complementary and Integrative Health,
National Institutes of Health, Bethesda, MD, United States
(Rosenberg, Stylianou) National Heart, Lung and Blood Institute, National
Institutes of Health, Bethesda, MD, United States
(Jones) National Institute of Diabetes and Digestive and Kidney Diseases,
National Institutes of Health, Bethesda, MD, United States
(Joubert) National Institute of Environmental Health Sciences, National
Institutes of Health, Durham, NC, United States
(Wen, Nemeth, Huang, Mark) Duke Clinical Research Institute, Duke
University, Durham, NC, United States
(Fonseca) Tulane University School of Medicine, New Orleans, LA, United
States
(Nathan) Massachusetts General Hospital Diabetes Research Center, Harvard
Medical School, Boston, United States
(Uwaifo) Southern Illinois University School of Medicine, Springfield,
United States
(Arenas) Salem Health, Salem, OR, United States
(Baker) Central Florida Heart Center, Ocala, United States
(Visentin) Clinical Research Prime, Idaho Falls, ID, United States
(Visentin) South Simcoe Cardiac Services, Barrie, ON, Canada
(Paixao) Arkansas Heart Hospital, Little Rock, United States
(Schmedtje) Roanoke Heart Institute, Roanoke, VA, United States
Publisher
American Medical Association
Abstract
IMPORTANCE In 2013, the Trial to Assess Chelation Therapy (TACT) reported
that in 1708 patients with stable coronary disease and prior myocardial
infarction (MI), oral multivitamins and multiminerals (OMVMs), in a
factorial design with edetate disodium (EDTA) chelation therapy, did not
reduce cardiovascular events relative to placebo OMVMs, but active EDTA
combined with active OMVMs was superior to placebo OMVM/placebo EDTA.
OBJECTIVE To compare OMVM vs placebo in terms of efficacy for reducing
major adverse cardiovascular events in patients with diabetes and prior
MI. DESIGN, SETTING, AND PARTICIPANTS The TACT2 randomized, multicenter
double-masked 2 x 2 factorial clinical trial took place across 88 sites in
the US and Canada. Participants were 50 years or older, had diabetes, and
had an MI 6 weeks ago or more. TACT2 participants were enrolled between
September 2016 and December 2020. Data were collected between October 2016
and June 2023. INTERVENTIONS Six caplets daily of a 28 component OMVM or
matching OMVM placebo, and 40 weekly infusions of an EDTA-based chelation
solution or matching placebo, in a 1:1:1:1 allocation ratio. MAIN OUTCOMES
AND MEASURES The primary end point was the composite of all-cause
mortality, MI, stroke, coronary revascularization, or hospitalization for
unstable angina. RESULTS A total of 1000 participants were randomized (500
in the active OMVM group and 500 in the placebo group). The median (IQR)
age was 67 (60-72) years, and 730 (73%) were male. Median (IQR) follow-up
was 48 (34-58) months. The primary end point occurred in 175 participants
(35%) in the active OMVM group and 175 (35%) in the placebo group (hazard
ratio [HR], 0.99 [95% CI, 0.80-1.22]; P = .92). The 5-year event rate for
the primary end point in the EDTA chelation + active OMVM group was 34.0%;
in the EDTA chelation + placebo OMVM group, 35.7%; in the placebo infusion
+ active OMVM group, 36.0%; and in the placebo infusion + placebo OMVM
group, 34.3%. The comparison of the active infusion + active OMVM with the
placebo infusion + placebo OMVM was not significant (HR, 0.91 [95% CI,
0.67-1.23]; P = .54). Although nonsignificant, there was a numerically
higher event rate of MI, stroke, mortality from cardiovascular causes in
the active OMVM compared to placebo OMVM group. CONCLUSIONS AND RELEVANCE
The results of this randomized clinical trial demonstrated that, for
participants with chronic coronary disease, diabetes, and a previous MI,
high-dose OMVM alone or in conjunction with EDTA-based chelation did not
reduce cardiovascular events.<br/>Copyright &#xa9; 2025 Ujueta F et al.

<30>
Accession Number
2040111257
Title
The Financial Divide in Congenital Heart Surgery: Global Challenges and
Solutions.
Source
Reviews in Cardiovascular Medicine. 26(7) (no pagination), 2025. Article
Number: 43778. Date of Publication: 01 Jul 2025.
Author
Prothasis S.; Prothasis P.; Mathews V.; Francis J.
Institution
(Prothasis, Francis, Prothasis, Mathews, Francis) Department of
Cardiothoracic Surgery, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
Publisher
IMR Press Limited

<31>
Accession Number
2040124687
Title
Psychological well-being and the effects of supportive coaching during
SPECT myocardial perfusion imaging in patients with suspected ischemic
heart disease.
Source
Journal of Psychosomatic Research. 197 (no pagination), 2025. Article
Number: 112355. Date of Publication: 01 Oct 2025.
Author
Roovers T.; Vermeltfoort I.A.C.; Widdershoven J.W.; Kop W.J.
Institution
(Roovers, Widdershoven, Kop) Department of Medical and Clinical
Psychology, Center of Research on Psychological Disorders and Somatic
Diseases (CoRPS), Tilburg University, Tilburg, Netherlands
(Vermeltfoort) Department of Nuclear Medicine, Institute Verbeeten,
Tilburg, Netherlands
(Widdershoven) Department of Cardiology, Elisabeth-TweeSteden Hospital,
Tilburg, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Diagnostic procedures for ischemic heart disease are common,
but the consequences for the patient's psychological well-being are not
well understood. The current study investigates changes in negative affect
as a measure of psychological well-being during myocardial perfusion
imaging (MPI-SPECT) and whether supportive coaching during diagnostic
testing improves well-being, reduces symptom burden, and increases patient
satisfaction. <br/>Method(s): Patients undergoing MPI-SPECT were randomly
assigned to a supportive coaching intervention group or a care-as-usual
control group. Negative affect was assessed at nine time-points throughout
the 2-day diagnostic MPI visits. Anginal and adenosine-related symptoms
were evaluated during cardiac stress testing (CST) and patient
satisfaction at completion of MPI-SPECT. Data were analyzed using
regression analysis, t-tests, and linear mixed models. <br/>Result(s): A
total of 149 patients were randomized (mean age = 68.5 [SD = 9.6] years,
41.6 % women; 74 intervention and 75 control condition). Negative affect
changed significantly throughout the MPI procedure (F(8, 244.098) = 8.689,
p < .001), with the highest level occurring during the peak phase of CST.
Negative affect was associated with higher concurrent anginal (beta =
0.285, p = .001) and adenosine-related symptoms (beta = 0.252, p = .004)
during CST. No significant benefits of supportive coaching were found for
well-being or symptoms, inducibility of ischemia, or patient satisfaction
(all p-values > .200). <br/>Conclusion(s): Negative affect during
MPI-SPECT is associated with cardiac symptoms during CST. No benefits were
found of the short-term supportive coaching intervention during the
MPI-SPECT procedure. Patient well-being might be improved by providing
support during the entire diagnostic phase for ischemic heart disease
rather than just during the MPI-SPECT procedure. Trial registration
#NCT05896982. Open science statement/Preregistration: Medical Ethics
Committee METC-Brabant NL81600.028.22 / P2234.<br/>Copyright &#xa9; 2025
The Authors

<32>
Accession Number
2037015708
Title
The effect of reflexology on blood pressure and heart rate in
cardiovascular patients: a meta-analysis study.
Source
Revista da Associacao Medica Brasileira. 71(7) (no pagination), 2025.
Article Number: e20250059. Date of Publication: 2025.
Author
Camci G.; Bayrak B.
Institution
(Camci) Marmara University, Faculty of Health Sciences, Department of
Nursing, Department of Internal Medicine Nursing, Istanbul, Turkey
(Bayrak) Suleyman Demirel University, Faculty of Health Sciences,
Department of Nursing, Department of Internal Medicine Nursing, Isparta,
Turkey
Publisher
Associacao Medica Brasileira
Abstract
OBJECTIVE: The aim of the study was to conduct a meta-analysis of studies
on the effect of reflexology on blood pressure and heart rate in patients
with cardiovascular disease. <br/>METHOD(S): The study collected data from
PubMed, ScienceDirect, MEDLINE, Web of Science, Google Scholar, and
Cochrane Library databases. The study had randomized-controlled,
non-randomized-controlled, and quasi-experimental designs. Patients aged
>18 years with coronary artery disease, coronary angiography, percutaneous
coronary intervention, open-heart surgery, or coronary bypass were
included. All analyses were performed using Comprehensive Meta-Analysis.
<br/>RESULT(S): This study included 1,041 patients aged 18-75 years from
12 studies. According to the random-effects model, reflexology
significantly reduced systolic blood pressure (95%CI, Hedges' g=-0.41,
Z=-2.27, p=0.02) and diastolic blood pressure (95%CI, Hedges' g=-0.38,
Z=-2.69, p=0.01). However, reflexology did not affect the heart rate
(95%CI, Hedges' g=0.16, Z=-1.54, p=0.12). <br/>CONCLUSION(S): The results
suggest that reflexology has a positive effect on the systolic and
diastolic blood pressures of cardiovascular patients, but no significant
effect on the heart rate was observed.<br/>Copyright &#xa9; 2025,
Associacao Medica Brasileira. All rights reserved.

<33>
Accession Number
2035808896
Title
Optimizing antithrombotic therapy following mitral valve repair: a
comprehensive network meta-analysis.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
628. Date of Publication: 01 Dec 2025.
Author
Gbreel M.I.; Elkasaby M.H.; Hassan M.; Becher M.U.; Balata M.
Institution
(Gbreel) Faculty of Medicine and Surgery, October 6 University, Giza,
Egypt
(Gbreel) Department of Cardiology, Epyptian Railway Medical Centre (ERMC),
Cairo, Egypt
(Elkasaby) Faculty of Medicine and Surgery, Al-Azhar University, Cairo,
Egypt
(Hassan) Department of Immunology, Theodor Bilharz Research Institute,
Giza, Egypt
(Becher) Department of Cardiology, Stadtisches Klinikum Solingen,
Solingen, Germany
(Balata) Department of cardiology, University hospital Rostock, Rostock,
Germany
Publisher
BioMed Central Ltd
Abstract
Background: Mitral regurgitation (MR) presents either as primary or
secondary, with options for surgical or transcatheter repair.
Thromboembolic risks following surgery are significant despite the use of
antithrombotic medications, and guidelines for postoperative
anticoagulation therapy lack consistency. This systematic review aims to
compare antithrombotic medications after mitral valve repair (MVR). In
this study, we intend to compare antithrombotic medications after MVR.
<br/>Material(s) and Method(s): The study followed the Cochrane handbook
and PRISMA guidelines. We systematically searched databases (PubMed,
Scopus, Ovid, Cochrane, Web of Science) until June 2024 for TMVR studies
using specific criteria. Quality assessment utilized the Newcastle-Ottawa
scale. Data extraction encompassed study characteristics and outcomes.
Primary outcomes included thromboembolic events and bleeding within six
months. Statistical analysis employed R software to assess heterogeneity
and publication bias. <br/>Result(s): From the 121 articles screened, 12
were included in the study. These cohort studies, involving 20,644
participants, spanned from 2008 to 2022. While most studies were of good
to high quality, some exhibited lower quality. Analysis favored oral
anticoagulants (OAC) over single antiplatelet therapy (SAPT) for reducing
bleeding risk (RR = 0.31, 95% CI: [0.11-0.87], P < 0.05), with moderate
heterogeneity. Thromboembolic events did not significantly differ among
interventions. Transient ischemic attacks and stroke outcomes were similar
between SAPT and vitamin K antagonists (VKA). Six-month mortality rates
were comparable between SAPT and VKA, with notable heterogeneity and
higher mortality with SAPT in one study. Qualitative synthesis highlighted
procedural success rates and bleeding complications across different
interventions in transcatheter mitral valve repair studies.
<br/>Conclusion(s): OACs showed a lower risk of bleeding compared to
antiplatelet therapies, while VKAs and OAC + SAPT may reduce
thromboembolic events. No significant differences were found in stroke,
TIA, or short-term mortality. These findings support individualized
therapy and highlight the need for further randomized
trials.<br/>Copyright &#xa9; The Author(s) 2025.

<34>
Accession Number
2039520511
Title
Comparative effectiveness and safety of self-expanding versus
balloon-expandable transcatheter aortic valve replacement: A systematic
review and meta-analysis.
Source
American Journal of the Medical Sciences. 370(3) (pp 224-230), 2025. Date
of Publication: 01 Sep 2025.
Author
Elkholy M.; Akkawi M.; Kidess G.G.; Abdulelah Z.; Rayyan A.; Al-Dqour
M.R.; Damlakhy A.; Bahar Y.; Alraies M.C.
Institution
(Elkholy, Akkawi, Damlakhy) Wayne State University School of Medicine,
Detroit Medical Center, Detroit, MI, United States
(Kidess) Wayne State University School of Medicine, Detroit, MI, United
States
(Abdulelah) Department of Cardiology, Royal Papworth Hospital, Cambridge,
United Kingdom
(Rayyan) School of Medicine, University of Jordan, Amman, Jordan
(Al-Dqour) Department of Internal Medicine, East Tennessee State
University, United States
(Bahar) Wayne State University, Detroit, MI, United States
(Alraies) Cardiovascular Institute, Detroit Medical Center, Detroit, MI,
United States
Publisher
Elsevier B.V.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is a safe
alternative to surgical aortic valve replacement for patients with
symptomatic severe aortic stenosis at increased surgical risk. However,
comparative data on self-expanding valves (SEV) versus balloon-expanding
valves (BEV) remain limited. <br/>Method(s): A comprehensive review of
PubMed and Embase was conducted through April 2024, identifying eight
studies (five randomized controlled trials and three propensity-matched
observational studies) comparing SEV and BEV in TAVR. Primary outcomes
included all-cause mortality, cardiovascular mortality, and device success
per Valve Academic Research Consortium criteria, while secondary outcomes
assessed bioprosthetic valve dysfunction and adverse events (annulus
rupture/dissection, coronary artery occlusion, valve
dislocation/embolization, valve thrombosis, moderate and severe
paravalvular aortic regurgitation, endocarditis, permanent pacemaker
implantation, major or life-threatening bleeding, acute kidney injury, and
stroke). <br/>Result(s): The analysis included 4032 patients (SEV = 2006;
BEV = 2017). SEV was associated with higher rates of moderate-to-severe
paravalvular aortic regurgitation [OR, 1.76; CI 1.13-2.74; P = 0.01] and
permanent pacemaker placement [OR, 1.57; CI, 1.23-2.00; P = 0.0002]
compared to BEV. No significant differences were observed in 30-day or
1-year all-cause mortality, cardiovascular mortality, device success,
bioprosthetic valve dysfunction, valve dislocation/embolization, valve
thrombosis, endocarditis, major or life-threatening bleeding, coronary
artery occlusion, stroke, rehospitalization, or acute kidney injury.
<br/>Conclusion(s): SEV and BEV demonstrated comparable outcomes in
mortality and device success. However, the higher risk of
moderate-to-severe paravalvular aortic regurgitation and permanent
pacemaker placement with SEV should be considered when selecting the
optimal TAVR valve for individual patients.<br/>Copyright &#xa9; 2025

<35>
Accession Number
2035659617
Title
Nitric oxide for the prevention of postoperative acute kidney injury in
patients undergoing surgery for Stanford type A aortic dissection: study
protocol for a randomized controlled trial.
Source
Trials. 26(1) (no pagination), 2025. Article Number: 284. Date of
Publication: 01 Dec 2025.
Author
Chen Z.; Han X.; Li L.; Liu M.; Yu L.; Cheng S.; Yu Y.; Liu N.
Institution
(Chen, Li, Liu, Yu, Cheng, Yu, Liu) Center for Cardiac Intensive Care,
Beijing Anzhen Hospital, Capital Medical University, Beijing, China
(Han) Department of Emergency, University of Health and Rehabilitation
(Qingdao Municipal Hospital), Qingdao, Qingdao Hospital, China
Publisher
BioMed Central Ltd
Abstract
Background: Acute kidney injury (AKI) is a frequent and serious
complication following surgery for acute type A aortic dissection (ATAAD).
Nitric oxide (NO) may reduce AKI incidence through renal-protective
mechanisms, but evidence in the ATAAD population remains limited. This
trial aims to evaluate whether perioperative administration of NO can
reduce the incidence of postoperative AKI in this population.
<br/>Method(s): This single-center, randomized, parallel-group superiority
trial will enroll 106 adult patients undergoing ATAAD emergency surgery.
Participants will be randomly allocated in a 1:1 ratio to either receive
60 parts per million of NO during cardiopulmonary bypass and for 12 h
post-surgery, or to receive standard care without NO. The primary outcome
is AKI incidence within 48 h postoperatively, defined by Kidney Disease:
Improving Global Outcomes (KDIGO) criteria. Secondary outcomes include AKI
severity, urine output, vasoactive-inotropic score, neutrophil
gelatinase-associated lipocalin levels, sequential organ failure
assessment score, ventilator support duration, intensive care unit (ICU)
and hospital length of stay, and major adverse kidney events, cumulative
mediastinal and pericardial drainage volume. <br/>Discussion(s): This
trial will evaluate whether perioperative NO administration can reduce
early AKI and improve renal and clinical outcomes in high-risk ATAAD
patients. Findings may provide evidence for a novel nephroprotective
strategy in aortic surgery. Trial registration: ClinicalTrials.gov
NCT06622291. Registered on June 26, 2024.<br/>Copyright &#xa9; The
Author(s) 2025.

<36>
Accession Number
2040084428
Title
Impact of short duration smoking cessation on post-operative
complications: A systematic review and meta-analysis.
Source
Journal of Clinical Anesthesia. 106 (no pagination), 2025. Article Number:
111967. Date of Publication: 01 Sep 2025.
Author
Tang E.; Rodriguez R.M.; Srivastava A.; Malhan R.; Laksono I.; Yan E.;
Englesakis M.; Wong J.; Chung F.
Institution
(Tang, Rodriguez, Srivastava, Malhan, Laksono, Yan, Wong, Chung)
Department of Anesthesia and Pain Management, Toronto Western Hospital,
University Health Network, University of Toronto, Toronto, ON, Canada
(Yan, Wong, Chung) Institute of Medical Science, Temerty Faculty of
Medicine, University of Toronto, ON, Canada
(Englesakis, Wong) Library & Information Services, University Health
Network, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Use of tobacco poses significant health risks, particularly in
surgical patients, where smoking is a well-established risk factor for
postoperative complications. Patients are often seen in the pre-assessment
clinic 2-4 weeks prior to surgery, presenting a window of opportunity to
intervene. The objective of our systematic review and meta-analysis is to
explore the impact of short-term smoking cessation on postoperative
outcomes, focusing on the critical 2-4-week period preceding surgery.
<br/>Design(s): Systematic review and meta-analysis. <br/>Setting(s):
MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and
Cochrane Database of Systematic Reviews. <br/>Patient(s): Adults
undergoing surgical procedures with a defined smoking cessation
pre-operative smoking cessation interval. Measurement: Post-operative
complications including pulmonary complications, surgical site infection,
wound complication, bleeding, mortality, and composite complications.
<br/>Result(s): Fifty-five studies were included in the systematic review
and meta-analysis. Pulmonary complications were more prevalent in former
smokers compared to non-smokers, even after cessation. Progressively
longer smoking cessation periods showed improved outcomes. Compared to
active smokers, preoperative cessation reduced pulmonary complications by
27 % at >=2 weeks (RR 0.73, 95 % CI 0.60-0.89), 29 % at >=4 weeks (RR
0.71, 95 % CI 0.61-0.82), and 37 % at >=8 weeks (RR 0.63, 95 % CI
0.41-0.95). With >=4 weeks of cessation, there was a 33 % lower risk of
wound complications (RR 0.67, 95 % CI 0.47-0.94), 31 % lower risk of
composite complications (RR 0.69, 95 %CI 0.63-0.76), and 14 % lower risk
of mortality (RR 0.86, 95 % CI 0.77-0.97). Short term cessation did not
seem to have a significant impact on surgical site infections or bleeding.
<br/>Conclusion(s): Short term cessation of at least 2-4 weeks
demonstrates benefits in reducing post-operative
complications.<br/>Copyright &#xa9; 2025 The Authors

<37>
Accession Number
2040068073
Title
Transcatheter therapies for tricuspid regurgitation: A meta-analysis of
randomized trials.
Source
International Journal of Cardiology. 441 (no pagination), 2025. Article
Number: 133777. Date of Publication: 15 Dec 2025.
Author
Tartaglia F.; Gitto M.; Villaschi A.; Calamita G.; Stefanini G.; Reimers
B.; Regazzoli D.; Colombo A.; Mangieri A.
Institution
(Tartaglia, Gitto, Villaschi, Calamita, Stefanini, Colombo) Department of
Biomedical Sciences, Humanitas University; Pieve Emanuele-, Milan, Italy
(Tartaglia, Gitto, Villaschi, Calamita, Stefanini, Reimers, Regazzoli,
Colombo, Mangieri) IRCCS Humanitas Research Hospital; Rozzano-, Milan,
Italy
(Colombo) EMO-GVM Centro Cuore Columbus, Milan, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Background: Severe tricuspid regurgitation (TR) is prevalent in elderly
patients and associated with poor prognosis. Transcatheter tricuspid valve
interventions (TTVI) have emerged as a therapeutic option for patients at
high surgical risk. However, the clinical benefit of TTVI compared with
optimal medical therapy (OMT) remains uncertain. <br/>Objective(s): To
assess the impact of TTVI versus OMT alone on clinical outcomes in
patients with severe symptomatic TR. <br/>Method(s): We conducted a
systematic review and meta-analysis of randomized controlled trials (RCTs)
comparing TTVI (either transcatheter edge-to-edge repair [TEER] or
replacement [TTVR]) with OMT in patients with severe symptomatic TR.
MEDLINE was searched for RCTs published from January 2010 to December
2024. Outcomes of interest at one year included all-cause mortality,
cardiovascular mortality, hospitalization for heart failure (HFH), and
tricuspid valve re-intervention. A random-effects model was used to
estimate odds ratios (ORs). Individual patient data were reconstructed
from Kaplan-Meier curves where necessary. <br/>Result(s): Three RCTs (1050
patients) were included. No significant differences were observed in
all-cause mortality (OR 1.01; 95 % CI: 0.63-1.60), cardiovascular death
(OR 1.04; 95 % CI: 0.61-1.77), or HFH (OR 0.87; 95 % CI: 0.61-1.25).
Tricuspid re-intervention rates were numerically lower with TTVI (OR 0.43;
95 % CI: 0.14-1.29). <br/>Conclusion(s): In this meta-analysis of RCTs,
TTVI did not significantly reduce hard clinical endpoints at one year
compared with OMT alone. Further studies with longer follow-up are
needed.<br/>Copyright &#xa9; 2025 Elsevier B.V.

<38>
Accession Number
2040104637
Title
Effects of ciprofol on postoperative delirium and outcomes in older
patients undergoing major thoracic surgery: Protocol for a multicentre,
prospective, single-blinded, randomised controlled study.
Source
BMJ Open. 15(8) (no pagination), 2025. Article Number: 105818. Date of
Publication: 19 Aug 2025.
Author
Hong P.; Liu Q.; Ouyang W.; Luo A.; Wang E.; Gu X.; Wang L.; Chen S.; Wang
H.; Xiao W.; Wang T.
Institution
(Hong, Liu, Xiao, Wang) Department of Anesthesiology, Xuanwu Hospital
Capital Medical University, Beijing, China
(Hong) Department of Anesthesiology, Zhujiang Hospital, Southern Medical
University, Guangdong, Guangzhou, China
(Ouyang) Department of Anesthesiology, Third Xiangya Hospital, Central
South University, Hunan, Changsha, China
(Luo) Department of Anesthesiology, Huazhong University of Science and
Technology, Tongji Medical College, Tongji Hospital, Hubei, Wuhan, China
(Wang) Department of Anesthesiology, Xiangya Hospital, Central South
University, Hunan, Changsha, China
(Gu) Department of Anesthesiology, Nanjing University, Medical School,
Affiliated Nanjing Drum Tower Hospital, Jiangsu, Nanjing, China
(Wang) Department of Anesthesiology, The First Hospital of Hebei Medical
University, Hebei, Shijiazhuang, China
(Chen) Department of Anesthesiology, First Affiliated Hospital of Nanchang
University, Jiangxi, Nanchang, China
(Wang) Department of Anesthesiology, Jinan University First Affiliated
Hospital, Guangdong, Guangzhou, China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative delirium (POD) is a notable complication in
older adults undergoing major thoracic surgery and is associated with poor
clinical outcomes. Ciprofol, an innovative sedative known for its
haemodynamic stability, holds the potential to lower the risk of POD.
However, high-quality evidence supporting this claim is limited. The
objective of this study is to evaluate the effect of ciprofol compared
with propofol on the incidence of POD and postoperative outcomes in older
patients undergoing thoracic surgeries. Methods and analysis This
multicentre, prospective, single-blinded, randomised controlled trial will
recruit patients aged >=65 years scheduled for elective thoracoscopic
lobectomy or segmentectomy, with an anticipated anaesthesia duration of at
least 2 hours. Participants will be randomised to receive either ciprofol
(0.25-1.5 mg/kg/hour) or propofol (1-6 mg/kg/hour) in a 1:1 ratio. The
primary outcome is the incidence of POD within 7 days postoperatively,
assessed via the three-dimensional confusion assessment method. Secondary
outcomes include emergence delirium assessed using the confusion
assessment method for the intensive care unit, the incidence of combined
adverse events during induction and maintenance of anaesthesia, duration
of intraoperative hypotension, minimum mean intraoperative arterial
pressure, duration of Wavelet Index <40, other adverse events identified
during the follow-up period, length of stay, first exhaust time and
postoperative first time to taking food. A non-inferiority margin of 5% is
applied for sample size calculation, yielding a total of 214 participants,
adjusted for a 10% attrition rate. Ethics and dissemination Approval on
ethical grounds has been received from the ethics committee of Xuanwu
Hospital, Capital Medical University (LinYanShen (2024)-NO.201-003-Revised
V.1). We will publish the findings in peer-reviewed journals. Trial
registration number NCT06674226.<br/>Copyright &#xa9; 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.

<39>
Accession Number
2040160080
Title
Optimizing the handling of missing data in the UNOS database.
Source
Journal of Heart and Lung Transplantation. 44(9) (pp 1525), 2025. Date of
Publication: 01 Sep 2025.
Author
Yang H.; Fu Y.; Ji Z.
Institution
(Yang, Fu, Ji) Department of Surgery, Beijing Organ Transplant Center,
Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
Publisher
Elsevier Inc.

<40>
[Use Link to view the full text]
Accession Number
2040108414
Title
Comments on "effects of music therapy on anxiety among patients undergoing
cardiac procedures: A systematic review and meta-analysis".
Source
Annals of Medicine and Surgery. 87(8) (pp 5340-5341), 2025. Date of
Publication: 01 Aug 2025.
Author
Farnoosh N.; Shakeri A.
Institution
(Shakeri, Farnoosh) Department of Anesthesiology, School of Allied Medical
Sciences, Zahedan University of Medical Sciences, Zahedan, Iran, Islamic
Republic of
(Shakeri) Department of Neurosurgery, School of Medicine, Arak University
of Medical Sciences, Arak, Iran, Islamic Republic of
Publisher
Lippincott Williams and Wilkins

<41>
[Use Link to view the full text]
Accession Number
2037425426
Title
Management of Kidney Disease in Heart Transplant Patients: A National
Delphi Survey-based Consensus Expert Paper.
Source
Transplantation. 109(9) (pp e431-e445), 2025. Date of Publication: 01 Sep
2025.
Author
Carmena M.D.G.-C.; Farrero M.; Peiro M.T.B.; Crespo M.; Jimenez J.D.;
Molina B.D.; Rivera C.F.; Bravo I.P.G.; Lopez Jimenez V.; Melilli E.;
Perez S.M.; Tamajon M.L.P.; Sousa D.R.; Rodrigo E.; Cruzado J.M.; Marrero
D.H.
Institution
(Carmena) Cardiology Department, Hospital Universitario 12 de Octubre,
Imas12, CIBERCV, Madrid, Spain
(Farrero) Cardiology Department, Hospital Clinic, Barcelona, Spain
(Peiro) Cardiology Department, Hospital Universitario Miguel Servet,
Zaragoza, Spain
(Crespo) Nephrology Department, Hospital del Mar, Hospital del Mar
Research Institute, National Network for Kidney Research RICORS2040, RD21,
Barcelona, Spain
(Jimenez) Cardiology Department, Hospital Universitario 12 de Octubre,
Imas12, CIBERCV, Universidad Complutense de Madrid, Madrid, Spain
(Molina) Cardiology Department, Hospital Universitario Central de
Asturias, Oviedo, Spain
(Rivera) Nephrology Department, Complexo Hospitalario Universitario A
Coruna, A Coruna, Spain
(Bravo) Cardiology Department, Hospital Clinico Universitario Virgen de la
Arrixaca, El Palmar, Murcia, Spain
(Lopez Jimenez) Nephrology Department, Hospital Regional Universitario de
Malaga, National Network for Kidney Research RICORS2040 RD21, Instituto
Biomedico de Investigacion de Malaga (IBIMA), Universidad de Malaga,
Malaga, Spain
(Melilli) Nephrology Department, Hospital Universitario de Bellvitge,
Barcelona, Spain
(Perez) Cardiology Department, Hospital de la Santa Creu i Sant Pau,
CIBERCV, Barcelona, Spain
(Tamajon) Nephrology Department, Complejo Hospitalario Universitario de
Canarias, Santa Cruz de Tenerife, Spain
(Sousa) Cardiology Department, Hospital Universitario Virgen del Rocio,
Sevilla, Spain
(Rodrigo) Nephrology Department, Hospital Universitario Marques de
Valdecilla, IDIVAL, Santander, Spain
(Cruzado) Nephrology Department, Hospital Universitario de Bellvitge,
Bellvitge Institute for Biomedical Research (IDIBELL), University of
Barcelona, Barcelona, Spain
(Marrero) Nephrology Department, Hospital Universitario de Canarias,
National Network for Kidney Research RICORS2040 RD21/0005/0012, Instituto
de Tecnologias Biomedicas, Universidad de La Laguna, Santa Cruz de
Tenerife, Spain
Publisher
Lippincott Williams and Wilkins
Abstract
Kidney disease is a common complication in heart transplant recipients and
requires a comprehensive and personalized approach. The interplay between
preexisting kidney disease, perioperative factors, immunosuppression, and
cardiovascular complications makes the management of kidney dysfunction
challenging in these patients. The objective of this expert consensus was
to look for agreements for the management of chronic kidney disease in
heart transplant recipients. A panel of Spanish cardiologists and
nephrologists with expertise in heart and kidney transplantation reviewed
the evidence related to the current management of chronic kidney disease
in heart transplant recipients and consensus statements were developed
using a 2-round Delphi methodology. Consensus statements were proposed
covering key topics, including the identification and management of kidney
disease in heart transplant recipients and the indications for kidney
transplantation. These statements provide additional expert guidance for
the management of kidney disease in patients undergoing heart
transplantation where published clinical evidence is scarce.<br/>Copyright
&#xa9; 2025 Wolters Kluwer Health, Inc. All rights reserved.

<42>
Accession Number
2038689941
Title
Cardiorespiratory fitness in children with surgically corrected congenital
heart disease: A meta-analysis and meta-regression.
Source
Trends in Cardiovascular Medicine. 35(7) (pp 417-426), 2025. Date of
Publication: 01 Oct 2025.
Author
Haas S.D.; van der Hulst A.E.; Adel C.; Malekzadeh A.; Blom N.A.; Konigs
M.; van den Aardweg J.G.; Kuipers I.M.; Oosterlaan J.
Institution
(Haas, Adel, Konigs, Oosterlaan) Department of Pediatrics, Emma Children's
Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam,
Netherlands
(Haas, van der Hulst, Adel, Blom, Kuipers) Department of Pediatric
Cardiology, Emma Children's Hospital, Amsterdam UMC location University of
Amsterdam, Amsterdam, Netherlands
(Malekzadeh) Medical Library, Amsterdam UMC location University of
Amsterdam, Amsterdam, Netherlands
(Blom) Department of Pediatric Cardiology, Willem-Alexander's Children's
Hospital, Leiden UMC, Leiden, Netherlands
(Konigs) Emma Neuroscience Group, Department of Pediatrics, Emma
Children's Hospital, Amsterdam UMC location University of Amsterdam,
Amsterdam, Netherlands
(Konigs, Oosterlaan) Amsterdam Reproduction and Development research
institute, Amsterdam, Netherlands
(van den Aardweg) Department of Pulmonology, Amsterdam UMC location
University of Amsterdam, Amsterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Congenital heart disease (CHD) is the most common birth defect, and
despite advancements in medical care, children with surgically corrected
CHD often experience reduced cardiorespiratory fitness, which is
associated with negative long-term health outcomes. This meta-analysis
aimed to quantify peak oxygen consumption (VO<inf>2peak</inf>) impairments
in children with surgically corrected CHD, examine isolated
diagnosis-specific impairments, and explore the relationship between
clinical variables and cardiorespiratory fitness. A total of 45 studies
encompassing 2,536 children with CHD and 3,108 healthy controls were
included in the meta-analysis, revealing that children with CHD had
significantly lower VO<inf>2peak</inf> (standardized mean difference =
1.13, 95 % CI 0.98 to 1.28), with those having univentricular hearts being
most affected (standardized mean difference = 1.61, 95 % CI 1.34 to 1.87).
Reduced saturation during exercise, chronotropic impairment and early
onset of anaerobic threshold are likely to play a role in this
impairment.<br/>Copyright &#xa9; 2025

<43>
Accession Number
2038571674
Title
Individual patient data meta-analysis of paclitaxel-coated balloons vs.
drug-eluting stents for small-vessel coronary artery disease: the
ANDROMEDA study.
Source
European Heart Journal. 46(17) (pp 1586-1599), 2025. Date of Publication:
01 May 2025.
Author
Fezzi S.; Giacoppo D.; Fahrni G.; Latib A.; Alfonso F.; Colombo A.;
Mahfoud F.; Scheller B.; Jeger R.; Cortese B.
Institution
(Fezzi) Division of Cardiology, Department of Medicine, Verona University
Hospital, Verona, Italy
(Giacoppo) Department of General Surgery and Medical-Surgical Specialties,
University of Catania, Catania, Italy
(Giacoppo) Cardiovascular Research Institute Dublin, Royal College of
Surgeons in Ireland, Dublin, Ireland
(Giacoppo) ISAResearch Zentrum, Deutsches Herzzentrum Munchen, Munich,
Germany
(Fahrni, Jeger) Division of Cardiology, Department of Medicine, Triemli
Hospital Zurich, Zurich, Switzerland
(Latib) Montefiore-Einstein Center for Heart and Vascular Care, Montefiore
Medical Center, Albert Einstein College of Medicine, Bronx, NY, United
States
(Alfonso) Servicio de Cardiologia, Hospital Universitario de la Princesa,
IIS-IP, CIBERCV, Universidad Autonoma de Madrid, Madrid, Spain
(Colombo) Cardio Center, Humanitas Clinical and Research Hospital IRCCS,
Rozzano, Milan, Italy
(Mahfoud) Department of Cardiology, University Hospital Basel, Basel,
Switzerland
(Scheller, Cortese) University of Saarland, Homburg/Saar, Germany
(Jeger) University of Basel, Basel, Switzerland
(Cortese) Fondazione Ricerca e Innovazione Cardiovascolare, Via E. Ponti,
49, Milan, Italy
(Cortese) DCB Academy, Milan, Italy
Publisher
Oxford University Press
Abstract
Background and Aims: In randomized clinical trials of patients undergoing
percutaneous coronary intervention (PCI) for de novo small-vessel coronary
artery disease (SV-CAD), paclitaxel-coated balloon (PCB) angioplasty
showed mid-term angiographic or clinical non-inferiority to drug-eluting
stent (DES) implantation. Nevertheless, these trials have sample size
limitations, and the relative safety and efficacy beyond the first year
remain uncertain. <br/>Method(s): The ANDROMEDA study was a collaborative,
investigator-initiated, individual patient data meta-analysis comparing 3
year clinical outcomes between PCB angioplasty and DES implantation for
the treatment of de novo SV-CAD. Multiple electronic databases (PubMed,
Scopus, ScienceDirect, and Web of Science) were searched from May 2010 to
June 2024 to identify eligible trials. All the following eligibility
criteria were required: (i) random allocations of treatments; (ii)
patients with SV-CAD; (iii) treatment with PCB or DES; and (iv) clinical
follow-up of at least 36 months. The primary and co-primary endpoints were
major adverse cardiac events (MACE) and target lesion failure (TLF),
respectively. The protocol was registered with PROSPERO (CRD42023479035).
<br/>Result(s): Individual patient data from three randomized trials,
including a total of 1154 patients and 1360 lesions, were combined. At 3
years, PCB was associated with a lower risk of MACE compared with DES
[hazard ratio (HR) 0.67, 95% confidence interval (CI) 0.47-0.96], due to a
lower risk of myocardial infarction and target vessel revascularization.
This benefit persisted after multivariable adjustment (HR 0.75, 95% CI
0.58-0.96), but did not reach statistical significance in the two-stage
analysis (HR 0.67, 95% CI 0.43-1.04). At the landmark analysis, the risk
of MACE between groups was consistent over time. At 3 years, TLF was not
significantly different between PCB and DES groups. Reconstructed
time-to-event information from a fourth trial was included in a
sensitivity analysis (1384 patients and 1590 lesions), showing consistent
results in terms of TLF (HR 0.87, 95% CI 0.63-1.20). The comparison
between PCB and second-generation DES did not reveal significant
differences in 3 year TLF (HR 1.03, 95% CI 0.70-1.50). <br/>Conclusion(s):
In patients undergoing PCI for de novo SV-CAD, PCB angioplasty is
associated with a reduction in MACE and a non-significant difference in
TLF at 3 year follow-up compared with DES implantation. The restriction of
the comparator group to second-generation DES does not alter the main
conclusions. Larger trials comparing contemporary devices at a more
prolonged follow-up are warranted to confirm these findings.<br/>Copyright
&#xa9; 2025 The Author(s). Published by Oxford University Press on behalf
of the European Society of Cardiology. All rights reserved. For commercial
re-use, please contact reprints@oup.com for reprints and translation
rights for reprints. All other permissions can be obtained through our
RightsLink service via the Permissions link on the article page on our
site - for further information please contact
journals.permissions@oup.com.

<44>
Accession Number
2034981588
Title
Tirzepatide for reduction of morbidity and mortality in adults with
obesity: rationale and design of the SURMOUNT-MMO trial.
Source
Obesity. 33(9) (pp 1645-1656), 2025. Date of Publication: 01 Sep 2025.
Author
Lam C.S.P.; Rodriguez A.; Aminian A.; Ferrannini E.; Heerspink H.J.L.;
Jastreboff A.M.; Laffin L.J.; Pandey A.; Ray K.K.; Ridker P.M.; Sanyal
A.J.; Yki-Jarvinen H.; Mason D.; Strzelecki M.; Bartee A.K.; Cui C.; Hurt
K.; Linetzky B.; Bunck M.C.; Nissen S.E.
Institution
(Lam) Cardiovascular and Metabolic Disorders Programme, Duke-National
University of Singapore Medical School, Singapore, Singapore
(Lam) National Heart Centre Singapore, Singapore, Singapore
(Rodriguez, Bartee, Cui, Hurt, Linetzky, Bunck) Eli Lilly and Company,
Indianapolis, IN, United States
(Aminian) Bariatric and Metabolic Institute, Department of General
Surgery, Cleveland Clinic, Cleveland, OH, United States
(Ferrannini) Endocrinology and Metabolic Diseases, CNR Institute of
Clinical Physiology, Pisa, Italy
(Heerspink) Department of Clinical Pharmacy and Pharmacology, University
of Groningen, University Medical Center Groningen, Groningen, Netherlands
(Heerspink) The George Institute for Global Health, Sydney, NSW, Australia
(Jastreboff) Department of Medicine (Endocrinology and Metabolism) and
Pediatrics (Pediatric Endocrinology), Yale University School of Medicine,
New Haven, CT, United States
(Laffin) Section of Preventive Cardiology and Rehabilitation, Department
of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH,
United States
(Pandey) Division of Cardiology, Department of Internal Medicine,
University of Texas Southwestern Medical Center, Dallas, TX, United States
(Ray) Department of Primary Care and Public Health, Imperial College
London, London, United Kingdom
(Ridker) Divisions of Cardiovascular Medicine and Preventive Medicine,
Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United
States
(Sanyal) Stravitz-Sanyal Institute for Liver Disease and Metabolic Health
and Division of Gastroenterology, Hepatology and Nutrition, Virginia
Commonwealth University School of Medicine, Richmond, VA, United States
(Yki-Jarvinen) Department of Medicine, University of Helsinki and Helsinki
University Hospital, Helsinki, Finland
(Yki-Jarvinen) Minerva Foundation Institute for Medical Research,
Helsinki, Finland
(Mason, Strzelecki) Cleveland Clinic Coordinating Center for Clinical
Research, Cleveland, OH, United States
(Nissen) Cleveland Clinic Coordinating Center for Clinical Research,
Cardiology/Clinical Trials, Cleveland, OH, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: Obesity is a major cause of morbidity and mortality worldwide.
Tirzepatide is a glucose-dependent insulinotropic polypeptide receptor and
glucagon-like peptide-1 receptor agonist providing substantial weight
reduction and metabolic benefits both in type 2 diabetes and obesity. We
hypothesized that tirzepatide can improve morbidity and mortality in
adults with obesity or overweight but without diabetes. <br/>Method(s):
SURMOUNT-MMO is a randomized, double-blind, event-driven trial to
investigate the impact on morbidity and mortality with once-weekly
tirzepatide compared with placebo in adults living with obesity, without
diabetes, and with, or at risk of, cardiovascular disease. The primary
endpoint is time to first occurrence of a five-component composite outcome
of nonfatal myocardial infarction, nonfatal stroke, coronary
revascularization, heart failure events, or death from any cause.
<br/>Result(s): The trial will enroll ~15,000 participants aged >=40 from
664 sites across 27 countries with BMI >=27.0 kg/m² and either
established cardiovascular disease or multiple cardiovascular risk
factors. <br/>Conclusion(s): SURMOUNT-MMO will provide evidence of the
clinical benefits of tirzepatide on multiple outcomes among individuals
with overweight or obesity but without diabetes. This is the first outcome
trial of an incretin medication that assesses both primary and secondary
cardiovascular disease prevention.<br/>Copyright &#xa9; 2025 The Obesity
Society.

<45>
Accession Number
2021080771
Title
A meta-analysis examined the effect of topical vancomycin application in
decreasing sternal wound infections post cardiac surgery.
Source
International Wound Journal. 20(6) (pp 2068-2074), 2023. Date of
Publication: 01 Aug 2023.
Author
Zhang Y.; Zhang P.; Li H.; Chi H.; Zheng N.; Pan X.; Tang C.
Institution
(Zhang, Zhang, Li, Chi, Zheng, Pan, Tang) Department of Cardiovascular
Surgery, Sixth Medical Center, General Hospital of the Chinese People's
Liberation Army, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
To assess the impact of topical vancomycin (TV) application in decreasing
sternal wound infections (SWIs) post cardiac surgery (CS), we lead a
meta-analysis. Twenty-three thousand seven hundred and forty five
participants had CS at the outset of the investigations, according to a
thorough evaluation of the literature done up to November 2022; 8730 of
them used TV, while 15 015 were controls. To assess the effectiveness of
TV application in lowering SWIs following CS, odds ratios (OR) with 95%
confidence intervals (CIs) were computed with dichotomous technique with a
fixed- or random-effect model. The TV had significantly lower SWIs post CS
(OR, 0.34; 95% CI, 0.20-0.57; P <.001), and deep SWIs post CS (OR, 0.26;
95% CI, 0.11-0.65; P =.004) compared with control as shown in Figures 2
and 3. Yet, there was no significant difference found amongst TV and
control in superficial SWIs post CS (OR, 0.30; 95% CI, 0.07-1.30; P
=.011). The TV had significantly lower SWIs, and deep SWIs post CS, and no
significant difference was found in superficial SWIs post CS compared with
control. The low number of included studies in this meta-analysis for
superficial SWIs calls for precaution when analysing the
outcomes.<br/>Copyright &#xa9; 2023 The Authors. International Wound
Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons
Ltd.

<46>
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. 23(8) (pp 415-426), 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.<br/>Copyright &#xa9;
2025 Informa UK Limited, trading as Taylor & Francis Group.

<47>
Accession Number
2038130004
Title
Postoperative Brain Attack: Current Perspectives and Future Directions.
Source
Seminars in Thoracic and Cardiovascular Surgery. 37(3) (pp 281-292), 2025.
Date of Publication: 01 Sep 2025.
Author
Quinlan M.; Arora R.; Cho S.M.
Institution
(Quinlan, Cho) Division of Neurosciences Critical Care, Department of
Anesthesiology & Critical Care Medicine, Johns Hopkins University School
of Medicine, Baltimore, Maryland, United States
(Quinlan, Cho) Department of Neurology, Johns Hopkins University School of
Medicine, Baltimore, Maryland, United States
(Quinlan, Arora, Cho) Case Western Reserve University, Department of
Surgery, Cleveland, Ohio, United States
(Arora) Harrington Heart and Vascular Institute, Division of Cardiac
Surgery, University Hospitals, Cleveland, Ohio, United States
(Cho) Division of Cardiac Surgery, Department of Surgery, Johns Hopkins
University School of Medicine, Baltimore, Maryland, United States
Publisher
W.B. Saunders
Abstract
The incidence of stroke after cardiac surgery poses significant
challenges. This expert review piece explores current knowledge,
challenges, future directions, and offers insights into improving patient
outcomes through optimal prevention, early recognition, and management
strategies. By addressing the challenges and opportunities in this area,
we can enhance patient care, reduce long-term disabilities, and improve
the overall quality of life for affected individuals. This expert review
aims to provide a comprehensive framework for managing postoperative
stroke: mechanisms, risk factors, diagnosis, treatment, systems of care,
and ethical considerations.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<48>
[Use Link to view the full text]
Accession Number
2039191018
Title
Comparison of TAVR with SAVR on clinical outcomes in patients with aortic
stenosis: A systematic review and meta-analysis.
Source
Annals of Medicine and Surgery. 87(6) (pp 3768-3776), 2025. Date of
Publication: 01 Jun 2025.
Author
Khan K.G.; Garcia I.; Rodriguez A.; Wright W.; Shahid H.; Alrashed A.;
Pornchai A.; Manoj M.P.; Fagbamila O.; Mylavarapu M.
Institution
(Khan, Garcia) Department of Internal Medicine, Baqai Medical University,
Karachi, Pakistan
(Khan, Garcia) Department of Internal Medicine, St. George's University,
Grenada
(Rodriguez) Department of Internal Medicine, Universidad de Los Andes,
Merida, Venezuela
(Wright) Department of Internal Medicine, Texila American University,
Georgetown, Guyana
(Shahid) Department of Internal Medicine, Bahcesehir University, Istanbul,
Turkey
(Alrashed) Department of Internal Medicine, Imperial College London,
London, United Kingdom
(Pornchai) Department of Internal Medicine, University of Pittsburg
Medical Center, Pittsburg, PA, United States
(Manoj) Department of General Medicine, Government Medical College,
Kerala, India
(Fagbamila) Department of Anatomy, Saint James School of Medicine, Arnos
Vale, Saint Vincent and the Grenadines
(Mylavarapu) Department of Public Health, Adelphi University, Garden City,
NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: The advances and studies carried out in the area have shown
that patients with aortic stenosis (AS) undergoing surgical valve
replacement (SAVR) did not have encouraging outcomes. This study aims to
compare the different risk factors in patients with AS undergoing
transcatheter aortic valve replacement (TAVR) vs. SAVR, respectively, to
offer options and more favorable results based on the results obtained in
patients with these conditions. <br/>Method(s): The study was in
accordance with the PRISMA guidelines. Studies comparing outcomes of
surgical and transaortic catheter valve replacements in adults were
included. Descriptive statistics, binary random effects, and continuous
random effects were used. I² statistics were used to assess for
heterogeneity. A P-value <=0.05 was considered statistically significant.
<br/>Result(s): In total, eight studies with 18 671 patients were included
in our study. All-cause mortality (2.48% vs. 3.03%), major bleeding
(11.25% vs. 31.05%), and atrial fibrillation (2.39% vs. 50.42%) were lower
in TAVR compared to SAVR. Furthermore, odds of all-cause mortality (odds
ratio [OR]: 0.79; 95% CI: 0.63-1.00; P = 0.05), stroke (OR: 0.71; 95% CI:
0.58-0.87; P = 0.0008), and acute kidney injury (AKI) (OR: 0.38; 95% CI:
0.29-0.49; P < 0.00001) were lower in the TAVR group compared to the SAVR
group. <br/>Conclusion(s): TAVR is superior to SAVR and significantly
reduces the risks associated with all-cause mortality, stroke, AKI, and
other clinical outcomes. Furthermore, additional research is regarding the
long-term effects of transcatheter aortic valve replacement.<br/>Copyright
&#xa9; 2025 The Author(s). Published by Wolters Kluwer Health, Inc.

<49>
[Use Link to view the full text]
Accession Number
2040103174
Title
Association of Polygenic Susceptibility to Hyperlipidemia With Cholesterol
Control and Recurrent Stroke in Ischemic Stroke Survivors.
Source
Neurology. 105(5) (no pagination), 2025. Article Number: e213966. Date of
Publication: 09 Sep 2025.
Author
Wu K.; Huo S.; Rivier C.A.; Torres-Lopez V.; Sharma R.; De Havenon A.;
Worrall B.B.; Sheth K.N.; Falcone G.J.
Institution
(Wu, Huo, Rivier, Torres-Lopez, Sharma, Sheth, Falcone) Department of
Neurology, Yale School of Medicine, New Haven, CT, United States
(De Havenon) Yale Center for Brain and Mind Health, Yale School of
Medicine, New Haven, CT, United States
(Worrall) Departments of Neurology and Public Health Sciences, University
of Virginia School of Medicine, Charlottesville, VA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background and ObjectivesCommon genetic variation significantly influences
the risk of stroke, and previous research has indicated that polygenic
susceptibility to hypertension and diabetes negatively affects the
clinical trajectory of ischemic stroke survivors. We hypothesize that
polygenic susceptibility to hyperlipidemia (PSH) negatively affects
cholesterol control in this same population.MethodsWe conducted a genetic
association study using data from the Vitamin Intervention Stroke
Prevention (VISP) study, a clinical trial that enrolled survivors of
ischemic stroke. PSH was modeled using a polygenic risk score built with
38 independent genetic risk variants for low-density lipoprotein
cholesterol (LDL-c), which was divided into <20, 20-80, and >80 percentile
categories labeled as low, intermediate, and high PSH, respectively. We
used multivariable linear, logistic, and Cox regression, as appropriate,
to test whether high PSH was associated with risk of uncontrolled
hyperlipidemia (HLD) (LDL-c >100 mg/dL), resistant HLD (LDL-c >100 mg/dL
despite statin treatment), and clinical outcomes. We replicated our
findings in a cohort of ischemic stroke survivors enrolled in the UK
Biobank.ResultsA total of 1,567 ischemic stroke survivors (mean age 68
years, 35% female) enrolled in VISP were included in the study. Stroke
survivors with higher vs low PSH had 66% higher risk of uncontrolled HLD
(OR 1.66, 95% CI 1.17-2.35), 80% higher risk of resistant HLD (1.80, 95%
CI 0.99-3.29), twice the risk of recurrent stroke (hazard ratio [HR] 2.12,
95% CI 1.19-3.78), and 87% higher risk of acute coronary events (HR 1.87,
95% CI 1.21-2.87). The association between high PSH and higher risk of
uncontrolled and resistant HLD was replicated in 1,634 stroke survivors
(mean age 61, 32% female) enrolled in the UK Biobank (OR 2.34, 95% CI
1.67-3.27, and OR 2.33, 95% CI 1.61-3.37, respectively).DiscussionAmong
acute ischemic stroke survivors, higher PSH is associated with worse lipid
control and higher risk of recurrent vascular events. Our findings,
combined with existing evidence on the role of adverse genetic profiles in
blood pressure and glycemic control in this population, support the
comprehensive evaluation of polygenic profiles as a cause of failed risk
factor control in stroke survivors and its role in developing precision
medicine tools for post-stroke clinical management.<br/>Copyright &#xa9;
2025 American Academy of Neurology.

<50>
Accession Number
2040068578
Title
Prevalence and associated outcomes of right ventricular dysfunction in
peripartum cardiomyopathy: A systematic review, meta-analysis and
meta-regression.
Source
Open Heart. 12(2) (no pagination), 2025. Article Number: e003253. Date of
Publication: 17 Aug 2025.
Author
Wijayanto M.A.; Tristan C.D.; Lukas G.A.; Rahma A.A.; Ilyas M.F.; Myrtha
R.; Muliawan H.S.; Siswanto B.B.
Institution
(Wijayanto, Tristan, Lukas, Rahma, Ilyas) Faculty of Medicine, Universitas
Sebelas Maret, Central Java, Surakarta, Indonesia
(Myrtha) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, Universitas Sebelas Maret, Central Java, Surakarta, Indonesia
(Myrtha) Department of Cardiology and Vascular Medicine, Universitas
Sebelas Maret Hospital, Central Java, Sukoharjo, Indonesia
(Muliawan, Siswanto) Department of Cardiology and Vascular Medicine,
Faculty of Medicine, Universitas Indonesia, Jakarta, Central Jakarta,
Indonesia
(Muliawan) Department of Cardiology and Vascular Medicine, Universitas
Indonesia Hospital, West Java, Depok, Indonesia
(Siswanto) National Cardiovascular Center Harapan Kita, West Jakarta,
Jakarta, Indonesia
Publisher
BMJ Publishing Group
Abstract
Introduction Recent studies have highlighted the presence of right
ventricular dysfunction (RVD) in a substantial proportion of peripartum
cardiomyopathy (PPCM), with evidence suggesting that RVD is associated
with worse outcomes and a lower likelihood of left ventricular (LV)
recovery. This study aims to comprehensively assess the pooled prevalence,
associated outcomes and LV recovery of RVD in PPCM. Methods PubMed, Scopus
and ScienceDirect were used to identify relevant literature prior to 19
January 2025. Statistical analysis was conducted using RStudio. All
meta-analyses were performed using random effects, with subsequent
subgroup analysis and univariate meta-regression conducted for prevalence
meta-analysis. Results The pooled prevalence of RVD in PPCM was 0.48 (95%
CI: 0.36 to 0.59; I2 95.3%) across 14 studies (1385 patients). RVD was
diagnosed using multimodality imaging (e.g., echocardiography and cardiac
magnetic resonance imaging), with diagnostic criteria defined in the
original studies. Meta-regression showed a decreasing trend in RVD
prevalence in more recent publications (p=0.03), with variability based on
study design, location and diagnostic modality on subgroup analysis.
Patients with RVD had a significantly higher risk of composite adverse
outcomes (including death, LV assist device implantation, heart
transplantation or the use of extracorporeal membrane oxygenation; hazard
ratio 2.71; 95% CI 1.08 to 6.84; p=0.04; three studies) and heart
transplantation (risk ratio (RR) 4.71; 95% CI 1.82 to 12.20; p<0.01; two
studies). Additionally, RVD was associated with a lower baseline LV
ejection fraction (mean difference -10.94; 95% CI -14.80 to -7.08; p<0.01;
six studies) and an increased risk of unrecovered LV function (RR 1.62;
95% CI 1.25 to 2.11; p<0.01; four studies). Conclusion RVD occurs in
nearly half of patients with PPCM and is associated with a poor prognosis.
It may represent a crucial marker for prognostic stratification,
particularly for the risk of unrecovered LV function. PROSPERO
registration number CRD42025626739.<br/>Copyright &#xa9; 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.

<51>
Accession Number
2034563289
Title
Hyperintense acute reperfusion marker and gadolinium leakage in ocular
structures in stroke: a systematic review.
Source
Neuroradiology. 67(6) (pp 1365-1380), 2025. Date of Publication: 01 Jun
2025.
Author
Bousfiha C.; Saccaro L.F.; Consoli A.; Pico F.
Institution
(Bousfiha, Pico) Department of Neurology and Stroke Center, Mignot
Hospital, Versailles, France
(Bousfiha) Paris Brain Institute- ICM, Sorbonne University, CNRS, INRIA,
INSERM, AP-HP, Hopital de la Pitie Salpetriere, Paris, France
(Saccaro) Psychiatry Department, Geneva University Hospital, Geneva,
Switzerland
(Saccaro) Psychiatry Department, Faculty of Medicine, University of
Geneva, Geneva, Switzerland
(Consoli) Department of Stroke and Diagnostic and Interventional
Neuroradiology, Foch Hospital, Suresnes, France
(Pico) Versailles Saint Quentin en Yvelines and Paris Saclay University,
Paris, France
(Pico) INSERM U 1148- LVTS- Laboratoire de Recherche Vasculaire
Translationnelle, Paris, France
(Bousfiha) Hopital de la Pitie Salpetriere, 47-83 Bd de l'Hopital, Paris,
France
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Introduction: The Hyperintense Acute Reperfusion Marker (HARM) and
Gadolinium Leakage in Ocular Structures (GLOS) are pivotal radiological
findings in post-contrast fluid-attenuated inversion recovery imaging
(pcFLAIR), attesting to gadolinium leakage into the cerebrospinal fluid
(CSF) in various neurological disorders. Often observed following acute
strokes, HARM and GLOS, however, exhibit considerable variability in their
prevalence ranging from 5.5 to 85% and 30-76%, respectively. Given their
similarity and association of HARM with poor outcomes in stroke,
accurately evaluating these markers may be crucial for advancing our
understanding of stroke pathophysiology and improving clinical management.
Our work aims to identify the major methodological challenges and
confounding factors limiting the understanding of HARM and GLOS in stroke.
<br/>Method(s): To address these issues, we thoroughly conducted a
literature search in Embase, Scopus, and PubMed until July 2022. Our
search yielded 38 stroke studies, with only 6 evaluating GLOS. Guided by
major findings, we adapted the Newcastle-Ottawa scale for bias risk
assessment. Effect estimates were synthetized considering cohort size,
statistical significance, and bias risk. <br/>Result(s): Methodological
issues emerged from the lack of time-specific data, omission of
differential CSF hyperintensities, imprecise definitions, and overlooking
of adjusting variables like assessment timing, contrast dosages or renal
function. Discrepancy results mainly arise from an inadequate time window
of investigation, and further research should stratify patients based on
the timing of gadolinium injection. <br/>Conclusion(s): Our findings
emphasize the importance of a more detailed exploration of their timing
and localization, rather than simply their binary presence, extent, or
severity.<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer-Verlag GmbH Germany, part of Springer Nature 2025.

<52>
Accession Number
2035710827
Title
Clinical and Inflammatory Outcomes of Rotational Atherectomy in Calcified
Coronary Lesions: A Systematic Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 14(15) (no pagination), 2025. Article
Number: 5389. Date of Publication: 01 Aug 2025.
Author
Nashar A.H.; Qanitha A.; Alkatiri A.H.; Alatsari M.A.; Larassaphira N.P.;
Hanifah R.; Rasiha R.; Qalby N.; Muzakkir A.F.
Institution
(Nashar, Alkatiri, Muzakkir) Makassar Cardiac Center, Dr. Wahidin
Sudirohusodo General Teaching Hospital, South Sulawesi, Makassar,
Indonesia
(Nashar, Qanitha, Alkatiri, Muzakkir) Department of Cardiology and
Vascular Medicine, Faculty of Medicine, Hasanuddin University, South
Sulawesi, Makassar, Indonesia
(Qanitha) Department of Physiology, Faculty of Medicine, Hasanuddin
University, South Sulawesi, Makassar, Indonesia
(Alatsari, Larassaphira, Hanifah, Rasiha) Faculty of Medicine, Hasanuddin
University, South Sulawesi, Makassar, Indonesia
(Qalby) Department of Cardiology, Heart and Lung Division, University
Medical Center Utrecht, Utrecht, Netherlands
(Qalby) Department of Public Health and Community Medicine, Faculty of
Medicine, Hasanuddin University, South Sulawesi, Makassar, Indonesia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Objectives: To assess the clinical and inflammatory outcomes of patients
with calcified coronary arteries treated with rotational atherectomy (RA),
compared to those with other intervention procedures. <br/>Method(s): We
conducted a systematic search of PubMed (Medline) and Embase. This review
followed the PRISMA (Preferred Reporting Items for Systematic Reviews and
Meta-Analyses) guidelines and applied the PICO criteria. <br/>Result(s): A
total of 110 articles were analyzed, comprising 2,328,417 patients with
moderate to severe coronary calcified lesions treated with RA,
conventional percutaneous coronary intervention (PCI), or other advanced
interventions. The pooled incidence of short- to mid-term major adverse
cardiovascular events (MACEs) was 6% (95% CI 4-7%), increasing to 17% (95%
CI 15-21%) at 6 months. Mortality was 2% (95% CI 1-3%) within 6 months,
rising to 7% (95% CI 6-9%) thereafter. RA significantly increased the risk
of long-term MACEs, mortality, total lesion revascularization (TLR),
bleeding, and fluoroscopy time, and was borderline associated with an
increased risk of short-term myocardial infarction and a reduced risk of
coronary dissection. RA and other invasive procedures showed similar risks
for short-term MACEs, mortality, total vascular revascularization (TVR),
stent thrombosis, heart failure, stroke, and inflammation.
<br/>Conclusion(s): RA is linked to higher long-term risks of MACEs,
mortality, TLR, bleeding, and fluoroscopy time compared to other
interventions. While RA shows comparable outcomes for short-term MACEs and
mortality with other procedures, it may slightly reduce the risk of
coronary dissection. These findings underscore the importance of careful
patient selection and weighing long-term risks when considering RA for
calcified coronary lesions.<br/>Copyright &#xa9; 2025 by the authors.

<53>
Accession Number
2036987137
Title
Post-heart Surgery and Levothyroxine Therapy: A Narrative Review.
Source
Journal of Comprehensive Pediatrics. 16(4) (no pagination), 2025. Article
Number: e161996. Date of Publication: 30 Nov 2025.
Author
Mirhaghjoo Z.S.; Hassanzadeh Rad A.; Nikpour S.
Institution
(Mirhaghjoo, Hassanzadeh Rad, Nikpour) Pediatric Diseases Research Center,
Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of
Publisher
Brieflands
Abstract
Context: Cardiopulmonary bypass (CPB), commonly used in cardiac surgeries,
often disrupts thyroid hormone levels, leading to conditions like sick
euthyroid syndrome (SES), which can impair myocardial function and delay
recovery. <br/>Objective(s): This narrative review examines the impact of
levothyroxine therapy on cardiac performance and survival outcomes in
patients undergoing heart surgery, particularly those with thyroid
dysfunction. <br/>Method(s): This narrative review was conducted through a
literature search on articles in English with the relevant keywords.
<br/>Result(s): The review highlights that levothyroxine, a synthetic
thyroid hormone, helps restore normal thyroid function, improving
hemodynamic stability and cardiac output, and reducing postoperative
complications. Studies suggest that levothyroxine therapy facilitates
faster recovery, shorter ICU stays, and potentially lower mortality rates.
However, the optimal dosing, timing, and duration of therapy remain
unclear. <br/>Conclusion(s): While short-term benefits are evident,
further research is needed to evaluate the long-term effects of
levothyroxine on cardiac function and survival.<br/>Copyright &#xa9; 2025,
Mirhaghjoo et al.

<54>
Accession Number
2039377138
Title
Cardiovascular Prehabilitation in Patients Awaiting Heart Transplantation-
Addressing Clinical Needs (the PREHAB HTx Study).
Source
CJC Open. 7(8) (pp 1110-1119), 2025. Date of Publication: 01 Aug 2025.
Author
Reed J.L.; Tulloch H.E.; Ross H.; Terada T.; Mistura M.; Marcal I.R.; Oh
P.; Chih S.
Institution
(Reed, Tulloch, Terada, Mistura, Marcal, Chih) University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Reed, Marcal) School of Human Kinetics, Faculty of Health Sciences,
University of Ottawa, Ottawa, ON, Canada
(Reed) School of Epidemiology and Public Health, Faculty of Medicine,
University of Ottawa, Ottawa, ON, Canada
(Tulloch) Department of Medicine, Faculty of Medicine, University of
Ottawa, Ottawa, ON, Canada
(Ross) Toronto General Hospital Research Institute, University of Toronto,
Toronto, ON, Canada
(Terada) School of Life Sciences, Division of Physiology, Pharmacology,
and Neuroscience, University of Nottingham, Nottingham, United Kingdom
(Oh) Toronto Rehabilitation Institute, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: To compare the effects of a 12-week prehabilitation (PREHAB)
program vs usual care (UC) on functional capacity in adults listed for
heart transplantation. Secondary aims included comparing peak oxygen
uptake (VO<inf>2</inf>peak), frailty, physical activity, mental health,
cognitive function, quality of life (QoL), and dietary habits.
<br/>Method(s): A multicentre randomized controlled trial was conducted.
Participants were randomized to PREHAB or UC. The 12-week PREHAB program
included twice weekly high-intensity interval training sessions on an
upright cycle ergometer, a stress management course, and a nutrition
workshop. The primary outcome was functional capacity (6-minute walk test
distance) from baseline to 12 weeks of follow-up. Secondary outcomes
included changes in VO<inf>2</inf>peak, frailty, physical activity,
severity of anxiety, depression, and stress, cognitive function, QoL, and
dietary habits. <br/>Result(s): Trial recruitment began in October 2018
and closed, due to the COVID-19 pandemic, in October 2020. Of 84 patients
screened, 17 were recruited (age: 44 +/- 9 years, 71% male), and 4 were
randomized (PREHAB = 2; UC = 2). Both patients completed PREHAB, and 1
patient completed UC. Reasons for dropout throughout the trial included
the following: receiving a transplant; medication and device
contraindications; commitment and travel constraints; and lack of
interest. PREHAB showed potential for improvements in the 6-minute walk
test distance (Baseline [B]: 343 +/- 120; follow-up [FU]: 465 m),
VO<inf>2</inf>peak (B: 14.9 +/- 0.1; FU: 15.8 +/- 0.4 mL/kg/min), and QoL
measured using the Minnesota Living with Heart Failure Questionnaire (B:
41 +/- 33; FU: 26 +/- 1 points). <br/>Conclusion(s): Recruitment for and
completion of PREHAB for patients listed for heart transplantation proved
challenging. Given wait-time limitations, future research should examine
alternative PREHAB programming, offered sooner following listing, that
addresses reported barriers to participation. Clinical Trial Registration:
NCT02957955.<br/>Copyright &#xa9; 2025 The Authors

<55>
[Use Link to view the full text]
Accession Number
2040079105
Title
Renal failure after surgical mitral valve interventions: a meta-analytical
approach.
Source
Annals of Medicine and Surgery. 86(11) (pp 6364-6365), 2024. Date of
Publication: 01 Nov 2024.
Author
Ahmed H.; Ismayl M.; Palicherla A.; Ann Mathew Kalathil R.; Dufani J.;
Kabach A.; Aboeata A.
Institution
(Ahmed, Palicherla, Ann Mathew Kalathil, Dufani) Department of Medicine,
Division of Internal Medicine, Creighton University School of Medicine,
Omaha, NE, United States
(Ismayl) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Kabach, Aboeata) Department of Medicine, Division of Cardiovascular
Disease, Creighton University School of Medicine, Omaha, NE, United States
Publisher
Lippincott Williams and Wilkins

<56>
Accession Number
2035746752
Title
The Incidence of Pressure Ulcers in Surgical Patients: A Systematic
Review.
Source
International Wound Journal. 22(8) (no pagination), 2025. Article Number:
e70738. Date of Publication: 01 Aug 2025.
Author
Kurian S.; Moore Z.; Patton D.; George S.
Institution
(Kurian, Moore, Patton, George) School of Nursing & Midwifery, Royal
College of Surgeons, University of Medicine and Health Sciences, Dublin 2,
Ireland
(Kurian) St. Vincent's University Hospital, Dublin 4, Ireland
(Moore, Patton) School of Nursing & Midwifery, Griffith University,
Brisbane, Australia
(Moore) National Health and Medical Research Council Centre of Research
Excellence in Wiser Wound Care, Menzies Health Institute Queensland,
Casuarina, Australia
(Moore) School of Health Sciences, Faculty of Life and Health Sciences
Ulster University, Belfast, United Kingdom
(Moore) Cardiff University, Cardiff, United Kingdom
(Moore, Patton) Department of Nursing, Fakeeh College for Medical
Sciences, Jiddah, Saudi Arabia
(Moore) Department of Public Health, Faculty of Medicine and Health
Sciences, Ghent University, Gand, Belgium
(Moore) Lida Institute, Shanghai, China
(Patton) University of Wollongong, Wollongong, Australia
Publisher
John Wiley and Sons Inc
Abstract
The aim is to assess the incidence of pressure ulcers among adults
undergoing surgery. Systematic review methodology was employed. Databases
including Cochrane, Ovid Medline, Embase, EBSCO, CINAHL Plus and Scopus
were searched in August 2024. The data extracted were imported into Excel
for analysis. Simple descriptive statistics were used for the analysis
purposes. The data are presented using means and standard deviations. The
evidence-based Librarian checklist was used for the quality appraisal. The
Systematic Review Protocol was registered in PROSPERO (CRD42023449194). A
total of 35 studies were included. The mean pressure ulcer incidence was
17.22% (range from 0.05% to 74.2%). Studies from orthopaedics, mainly
including patients undergoing hip surgeries, reported the highest pressure
ulcer incidence. The most commonly reported pressure ulcer grade was stage
one, and the most common anatomical locations were the sacral region and
heels. Pressure ulcers remain a significant concern for surgical patients,
especially those undergoing orthopaedic and cardiac surgeries. Most
develop in early stages, often affecting the sacral and heel regions.
However, gaps in data make it difficult to fully synthesise the scope of
the problem. Standardised reporting and targeted prevention efforts are
essential to reducing incidence and improving patient care.<br/>Copyright
&#xa9; 2025 The Author(s). International Wound Journal published by
Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<57>
Accession Number
2040108019
Title
Long-term outcome of surgery for lung cancer in Africa: a systematic
review and meta-analysis.
Source
ecancermedicalscience. 19 (no pagination), 2025. Article Number: 1951.
Date of Publication: 2025.
Author
Gift A.B.; Otorkpa M.J.; Olayode O.O.; Joseph E.D.; Abdulhakeem A.;
Nchonganyi E.J.P.; Anele F.C.; Habib A.A.; Ghislain F.S.; Akintoye O.O.;
Benjamin O.
Institution
(Gift, Otorkpa, Olayode, Joseph, Abdulhakeem, Nchonganyi, Anele, Habib,
Ghislain, Akintoye, Benjamin) Cardiothoracic Surgery, Surgery Interest
Group of Africa, Lagos, Nigeria
Publisher
ecancer Global Foundation
Abstract
Background: Lung cancer is the leading cause of cancer death worldwide,
with an estimated 1.8 million deaths in 2020. Despite the advancement of
new treatment strategies that have emerged over time, surgery remains a
very important aspect of cancer treatment. This study aims to highlight
the long-term outcomes of surgery as well as the healthcare gaps in the
diagnosis and treatment of Lung cancer in Africa by providing a
comprehensive systematic review and meta-analysis. <br/>Method(s): This
systematic review was conducted using database searches from PubMed and
Google Scholar to identify published data reporting on the surgical
outcomes of lung cancer in Africa from inception till August 2024. We
followed the Preferred Reporting Items for Systematic Reviews and
Meta-Analysis guidelines to conduct this study. The primary outcomes of
interest were overall mortality, 1- and 5-year survival rates, metastasis,
morbidity and recurrence. Data were pooled together and analysed using a
random-effect model for meta-analysis with R software. Out of a total of
381 articles identified, only eight papers met our inclusion criteria
following deduplication and screening. The five countries with published
research on our topic include Egypt, Kenya, Tunisia, Nigeria and Morocco,
with a total sample size of 2150 patients. <br/>Result(s): The
meta-analysis of the reported outcomes produced an overall mortality rate
of 27%, a 1-year survival rate of 56%, a 5-year survival rate of 13%,
metastases of 76.9%, morbidity of 7.7% and recurrence of 11.4%.
<br/>Conclusion(s): The burden of lung cancer is relatively high across
the African continent, with surgical treatment significantly underutilised
due to several factors, including an inadequate number of skilled
healthcare workers, limited cardiothoracic surgical services and the
advanced stage at which most patients present. Nevertheless, there is room
for improvement by addressing these gaps through targeted investments in
cardiothoracic surgical training, research and infrastructure, alongside
increased awareness of lung cancer and the benefits of screening services
across Africa. These measures, combined with joint international and
governmental funding efforts, could significantly improve survival
outcomes.<br/>Copyright &#xa9; the authors; licensee
ecancermedicalscience.

<58>
Accession Number
2040110911
Title
Short-term Effects of High Thoracic Epidural Blockade in Patients With
Ischemic Heart Disease and Heart Failure: A Systematic Review and Data
Synthesis.
Source
Reviews in Cardiovascular Medicine. 26(7) (no pagination), 2025. Article
Number: 37886. Date of Publication: 01 Jul 2025.
Author
Guo D.; Chen M.; Zhu C.; Liu Y.
Institution
(Guo, Zhu, Liu) Department of Internal Medicine and Pediatrics, Clinical
College of Qilu Medical University, Shandong, Zibo, China
(Chen) Department of Nursing Science, Clinical College of Qilu Medical
University, Shandong, Zibo, China
(Liu) Department of Cardiology, Affiliated Hospital of Qilu Medical
University, Shandong, Zibo, China
Publisher
IMR Press Limited
Abstract
Background: High thoracic epidural blockade (HTEB) with local
anti-sympathetic effects modulates cardiac performance in patients
undergoing cardiac or non-cardiac surgeries. However, the short-term
cardio-protective effects of HTEB in non-operative patients with ischemic
heart disease (IHD) and heart failure (HF) remain unclear. Our study aimed
to pool evidence regarding the benefits of adjunctive HTEB intervention in
patients with IHD and HF. <br/>Method(s): Exposures were defined as
non-operative patients with IHD and HF who received adjunctive HTEB
intervention and/or conventional medical treatment (CMT). The primary
outcomes were clinical recovery indicator assessments,
electrocardiographic and ultrasonic index improvement, laboratory tests,
and hemodynamic benefits provided by adjunctive HTEB treatment. The
secondary outcome was the effectiveness rate and adverse side effects
after HTEB intervention. The pooled analyses of continuous variables were
conducted using a fixed-effects model and the effects were represented by
the weighted mean difference (WMD) and a 95% confidence interval (CI). The
effective rates of HTEB treatment were represented using odds ratios (ORs,
95% CI) or effect size (ES, 95% CI). The I² statistic was used
to identify any inconsistency in the pooled results from individual
trials. A meta-regression and subgroup analysis were conducted when
inconsistencies in individual trials were detected. <br/>Result(s): HTEB
treatment was associated with a significant 10% increase in left
ventricular ejection fraction (summary WMD, 9.651 [95% CI: 9.082 to
10.220]), a decline in neuroendocrine hormone levels, myocardial ischemia
relief, improvement in hemodynamics, and the reversal of decompensated
cardiac remodeling. HTEB treatment is more effective than conventional
medical treatment (odds ratio, 5.114 [95% CI: 3.189 to 8.203]) in treating
HF and angina pectoris. <br/>Conclusion(s): Our results suggest that HTEB
intervention may be a complementary approach for cardiac rehabilitation in
patients with IHD and HF. However, more data are necessary to confirm
these findings due to the significant heterogeneity of the included
studies.<br/>Copyright &#xa9; 2025 The Author(s). Published by IMR Press.

<59>
Accession Number
2037038794
Title
A comparative cost analysis study of pulmonary robotic and video-assisted
lobectomy: results of a randomized controlled trial (BRAVO Study).
Source
Revista do Colegio Brasileiro de Cirurgioes. 52 (no pagination), 2025.
Article Number: e20253553. Date of Publication: 2025.
Author
Terra R.M.; Trindade J.R.M.; de Araujo P.H.X.N.; Lauricella L.L.; Zaidan
E.P.; Fernandesa P.M.P.
Institution
(Terra, Trindade, de Araujo, Lauricella, Zaidan) Universidade de Sao
Paulo, Instituto do Cancer do Estado de Sao Paulo, Departamento de
Cirurgia Toracica, SP, Sao Paulo, Brazil
(Fernandesa) Universidade de Sao Paulo Instituto do Coracao, Departamento
de Cirurgia Toracica, SP, Sao Paulo, Brazil
Publisher
Colegio Brasileiro de Cirurgioes
Abstract
Introduction: Robotic thoracic surgery has potential benefits, but the
cost is still considered a limiting factor for its wide dissemination in
most countries. <br/>Method(s): We compared the costs of robotic-assisted
(RATS) and video-assisted thoracic surgery (VATS) in the treatment of lung
cancer or pulmonary metastasis. Cost analysis was based on micro-costing
and individual cost analysis during surgical admission and frequency of
services (emergency service, clinic visits, imaging exams, chemotherapy
and radiotherapy, reoperation or additional procedures, rehospitalization,
and ICU stay) during postoperative 90-day follow-up. <br/>Result(s): A
total of 76 patients were included in this cost analysis (RATS=37,
VATS=39). Groups were equivalent in terms of age, gender, comorbidities,
and pre-operative status. Total costs of pulmonary lobectomy did not
differ between the RATS and VATS groups when considering cost of surgical
hospitalization and follow-up of up to 90 days. Mean individual cost per
patient in the RATS group was R$35,590.41 (+/-12,514.97) and R$41,066.98
(+/-25,891.04) in the VATS group, p=0.564. <br/>Conclusion(s): Robotic and
video-assisted thoracic surgery had similar costs, but longer follow-up
studies could be important to demonstrate RATS and VATS costs
differences.<br/>Copyright &#xa9; 2025, Colegio Brasileiro de Cirurgioes.
All rights reserved.

<60>
Accession Number
2035891134
Title
A Combined Approach to the Prevention of Postoperative Atrial Fibrillation
in Cardiac Surgery.
Source
Biomedicines. 13(8) (no pagination), 2025. Article Number: 1999. Date of
Publication: 01 Aug 2025.
Author
Diakova M.L.; Kuznetsov M.S.; Vechersky Y.Y.; Kim E.B.; Zyryanov S.V.;
Petlin K.A.; Kozlov B.N.
Institution
(Diakova, Kuznetsov, Vechersky, Kim, Zyryanov, Petlin, Kozlov) Cardiology
Research Institute, Tomsk National Research Medical Center, Russian
Academy of Sciences, Tomsk, Russian Federation
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Postoperative atrial fibrillation (POAF) is a common
complication after cardiac surgery with cardiopulmonary bypass (CPB)
affecting between 5% and 40% of patients, which leads to hemodynamic
instability, an increased risk of thromboembolism, decompensated heart
failure, prolonged hospitalization, and higher treatment costs. Currently,
there are no universally accepted guidelines for preventing POAF.
<br/>Method(s): A single-center, prospective, randomized controlled trial,
"The Effect of Colchicine on the Occurrence of Atrial Fibrillation after
Cardiac Surgery" (CAFE), ClinicalTrials.gov ID: NCT06798714, was
conducted. The study included 140 patients with coronary artery disease
randomized into two groups of 70 patients each. Group 1 (control group)
received standard postoperative care. Group 2 (intervention group)
received colchicine (Colchicum-Dispert at a dose of 500 mcg 4 h before
coronary artery bypass grafting (CABG) with CPB and at a dose of 500 mcg
twice daily for 10 days postoperatively) and underwent intraoperative
pericardial fenestration using an original technique. <br/>Result(s):
Perioperative colchicine administration combined with intraoperative
pericardial fenestration reduced POAF incidence to 2.9% compared to the
control group with POAF incidence of 12.9% (p < 0.05). This management
strategy was not associated with an increased incidence of infectious
complications, gastrointestinal disorders, or elevated levels of alanine
aminotransferase, aspartate aminotransferase, or creatinine.
<br/>Conclusion(s): Perioperative colchicine administration combined with
pericardial fenestration during CABG with CPB is associated with a reduced
POAF incidence, good tolerability, and does not contribute to an increased
incidence of infectious complications or impaired liver and renal
function.<br/>Copyright &#xa9; 2025 by the authors.

<61>
Accession Number
2040251125
Title
Digital clinical teaching of cardiovascular surgery supported by precision
imaging and 3D printing technology: a randomized parallel-controlled
trial.
Source
Cardiovascular Diagnosis and Therapy. 15(4) (pp 714-725), 2025. Date of
Publication: 30 Aug 2025.
Author
Zhao T.; Wang Y.; Wang B.; Liu Y.; Chen Z.; Wu Y.
Institution
(Zhao, Liu, Chen) Department of Cardiovascular Surgery, The Second
Hospital of Hebei Medical University, Shijiazhuang, China
(Zhao, Wu) Department of Physiology, Hebei Medical University,
Shijiazhuang, China
(Wang) Office of Postgraduate Education, The Second Hospital of Hebei
Medical University, Shijiazhuang, China
(Wang) Department of Anesthesiology, The Third Hospital of Hebei Medical
University, Shijiazhuang, China
Publisher
AME Publishing Company
Abstract
Background: Cardiovascular surgery demands deep knowledge of the heart's
intricate three-dimensional (3D) anatomy, but current teaching methods do
not adequately develop students' spatial skills. Advances in precise
imaging and 3D printing offer transformative potential for clinical
education. In this study, taking the teaching of cardiovascular surgery as
an example, we aimed to integrate precision imaging and 3D printing
technologies with case-based learning (CBL), problem-based learning (PBL),
and team-based learning (TBL). Our objective was to explore digital
teaching approaches in clinical surgery and address the limitations of
current learning models in spatial visualization training. <br/>Method(s):
This study employed a parallel design randomized controlled trial (RCT)
methodology. A total of 80 clinical medicine students from the 2020
cohort, currently undertaking their practicum in the Department of Cardiac
Great Vascular Surgery at The Second Hospital of Hebei Medical University,
were randomly assigned into two groups: a digital teaching group and a
case-, problem-, and team-based learning (C-P-TBL) teaching group, each
comprising 40 students. The digital teaching group utilized an innovative
digital teaching approach, enhanced by precision imaging and 3D printing
technology. In contrast, the C-P-TBL teaching group employed an integrated
teaching model combining CBL, PBL, and TBL. The two groups were compared
via theoretical and skills assessment, along with the analysis of teaching
quality questionnaires and teaching satisfaction metrics, so as to
evaluate the incremental benefits conferred by digital tools within the
existing teaching framework. <br/>Result(s): The digital teaching group
demonstrated superior performance compared to the C-P-TBL teaching group,
as evidenced by higher scores in theoretical knowledge (86.28+/-10.756 vs.
80.25+/-9.440), clinical skills (87.90+/-7.530 vs. 83.05+/-7.473), and
overall assessment (86.93+/-8.131 vs. 81.37+/-7.716). Based on the results
of the teaching quality questionnaires, the digital teaching group
demonstrated a statistically significant superiority over the C-P-TBL
teaching group in several areas: self-learning ability, comprehension and
application of theoretical knowledge, problem discovery and analysis
skills, spatial imagination capability, and overall self-comprehensive
ability. <br/>Conclusion(s): The integration of digital technologies,
exemplified by precision imaging and 3D printing, with CBL, PBL, and TBL
methodologies, has been shown to significantly enhance the spatial
visualization skills of medical students. This approach not only improves
their theoretical understanding and technical proficiency, but also leads
to higher self-assessment of abilities and increased satisfaction with the
teaching process. Consequently, this pedagogical strategy merits
consideration for widespread implementation in the clinical education of
cardiovascular surgery.<br/>Copyright &#xa9; AME Publishing Company.

<62>
Accession Number
2040225261
Title
Anaesthetic depth and short-term delirium after cardiac surgery
intervention: the study protocol of the BISCAR multicentre randomised
clinical trial.
Source
BMJ Open. 15(8) (no pagination), 2025. Article Number: e103105. Date of
Publication: 28 Aug 2025.
Author
Ellouze O.; Zogheib E.; Abdelhafidh K.; Lemaire A.; Berger J.; Charfeddine
A.; Bouzguenda H.; Konstantinou M.; Molinari N.; Bonnet N.; Geri G.; Nappi
F.
Institution
(Ellouze, Abdelhafidh, Lemaire, Berger, Charfeddine, Bouzguenda,
Konstantinou) Department of Anesthesia and Critical Care, Centre
Cardiologique du Nord, Saint-Denis, France
(Zogheib) Department of Anesthesia, Groupe Hospitalier Prive Ambroise
Pare-Hartmann, Neuilly-sur-Seine, France
(Molinari) Department of Statistics, Lapeyronie Hospital, University of
Montpellier, Montpellier, France
(Bonnet, Nappi) Department of Cardiac Surgery, Centre Cardiologique du
Nord, Saint-Denis, Paris, France
(Geri) Department of Critical Care, Groupe Hospitalier Prive Ambroise
Pare-Hartmann, Neuilly-sur-Seine, France
Publisher
BMJ Publishing Group
Abstract
Introduction Perioperative cognitive disorders include three essential
elements: the progression of a pre-existing neurocognitive lesion, the
occurrence of postoperative delirium (POD) and, finally, a mild or severe
postoperative neurocognitive disorder. These perioperative disorders are
associated with increased morbidity and mortality. Numerous risk factors
are associated with perioperative cognitive disorders, the most salient
being advanced age and the type of surgery. Specifically, major surgeries
and cardiac surgery with associated tissue injuries and inflammation are
significant causes of these cognitive impairments. The depth of
anaesthesia has recently emerged as an important risk factor for
perioperative cognitive disorders, particularly in older patients. The aim
of our study is to evaluate whether a reduction in anaesthesia depth is
associated with perioperative cognitive disorders in patients aged over 75
years who undergo planned cardiac surgery. Methods and analysis This is a
multicentric randomised controlled trial with the aim to investigate
whether a lower level of anaesthesia evaluated with a Bispectral Index (35
vs 55) reduces the prevalence of POD in patients aged 75 years and over
who undergo planned cardiac surgery (heart valve surgery, coronary artery
bypass graft surgery, aortic surgery or combined surgery). 200 patients
are planned for enrolment. The analysis evaluates the prevalence of
delirium during the first 3 days after surgery with the Confusion
Assessment Method for the Intensive Care Unit Scale. Ethics and
dissemination The study protocol has been approved by the relevant French
medical review board: the French Committee for Protection of Persons (ID:
2022-A02200-43, Comite de protection des personnes Est III). We plan to
present the results at (inter)national conferences after the completion of
the study and to publish them in peer-reviewed journals.<br/>Copyright
&#xa9; 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.

<63>
Accession Number
2040191543
Title
Complex uniportal robotic-assisted sleeve resections under spontaneous
ventilation and with double lumen intubation: a case series and a
narrative review of the literature.
Source
Translational Lung Cancer Research. 14(8) (pp 3170-3182), 2025. Date of
Publication: 31 Aug 2025.
Author
Gonzalez-Rivas D.; Gomes-Da Silva de Rosenzweig P.; Arana Bolanos L.F.;
Pimienta Ibarra A.S.; Walji H.D.; Dohetty P.S.; Zhao J.; Li C.; Bosinceanu
M.; Bolanos Morales F.V.
Institution
(Gonzalez-Rivas) Department of Thoracic Surgery and Minimally Invasive
Thoracic Surgery Unit (UCTMI), Coruna University Hospital, Coruna, Spain
(Gomes-Da Silva de Rosenzweig, Walji) Department of Cardio-Thoracic
Surgery, University Hospitals Coventry and Warwickshire, Coventry, United
Kingdom
(Arana Bolanos, Pimienta Ibarra, Dohetty, Bolanos Morales) Department of
Thoracic Surgery, Instituto Nacional de Enfermedades Respiratorias Ismael
Cosio Villegas, Mexico City, Mexico
(Zhao, Li) Department of Thoracic Surgery, The First Affiliated Hospital
of Soochow University, Suzhou, China
(Bosinceanu) Department of Thoracic Surgery, Memorial Oncological
Hospital, Bucharest, Romania
Publisher
AME Publishing Company
Abstract
Background and Objective: Sleeve lobectomy (SL) has evolved into the
preferred surgical option for centrally located non-small cell lung cancer
(NSCLC) and other complex thoracic tumors, offering superior functional
and oncological outcomes compared to pneumonectomy. The recent advent of
robotic-assisted thoracic surgery (RATS), including its uniportal approach
(uRATS), has extended the feasibility of SL to minimally invasive
approaches. The objective of this study is to present our experience with
uRATS sleeve resections, highlighting five complex cases, involving four
sleeve lobectomies and one tracheal resection, performed using two
different robotic platforms (da Vinci and ShuRui). Additionally, we aim to
provide an up-to-date review of SL as a treatment strategy for NSCLC and
centrally located tumors. <br/>Method(s): We performed a narrative review
covering publications from 2010 to 2025. The search was conducted across
PubMed, EMBASE, and Scopus databases. Key Content and Findings: Although
data on RATS SL remains limited, several publications have highlighted the
potential benefits of this approach. Comparative studies evaluating
different operative approaches for SL have shown that RATS offers
advantages over both open and video-assisted thoracic surgery. uRATS SL
represents a novel and evolving technique that combines technical
precision with favorable perioperative outcomes. However, its adoption is
often slow due to the inherent complexity and steep learning curve
associated with the procedure. <br/>Conclusion(s): uRATS SL carinal and
tracheal reconstructions have emerged as promising treatment strategies
for centrally located tumors. However, there remains an urgent need for
further comparative studies assessing both short- and long-term outcomes,
as well as evaluating oncologic outcomes and their impact on patients'
quality of life.<br/>Copyright &#xa9; AME Publishing Company.

<64>
Accession Number
2040217718
Title
Impact of Diabetes on ICU and Hospital Length of Stay Following Cardiac
Surgery With CPB: A Systematic Review and Meta-Analysis.
Source
Endocrine Practice. Conference: AACE Annual Meeting 2025. Orlando United
States. 31(9 Supplement) (pp S181), 2025. Date of Publication: 01 Sep
2025.
Author
Anonymous
Publisher
Elsevier B.V.
Abstract
Author Block: David D. Araujo, Faculty of Medicine, University of Sao
Paulo, Gustavo Meneses Dantas, Faculty of Medicine, University of Sao
Paulo, Suely Pereira Zeferino, Heart Institute of the University of Sao
Paulo Medical School, Daniel Cruz, Faculty of Medicine, University of Sao
Paulo, Luis Fernando de Vasconcelos Sousa, Faculty of Medicine, University
of Sao Paulo, Fabio Biscegli Jatene, Faculty of Medicine, University of
Sao Paulo, Filomena Galas, Faculty of Medicine, University of Sao Paulo
Description: Diabetes mellitus is purported to exacerbate complications in
cardiac surgeries utilizing extracorporeal circulation. This systematic
review critically assessed the impact of diabetes on intensive care unit
(ICU) and hospital length of stay (HLOS), synthesizing existing evidence
and exploring correlations to enhance postoperative management in diabetic
patients. <br/>Objective(s): This study evaluates the correlation between
diabetic patients and ICU stay after cardiac surgery with extracorporeal
circulation. It also examines diabetes' impact on hospital stay and the
influence of age, sex, and body mass index (BMI) on these outcomes.
<br/>Method(s): A systematic review was conducted using PubMed, Scopus,
Embase, and Cochrane, focusing on trials from 2004 to 2024. Primary
outcome was the correlation between diabetic proportion and ICU stay.
Secondary outcomes included HLOS, age, sex, and BMI. <br/>Result(s): Among
1588 patients, the correlation between diabetic proportion and ICU stay
was weak and nonsignificant (-0.176, P = .574). A weak but significant
negative correlation was found for HLOS (-0.2545, P = .002). Age, sex, and
BMI had no impact. <br/>Conclusion(s): Diabetes does not impact ICU stay
but may shorten hospital stays, an unexpected finding. The effect of sex
is important for future research, and age and BMI, although not
significant here, remain relevant for postoperative outcomes. Further
research is needed.<br/>Copyright &#xa9; 2025

<65>
[Use Link to view the full text]
Accession Number
2034916688
Title
Ablation Strategies for Repeat Procedures in Atrial Fibrillation
Recurrences Despite Durable Pulmonary Vein Isolation: The Prospective
Randomized ASTRO AF Multicenter Trial.
Source
Circulation. 150(25) (pp 2007-2018), 2024. Date of Publication: 17 Dec
2024.
Author
Schmidt B.; Bordignon S.; Metzner A.; Sommer P.; Steven D.; Dahme T.;
Busch M.; Tilz R.R.; Schaack D.; Rillig A.; Sohns C.; Sultan A.;
Weinmann-Emhardt K.; Hummel A.; Vogler J.; Fink T.; Lueker J.; Pott A.;
Heeger C.; Chun K.R.J.
Institution
(Schmidt, Bordignon, Schaack, Chun) Cardioangiologisches Centrum
Bethanien, Frankfurt, Germany
(Schmidt) Universitatsklinikum Frankfurt, Medizinische Klinik 3-Klinik fur
Kardiologie, Frankfurt, Germany
(Metzner, Rillig) University Heart and Vascular Center Hamburg (UHZ),
Germany
(Sommer, Sohns, Fink) Clinic for Electrophysiology, Herz- und
Diabeteszentrum Nordrhein-Westfalen, Ruhr-Universitat Bochum, Bad
Oeynhausen, Germany
(Steven, Sultan, Lueker) University Hospital Cologne-Heart Center, Germany
(Dahme, Weinmann-Emhardt, Pott) Uniklinik Ulm, Klinik fur Innere Medizin
II, Ulm, Germany
(Dahme) Klinikum Esslingen, Klinik fur Kardiologie, Angiologie und
Pneumologie, Esslingen, Germany
(Busch, Hummel) Universitaetsmedizin Greifswald, Germany
(Busch) Helios Hanseklinikum Stralsund, Klinik fur Innere Medizin und
Kardiologie, Stralsund, Germany
(Tilz, Vogler, Heeger) Schleswig-Holstein University Clinic, Lubeck
Campus, Germany
(Pott) Bonifatius Hospital Lingen, Klinik fur Kardiologie und
Rhythmologie, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Ablation strategies for patients with symptomatic atrial
fibrillation and isolated pulmonary veins vary and their effects on
arrhythmia recurrence remain unclear. A prospective randomized German
multicenter trial sought to compare 2 ablation strategies in this patient
cohort. <br/>METHOD(S): Patients with atrial fibrillation despite durable
pulmonary vein isolation were randomly assigned at 7 centers to undergo
low-voltage area ablation using 3-dimensional mapping and irrigated
radiofrequency current ablation (group A) or empirical left atrial
appendage isolation (LAAI) using the cryoballoon followed by staged
interventional left atrial appendage closure (group B). The primary end
point was freedom from atrial tachyarrhythmias between 91 and 365 days
after index ablation. The study was powered for superiority of LAAI
compared with low-voltage area. <br/>RESULT(S): Patients (40% women; mean
age, 68.8+/-8 years) with paroxysmal (32%) or persistent atrial
fibrillation (68%) were randomized to undergo low-voltage area ablation
(n=79) or cryoballoon-guided LAAI (n=82). After a planned interim
analysis, enrollment was halted for futility on January 10, 2023. In the
LAAI group, 77 of 82 left atrial appendages were successfully isolated
with subsequent left atrial appendage closure in 57 patients.
Procedure-related complications occurred in 4 (5%) and 11 (13.5%) patients
in group A and B, respectively (P=0.10). The median follow-up was 367 days
(interquartile range, 359-378). The Kaplan-Meier point estimate for
freedom from atrial tachyarrhythmias was 51.7% (CI, 40.9%-65.4%) for group
A and 55.5% (CI, 44.4%-69.2%; P=0.8069) for group B. <br/>CONCLUSION(S):
The current study did not detect superiority of cryoballoon-guided LAAI
over low-voltage area ablation in patients with atrial fibrillation
despite durable PVI. REGISTRATION: URL: https://www.clinicaltrials.gov;
Unique identifier: NCT04056390.<br/>Copyright &#xa9; 2024 American Heart
Association, Inc.

<66>
Accession Number
2039162808
Title
Effects of combining transversus thoracic muscle and serratus anterior
plane blocks on postoperative analgesia and the inflammatory response in
patients undergoing heart valve replacement surgery: A randomized
controlled trial.
Source
Asian Journal of Surgery. 48(9) (pp 5483-5484), 2025. Date of Publication:
01 Sep 2025.
Author
Xing Z.; Zhang S.; Fan Q.; Wang P.; Yuan H.
Institution
(Xing, Fan, Wang, Yuan) Department of Anesthesiology, The First Affiliated
Hospital of Hebei North University, Hebei, Zhangjiakou, China
(Zhang) Department of Anesthesiology, Tianjin Beichen Hospital, Tianjin,
China
Publisher
Elsevier (Singapore) Pte Ltd

<67>
Accession Number
648375088
Title
Colchicine as Atrial Fibrillation Prophylaxis Post Cardiac Surgery: A
Meta-analysis.
Source
Indonesian Journal of Cardiology. Conference: 32nd Annual Scientific
Meeting of the Indonesian Heart Association, ASMIHA 2023. Jakarta
Indonesia. 44(Supplement A) (pp 60), 2023. Date of Publication: 01 Aug
2023.
Author
Rachmanadi M.B.; Reza S.M.; Rosa J.; Kristianto T.
Institution
(Rachmanadi, Reza, Rosa, Kristianto) Rumah Sakit Umum Daerah Cabangbungin,
West Java, Bekasi Regency, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background and aims: Postoperative Atrial Fibrillation (POAF) is a common
complication of cardiac surgery and a significant source of morbidity and
mortality. Colchicine is an anti-inflammatory drug that has various
cardiovascular benefits. This meta-analysis aims to evaluate the use of
Colchicine as POAF prophylaxis postcardiac surgery. <br/>Method(s): We
searched PubMed, Cochrane, and Medline until March 2023 to identify
randomized control trials (RCTs) using the terms Atrial Fibrillation,
Colchicine, and Cardiac Surgery. The primary outcome is the occurrence of
POAF in cardiac surgery that includes Coronary Artery Bypass Graft (CABG)
surgery, valvular surgery, and other cardiac surgery. We calculated
estimated odd ratios (OR) and 95% Confidence Interval using the
Mantel-Haenszel formula. Data were analyzed using Review Manager 5.4.
<br/>Result(s): Eight studies enrolling a total of 1905 patients were
included in this meta-analysis. The incidence of POAF post-cardiac surgery
was significantly lower in the colchicine treatment group than in the
control group (OR 0.59; 95%CI 0.47-0.74; p < 0.00001, I2 =0%). Regarding
the type of cardiac surgery, colchicine reduced the risk of POAF in the
CABG group (OR 0.47; 95%CI 0.33-0.68; p < 0.0001, I2 =0%) but no
significant difference in the non-CABG or combined group (OR 0.71; 95%CI
0.38-1.32; p = 0.28, I2 =0%). However, the use of colchicine is associated
with an increased risk of diarrhea as an adverse event compared to placebo
(OR 3.05; 95%CI 2.17-4.29; p < 0.00001, I2 =5%) <br/>Conclusion(s): This
meta-analysis showed that Colchicine decreased the occurrence of POAF
post-cardiac surgery, especially in CABG surgery. Further studies are
needed to figure out the optimal Colchicine dose, duration, and time
administration to overcome the risk of diarrhea as an adverse event.

<68>
Accession Number
2040191427
Title
Comparison consequences of Jackson-Pratt drain versus chest tube after
coronary artery bypass grafting: A randomized controlled clinical trial.
Source
Journal of Research in Medical Sciences. 22(1) (no pagination), 2017.
Article Number: 134. Date of Publication: 2017.
Author
Mirmohammad-Sadeghi M.; Pourazari P.; Akbari M.
Institution
(Mirmohammad-Sadeghi, Pourazari) Department of Cardiac Surgery, School of
Medicine, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic
Republic of
(Akbari) Department of Epidemiology, School of Health, Shiraz University
of Medical Sciences, Shiraz, Iran, Islamic Republic of
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Chest tubes are used in every case of coronary artery bypass
grafting (CABG) to evacuate shed blood from around the heart and lungs.
This study was designed to assess the effective of Jackson-Pratt drain in
compare with conventional chest drains after CABG. <br/>Material(s) and
Method(s): This was a randomized controlled trial that conducted on 218
patients in Chamran hospital from February to December 2016. Eligible
patients were randomized in a 1:1 ratio. Jackson-Pratt drain group had 109
patients who received a chest tube insertion in the pleural space of the
left lung and a Jackson-Pratt drain in mediastinum, and Chest tube
drainage group had 109 patients who received double chest tube insertion
in the pleural space of the left lung and the mediastinum. <br/>Result(s):
The incidence of pleural effusions in Jackson-Pratt drain group and chest
tube group were not statistically different. The pain score at 2-h in
Drain group was significantly higher than chest tube group (P = 0.001),
but the trend of pain score between groups was not significantly different
(P = 0.097). The frequency of tamponade and atrial fibrillation (AF) were
significantly lower in Jackson-Pratt drain group (P < 0.05).
<br/>Conclusion(s): The Jackson-Pratt drain is equally effective for
preventing cardiac tamponade, pleural effusions, and pain intensity in
patients after CABG when compared with conventional chest tubes, but was
significantly superior regarding efficacy to hospital and Intensive Care
Unit length of stay and the incidence of AF.<br/>Copyright &#xa9; 2017
Journal of Research in Medical Sciences.

<69>
Accession Number
2035875658
Title
The Role of Myocardial Revascularization in Ischemic Heart Failure in the
Era of Modern Optimal Medical Therapy.
Source
Medicina (Lithuania). 61(8) (no pagination), 2025. Article Number: 1451.
Date of Publication: 01 Aug 2025.
Author
Blaj-Tunduc I.-P.; Brisc C.M.I.; Brisc C.M.; Zaha D.-C.; Bustea C.-M.;
Babes V.-V.; Sirca-Tirla T.; Muste F.-A.; Babes E.-E.
Institution
(Blaj-Tunduc, Brisc, Brisc, Zaha, Bustea, Sirca-Tirla, Muste, Babes)
Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy,
University of Oradea, Oradea, Romania
(Brisc, Brisc, Babes, Babes) Department of Medical Disciplines, Faculty of
Medicine and Pharmacy, University of Oradea, Oradea, Romania
(Zaha, Bustea) Department of Preclinical Disciplines, Faculty of Medicine
and Pharmacy, University of Oradea, Oradea, Romania
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Heart failure (HF) with reduced ejection fraction
(EF) has, in more than 50% of cases, an ischemic etiology and continues to
be associated with increased mortality and morbidity despite all the
progress registered in the field of medical therapy and interventional
revascularization. Myocardial revascularization is extensively used in
clinical practice based on the traditional concept that it can improve
myocardial function and outcome in ischemic HF. This review is aimed at
presenting current knowledge regarding revascularization in patients with
chronic ischemic HF and reduced EF. <br/>Method(s): The impact of
revascularization on symptomatology, left ventricle reverse remodeling,
major adverse cardiac events (MACEs), and the role of complete
revascularization and of percutaneous interventional revascularization in
chronic total occlusion (PCI-CTO) were analyzed. The best therapeutic
strategies, revascularization and/or optimal medical therapy (OMT), are
debated in different categories of patients, in order to identify who will
benefit more from revascularization strategies. <br/>Result(s): Based on
the long-term results of the STICH trial incorporated in the guidelines
with a class I-b recommendation, coronary artery bypass graft (CABG)
remains the main modality of revascularization for prognostic improvement
in ischemic HF with multivessel disease. But real-life patients are
usually old with multiple comorbidities and high surgical risk. In this
category, the Heart Team opinion is required to evaluate the probability
of complete revascularization and to choose between percutaneous coronary
intervention (PCI) and CABG according to clinical status and coronary
anatomy. <br/>Conclusion(s): However, until further studies are available,
the results of the REVIVED-BCIS2 trial encourage OMT over PCI in patients
with ischemic cardiomyopathy. The available randomized controlled trials
(RCTs) showed improved angina and quality of life in PCI-CTO versus OMT,
but the effect on MACEs was not demonstrated.<br/>Copyright &#xa9; 2025 by
the authors.

<70>
Accession Number
648374131
Title
Comparison Between Novel Oral Anticoagulant and Vitamin K Antagonist After
Transcatheter Aortic Valve Implantation in Patients with Concomitant
Indication for Oral Anticoagulation: A Pooled StudyLevel Meta Analysis.
Source
Indonesian Journal of Cardiology. Conference: 32nd Annual Scientific
Meeting of the Indonesian Heart Association, ASMIHA 2023. Jakarta
Indonesia. 44(Supplement A) (pp 65), 2023. Date of Publication: 01 Aug
2023.
Author
Labi N.T.; Purnomo V.N.; Nuralele J.; Rampengan S.H.; Rampengan D.
Institution
(Labi, Purnomo, Rampengan) Faculty of Medicine, Universitas Sam Ratulangi
Manado, Indonesia
(Nuralele) Faculty of Medicine, Universitas Kristen Indonesia Jakarta,
Indonesia
(Rampengan) Department of Cardiology and Vascular Medicine, Prof Dr. R. D.
Kandou General Hospital Manado, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background and Aim Transcatheter aortic valve implantation (TAVI) has
emerged as a crucial treatment option for aortic stenosis (AS) patients
with a high surgical risk. This procedure is often performed on patients
with indication for oral anticoagulation (OAC), such as atrial
fibrillation (AF). However, the best approach to anticoagulation in this
group of patients is a matter of debate. We aimed to compare the efficacy
and safety of novel oral anticoagulants (NOAC) and vitamin K antagonists
(VKA) in patients undergoing TAVI with concomitant indication for OAC.
Method We comprehensively searched the databases of PubMed, ScienceDirect,
and Cochrane Library from inception to January 2023. Included studies were
published cohorts or randomized controlled trials (RCT) that compared
clinical outcomes between NOAC and VKA after TAVI in patients with
concomitant indication for OAC. Primary outcome is all-cause mortality.
Secondary outcomes are major and/or life-threatening bleeding and stroke.
Data from each study were combined using the fixed and random-effects
model. Result Our analysis included eleven studies with a total of 29,186
patients who underwent TAVI and required OAC (11,718 received NOAC and
17,468 received VKA). Most patients had AF as the indication for OAC. The
allcause mortality and stroke outcome showed no significant difference
between the two groups ([OR] 0.82, 95% CI 0.61-1.11, I2 =87%, p=0.20 and
[OR] 1.02, 95% CI 0.88-1.19, I2 =4%, p=0.80, respectively). Furthermore,
there was trend in lower incidence of major and/or life-threatening
bleeding patients who received NOAC compared to VKA ([OR] 0.80, 95% CI
0.63-1.02, I2 =64%, p=0.07). Conclusion Our findings indicate that, in
patients who underwent TAVI and required OAC, NOAC was linked to a trend
in lower incidence of major and/or life-threatening bleeding and similar
rates of all-cause mortality and stroke compared to VKA.

<71>
Accession Number
648373351
Title
Can enhanced external counterpulsation be used as a promising modality in
treatment of refractory angina pectoris patients? : A meta-analysis.
Source
Indonesian Journal of Cardiology. Conference: 10th Annual Scientific
Meeting of the Indonesian Heart Rhythm Society, InaHRS 2023. Jakarta
Indonesia. 44(Supplement B) (pp 20), 2023. Date of Publication: 01 Oct
2023.
Author
Anggriani H.A.
Institution
(Anggriani) Menteng Mitra Afia Hospital, Jakarta, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background and aims Enhanced external counterpulsation (EECP) is a
non-invasive treatment for patients with stable coronary artery disease
(CAD) or patient with refractory angina pectoris. Despite of treatment
with PCI or CABG generally successful, number of patients with ischemic
chest pain has increase or increase hospitalization rates. To cope with
these problems, EECP method in several studies was reported as one of the
promising treatments for relieving angina symptoms. The aim of this study
was to evaluate the effectiveness of EECP for the treatment of patients
with refractory angina pectoris Materials and Methods Compherensive
collection of literature sources extracted from the PubMed, Google Scholar
and Scopus database which assessed the effect of Enhanced external
counterpulsation (EECP) treatment on patients with chronic stable angina.
The keywords used are ; eecp (enhanced external counterpulsation),
refractory angina, hospitalization, nitroglycerin. Data were analyzed
using Review Manager 5.3. Standard mean difference method were used to
pool the data. Pooled estimate is performed using random-effects model in
case of heterogeneity. Result Ten studies were reviewed with total 5677
participants in comparing the condition of pre and post EECP patients
within a certain time. The parameters assessed were weekly angina
frequency, use of nitroglycerin, and hospitalizations rate. The results
showed significant effect post EECP treatment in all parameters; weekly
use og nitroglycerin (Std mean difference = 1.78, 95% CI (0.48-0.99), p<
0.00001) ; weekly angina frequency (Std mean difference = 0.68, 95% CI
(0.51-0.85), p< 0.00001) ; Hospitalization rate (Std mean difference =
0.79, 95% CI (0.32-1.26), p< 0.00001 Conclusion There is significant
effect post EECP in reducing angina symptoms in patients with refractory
angina pectoris, it also provide change in use of nitroglycerin, and
reduce the number of hospitalization. Keyword Enhanced external
counterpulsation (EECP), refractory angina pectoris, Nitroglycerin.

<72>
Accession Number
2040185858
Title
Commentary on manuscript entitled "Association of vasoactive
active-inotropic score and poor outcomes in patients who underwent
coronary artery bypass grafting: Systematic review and meta-analysis" in
press Perfusion.
Source
Perfusion (United Kingdom). (no pagination), 2025. Article Number:
02676591251372494. Date of Publication: 2025.
Author
Flores J.; Nugent K.
Institution
(Flores, Nugent) Department of Internal Medicine, Texas Tech University
Health Sciences Center, Lubbock, TX, United States
Publisher
SAGE Publications Ltd

<73>
Accession Number
2037054543
Title
Cardiovascular Outcomes and Efficacy of the PCSK9 Inhibitor Evolocumab in
Individuals With Type 1 Diabetes: Insights From the FOURIER Trial.
Source
Diabetes Care. 48(9) (pp 1512-1516), 2025. Date of Publication: 01 Sep
2025.
Author
Kang Y.M.; Giugliano R.P.; Ran X.; Deedwania P.; De Ferrari G.M.; George
J.T.; Gouni-Berthold I.; Lima G.P.D.S.; Handelsman Y.; Lewis B.S.; Ohman
E.M.; Wang H.; Lopez J.A.G.; Monsalvo M.L.; Sabatine M.S.; Leiter L.A.
Institution
(Kang, Giugliano, Ran, Sabatine) TIMI Study Group, Cardiovascular
Division, Department of Medicine, Brigham and Women's Hospital and Harvard
Medical School, Boston, MA, United States
(Kang) Division of Endocrinology, Diabetes, and Hypertension, Department
of Medicine, Brigham and Women's Hospital and Harvard Medical School,
Boston, MA, United States
(Deedwania) University of California San Francisco Fresno, Fresno, CA,
United States
(De Ferrari) Division of Cardiology, Cardiovascular and Thoracic
Department, University of Turin, Citta della Salute e della Scienza
Hospital, Turin, Italy
(George, Lima, Ohman, Wang, Lopez, Monsalvo) Global Development, Amgen,
Inc., Thousand Oaks, CA, United States
(Gouni-Berthold) Center for Endocrinology, Diabetes and Preventive
Medicine, Faculty of Medicine, University Hospital Cologne, University of
Cologne, Cologne, Germany
(Handelsman) Metabolic Institute of America, Tarzana, CA, United States
(Lewis) Technion-Israel Institute of Technology and Lady Davis Carmel
Medical Center, Haifa, Israel
(Leiter) Li Ka Shing Knowledge Institute of St Michael's Hospital,
University of Toronto, Toronto, ON, Canada
Publisher
American Diabetes Association Inc.
Abstract
OBJECTIVE To evaluate the clinical efficacy of intensive LDL cholesterol
(LDL-C) lowering in type 1 diabetes mellitus (T1DM). RESEARCH DESIGN AND
METHODS Further Cardiovascular Outcomes Research With PCSK9 Inhibition in
Subjects With Elevated Risk (FOURIER) randomized participants with
atherosclerotic cardiovascular disease (ASCVD) on statins to evolocumab or
placebo (median follow-up 2.2 years). The primary end point (PEP) was
cardiovascular death, myocardial infarction, stroke, hospitalization for
unstable angina, or coronary revascularization. RESULTS Of 27,564
participants, 10,834 (39.3%) had type 2 diabetes mellitus (T2DM), and 197
(0.7%) had T1DM. In the placebo arm, there was a stepwise increase in the
2.5-year PEP Kaplan-Meier rate from 11.0% to 15.2% to 20.4% in
participants with no diabetes, T2DM, and T1DM, respectively (P < 0.0001).
Hazard ratios for PEP with evolocumab were 0.87 (95% CI 0.79-0.96), 0.84
(0.75-0.93), and 0.66 (0.32-1.38) in the no diabetes, T2DM, and T1DM
groups, and absolute risk reduction was 1.3%, 2.5%, and 7.3%,
respectively. CONCLUSIONS Intensive LDL-C lowering may provide substantial
clinical benefit in individuals with T1DM and ASCVD. Additional randomized
controlled cardiovascular outcomes trials are needed in this
population.<br/>Copyright &#xa9; 2025, American Diabetes Association Inc..
All rights reserved.

<74>
Accession Number
2035868566
Title
The Natural History and Clinical Outcomes of Transmembrane Protein 43
Cardiomyopathy: A Systematic Review.
Source
Journal of Clinical Medicine. 14(16) (no pagination), 2025. Article
Number: 5611. Date of Publication: 01 Aug 2025.
Author
Cecere A.; Martini M.; Bueno Marinas M.; Rigato I.; Parodi A.; Pilichou
K.; Bauce B.
Institution
(Cecere, Martini, Bueno Marinas, Rigato, Parodi, Pilichou, Bauce)
Department of Cardiac, Thoracic, and Vascular Sciences and Public Health,
University of Padova, Padova, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Arrhythmogenic cardiomyopathy (ACM) is an inherited heart
disorder characterized by structural and functional myocardial
alterations, often accompanied by ventricular arrhythmias (VAs), which may
ultimately result in sudden cardiac death (SCD). While mutations in genes
coding for desmosomal components are commonly identified in affected
individuals, genetic variants involving non-desmosomal proteins have
recently been recognized as contributors to the disease's etiology. In
2008, a mutation in the transmembrane protein 43 (TMEM43) was identified
as being responsible for a fully penetrant, sex-related, and severe form
of ACM. This review aimed to systematically synthesize the current
evidence on the natural history, electrocardiographic, and imaging
findings as well as the clinical outcomes of TMEM43 cardiomyopathy.
<br/>Method(s): A systematic search was performed in the PubMed, Scopus,
and Web of Science databases, following the PRISMA guidelines, using the
terms "TMEM43" AND "cardiomyopathy". After an initial screening of 144
retrieved articles, 80 were considered relevant. Upon a full-text review
and eligibility assessment, 12 studies involving 903 individuals harboring
TMEM43 variants were selected for inclusion. <br/>Result(s): Male patients
more frequently carried the pathogenic TMEM43 variant (n = 505, 55.9%) and
exhibited an earlier arrhythmic onset of the disease (33.2 years old
versus 46.2 years old in female patients), supporting the need for earlier
implantable cardioverter-defibrillator implantation (30.4 versus 42.2
years old). Palpitations, chest pain, and syncope were the most common
presenting symptoms. Baseline electrocardiograms commonly demonstrated
poor R wave progression, QRS prolongation, and premature ventricular
contractions (PVCs). Arrhythmic events, including malignant VAs and SCD,
were early manifestations of the disease, especially in male patients.
Frequent PVCs and left ventricular dilation were considered early markers
of the disease and were predictive of arrhythmic events. Conversely, heart
failure was reported as a late clinical outcome, requiring heart
transplantation in a minority of cases (1.5%). <br/>Conclusion(s): TMEM43
cardiomyopathy is a fully penetrant autosomal dominant form of ACM,
characterized by a well-defined clinical phenotype that is more severe and
presents earlier in male patients.<br/>Copyright &#xa9; 2025 by the
authors.

<75>
Accession Number
648373233
Title
Amiodarone for Atrial Fibrillation Post-Cardiac Valve Replacement Surgery:
Meta-analysis Reveals Improved Sinus Rhythm and Intensive Care Outcomes.
Source
Indonesian Journal of Cardiology. Conference: 10th Annual Scientific
Meeting of the Indonesian Heart Rhythm Society, InaHRS 2023. Jakarta
Indonesia. 44(Supplement B) (pp 14), 2023. Date of Publication: 01 Oct
2023.
Author
Joyo E.O.; Rafiq A.; Patrihady H.W.; Pintaningrum Y.
Institution
(Joyo, Patrihady) General Practitioner,West Nusa Tenggara Regional General
Hospital, Mataram, Indonesia
(Rafiq) Faculty of Medicine, Univeristy of Mataram, Mataram, Indonesia
(Pintaningrum) Department of Cardiology and Vascular Medicine, West Nusa
Tenggara Regional General Hospital, University of Mataram, Mataram,
Indonesia
Publisher
Indonesian Heart Association
Abstract
Background and aims: Postoperative atrial fibrillation (POAF) is a common
and concerning complication following cardiac surgery. Amiodarone, an
antiarrhythmic medication, has been investigated as a potential preventive
strategy for POAF. This meta-analysis aims to evaluate the effectiveness
of amiodarone compared to placebo or standard treatment in reducing the
incidence of POAF in patients undergoing cardiac surgery without
preexisting atrial fibrillation. <br/>Material(s) and Method(s): A
systematic literature search was conducted in Pubmed, EMBASE, Scopus,
Proquest, and ScienceDirect for articles published until July 2023.
Randomized controlled trials (RCT) comparing amiodarone with a placebo or
standard therapy for the prevention or treatment of POAF in patients after
cardiac valve replacement were included. Data extraction and quality
assessment were performed independently by two reviewers. The primary
outcome measures were the composite sinus rhythm conversion and
maintenance, and the secondary outcomes were intensive care unit length of
stay (ICU LOS) and inotropic use. <br/>Result(s): A total of 4 RCTs
involving 308 patients undergoing cardiac valve surgery were included in
the meta-analysis. The pooled analysis using the random-effect model
demonstrated that amiodarone significantly increased the composite sinus
rhythm conversion and maintenance compared to control groups (OR 2.21
[95%CI: 1.07-4.56]; I 2 = 48%). Additionally, amiodarone was found to
benefit the clinical outcomes in the ICU, with a significant reduction in
inotropic use (OR 0.20 [95%CI: 0.07-0.54]; I 2 = 0%) and a shortened ICU
LOS (SMD -2.18 [95%CI: -3.27 to -1.09]; I 2 = 89%). <br/>Conclusion(s):
This meta-analysis provides robust evidence supporting the use of
amiodarone for postoperative atrial fibrillation (POAF) management in
patients after cardiac valve replacement. Amiodarone significantly
increased the composite sinus rhythm conversion and maintenance,
indicating its efficacy in restoring and sustaining normal heart rhythm.
Moreover, using amiodarone was associated with improved clinical outcomes
in the ICU, including a reduction in inotropic use and a shortened length
of stay. These findings suggest that amiodarone benefits arrhythmia
control and patient recovery following cardiac valve replacement.

<76>
Accession Number
648373687
Title
5th Indonesian Intensive and Acute Cardiovascular Care Meeting.
Source
Indonesian Journal of Cardiology. Conference: 5th Indonesian Intensive and
Acute Cardiovascular Care Meeting. Online. 43(Supplement A) (no
pagination), 2022. Date of Publication: 01 Feb 2022.
Author
Anonymous
Publisher
Indonesian Heart Association
Abstract
The proceedings contain 125 papers. The topics discussed include:
acute/chronic glycemic ratio is a better predictor of in-hospital outcomes
than admission blood glucose in diabetic acute coronary syndrome patients;
the prevalence of transfusion associated circulatory overload in CVCU of
Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia; how to
manage mitral stenosis patient with ongoing atrial fibrillation and atrial
flutter episode in remote cardiac clinic; systolic blood pressure
variability as predictor of adverse outcomes in patients underwent
myocardial revascularization: a systematic review and meta-analysis; risk
of myocardial infarction in human immunodeficiency virus-positive
patients; and SARS-CoV2/COVID-19 treatments and class III antiarrhythmic
agents: a systematic review of potential drug-drug interactions.

<77>
Accession Number
648374302
Title
Meta-Analysis of Randomized Controlled Trials: Comparing Amiodarone and
Beta-Blockers for Preventing Postoperative Atrial Fibrillation in Cardiac
Surgery Patients.
Source
Indonesian Journal of Cardiology. Conference: 10th Annual Scientific
Meeting of the Indonesian Heart Rhythm Society, InaHRS 2023. Jakarta
Indonesia. 44(Supplement B) (pp 6), 2023. Date of Publication: 01 Oct
2023.
Author
Rafiq A.; Joyo E.O.; Pintaningrum Y.
Institution
(Rafiq) Faculty of Medicine, Universitas Mataram, West Nusa Tenggara,
Mataram, Indonesia
(Joyo) West Nusa Tenggara Regional General Hospital, Mataram, West Nusa
Tenggara, Indonesia
(Pintaningrum) Department of Cardiology and Vascular Medicine, West Nusa
Tenggara Regional General Hospital, West Nusa Tenggara, Mataram, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background and aims: Postoperative atrial fibrillation (POAF) is a common
and concerning complication following cardiac surgery. Amiodarone and
beta-blockers are commonly employed pharmacological agents for the
prevention of POAF. This meta-analysis aims to compare the effectiveness
of amiodarone versus beta-blockers in preventing POAF among patients
undergoing cardiac surgery without preexisting atrial fibrillation (AF).
<br/>Method(s): A systematic literature search was conducted across
electronic databases to identify relevant randomized controlled trials
(RCTs) comparing the use of amiodarone and beta-blockers for POAF
prevention in patients without preexisting AF. The primary outcome measure
was the incidence of POAF. Pooled risk ratios (RRs) and standard mean
difference (SMD) with 95% confidence intervals (95%CI) were calculated
using a random-effects model. Subgroup analyses were performed based on
specific surgical procedures and different beta-blocker drugs.
<br/>Result(s): The meta-analysis included 7 RCTs involving 1,148 patients
undergoing cardiac surgery. The pooled analysis revealed no significant
difference in the incidence of POAF between amiodarone and beta-blockers
(RR 0.93 [95%CI 0.77 - 1.13]; I 2 = 0%). Subgroup analyses based on
surgical procedures and different beta-blocker drugs showed no
statistically significant effect on POAF prevention. Furthermore, no
significant differences in mortality (RR 0.80 [95%CI 0.38-1.68]; I 2 = 0%)
and hospital length of stay (SMD -0.02 [95%CI -0.16 to 0.20; I 2 = 0%])
were observed between the amiodarone and beta-blocker groups.
<br/>Conclusion(s): This comprehensive meta-analysis found no significant
difference in the efficacy of amiodarone versus beta-blockers for
preventing POAF in patients undergoing cardiac surgery without preexisting
AF. Both pharmacological strategies demonstrated similar outcomes
regarding POAF prevention, mortality, and hospital length of stay.
Individual patient characteristics, potential side effects, and other
relevant clinical considerations should guide the selection of amiodarone
or betablockers.

<78>
Accession Number
648373073
Title
Cost-effectiveness of transcatheter aortic valve implantation in patient
with Severe Symptomatic Aortic Stenosis and intermediate surgical risk: A
Systematic Review.
Source
Indonesian Journal of Cardiology. Conference: 13th Indonesian Society of
Interventional Cardiology Annual Meeting. Virtual. 42(Supplement B) (no
pagination), 2021. Date of Publication: 01 Nov 2021.
Author
Anantawikrama W.P.; Ardianty M.A.; Nurkusumasari N.
Institution
(Anantawikrama) Hospital Management, Faculty of Medicine, Public Heallth,
Nursing Universitas Gadjah Mada, Indonesia
(Ardianty) Universitas Indonesia Hospital, Indonesia
(Nurkusumasari) Faculty of Medicine, University of Muhammadiyah Surakarta,
Indonesia
Publisher
Indonesian Heart Association
Abstract
Background and aims: Transcatheter aortic valve implantation (TAVI) has
rapidly emerged as a standard of care for inoperable patients and
"preferred" less invasive alternative to surgical aortic valve replacement
(SAVR) for patients with severe symptomatic aortic stenosis and high
surgical risk. This study was conducted to analyse the cost-effectiveness
of this novel technique for patients with intermediate operative risk.
<br/>Method(s): The systematic review was conducted by two reviewers using
3 electronic databases with timeframe of January 2016 to August 2021 as
per PRISMA guidelines. The primary endpoints were the incremental
cost-effectiveness ratio (ICER) and the probability of cost-effectiveness.
The eligible studies included those in which the cost-effectiveness data
were measured or projected for TAVI and SAVR in patients with severe
aortic stenosis with intermediate surgical risk. All forms of TAVI were
included, and all retrieved publications were limited to the English
language. <br/>Result(s): Five studies were included for quantitative
assessment. The ICER for TAVI compared with SAVR for intermediate-risk
surgical candidate are TAVI dominant in two studies, and calculatable ICER
ranged from US$ 8,622 to US$ 25,036 per quality-adjusted life year (QALY)
gained. The probability of TAVI being cost-effective compared with medical
therapy ranged from 0.75 to 0.98, with four of five studies shown
cost-effective probability over 90%. <br/>Conclusion(s): The use of TAVI
is potentially a cost-effective option compared to SAVR in treating
patient with severe symptomatic aortic stenosis with intermediate surgical
risk.

<79>
Accession Number
2040185860
Title
The role of acute normovolemic hemodilution and retrograde autologous
priming in reducing intraoperative packed red blood cell transfusion needs
in coronary artery bypass surgery: A randomized controlled trial.
Source
Perfusion (United Kingdom). (no pagination), 2025. Article Number:
02676591251372497. Date of Publication: 2025.
Author
Boom C.E.; Cintyandy R.; Widodo H.; Putri A.; Givano M.R.; Parmana I.M.A.
Institution
(Boom, Cintyandy, Givano, Parmana) Department of Anesthesiology and
Intensive Care, National Cardiovascular Center Harapan Kita, Jakarta,
Indonesia
(Widodo, Putri) Department of Cardiovascular Surgery, National
Cardiovascular Center Harapan Kita, Jakarta, Indonesia
Publisher
SAGE Publications Ltd
Abstract
Background: Acute normovolemic hemodilution (ANH) and retrograde
autologous priming (RAP) are blood conservation techniques designed to
reduce transfusion requirements. <br/>Purpose(s): This study evaluated the
impact of combining ANH and RAP compared to RAP alone on intraoperative
packed red blood cell (PRBC) transfusion and postoperative outcomes in
coronary artery bypass grafting (CABG) surgery. Research design: A
single-center randomized controlled trial. Study sample: 72 patients
scheduled for CABG surgery from July 2024 to December 2024 at the National
Cardiovascular Center Harapan Kita in Indonesia. Patients were randomly
assigned to ANH + RAP group (n = 36) and RAP group (n = 36). Data
analysis: Multivariate analysis assessed factors influencing final
hemoglobin levels and intraoperative PRBC transfusion needs.
<br/>Result(s): The ANH + RAP group experienced a significant reduction in
the transfusion rate (19.4% vs 47.2%, p = 0.024) and the intraoperative
allogeneic packed red blood cell units (0.2 +/- 0.4 vs 0.5 +/- 0.6, p =
0.012). The optimal ANH volume reduces intraoperative allogeneic PRBC
transfusion was 380 mL (ROC area 0.862, 95% CI 0.703-1.000, p = 0.003).
Single RAP procedure approaches were less effective when compared to the
combination procedure for achieving higher final hemoglobin levels (beta =
-0.824, 95% CI -1.314 to -0.334, p = 0.001) and reducing the likelihood of
intraoperative allogeneic PRBC transfusion (OR = 13.370, 95% CI 2.206 to
81.026, p = 0.005). Postoperative outcomes did not differ between groups.
<br/>Conclusion(s): The combined use of ANH and RAP significantly reduces
intraoperative allogeneic PRBC needs compared to RAP alone without
affecting postoperative outcomes.<br/>Copyright &#xa9; The Author(s) 2025

<80>
Accession Number
648374879
Title
Predictors of In-Stent Restenosis After Percutaneous Coronary Intervention
Using Drug Eluting Stent: A Systematic Review and Meta-Analysis.
Source
Indonesian Journal of Cardiology. Conference: 32nd Annual Scientific
Meeting of the Indonesian Heart Association, ASMIHA 2023. Jakarta
Indonesia. 44(Supplement A) (pp 48), 2023. Date of Publication: 01 Aug
2023.
Author
Alamsyaputra A.; Farissa I.P.; Uddin I.; Pradipta L.D.
Institution
(Alamsyaputra, Farissa, Uddin, Pradipta) RSUP Dr. Kariadi Semarang /
Universitas Diponegoro, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background and aims In-stent restenosis (ISR) may still occur in as many
as 2-10% of percutaneous coronary interventions (PCI), even though
drug-eluting stents (DES) are used. Individuals with ISR are considerably
more likely to present with symptoms of unstable angina pectoris as
compared to individuals with de novo stenosis. In this study we sought to
determine predictors of ISR after coronary stenting. Method Multiple
databases including PubMed, Scopus, and ScienceDirect database were
searched for relevant studies in English from 2012 - 2023. Full-text
articles of studies are used to compare the various risk factors of ISR
after DES stenting. Review Manager 5.4 was used to estimate the effects of
those risk factors among eligible articles. The quality of research
methods was evaluated using Newcastle Ottawa Scale. Results There were
total of 9 studies with 19853 participants, comprising 5040 patients with
ISR and 14813 patients without ISR. The analysis results showed the
increase risk of restenosis in patient with: diabetic mellitus (OR = 1.39,
95% CI (1.24 - 1.5), p <0.0001), hypertension (OR = 1.13, 95% CI (1.05 -
1.21), p = 0.0006), previous PCI (OR = 1.8, 95% CI (1.22 - 2.66), p =
0.003), previous CABG (OR = 1.36, 95% CI (1.22 - 1.53), p <0.0001), low EF
(OR = 2.2, 95% CI (1.2 - 4.2), p = 0.04), multivessel disease (OR = 2.48,
95% CI (2.3 - 2,.7), p <0.0001), chronic total occlusion (OR = 1.91, 95%
CI (1.65 - 2.2), p <0.0001), ACC/AHA type B2/C lesion (OR = 1.6, 95% CI
(1.4 - 1.7), p <0.0001), and left main lesion (OR = 1.88, 95% CI (1.5 -
2.4), p <0.0001). Conclusion Our meta-analysis shows that diabetic
mellitus, hypertension, previous PCI, previous CABG, low EF, multivessel
disease, CTO, ACC/AHA type B2/C lesion, and left main lesion are the
predictors of in-stent restenosis.

<81>
Accession Number
648373511
Title
ENHANCING OUTCOMES: A SYSTEMATIC LITERATURE REVIEW and META-ANALYSIS of
GOAL-DIRECTED THERAPY in CARDIAC SURGERY.
Source
Indonesian Journal of Cardiology. Conference: 6th Indonesian Intensive and
Acute Cardiovascular Care Meeting, InaACC 2024. Manado Indonesia.
45(Supplement A) (pp 7), 2024. Date of Publication: 01 Sep 2024.
Author
Pradipta L.D.; Farissa I.P.; Alamsyaputra A.; Sungkar S.
Institution
(Pradipta, Farissa, Alamsyaputra, Sungkar) RSUP Dr. Kariadi, Semarang,
Faculty of Medicine Universitas Diponegoro, Semarang, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background: In recent years, there has been a decline in the postoperative
mortality rate following cardiac surgery; nonetheless, the postoperative
morbidity rate continues to be significant. Although there is evidence
that perioperative goal-directed haemodynamic treatment (GDT) may reduce
surgical mortality and morbidity in patients undergoing non-cardiac
surgery, the findings regarding its effectiveness in patients undergoing
cardiac surgery are less clear.This study's goal is to conduct a
meta-analysis on the clinical impact and postoperative complications of
GDT in patients who have undergone cardiac surgery. <br/>Method(s): We
searched for relevant studies in Pubmed, Scopus, ScienceDirect, and
ProQuest. The inclusion criteria were pre-emptive haemodynamic
intervention, mortality, complications, and cardiac surgery populations.
Studies that included were reviewed in their entirety and subjected to
quantitative analysis. Regardless the heterogeneity, random-effects model
was utilized in order to produce a synthesis of the data through the
utilization of odds ratios (OR) and mean differences (MD) for continuous
data in conjunction with 95% confidence intervals (CI). <br/>Result(s):
From 222 potential studies, 10 met all the inclusion criteria (3373
patients). The quantitative analysis showed that the use of GDT reduced:
the duration of mechanical ventilation (MD -1.49, 95% CI -2.51 - -0.48; p
= 0.004), hospital length of stay (MD -1.15, 95% CI -1.61 - -0.68; p =
<0.0001), ICU length of stay (MD -0.16, 95% CI -0.31 - -0.01; p = 0.03),
and in hospital mortality (OR 0.63, 95% CI 0.41 - 0.96; p = 0.03). The
used of GDT also reduced postoperative complications such as: acute kidney
injury (OR 0.66, 95% CI 0.53 - 0.82; p = 0.0002) and cerebrovascular
accident (OR 0.53, 95% CI 0.29 - 0.9; p = 0.04). <br/>Conclusion(s): The
use of GDT in cardiac surgery reduces mortality, length of stay, duration
of mechanical ventilation, and postoperative complications.

<82>
Accession Number
648373199
Title
Evaluating the Epicardial Application of Amiodarone in Preventing
Postoperative Atrial Fibrillation: A Systematic Review and Meta-analysis.
Source
Indonesian Journal of Cardiology. Conference: 10th Annual Scientific
Meeting of the Indonesian Heart Rhythm Society, InaHRS 2023. Jakarta
Indonesia. 44(Supplement B) (pp 12), 2023. Date of Publication: 01 Oct
2023.
Author
Patrihady H.W.; Joyo E.O.; Rafiq A.; Arsatt M.I.A.
Institution
(Patrihady, Joyo) General Practitioner, West Nusa Tenggara Regional
General Hospital, Mataram, Indonesia
(Rafiq) Faculty of Medicine, Univeristy of Mataram, Mataram, Indonesia
(Arsatt) Department of Cardiothoracic Surgery, West Nusa Tenggara Regional
General Hospital, University of Mataram, Mataram, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background and aims: Postoperative atrial fibrillation (POAF) is a common
arrhythmia following cardiac surgery associated with increased morbidity
and healthcare costs. Epicardial application of amiodarone has been
proposed as a potential preventive measure. This meta-analysis aims to
evaluate the efficacy of topical epicardial amiodarone in preventing POAF.
<br/>Material(s) and Method(s): A systematic literature search was
conducted in electronic databases until July 2023. Both randomized
controlled trials (RCT) and one observational study met the inclusion
criteria and were included in the meta-analysis. The primary outcome was
the incidence of POAF, and the secondary outcome was a stroke. Subgroup
analysis was performed to assess the effect of hydrogel preparation of
amiodarone. <br/>Result(s): Three hundred subjects from one RCT and one
observational study were included in the metaanalysis. The pooled analysis
found no significant association between topical epicardial amiodarone and
the incidence of POAF (pooled OR = 0.63 [95%CI: 0.12-3.40]; I 2 = 84%).
Subgroup analysis focusing on the hydrogel preparation of amiodarone also
did not reveal any significant association (pooled OR = pooled OR = 0.63
[95%CI: 0.12-3.36; I 2 = 83%). Furthermore, there was no significant
difference in stroke outcomes between the epicardial amiodarone and
control groups (pooled OR = 1.35 [95%CI: 0.16-11.19]; I 2 = 19%).
<br/>Conclusion(s): Meta-analysis suggests that epicardial application of
amiodarone may not significantly reduce the incidence of POAF in patients
undergoing cardiac surgery. Subgroup analysis focusing on hydrogel
preparation did not demonstrate any significant association either.
Additionally, there was no significant difference in stroke outcomes
between the amiodarone and control groups. These findings indicate that
using the epicardial application of amiodarone may not be effective in
preventing POAF or altering stroke outcomes.

<83>
Accession Number
2040210014
Title
Long-term outcomes of surgical repair versus replacement for tricuspid
valve endocarditis - A meta-analysis of reconstructed time-to-event data.
Source
IJC Heart and Vasculature. 60 (no pagination), 2025. Article Number:
101782. Date of Publication: 01 Oct 2025.
Author
Katsuyama E.; Fukunaga C.; Passos F.S.; Lee N.; Ventura de Santana de
Jesus A.C.; Ydy C.M.; Massuda S.J.F.; Kirov H.; Doenst T.; Caldonazo T.
Institution
(Katsuyama, Fukunaga, Massuda) Department of Medicine, Centro
Universitario Faculdade de Medicina do ABC, Santo Andre, Sao Paulo, Brazil
(Passos) Department of Thoracic Surgery, MaterDei Hospital, Bahia,
Salvador, Brazil
(Lee) Department of Medicine, Federal University of Sao Paulo, Sao Paulo,
Brazil
(Ventura de Santana de Jesus) Department of Medicine, Escola Bahiana de
Medicina e Saude Publica, Bahia, Salvador, Brazil
(Ydy) Department of Medicine, Universidade de Ribeirao Preto, Ribeirao
Preto, Sao Paulo, Brazil
(Kirov, Doenst, Caldonazo) Department of Cardiothoracic Surgery, Jena
University Hospital, Friedrich Schiller University of Jena, Jena, Germany
(Caldonazo) Department of Cardiothoracic Surgery, Well Cornell Medicine,
NY, United States
Publisher
Elsevier Ireland Ltd
Abstract
Introduction: Tricuspid valve infective endocarditis (TVIE) is surgically
managed by tricuspid valve repair (TVr) or replacement (TVR). However, the
differences in long-term endpoints and perioperative complications between
the two strategies remain unclear. Therefore, this updated meta-analysis
aimed to evaluate the efficacy and safety of TVr compared with TVR.
<br/>Method(s): MEDLINE, EMBASE, Cochrane Library, LILACS, and
ClinicalTrials.gov were searched. The endpoints of interest were long-term
all-cause mortality (primary), any reoperation, reinfection, postoperative
stroke, and postoperative acute kidney injury (AKI). Data are reported as
hazard ratios (HR) and odds ratios (OR) with their respective 95%
confidence intervals (CI). <br/>Result(s): We included 19 retrospective
cohorts comprising 9,734 patients, of which 59.7 % received TVr and 74.3 %
were intravenous drug users. One study was risk-adjusted. The median age
and follow-up were 35.9 years and 3.9 years, respectively. Compared with
TVR, TVr was associated with lower long-term mortality (HR: 0.77; 95 %CI:
0.60 to 0.98; P = 0.04) and lower odds of any reoperation (OR: 0.73; 95
%CI: 0.60 to 0.89; P < 0.01), reinfection (OR: 0.40; 95 %CI: 0.19 to 0.86;
P = 0.02), and postoperative AKI (OR: 0.79; 95 %CI: 0.68 to 0.92; P <
0.01). No differences were found in postoperative stroke (OR: 1.17; 95
%CI: 0.83 to 1.65; P = 0.41). <br/>Conclusion(s): In this meta-analysis,
TVr improved overall survival and reduced postoperative complications in
patients with TVIE. A possible treatment allocation bias needs to be
considered as a potential concern of series with observational
nature.<br/>Copyright &#xa9; 2025 The Author(s)

<84>
Accession Number
648374477
Title
Safety and Efficacy of Ivabradine on Patients with Cardiac Arrhythmia: A
Systematic Review.
Source
Indonesian Journal of Cardiology. Conference: 10th Annual Scientific
Meeting of the Indonesian Heart Rhythm Society, InaHRS 2023. Jakarta
Indonesia. 44(Supplement B) (pp 10), 2023. Date of Publication: 01 Oct
2023.
Author
Cendera C.A.; Sutanto R.; Sabran M.Z.
Institution
(Cendera, Sutanto, Sabran) Faculty of Medicine, University of Pelita
Harapan, Tangerang, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background and Aim Ivabradine is a widely used therapy for patients with
heart failure. Ivabradine is also used as an antiarrhythmic therapy,
especially for automatic arrhythmias. This is done by blocking the I(f)
channel, a determinant of the pacemaker function of the sinus node.
However, there was an underlying debate about whether or not Ivabradine
was safe and effective on arrhythmia patients. These were due to theories
regarding its adverse effects that may increase a patient's risk of
worsening or developing unwanted arrhythmia. This study aims to prove the
safety and efficacy of Ivabradine on patients with cardiac arrhythmia to
eradicate theories spread out in the medical society. Materials and
Methods Databases such as PubMed, Google Scholar, and SpringerLink were
systematically analyzed to extract studies on June 26, 2023. Keywords
including ivabradine AND arrhythmia were used to gain relevant studies.
Studies in English from the last five years with accessible full text,
mainly clinical trials, were included in this review. Studies that were
systematic reviews, meta-analyses, animal studies, and case reports were
excluded. The Newcastle Ottawa Scale was then used to assess the studies'
quality. Results Seven clinical trials and one open-label RCT are used in
this review, including 2414 participants. Six of the studies used were of
good quality, and two of the studies were of fair quality based on the
Newcastle Ottawa Scale. All studies show that Ivabradine is efficacious in
pediatry patients with congenital heart disorders and adults. It is also
associated with a limited effect on hemodynamic stability and cardiac
contractility, making it favorable for patients with structural heart
diseases and surgical procedures. Compared to other anti-arrhythmic
agents, such as metoprolol, digoxin, and amiodarone, there is not much
difference in the rate of adverse effects and rate reduction of patients
with permanent AF, and may even serve as an alternative for management
procedures in postoperative automatic arrhythmia patients. Conclusion
Ivabradine is a safe and efficient option in the treatment and management
procedures of patients with cardiac arrhythmia. However, further
large-scale, prospective, randomized controlled studies are required to
further prove the efficacy and safety of Ivabradine as most studies
included were small-scale and retrospective.

<85>
Accession Number
648374692
Title
The Comparison of Left Atrial Appendage Closure and Oral Anti-Coagulant in
the Prevention of Stroke in Non-Valvular Atrial Fibrillation: A Systematic
Review and Meta-Analysis.
Source
Indonesian Journal of Cardiology. Conference: 31st Annual Scientific
Meeting of the Indonesian Heart Association, ASMIHA 2022. Virtual.
43(Supplement C) (pp 256), 2022. Date of Publication: 01 Dec 2022.
Author
Hidayat S.; Sholikha M.M.; Wibowo R.R.
Institution
(Hidayat, Sholikha, Wibowo) Universitas Sebelas Maret, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background: Non-valvular atrial fibrillation (NVAF) has been known to
increase the risk of stroke. Stroke prevention using oral anti-coagulant
(OAC) is central in managing NVAF. Patients who cannot tolerate OAC are
encouraged to undergo left atrial appendage closure (LAAC), a
non-pharmacological approach to prevent stroke. This study aims to compare
LAAC and OAC to prevent stroke in NVAF patients. <br/>Method(s): We
conducted a systematic search using PubMed, SpringerLink, ProQuest, and
EBSCOHost. Studies that compared LAAC with either warfarin or new oral
anti-coagulants were included. The articles were collected using the
PRISMA diagram, critically appraised using PICO analysis, the data were
analyzed using manager 5.4.1. We analyzed stroke events as the primary
outcome and all-cause mortality, systemic embolism, and non-procedural
bleeding, as the secondary outcome. The results were effect size expressed
as risk ratio, heterogeneity, and study model. Risk of bias analysis was
performed using a revised tool for Risk of Bias in randomized trials (RoB
2 tool). <br/>Result(s): Five RCTs with a total of 2,625 NVAF patients
showed no significant difference between LAAC and OAC in preventing stroke
(RR= 0.61; 95% CI 0.22-1.66; p=0.33). There is a significant difference in
nonprocedural bleeding, but not in all-cause mortality and systemic
embolism outcomes (RR= 0.58; 95% CI 0.42- 0.80; p=0.0008; RR= 1.07; 95% CI
0.45-2.52; p=0.88; RR= 1.07; 95% CI 0.52-2.21; p=0.85, respectively).
However, when we conducted sub analysis between LAAC and warfarin, LAAC
appears to be significantly better than warfarin in decreasing stroke
event, non-procedural bleeding, and all-cause mortality (RR= 0.29; 95% CI
0.13-0.63; p=0.002; RR= 0.61; 95% CI 0.38-0.99; p=0.04; RR= 0.69; 95% CI
0.51-0.92; p=0.01, respectively). Whereas for systemic embolism, the
difference between LAAC and warfarin was not significant (RR= 1.27; 95% CI
0.58-2.79; p=0.55). Conclusion There is no significant difference in
stroke event, all-cause mortality, and systemic embolism between LAAC and
OAC. However, LAAC was better than OAC in decreasing non-procedural
bleeding risk. Furthermore, LAAC was better than warfarin in decreasing
stroke, all-cause mortality, and non-procedural bleeding risk. Thus, LAAC
is a reasonable alternative for stroke prevention in NVAF patients who
cannot tolerate OAC.

<86>
Accession Number
648373159
Title
The Role of Dexmedetomidine to Reduce New-Onset Atrial Fibrillation in
Patients Who Undergo Invasive Cardiac Treatment: A Systematic Review.
Source
Indonesian Journal of Cardiology. Conference: 8th Annual Scientific
Meeting of the Indonesian Heart Rhythm Society, InaHRS 2021. Virtual.
42(Supplement C) (pp 4), 2021. Date of Publication: 01 Dec 2021.
Author
Priyanti D.A.; Puratmaja N.
Institution
(Priyanti) Tebet Regional Public Hospital, South Jakarta, Indonesia
(Puratmaja) Faculty of Medicine, Universitas Indonesia, Pandega Regional
Public Hospital, Pangandaran, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background: One of common consequences of cardiac surgery or invasive
cardiac treatment is atrial fibrillation (AF) incidence. Activation of the
sympathetic nervous system and provocation of systemic inflammatory
responses after cardiac surgery reportedly contributes to the new-onset
AF. Dexmedetomidine (DEX), an exceptionally selective alpha2-adrenergic
receptor (alpha2-AR) agonist, depresses sinus nodes and ventricular nodal
function. That makes DEX considered for having the effect of reducing
new-onset AF, thus a reasonable prophylactic drug of choice to lower the
incidence of atrial fibrillation after invasive treatment. In this
systematic review, we aimed to know the role of a dexmedetomidine (DEX) to
reduce new-onset AF in patients who undergo cardiac surgery or invasive
cardiac treatment. <br/>Method(s): A systematic review of interventional
studies was performed. Four scientific databases (PubMed, EbscoHost,
ClinicalKey, and ScienceDirect) were included in the literature searching
strategy. Selected papers then explored by two independent authors
regarding the clinical use of dexmedetomidine. Relevance studies further
reviewed using the Centre for Evidence-based Medicine (CEBM) critical
appraisal tool. <br/>Result(s): Three studies that included in the review
were published within five years between 2016 to 2021. One of the three
studies suggest that dexmedetomidine infusions were more likely to have
less incidence of postoperative atrial fibrillation (POAF). In contrast,
the other two articles concluded that did not decrease postoperative
atrial arrhythmias or delirium. In patients recovering from cardiac
surgery, DEX may impair sinus and AV nodal function, however, it may not
reduce the AF inducibility. <br/>Conclusion(s): Atrial fibrillation still
becomes one of the risks after invasive cardiac treatment. The
administration of DEX is still untimely to become the solution to prevent
arrhythmic complications. Further data needed to give a better
understanding.

<87>
Accession Number
2040190350
Title
Development of thoracic spine kyphosis and lumbar spine lordosis in the
growing child from birth to adulthood: protocol for a systematic review.
Source
BMJ Open. 15(8) (no pagination), 2025. Article Number: e095947. Date of
Publication: 25 Aug 2025.
Author
Al-Allaf O.; Mostafa O.E.S.; Henegan N.; Austin-Davies H.; Gardner A.
Institution
(Al-Allaf, Austin-Davies, Gardner) The Royal Orthopaedic Hospital NHS
Foundation Trust, Birmingham, United Kingdom
(Mostafa) Russells Hall Hospital, Dudley, United Kingdom
(Henegan) University of Birmingham, School of Sport and Exercise Sciences,
Birmingham, United Kingdom
(Gardner) University Of Birmingham, Birmingham, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Thoracic kyphosis, a posterior curvature of the thoracic
spine and lumbar lordosis, an anterior curvature of the lumbar spine, are
essential components of spinal alignment that facilitate a biomechanically
efficient upright stance. Understanding the normal growth of the spine and
its constituents, especially during periods of rapid growth, is important
as deviations from normal growth are thought to be initiating factors of
spinal conditions such as scoliosis. While in the coronal plane the spine
is straight, there is variability in the reported normative values of
sagittal spinal shape, reported in the paediatric population. This
variability may well represent the range of normality allowing for
population differences of ethnicity and sex, but could also be attributed
to differing imaging techniques and measurement methods. The aim of this
systematic review is to investigate the normative values for thoracic
kyphosis and lumbar lordosis between birth and adulthood. The review's
findings should enhance the understanding of the development of the spine
and aid in establishing the range that results from differences in
techniques of measurement and imaging modalities used. Methods and
analysis This review protocol is reported in line with the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses Protocols.
Inclusion criteria are participants aged 18 years or less without pain or
spinal pathology, such as scoliosis, any spinal or thoracic surgery and
any other medical conditions that could affect spinal growth and
development. The review will consider studies reporting serial
quantitative measurements of thoracic kyphosis and lumbar lordosis.
Inclusion will be limited to studies published in English. The PubMed,
Embase, Ovid MEDLINE and Cochrane Library databases will be searched.
Following Cochrane guidance, a dual reviewer system will be used where
both reviewers will screen 20% of titles and abstracts to confirm
concordance, and then one reviewer will screen the remaining articles.
During full-text screening, one reviewer will review all the full-text
articles while the second reviewer will review all the articles excluded
by the first reviewer, with a third reviewer being involved to resolve any
discrepancies. A risk of bias assessment will be performed on the
identified studies. The data extracted will be analysed through
meta-analysis if it proves feasible, synthesising continuous data such as
the size of the kyphosis and lordosis, with further subcategorisation by
sex and ethnicity as appropriate. Correlation coefficients will be used to
analyse relationships between variables, and I² values will be
used to assess heterogeneity. Alternatively, if a meta-analysis is not
possible, the data will be presented narratively using the synthesis
without meta-analysis guidelines. An overall statement of confidence in
the cumulative results and findings will be provided using the Grading of
Recommendations, Assessment, Development and Evaluation system. Ethics and
dissemination Ethical approval is not required for this study as no
original data will be collected. The findings will be disseminated to
academic audiences through peer-reviewed journals and conference
presentations.<br/>Copyright &#xa9; Author(s) (or their employer(s) 2025.

<88>
Accession Number
648373400
Title
TETRALOGY of FALLOT INTERVENTION STRATEGIES: A META-ANALYSIS of COMPLETE
VERSUS STAGED REPAIR.
Source
Indonesian Journal of Cardiology. Conference: 6th Indonesian Intensive and
Acute Cardiovascular Care Meeting, InaACC 2024. Manado Indonesia.
45(Supplement A) (pp 3), 2024. Date of Publication: 01 Sep 2024.
Author
Rampengan D.D.C.H.; Surya S.C.; Willyanto E.; Ramadhan R.N.; Gunawan F.A.;
Alamsyah A.H.
Institution
(Rampengan, Gunawan) Faculty of Medicine, Universitas Sam Ratulangi,
Manado, Indonesia
(Surya) Faculty of Medicine, Universitas Udayana, Bali, Indonesia
(Willyanto) Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
(Ramadhan) Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
(Alamsyah) Department of Cardiology and Vascular Medicine, Medical Faculty
of Udayana University, Prof. I.G.N.G Ngoerah General Hospital, Bali,
Indonesia
Publisher
Indonesian Heart Association
Abstract
Background: Tetralogy of Fallot (TOF) is observed in around 3 to 5 out of
every 10,000 live births and stands as the primary cause of death from
cyanotic congenital heart disease. Generally, asymptomatic patients
undergo elective surgical repair within the first year of life.
Conversely, symptomatic patients marked by severe cyanosis require a
neonatal procedure, involving a choice between complete repair and staged
repair. Despite extensive experience with surgical repairs for TOF, the
debate on the preferred approach persists, particularly in developing
nations where delayed diagnosis and resource constraints pose significant
challenges. Thus, this study was conducted to compare and evaluate the
peri- and post-operative outcomes of patients with ToF undergoing complete
or staged repair. <br/>Method(s): The meta-analysis was carried out
through a systematic exploration of five databases (PubMed, ScienceDirect,
EBSCO, Cochrane, and ProQuest) up to December 2023. Quality appraisal was
done using NOS, while meta-analysis used RevMan 5.4 Results: The
literature search resulted in the selection of 16 articles for analysis.
Quality assessment categorized ten studies as low-risk and six others as
high-risk of bias studies. Quantitative analysis revealed that complete
repair is superior in minimizing reoperation rates [OR=0.90; p=0.30],
homograft aortic valve replacement rates [OR=0.56; p<0.0001],
cardiopulmonary bypass time [MD=-41.85; p<0.00001], aortic cross-clamp
time [MD=-19.85; p<0.00001], and post-operative arrhythmia events
[OR=0.76; p=0.006]. Conversely, staged repair demonstrated greater
efficacy in limiting mortality rates [OR=1.33; p=0.0003], transannular
patch intervention rates [OR=1.47; p<0.00001], lengths of hospital and
intensive care unit stays [SMD=0.64; p<0.00001 and MD=1.40; p<0.00001],
requirements for mechanical ventilation [MD=1.40; p<0.00001],
post-operative extracorporeal membrane oxygenation rates [OR=1.12;
p=0.20], and post-operative pacemaker implantation rates [OR=4.39;
p<0.00001]. <br/>Conclusion(s): Both complete and staged repair procedures
exhibited superiority in minimizing various peri- and post-operative
outcomes. Determining the optimal surgical approach for TOF should be
personalized for each patient, considering their preferences.

<89>
Accession Number
648373942
Title
Rate or Rhythm? The Ultimate Strategy for Atrial Fibrillation in Patients
Undergoing Transcatheter Edge-to-Edge Mitral Valve Repair - A Systematic
Review.
Source
Indonesian Journal of Cardiology. Conference: 11th Annual Scientific
Meeting of the Indonesian Heart Rhythm Society, InaHRS 2024. Jakarta
Indonesia. 45(Supplement B) (no pagination), 2024. Date of Publication: 01
Oct 2024.
Author
Hariyanto J.N.; Setiawan J.A.; Hardi C.J.
Institution
(Hariyanto, Setiawan, Hardi) Faculty of Medicine, Universitas Pelita
Harapan, Tangerang, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background and aims: AF is the most common comorbidity in severe MR, but
data on TEER patients are scarce. The optimal strategyrate or rhythm
controlremains unclear. This systematic review compares these approaches.
<br/>Material(s) and Method(s): PubMed, Scopus, and Cochrane were reviewed
for studies regarding treatment strategies in AF patients undergoing TEER.
<br/>Result(s): We included 5 observational studies with 2374 patients,
70.6% with AF. Jabs 2017 found AF was not a significant predictor of
30-day mortality (p=0.055; HR 1.74, 95% CI: 0.99-3.07). Waechter 2020
found AF did not affect procedural success (OR 0.62, 95% CI: 0.29-1.39;
p=0.27), with rate control mainly with beta-blockers (BB), predominant in
57%. Waechter 2021 reported lower 3-year survival for AF patients vs.
non-AF (47.3% vs. 58.3%, HR 1.4, 95% CI 1.004-2.03, p=0.047) but no impact
on procedural success or adverse events. Rate control was superior, as
rhythm control reduced 3-year survival (46.7% vs. 56.5%, HR 1.5, 95% CI:
03-2.06, p=0.032). Amiodarone predicted higher mortality (HR 1.5, 95% CI
1.1-2.1, p=0.02) while digoxin was not a significant predictor. Ausbuettel
2023 showed pharmacological rhythm control had lower 3-year survival than
catheter ablation (CA) (49.4% vs. 75.5%, p = 0.009). CA had better
outcomes than pharmacological rhythm control (HR 0.6, p = 0.03) and rate
control (HR 0.45, p = 0.006), with no significant survival difference
compared to non-AF patients at 3 years (68.3% vs. 75.5%, p = 0.36). Lee
2020 revealed successful DC cardioversion in AF patients significantly
improved 6MWT (p = 0.047) It reduced NT-proBNP at 1 month (p = 0.026) but
showed no significant difference in 1-year survival between cardioverted
and non-cardioverted groups (p = 0.52). <br/>Conclusion(s): In AF patients
undergoing TEER, rate control showed superior survival and outcome
compared to rhythm control. However, rhythm control via DC cardioversion
improved exercise capacity at 1 month. Further research is needed to
determine the long-term benefits of respective strategies.

<90>
Accession Number
648373576
Title
Systolic Blood Pressure Variability as Predictor of Adverse Outcomes in
Patients Underwent Myocardial Revascularization: A Systematic Review and
Meta-Analysis.
Source
Indonesian Journal of Cardiology. Conference: 5th Indonesian Intensive and
Acute Cardiovascular Care Meeting. Online. 43(Supplement A) (no
pagination), 2022. Date of Publication: 01 Feb 2022.
Author
Anantawikrama W.P.; Handayani R.; Ransun T.; Candrasatria R.M.; Iustitia
S.P.
Institution
(Anantawikrama, Handayani, Ransun, Candrasatria, Iustitia) Abdul Moeloek
General Hospital, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background: Coronary Arterial Disease (CAD) has a large morbidity and
mortality burden, becoming the leading cause of death worldwide. High
Systolic Blood Pressure (SBP) Variability has been associated with
increased cardiovascular disease risk. However, the evidence of its impact
on myocardial revascularization outcome is still lacking. This study aimed
to investigate the SBP variability prognostic value in patients who
received myocardial revascularization. <br/>Method(s): Literature search
was conducted on PubMed, EMBASE, Cochrane Library, Google Scholar, and
ProQuest. The outcomes were all-cause mortality and major adverse
cardiovascular events (MACEs). <br/>Result(s): Five cohort studies
involving a total of 11,214 patients received myocardial revascularization
were included, of which three studies reported data in Percutaneous
Coronary Intervention (PCI) and two studies analyze the outcome on
Coronary Arterial Bypass Grafting (CABG). On pooled analysis of PCI group,
elevated SBP variability significantly associated with higher all-cause
mortality (Hazard ratio [HR] 1.63; 95% confidence interval [CI] 1.34-1.98;
p < 0.0001; I² = 0%) and increased MACEs (Hazard ratio [HR]
1.38; 95% confidence interval [CI] 1.19-1.62; p < 0.0001; I² =
12%). On pooled analysis of CABG group, increased SBP variability have
non-significant association with higher mortality (Hazard ratio [HR] 1.29;
95% confidence interval [CI] 0.85-1.94; p <=0.24; I² = 85%)
<br/>Conclusion(s): Increased SBP variability was significantly associated
with higher all-cause mortality and MACEs in patients undergoing PCI, but
its association is insignificant to all-cause mortality in patients who
received CABG.

<91>
Accession Number
2035850489
Title
Ex-Vivo Heart Perfusion Machines in DCD Heart Transplantation Model: The
State of Art.
Source
Transplant International. 38 (no pagination), 2025. Article Number: 12987.
Date of Publication: 2025.
Author
Tessari C.; Lucertini G.; Addonizio M.; Geatti V.; Bacich D.; Pradegan N.;
Fabozzo A.; Bianco R.; Toscano G.; Tarzia V.; Gerosa G.
Institution
(Tessari, Lucertini, Addonizio, Geatti, Bacich, Pradegan, Fabozzo, Bianco,
Toscano, Tarzia, Gerosa) Cardiac Surgery Unit, Cardio-Thoraco-Vascular and
Public Health Department, Padova University Hospital, University of Padua,
Padova, Italy
Publisher
Frontiers Media SA
Abstract
The Donation-after-Circulatory-Death (DCD) heart transplantation program
increases donor pool but resulting in more serious ischemic-related
myocardial injury (IRI), leading to higher incidence of primary graft
dysfunction (PGD). Ex-vivo machine perfusion (EVMP) for DCD heart is being
considered a useful aid in improving grafts number and quality assessment,
aiming to better outcomes. In this review we will analyze the role of EVMP
techniques in the context of DCD with special attention to their clinical
aims and results and future perspectives. A review of available clinical
and pre-clinical studies involving EVMP with DCD donation model was
performed. Thirty-four original articles about preclinical studies were
found. First studies were designed to evaluate graft function in DCD
hearts after EVMP, while recent research focus on possible therapies that
could be associated with EVMP. Twenty-one original articles about clinical
studies were found with the Organ-Care-System (TransMedics) as MP used.
Outcomes, such as survival rates or rejection episodes, are comparable to
outcomes from donation-after-brain-death. EVMP in the setting of DCD heart
transplantation can be a valid tool for organ preservation and transport.
The role of pre-clinical research will be crucial to reduce IRI, achieve
organ reconditioning and reduce incidence of PGD.<br/>Copyright &#xa9;
2025 Tessari, Lucertini, Addonizio, Geatti, Bacich, Pradegan, Fabozzo,
Bianco, Toscano, Tarzia and Gerosa.

<92>
Accession Number
2035873276
Title
Treatment Strategies for Patients with Mitral Regurgitation: A
Meta-Analysis of Randomized Controlled Trials.
Source
Journal of Personalized Medicine. 15(8) (no pagination), 2025. Article
Number: 383. Date of Publication: 01 Aug 2025.
Author
Carassia C.; Simonetti F.; Alvarez Covarrubias H.A.; Wolf B.; Pellegrini
C.; Rheude T.; Fuchs P.; Roski F.; Kuhlein M.; Blum E.; Ndrepepa G.;
Trenkwalder T.; Joner M.; Kastrati A.; Cassese S.; Xhepa E.
Institution
(Carassia) Cardiology Department, Busto Arsizio Hospital, ASST Valle
Olona, Busto Arsizio, Italy
(Carassia, Simonetti, Alvarez Covarrubias, Wolf, Pellegrini, Rheude,
Fuchs, Roski, Kuhlein, Blum, Ndrepepa, Trenkwalder, Joner, Kastrati,
Cassese, Xhepa) Klinik fur Herz- und Kreislauferkrankungen, TUM Klinkum
Deutsches Herzzentrum, Technische Universitat Munchen, Munich, Germany
(Simonetti) Department of Advanced Biomedical Sciences, University of
Naples Federico II, Naples, Italy
(Alvarez Covarrubias) Departamento de Cardiologia, Hospital de
Cardiologia, Centro Medico Nacional Siglo XXI, Instituto Mexicano del
Seguro Social (IMSS), Mexico City, Mexico
(Joner, Kastrati) DZHK (German Center for Cardiovascular Research),
Partner Site Munich Heart Alliance, Munich, Germany
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Several treatment strategies are available for patients with
mitral valve regurgitation (MR). However, evidence regarding their
comparative effectiveness remains limited. We sought to compare the
performance of different treatment strategies for personalized treatment
of patients with MR. <br/>Method(s): We performed a pairwise and network
meta-analyses of randomized trials comparing treatment strategies for
patients with MR. Patients were divided in two groups: transcatheter
mitral valve repair (TMVR, including edge-to-edge repair and indirect
percutaneous annuloplasty) and control (surgery or optimal medical
therapy). The primary outcome of this analysis was all-cause death. Main
secondary outcomes were re-hospitalization for heart failure and
re-intervention. <br/>Result(s): A total of seven trials with 2324
participants, with mainly functional MR (TMVR, n = 1373-control, n = 951)
were available for the quantitative synthesis. The median follow-up
duration was 14 months. Compared to control therapy, TMVR significantly
reduced all-cause death (RR 0.77, 95% CI 0.65-0.91, p = 0.002) and
re-hospitalization for heart failure (RR 0.67, 95% CI 0.49-0.91, p =
0.01). Among TMVR strategies, the edge-to-edge repair with MitraClip
ranked as possibly the best option to reduce all-cause death.
<br/>Conclusion(s): In symptomatic patients with significant MR, TMVR is
associated with a significant reduction of all-cause death, and
re-hospitalization for heart failure, mainly in patients with functional
MR. Additional comparative studies are needed to investigate the best TMVR
treatment option, for patients with degenerative MR.<br/>Copyright &#xa9;
2025 by the authors.

<93>
Accession Number
648373371
Title
Efficacy Of Cell Therapies in Congenital Heart Disease: A Systematic
Review and MetaAnalysis.
Source
Indonesian Journal of Cardiology. Conference: 10th Annual Scientific
Meeting of the Indonesian Heart Rhythm Society, InaHRS 2023. Jakarta
Indonesia. 44(Supplement B) (pp 21), 2023. Date of Publication: 01 Oct
2023.
Author
Hendsun H.; Trisno A.O.
Institution
(Hendsun, Trisno) General Practitioner, Faculty of Medicine, Tarumanagara
University, Jakarta, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background and Aims: Less than one half of patients diagnosed with
critical congenital heart disease (CCHD) will survive into adulthood.
Although surgical advancements have prolonged survival, many patients will
develop cardiac morbidities that will eventually necessitate heart
transplantation. As pediatric donors are scarce, novel therapies are
warranted to preserve cardiac function. Literature in adults suggests
regenerative therapies are safe and efficacious in patients with heart
failure. Currently, early phase clinical trials utilizing regenerative
cells for CCHD and other pediatric heart conditions are ongoing. We
conducted a systematic review and meta-analysis of pre-clinical and
clinical studies to test the hypothesis that cell-based/derived therapies
for congenital heart disease. <br/>Material(s) and Method(s): This study
was traced from Google Scholar, Pubmed, Science Direct, and Elsevier
Clinicalkey digital search pages. This study included a phase I and II
study that assessed patients with congenital heart diseases and was given
with cell therapy VS control, followed by an assessment through
echocardiography and Cardiac MRI. Quality assessment was carried out using
Cochrane's Review Manager 5.4 application. A meta-analysis assessment was
performed based on the Mean Differences (MD), with a 95% confidence
interval (95% CI) and a significance value <0.05. <br/>Result(s): While
twelve of thirteen studies assessed EF, only three of those studies
underwent metaanalysis due to lack of a suitable control arm in the
remaining Three hundred sixty respondents were obtained from three
combined articles contributing to this study. All of these studies
compared the use of azithromycin alone and in combination. Cell-based
therapy preserved EF compared to controls [MD 5.93; 95% CI (2.28, 9.58); p
= 0.001]. <br/>Conclusion(s): Cell-based therapy effectively maintains
ejection fraction in children with congenital heart disease. Advanced
trials, such as phase three clinical trials and randomized controlled
trials, need to be conducted with caution in further assessing the benefit
of this therapy.

<94>
Accession Number
648374763
Title
Low-Dose Colchicine Reduce Future Ischemic Cardiovascular Events in
Coronary Artery Disease : A Systematic Review.
Source
Indonesian Journal of Cardiology. Conference: 32nd Annual Scientific
Meeting of the Indonesian Heart Association, ASMIHA 2023. Jakarta
Indonesia. 44(Supplement A) (pp 42), 2023. Date of Publication: 01 Aug
2023.
Author
Ahmad F.H.; Octaxena A.; Arthacya V.M.; Wibowo R.H.
Institution
(Ahmad, Arthacya, Wibowo) Department of Cardiology and Vascular Medicine,
Cibabat General Hospital, Cimahi, Indonesia
(Octaxena) Department of Cardiology and Vascular Medicine, Sumedang
General Hospital, Sumedang, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background Colchicine is a widely available, safe, and low-cost drug in
Indonesia. Colchicine acts through the inhibition of adhesion molecules
and cytokines, and the pyrin domain-containing protein 3 inflammasome, an
intracellular innate receptor that its activation results in release of
the pro-inflammatory cytokines IL-1beta and IL-18 which known to drive
atherosclerotic plaque progression and increase the risk for instability.
We performed a systematic review to determine the benefit of using low
dose colchicine to reduce ischemic cardiovascular events in patients with
coronary artery disease. Method A systematic search in electronic
databases of Science Direct were carried out to identify eligible studies.
We search with the keywords of '[(chronic coronary syndrome OR stable
angina) AND (prior acute coronary syndrome OR unstable angina OR
myocardial infarction)] AND Colchicine AND (recurrent unstable angina or
myocardial infarction OR re-ischemic cardiovascular event)'. Only
randomized controlled trials evaluating the cardiovascular effects of
colchicine in coronary artery disease were included Result We sorted 732
titles from both search engine and 103 titles were accepted through
thorough screening. The sorted 103 abstracts were screened and we finally
included 8 controlled trials that meet our criteria. Study by Tardif et
al, Nidorf et al, and Bouabdallaoui et al finds that low dose colchicine
significantly reduce future myocardial infarction or ischemia. Study by
Opstal et al shows that the benefits of colchicine are consistent to
reduce myocardial infarction, or ischemia-driven coronary
revascularization. The safety of using low-dose colchicine showed by
Opstal et al was not associated with an adverse effect on any specific
cause of death. Conclusion Colchicine should be considered as adjuvant
therapy for coronary artery disease considering its benefits and safety,
although its evidence to reduce all-cause mortality in patients with
coronary artery disease should undergo more investigation in the future.

<95>
[Use Link to view the full text]
Accession Number
2040182888
Title
Pressure-controlled ventilation versus volume-controlled ventilation for
adult patients with acute respiratory failure: A systematic review and
meta-analysis.
Source
Medicine (United States). 104(34) (pp e43774), 2025. Date of Publication:
22 Aug 2025.
Author
Suntrawanichakul S.; Ngamjarus C.; Sawanyawisuth K.; Khamsai S.
Institution
(Suntrawanichakul) Faculty of Medicine, Khon Kaen University, Khon Kaen,
Thailand
(Ngamjarus) Department of Epidemiology and Biostatistics, Faculty of
Public Health, Khon Kaen University, Khon Kaen, Thailand
(Sawanyawisuth, Khamsai) Department of Medicine, Faculty of Medicine, Khon
Kaen University, Khon Kaen, Thailand
Publisher
Lippincott Williams and Wilkins
Abstract
Background: There is limited data on the effectiveness of
pressure-controlled ventilation (PCV) and volume-controlled ventilation
(VCV) in adult patients with acute respiratory failure. This study aimed
to compare the effectiveness of these 2 ventilations. <br/>Method(s): We
performed a comprehensive search of 4 electronic databases, including
PubMed, Central, Scopus, and CINAHL, from inception to July 14, 2023. This
systematic review included randomized controlled trials that compared VCV
and PCV ventilator modes in intubated adult patients with acute
respiratory failure from any condition. Eligible studies were evaluated
for study characteristics and outcomes. Details of study characteristics
included authors, publication year, country, study aims, study design,
study population, and characteristics of eligible patients: age, sex,
disease severity, and comorbidities. The outcomes of interest were the
incidence of barotrauma or pneumothorax and the in-hospital mortality
rate. Meta-analysis with a fixed-effect model was used to pool the results
of included studies. <br/>Result(s): There were 27 articles that were
eligible; 4 articles met the study criteria. These studies included acute
respiratory distress syndrome patients (3 studies) and chronic obstructive
pulmonary disease patients with open heart surgery. The total patients in
the VCV and PCV groups were 581 and 548, respectively. There was no
significant difference in the incidence of barotrauma between the VCV and
PCV groups (risk ratio = 0.79, 95% confidence interval: 0.56-1.12). The
VCV group had a slightly higher mortality rate than the PCV group (risk
ratio = 1.15, 95% confidence interval: 1.00-1.33). <br/>Conclusion(s): PCV
and VCV had no significant difference in both barotrauma incidence and
mortality rate. PCV mode may have slightly lower mortality and may be a
preferable ventilator mode in patients with acute respiratory distress
syndrome. Further included studies may be required to confirm the results
of this study.<br/>Copyright &#xa9; 2025 the Author(s).

<96>
Accession Number
648373223
Title
Amiodarone as Prophylaxis for Postoperative Atrial Fibrillation after Open
Heart Surgery: A Meta-Analysis of Randomized Controlled Trials.
Source
Indonesian Journal of Cardiology. Conference: 10th Annual Scientific
Meeting of the Indonesian Heart Rhythm Society, InaHRS 2023. Jakarta
Indonesia. 44(Supplement B) (pp 13), 2023. Date of Publication: 01 Oct
2023.
Author
Joyo E.O.; Rafiq A.; Pintaningrum Y.
Institution
(Joyo) General Practitioner,West Nusa Tenggara Regional General Hospital,
Mataram, Indonesia
(Rafiq) Faculty of Medicine, Univeristas Mataram, Mataram, Indonesia
(Pintaningrum) Department of Cardiology and Vascular Medicine, West Nusa
Tenggara Regional General Hospital, Mataram, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background and aims: Postoperative atrial fibrillation (POAF) is a common
and concerning complication following cardiac surgery. Amiodarone, an
antiarrhythmic medication, has been investigated as a potential preventive
strategy for POAF. This meta-analysis aims to evaluate the effectiveness
of amiodarone compared to placebo or standard treatment in reducing the
incidence of POAF in patients undergoing cardiac surgery without
preexisting atrial fibrillation. <br/>Material(s) and Method(s): A
systematic literature search was conducted in Pubmed, EMBASE, Scopus,
Proquest, and ScienceDirect for articles published until July 2023. We
included randomized controlled trials (RCTs) that compared amiodarone with
placebo or standard treatment in patients undergoing cardiac surgery
without preexisting atrial fibrillation. The primary outcome was the
incidence of POAF. The secondary outcomes included mortality, stroke, and
intensive care unit (ICU) LOS. Subgroup analyses were also conducted to
assess the effects of amiodarone, specifically in patients undergoing
coronary artery bypass grafting (CABG). Random-effect models were used due
to anticipated heterogeneity. <br/>Result(s): The meta-analysis included
10 RCTs with 1,574 patients undergoing cardiac surgery. The pooled
analysis demonstrated that amiodarone significantly reduced the incidence
of POAF compared to placebo or standard treatment (RR 0.58 [95%CI 0.47 -
0.71; I 2 = 24%). The subgroup analysis focusing on patients undergoing
CABG also showed a significant reduction in the incidence of POAF with
amiodarone (RR 0.62 [95%CI 0.44 - 0.86; I 2 = 41%). Additionally,
amiodarone administration significantly reduced ICU LOS (SMD -0.55 [95%CI
-1.06 to -0.04]; I 2 = 89%). However, no significant effects were observed
on mortality (OR 0.92 [95%CI 0.49-1.76] I 2 = 0%) and stroke (OR 0.50
[95%CI 0.23-1.06]; I 2 = 0%). <br/>Conclusion(s): This meta-analysis
demonstrates the effectiveness of amiodarone as a prophylactic
intervention in reducing the incidence of postoperative atrial
fibrillation in patients undergoing cardiac surgery without preexisting
atrial fibrillation. While no significant effects were observed on
mortality and stroke outcomes, amiodarone administration was associated
with a significant reduction in ICU LOS. Incorporating amiodarone into the
perioperative management of cardiac surgery patients holds considerable
potential for improving clinical outcomes by mitigating the risks
associated with POAF.

<97>
Accession Number
648374034
Title
Safety and Efficacy of Leadless Pacemaker Implantation in Patients with
Transcatheter Aortic Valve Implantation.
Source
Indonesian Journal of Cardiology. Conference: 10th Annual Scientific
Meeting of the Indonesian Heart Rhythm Society, InaHRS 2023. Jakarta
Indonesia. 44(Supplement B) (pp 48), 2023. Date of Publication: 01 Oct
2023.
Author
Sutanto R.; Cendera C.A.; Sabran M.Z.; Subrata J.A.K.; Liauw R.
Institution
(Sutanto, Cendera, Sabran, Subrata, Liauw) Faculty of Medicine, University
of Pelita Harapan, Tangerang, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background and aim: Atrioventricular blockage or other complications
during transvenous pacemaker implantations are common in patients who
underwent transcatheter aortic valve implantations (TAVI). As an
intervention, conventional transvenous single-chamber pacemakers (SCPs) or
transvenous dualchamber pacemakers (DCPs) are usually used post-TAVIs.
However, a newer generation of leadless pacemakers (LPMs) has been
introduced. It may be suitable as an alternative for frail TAVI patients
or patients requiring ventricular pacing post-TAVI, due to its less
invasive nature. This study aims to prove the relevance and safety of
these leadless pacemakers in patients of post-TAVI or post-THVRs,
especially compared to the more common SCPs and DCPs. <br/>Material(s) and
Method(s): Databases such as PubMed, PMC, and SpringerLink were
systematically searched to extract studies on June 26, 2023. Keywords
including leadless pacemaker AND aortic valve were used to identify
relevant studies. Studies in English from the last 5 years with accessible
full text were included in this review. Studies that were systematic
reviews, meta-analyses, and case reports were excluded. Newcastle Ottawa
scale scores were then used to assess the studies' quality.
<br/>Result(s): After screening sixteen studies, four cohort studies were
included in this review comprising 411 participants. All studies showed
good quality based on the Newcastle-Ottawa scale. All studies showed that
leadless pacemakers are safe and efficient. It is associated with low
complications and relatively shorter hospital stays. LPMs may therefore
represent an effective pacing option for patients who had underwent aortic
valve implantation. <br/>Conclusion(s): Leadless pacemakers show that it
is a safe and efficient option to use in patients with aortic valve
intervention.

<98>
Accession Number
648374418
Title
Permanent Pacemaker Insertion in Transcatheter Aortic Valve Implantation :
A Systematic Review.
Source
Indonesian Journal of Cardiology. Conference: 10th Annual Scientific
Meeting of the Indonesian Heart Rhythm Society, InaHRS 2023. Jakarta
Indonesia. 44(Supplement B) (pp 8), 2023. Date of Publication: 01 Oct
2023.
Author
Sihombing A.; Lee J.V.; Sutanto R.; Lee J.B.
Institution
(Sihombing, Lee, Sutanto) Faculty of Medicine, University of Pelita
Harapan, Tangerang, Indonesia
(Lee) Faculty of Medicine, Atma Jaya Catholic University of Indonesia,
Jakarta, Indonesia
Publisher
Indonesian Heart Association
Abstract
Backgrounds and aims: Conduction defects requiring permanent pacemaker
insertion (PPI) are one of the most common complications after
transcatheter aortic valve implantation (TAVI). However, the predictor of
PPI in post-TAVI patients is still not well known. This review aims to
find out the predictor of permanent pacemaker insertion (PPI) in patients
after Transcatheter Aortic Valve Implantation. <br/>Material(s) and
Method(s): This review was conducted on 20-28 June 2023. Two independent
researchers systematically extracted data from several databases, such as
PubMed Central (PMC), Science Direct, and PUBMED by using MeSH terminology
of keywords Pacemaker, Transcatheter Aortic Valve Implantation, Predictor.
The extracted studies were then analyzed and selected according to our
inclusion criteria such as studies in the last 5 years, cohort studies,
case-control studies. We excluded systematic reviews, meta-analyses, case
series, case reports, studies on pregnant women, children, animals.
Research quality was assessed using Newcastle-Ottawa (NOS).
<br/>Result(s): From 6 studies (2568 subjects from various countries), 3
studies showed that prior Right Bundle Branch Block (RBBB) was an
independent predictor for PPI post-TAVI and 2 other studies showed
new-onset Left Bundle Branch Block (LBBB) also became a predictor. Besides
RBBB and LBBB, one study showed Complete Heart Block (CHB) could predict
the PPI utilization. All studies have proven good quality based on NOS.
<br/>Conclusion(s): In Conclusion, there were some conductions
abnormalities that were associated as a predictor of PPI utilization in
post-TAVI patients. However, further study is needed to confirm these
findings.

<99>
Accession Number
648373558
Title
EFFECTIVENESS of LUNG RECRUITMENT MANEUVER after CORONARY ARTERY BYPASS
SURGERY - A META-ANALYSIS of RANDOMIZED CONTROLLED TRIALS.
Source
Indonesian Journal of Cardiology. Conference: 6th Indonesian Intensive and
Acute Cardiovascular Care Meeting, InaACC 2024. Manado Indonesia.
45(Supplement A) (pp 9), 2024. Date of Publication: 01 Sep 2024.
Author
Pradipta L.D.; Farissa I.P.; Alamsyaputra A.; Sungkar S.
Institution
(Pradipta, Farissa, Alamsyaputra, Sungkar) RSUP Dr. Kariadi, Semarang,
Faculty of Medicine Universitas Diponegoro, Semarang, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background: Coronary artery bypass surgery (CABG) is a common procedure
performed in patient with coronary artery disease. Patients undergoing
CABG often experience postoperative complications such as atelectasis and
respiratory disturbances, which could worsen the clinical outcomes. In an
effort to prevent such complication, methods aimed at recruiting
potentially collapsed lung areas, such as Lung Recruitment Maneuver (LRM),
have been a subject of research. LRM involves the application of brief
positive pressure to open alveoli that may collapse during breathing.
However, the effectiveness of LRM in improving CABG outcome remains
controversial, with available randomized controlled studies providing
varied results.Therefore, this study aims to conduct a meta-analysis of
existing randomized controlled trial outcomes to comprehensively
investigate the effectiveness of RM in enhancing postoperative recovery in
CABG patients. <br/>Method(s): A search was conducted using various online
databases, including PubMed, Scopus, ScienceDirect, and ProQuest, to
locate randomized controlled trials (RCTs) that were written in English
and published before December 2023. The RCTs examined how LRM could
improve clinical outcome in patient undergoing isolated CABG surgery.
Independently, two reviewers extracted data and evaluated the quality of
the trials. Meta-analysis was performed using Review Manager 5.4 software.
<br/>Result(s): We reviewed 11 RCTs involving 993 patients undergoing
isolated CABG surgery. Patients receiving LRM had a reduced incidence of
pulmonary atelectasis (group with recruited pressure >30 mmHg: risk ratio
(RR) 0.31; 95%CI 0.13 - 0.76, p= 0.01; group with recruited pressure <30
mmHg: RR 0.54; 95%CI 0.33 - 0.89, p= 0.02), reduced incidence of pneumonia
(RR 0.35; 95%CI 0.16 - 0.78, p= 0.01), and improved
PaO<inf>2</inf>/FiO<inf>2</inf> ratio (mean difference (MD) 52.88; 95%CI
31.36 - 74.39, p< 0.001) without altering the cardiac index (MD 0.32;
95%CI -0.48 to 1.11, p= 0.43) or mean arterial pressure (MD -0.72; 95%CI
-3.75 to 2.31, p= 0.64) as compared with patient who treated by using
conventional ventilation. The incidence of pneumothorax was not
statistically significant between two groups (p= 0.61).
<br/>Conclusion(s): Lung recruitment maneuver may reduce postoperative
pulmonary atelectasis, pneumonia, and improve
PaO<inf>2</inf>/FiO<inf>2</inf> ratio without altering hemodynamic profile
in patients undergoing isolated CABG surgery.

<100>
Accession Number
2040212305
Title
Safety of cardioversion without anticoagulation in patients' status post
left atrial appendage occlusion: A systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Sawalha K.; Alakchar M.; Mamas M.A.; Johnson D.; Bhan A.; Goldsweig A.M.
Institution
(Sawalha, Goldsweig) Department of Cardiovascular Medicine, Baystate
Medical Center and Division of Cardiovascular Medicine, University of
Massachusetts Baystate, Springfield, MA, United States
(Alakchar) Department of Cardiovascular Medicine, Southern Illinois
University, Springfield, IL, United States
(Mamas) Keele Cardiovascular Research Group, Keele University, Stoke on
Trent, United Kingdom
(Johnson) Department of Cardiology, University of Illinois at Chicago,
Chicago, IL, United States
(Bhan) Department of Cardiology, Heart Vascular Institute, Advocate Christ
Medical Center, Oak Lawn, IL, United States
Publisher
Elsevier Inc.
Abstract
Background: Direct current cardioversion (DCCV) is commonly used for
rhythm control in atrial fibrillation (AF). Left atrial appendage
occlusion (LAAO) provides stroke prevention in patients with
contraindications to oral anticoagulation (OAC), but the safety of DCCV
without periprocedural anticoagulation in this group remains uncertain.
<br/>Objective(s): To evaluate the safety of performing DCCV without
systemic anticoagulation in patients with prior LAAO. <br/>Method(s): We
conducted a systematic review and meta-analysis following PRISMA
guidelines. PubMed, ScienceDirect, and the Cochrane Library were searched
(January 2010-April 2025). Studies comparing outcomes of patients
undergoing DCCV after LAAO, with versus without subsequent
anticoagulation, were included. Primary outcomes were thromboembolic
events and clinically significant bleeding. Odds ratios (ORs) were
calculated using random-effects modeling, with heterogeneity assessed via
I² statistic. <br/>Result(s): Five observational studies (1697
DCCV procedures; 965 patients receiving post-DCCV anticoagulation) met
inclusion criteria. Thromboembolic events occurred in 3.8 % of patients
without OAC versus 1.6 % with OAC, with no statistically significant
difference (OR 0.48; 95 % CI 0.16-1.43; p = 0.19; I² = 17 %).
Clinically significant bleeding occurred in 4.1 % without OAC and 4.0 %
with OAC, also without significant difference (OR 1.22; 95 % CI 0.75-2.00;
p = 0.42; I² = 0 %). Pre-DCCV imaging protocols varied widely
among studies. <br/>Conclusion(s): In selected patients post-LAAO with no
device-related thrombus or significant peri-device leak, DCCV without
subsequent anticoagulation demonstrated low thromboembolic and bleeding
risks. These findings, derived from limited observational data, require
confirmation by randomized controlled trials.<br/>Copyright &#xa9; 2025
Elsevier Inc.

<101>
Accession Number
2040190557
Title
Superficial parasternal intercostal plane blocks with liposomal
bupivacaine did not significantly reduce opioid use after cardiac surgery:
A randomized clinical trial.
Source
Regional Anesthesia and Pain Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Simon E.R.; Mallery A.; Silva J.; De Biasi A.; Osaki S.; Krause B.M.;
Meyer P.
Institution
(Simon, Mallery, Silva, Krause, Meyer) Department of Anesthesiology,
University of Wisconsin, Madison School of Medicine and Public Health,
Madison, WI, United States
(De Biasi, Osaki) Department of Surgery, University of Wisconsin, Madison
School of Medicine and Public Health, Madison, WI, United States
Publisher
BMJ Publishing Group
Abstract
Background: Acute pain after cardiac surgery via median sternotomy is
commonly managed with multimodal analgesia, but optimal regional
techniques remain uncertain. Superficial parasternal intercostal plane
(SPIP) blocks have shown promise for postoperative pain control, with the
use of catheters extending these benefits up to three days. This study
evaluated the efficacy of single-injection SPIP blocks with liposomal
bupivacaine in reducing opioid consumption following cardiac surgery.
<br/>Method(s): In this prospective, randomized, double-blind controlled
trial, 100 patients undergoing elective coronary artery bypass grafting or
valve surgery via median sternotomy were randomized to receive bilateral
SPIP blocks with either a mixture of bupivacaine and liposomal bupivacaine
or saline placebo prior to incision. The primary outcome was total opioid
consumption in oral morphine milligram equivalents (MME) over the first 72
postoperative hours. Secondary outcomes included pain scores, time to
extubation, intensive care unit (ICU) and hospital length of stay and
opioid use at 90 days. <br/>Result(s): Total opioid consumption in the
first 72 hours was not significantly different between groups (SPIP
intervention: 165 (IQR 103-284) MME vs saline placebo: 205 (IQR 145-282)
MME, p=0.30). Pain scores, extubation time, ICU and hospital length of
stay, and opioid use at 90 days were also similar between groups. No
serious adverse events were reported. <br/>Conclusion(s): Preincision
bilateral SPIP blocks with a mixture of bupivacaine and liposomal
bupivacaine did not significantly reduce opioid consumption or improve
postoperative analgesic outcomes compared with saline placebo in cardiac
surgical patients. These findings suggest that single-injection SPIP
blocks with liposomal bupivacaine may not be as effective as repeated
injections or catheters in cardiac surgical patients. Further studies
should explore modifications to block techniques such as multilevel
injections, the timing of the block relative to surgery, alternative local
anesthetics, and strategies specifically targeting chest tube-related
pain. Trial registration number: NCT04928339.<br/>Copyright &#xa9;
American Society of Regional Anesthesia & Pain Medicine 2025. No
commercial re-use. See rights and permissions. Published by BMJ Group.

<102>
Accession Number
2035868243
Title
Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention
for Left Main Coronary Artery Disease-Long-Term Outcomes.
Source
Journal of Clinical Medicine. 14(16) (no pagination), 2025. Article
Number: 5747. Date of Publication: 01 Aug 2025.
Author
Jonik S.; Gumiezna K.; Barus P.; Wilimski R.; Kusmierczyk M.; Opolski G.;
Grabowski M.; Kochman J.; Huczek Z.; Mazurek T.
Institution
(Jonik, Gumiezna, Barus, Opolski, Grabowski, Kochman, Huczek, Mazurek) 1st
Department of Cardiology, Medical University of Warsaw, Banacha 1a Str.,
Warsaw, Poland
(Wilimski, Kusmierczyk) Department of Heart, Thorax Surgery and
Transplantology, Medical University of Warsaw, Banacha 1a Str., Warsaw,
Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: The optimal revascularization strategy for patients with left
main coronary artery (LMCA) disease has been repeatedly addressed in
randomized controlled trials (RCTs), although outcomes from real-life
clinical studies are still poorly investigated. <br/>Objective(s): This
retrospective study aimed to assess the complete 5-year outcomes for
individuals with multivessel coronary artery disease (MVD) involving LMCA
disease treated with coronary artery bypass grafting (CABG) or
percutaneous coronary intervention (PCI) as recommended by a local HT.
<br/>Method(s): From 2016 to 2019, 176 Heart Team (HT) meetings were held.
Primary and secondary endpoints of 267 patients with MVD involving LMCA
disease qualified either for CABG or PCI (109 and 158 patients,
respectively) with subsequent optimal medical therapy (OMT) were assessed.
The primary endpoint of the study was as an overall mortality, while
secondary endpoints contained major adverse cardiac and cerebrovascular
events (MACCE)-specifically, stroke, myocardial infarction (MI), repeat
revascularization (RR), and the individual components of MACCE.
<br/>Result(s): At 5 years, we found no significant difference in overall
mortality between the both cohorts (22.9%-CABG vs. 24.7%-PCI, p = 0.74).
The rate of MI was higher in patients treated percutaneously (7.3% vs.
15.8% for PCI, p = 0.04), while the incidence of stroke was higher in
patients who underwent CABG (3.8% vs. 11.0% for CABG, p = 0.02). A MACCE
occurrence was higher in PCI cohort (77.2% vs. 55.0%, p < 0.001), mainly
driven by higher rates of RR was higher in patients treated percutaneously
(32.9% vs. 13.8%, p < 0.001). <br/>Conclusion(s): For patients with LMCA
disease, neither CABG nor PCI following HT decisions showed overwhelming
superiority in real-life clinical practice: occurrence of all-cause death
was similar, rates of MACCE, MI, and repeat revascularization advocated
CABG, while incidence of strokes favored PCI.<br/>Copyright &#xa9; 2025 by
the authors.

<103>
Accession Number
648374924
Title
Clinical Outcome of Fractional Flow Reserve-Guided Percutaneous Coronary
Intervention Versus Coronary Artery Bypass Grafting in Patients with Left
Main or Multivessel Disease: A Systematic Review and Meta-Analysis: A
Systematic Review and Meta-analysis.
Source
Indonesian Journal of Cardiology. Conference: 32nd Annual Scientific
Meeting of the Indonesian Heart Association, ASMIHA 2023. Jakarta
Indonesia. 44(Supplement A) (pp 50), 2023. Date of Publication: 01 Aug
2023.
Author
Sukmadja D.; Hayon S.; Triatmaja R.; Prasiddha K.C.
Institution
(Sukmadja) Hermina Hospital, Yogyakarta, Indonesia
(Hayon) Sitanala General Hospital, Tangerang, Indonesia
(Triatmaja) Faculty of Medicine and Health Science, Universitas
Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
(Prasiddha) Yogyakarta Regional General Hospital, Yogyakarta, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background and aims: Fractional Flow Reserve-Guided Percutaneous Coronary
Intervention (FFR PCI) has shown beneficial effects in treating left main
and multivessel disease. However, its efficacy compared with coronary
artery bypass grafting (CABG) is still not determined. This meta-analysis
aims to compare the clinical outcome of FFR PCI and CABG in patients with
left main or multivessel disease. <br/>Method(s): Studies from Pubmed,
Proquest, Google Scholar and Cochrane Library databases which compare the
clinical outcome of FFR PCI and CABG in patients with left main or
multivessel disease were included. The primary outcome parameters were
all-cause death, cardiovascular death, target vessel revascularization,
stroke and myocardial infarction events. <br/>Result(s): 2978 left main
and multivessel disease patients from 3 randomized controlled trials were
included in this study. It was found that CABG provide lower target vessel
revascularization events (RR: 2.15; p: 0.005; 95% CI 1.26-3.67) than FFR
PCI in the left main or multivessel patients. There was no significant
difference between the two groups in all cause death (RR: 1.13; p: 0.53;
95% CI 0.77-1.65), cardiovascular death (RR: 1.01; p: 0.96; 95% CI
0.70-1.47), stroke (RR: 0.84; p: 0.57; 95% CI 0.47-1.53), and myocardial
infarction (RR: 1.17; p: 0.49; 95% CI 0.76-1.80) events.
<br/>Conclusion(s): FFR PCI showed similar numbers from most of the
clinical outcome compared with CABG in left main or multivessel patients.
However, target vessel revascularization event was lower in CABG patients.

<104>
Accession Number
648374483
Title
Conduction disorders and permanent pacemaker implantation after
transcatheter aortic valve implantation - a systematic review,
meta-analysis, and meta-regression of outcomes.
Source
Indonesian Journal of Cardiology. Conference: 11th Annual Scientific
Meeting of the Indonesian Heart Rhythm Society, InaHRS 2024. Jakarta
Indonesia. 45(Supplement B) (no pagination), 2024. Date of Publication: 01
Oct 2024.
Author
Hariyanto J.N.; Hardi C.J.; Setiawan J.A.
Institution
(Hariyanto, Hardi, Setiawan) Faculty of Medicine, Universitas Pelita
Harapan, Tangerang, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background and aims: Despite advancements, conduction disturbances (CD)
after TAVI persist. This review analyzes outcomes in CD and PPM
implantation after TAVI. <br/>Material(s) and Method(s): We reviewed
PubMed, Scopus, and Cochrane for cohort studies on CD and PPM implantation
after TAVI from 2019, with statistical analysis in R. <br/>Result(s):
Badertscher (2023) noted LBBB in 25% of patients the day after TAVI, 86%
new-onset. Masoullie (2023) reported 30.6% developed high-grade CD within
12 months, 32.1% within 30 days, median onset 110 days. Nazif (2019) found
persistent new-onset LBBB increased all-cause (19.3% vs. 10.8%, P = 0.002)
and cardiovascular mortality (16.2% vs. 6.5%, P < 0.001),
rehospitalization (HR 1.94, 95% CI 1.11-2.43; p = 0.01), PPM implantation
(HR 3.02, 95% CI 1.72-5.29; p < 0.001), and decreased LVEF over 2 years
(-4.3 vs +0.1; p < 0.001). Chen (2024) found 61.7% of PPM indications were
for complete heart block and 12.1% for LBBB, with LVEF declining from
55.1% at 1 year to 60.4% at 5 years (p = 0.02). Meduri (2019) identified
baseline RBBB and valve implantation depth as predictors of PPM. PPM
recipients had higher 1-year mortality (HR 2.16, p = 0.03) and
cardiomyopathy (HR 14.8, p < 0.01) due to high RV stimulation
(Ananwattanasuk 2022). RV stimulation >10% was linked to increased 1-year
mortality and HF hospitalization (Dykun 2023). Across 13 studies with an
average follow-up of 480 days, PPM had a non-significant effect on
all-cause mortality (OR = 0.86, 95% CI 0.67-1.11; I2 = 81%).
Meta-regression showed significant associations with baseline 1st degree
AV block (p = 0.0149), RBBB (p = 0.0226), LBBB (p = 0.0493), renal
impairment (p = 0.0135), NYHA class III/IV (p = 0.0016), and AVG (p =
0.0009). PPM was linked to a higher risk of HF rehospitalization (OR =
1.22, 95% CI 1.16-1.29; I2 = 0%). <br/>Conclusion(s): Conduction disorders
after TAVI increases mortality, HF rehospitalization, and reduces LVEF.
PPM implantation is associated with HF rehospitalization but has no
significant effect on mortality.

<105>
Accession Number
648373460
Title
Efficacy of magnesium supplementation in preventing atrial fibrillation
after cardiac surgery: a metaanalysis and systematic review of randomized
controlled trials.
Source
Indonesian Journal of Cardiology. Conference: 11th Annual Scientific
Meeting of the Indonesian Heart Rhythm Society, InaHRS 2024. Jakarta
Indonesia. 45(Supplement B) (no pagination), 2024. Date of Publication: 01
Oct 2024.
Author
Immanuel S.S.; Tandecxi G.; Bandana V.; Posangi I.
Institution
(Immanuel, Bandana) Department of Internal Medicine, Faculty of Medicine
and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta,
Indonesia
(Tandecxi) Faculty of Medicine and Health Sciences, Atma Jaya Catholic
University of Indonesia, Jakarta, Indonesia
(Posangi) Faculty of Medicine and Health Sciences, Sam Ratulangi
University, Manado, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background and aims: Atrial fibrillation (AF) is a common complication
following cardiac surgery, associated with increased morbidity and
prolonged hospital stays. Recent studies suggest magnesium supplementation
may reduce the incidence of postoperative AF. This meta-analysis and
systematic review evaluates the efficacy of magnesium supplementation in
preventing AF after cardiac surgery. <br/>Material(s) and Method(s): We
conducted a comprehensive search of PubMed, ProQuest, SAGE, EBSCOHost, and
Wiley Online Library for randomized controlled trials (RCTs) published
from 2014 to 2024. The Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA) guidelines were followed. Studies included
human adults aged 18 and older undergoing cardiac surgery and receiving
magnesium supplementation perioperatively. Studies with multi-nutrient
supplementation or unclear magnesium regimens were excluded. Data were
extracted and analyzed using Review Manager software, focusing on the
incidence of postoperative AF as the primary outcome. The risk of bias was
assessed using the Cochrane risk-of-bias tool. <br/>Result(s): Seven RCTs
met the inclusion criteria, encompassing 1,248 patients. The risk of bias
assessment showed generally low risk for most domains except for other
biases, which were high in a few studies. Magnesium supplementation was
not associated with a statistically significant reduction in the incidence
of postoperative AF (Odds Ratio: 0.72, 95% Confidence Interval: 0.38-1.35,
p = 0.30). Subgroup analysis indicated similar results for oral and
intravenous magnesium, with no significant difference in efficacy between
the two forms (p = 0.45). Secondary outcomes such as length of intensive
care unit (ICU) stay and hospital stay showed improvement in the magnesium
group compared to controls, but these were not statistically significant
(p > 0.05). No significant adverse effects related to magnesium
supplementation were reported. <br/>Conclusion(s): Although magnesium
supplementation appeared to reduce the incidence of atrial fibrillation
following cardiac surgery, the reduction was not statistically
significant. Similarly, subgroup analysis did not show significant
differences between the efficacy of oral and intravenous magnesium. While
there were improvements in secondary outcomes such as ICU and hospital
stays, these were also not statistically significant. Further research
with larger sample sizes is needed to confirm these findings and establish
clear clinical guidelines.

<106>
Accession Number
2035844934
Title
Decreased vasoregulatory dysfunction associated with intra-operative
hemoadsorption treatment is related to mitigated post-transplant
procalcitonin rather than cytokine or complement response.
Source
Frontiers in Medicine. 12 (no pagination), 2025. Article Number: 1541519.
Date of Publication: 2025.
Author
Katona H.; Soltesz A.; Kovacs E.; Szakal-Toth Z.; Tamaska E.; Racz K.;
Radovits T.; Fintha A.; Kovacs K.; Hurler L.; Prohaszka Z.; Merkely B.;
Nemeth E.
Institution
(Katona, Soltesz, Kovacs, Szakal-Toth, Tamaska, Racz, Radovits, Merkely,
Nemeth) Heart and Vascular Center, Semmelweis University, Budapest,
Hungary
(Katona, Soltesz, Kovacs, Tamaska, Racz, Nemeth) University Department of
Anesthesiology and Intensive Therapy, Semmelweis University, Budapest,
Hungary
(Fintha) Department of Pathology and Experimental Cancer Research,
Semmelweis University, Budapest, Hungary
(Kovacs) Department of Laboratory Medicine, Semmelweis University,
Budapest, Hungary
(Hurler, Prohaszka) Department of Internal Medicine and Hematology,
Semmelweis University, Budapest, Hungary
Publisher
Frontiers Media SA
Abstract
Introduction: The aim of this study was to investigate the modulatory
effect of intraoperative hemoadsorption (HA) versus standard care on the
perioperative inflammatory profile of patients undergoing orthotopic heart
transplantation (OHT) and its correlation with the severity of
post-transplant vasoregulatory dysfunction. <br/>Method(s): In this
secondary analysis, data from NCT03145441, a prospective, single-center,
open-label, randomized controlled trial were used. <br/>Result(s):
Patients in the HA group had a lower median vasopressor score, rate of
severe vasoregulatory dysfunction (vasopressor score: 19.7 [7.9-37.8] vs.
35.6 [14.5-57.6], p = 0.031, respectively and severe vasoregulatory
dysfunction: 33.3% vs. 60.0% p = 0.048, respectively), and reduced
procalcitonin (PCT) level (PCT: 0.93 [0.38-2.36] mug/L vs. 2.08
[1.13-6.36] mug/L, p = 0.007, respectively) during the early postoperative
period than patients in the control group. The 24-h cytokine and
complement levels were comparable in the study groups. The 24-h
inflammatory profile of HA and control groups remained unchanged in the
cluster of severe vasoregulatory dysfunction. There was a moderate
positive correlation between the vasopressor score and the PCT
concentration in the control group (r<inf>S</inf>: 0.605, p = 0.002) which
was not identified in the HA group. <br/>Discussion(s): Intraoperative HA
treatment exerts a beneficial modulatory effect on the postoperative PCT
response in OHT recipients, which is directly associated with
significantly lower rates of post-transplant severe vasoregulatory
dysfunction compared to controls.<br/>Copyright &#xa9; 2025 Katona,
Soltesz, Kovacs, Szakal-Toth, Tamaska, Racz, Radovits, Fintha, Kovacs,
Hurler, Prohaszka, Merkely and Nemeth.

<107>
Accession Number
648373549
Title
Clinical Predictors of Postoperative Atrial Fibrillation after Coronary
Artery Bypass Grafting - A Systematic Literature Review and Meta-Analysis.
Source
Indonesian Journal of Cardiology. Conference: 10th Annual Scientific
Meeting of the Indonesian Heart Rhythm Society, InaHRS 2023. Jakarta
Indonesia. 44(Supplement B) (pp 28), 2023. Date of Publication: 01 Oct
2023.
Author
Pradipta L.D.; Alamsyaputra A.; Farissa I.P.; Yudanto A.; Ardhianto P.
Institution
(Pradipta, Alamsyaputra, Farissa, Yudanto, Ardhianto) Department of
Cardiology and Vascular Medicine, Faculty of Medicine, Diponegoro
University - Dr. Kariadi Central General Hospital Semarang, Indonesia
Publisher
Indonesian Heart Association
Abstract
Background and Aims: The most common arrhythmia following cardiac surgery
is atrial fibrillation (AF). Recent studies have showed that between 25
and 40 percent of postoperative patients get AF after undergoing coronary
artery bypass graft (CABG). Postoperative atrial fibrillation (POAF) has
been linked to an increased risk of mortality, heart failure,
cerebrovascular illness, longer hospitalisation, renal insufficiency, and
increased social expenditures. There are many risk models developed to
predict the incidence of POAF based on clinical characteristics, though
the result was conflicting between each models. This meta-analysis aim was
to determine the clinical models which could predict POAF in patient
underwent isolated CABG surgery. <br/>Material(s) and Method(s): Multiple
databases including PubMed, Scopus, and ScienceDirect database were
searched for relevant studies in English before June 2023. Full-text
articles of studies are used to compare the various clinical risk factors
of POAF after isolated CABG surgery. Review Manager 5.4 was used to
estimate the effects of those risk factors among eligible articles. The
quality of research methods was evaluated using Newcastle Ottawa Scale.
<br/>Result(s): There were total of 19 studies with 23.014 participants,
comprising 5248 patients with POAF and 17766 patients without POAF. The
analysis results showed that risk of POAF could increase in patient with:
older age, diabetic mellitus (DM), hypertension, chronic heart failure
(CHF), peripheral arterial disease (PAD), chronic obstructive pulmonary
disease (COPD), cerebrovascular disease (CVD), chronic kidney disease
(CKD), longer using inotropic agent post operative, higher level of
postoperative creatinine, using intra-aortic balloon pump (IABP), longer
cardiopulmonary bypass (CPB) time, and longer aortic cross clamp (ACC)
time. Among them older age had the greatest impact of POAF risk with OR
95%CI = 5.56 [4.76 - 6.35]. Preoperative statin treatment could reduce the
risk of POAF, surprisingly, history of dyslipidaemia and current smoking
also reduce those risk. <br/>Conclusion(s): Our meta-analysis shows that
older age, DM, hypertension, CHF, PAD, COPD, CVD, CKD, longer using
inotropic agent post operative, higher level of postoperative creatinine,
using IABP, longer CPB time, and longer ACC time were associated with
increased risk of POAF.

<108>
Accession Number
2040206760
Title
Impact of pharmacological and non-pharmacological strategies on
postoperative cognitive disfunction (POCD) in cardiac surgery.
Source
DOLOR. 40(2) (pp 53-66), 2025. Date of Publication: 01 Apr 2025.
Author
Alzate-Granados J.P.; Valencia-Angarita B.G.; Gonzalez-Gonzalez S.;
Corona-Arias C.A.; Torres-Menjura G.V.
Institution
(Alzate-Granados) Department of Pathology, Faculty of Medicine, National
University of Colombia, Bogota, Colombia
(Valencia-Angarita) Department of Medicine, Universidad Metropolitana,
Barranquilla, Colombia
(Gonzalez-Gonzalez) Department of Medicine, Universidad de Antioquia,
Medellin, Colombia
(Corona-Arias) Department of Medicine, Universidad Industrial de
Santander, Bucaramanga, Colombia
(Torres-Menjura) Department of Medicine, National University of Colombia,
Bogota, Colombia
Publisher
Permanyer Publications
Abstract
Postoperative cognitive dysfunction (POCD) is a common complication
following cardiac surgery, particularly in elderly patients, and is
characterized by deficits in memory, attention, and executive function.
Its etiology involves neuroinflammation, cerebral hypoperfusion, embolism,
and oxidative stress. A systematic review of randomized controlled trials
(RCTs) and observational studies was conducted. The databases consulted
included PubMed, EMBASE, Scopus, CENTRAL, and Web of Science (last search:
March 2024). Studies included adult patients undergoing cardiac surgery
who received either pharmacological interventions (e.g., dexmedetomidine,
ketamine) or non-pharmacological interventions, with cognitive outcomes
measured. Sixteen studies were included. Perioperative dexmedetomidine
reduced the incidence of early POCD by 40% to 60%. Low-dose ketamine (0.5
mg/kg) decreased POCD from 81% to 27% one week after surgery (p < 0.001).
Melatonin improved early cognitive scores and sleep quality. Cognitive
training significantly reduced the risk of POCD (relative risk ~0.35),
while NIRS monitoring showed short-term benefits (POCD: 28% vs. 52%, p =
0.002). Off-pump surgery and remote ischemic preconditioning demonstrated
transient benefits with no long-term effects. Lidocaine and donepezil did
not show significant cognitive improvement. Dexmedetomidine and ketamine
provide the strongest evidence among pharmacological
strategies.<br/>Copyright &#xa9; 2025 Dolor Investigacion, Clinica &
Terapeutica.

<109>
Accession Number
2040181543
Title
Beyond the Heart: The Significance of Depression in Cardiac Surgery.
Source
European Journal of Cardio-thoracic Surgery. 67(8) (no pagination), 2025.
Article Number: ezaf277. Date of Publication: 01 Aug 2025.
Author
Stenman M.; Jackson V.; Sarnholm J.; Falk A.; J Nielsen S.; Sartipy U.
Institution
(Stenman, Jackson, Sartipy) Department of Molecular Medicine and Surgery,
Karolinska Institutet, Stockholm, Sweden
(Stenman, Falk) Perioperative Medicine and Intensive Care Function,
Karolinska University Hospital, Stockholm, Sweden
(Jackson) Stockholm Healthcare Services, Region Stockholm, Stockholm,
Sweden
(Sarnholm) Department of Clinical Neuroscience, Division of Psychology,
Karolinska Institutet, Stockholm, Sweden
(Sarnholm) Center for Behavioral Cardiovascular Health, Columbia
University, Irving Medical Center, New York, NY, United States
(Falk) Department of Physiology and Pharmacology, Karolinska Institutet,
Stockholm, Sweden
(J Nielsen) Department of Molecular and Clinical Medicine, Sahlgrenska
Academy, Gothenburg University, Gothenburg, Sweden
(J Nielsen) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Sartipy) Department of Cardiothoracic Surgery, Karolinska University
Hospital, Stockholm, Sweden
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives Preoperative depression is common among patients with
cardiovascular disease and a significant risk factor for worse outcomes
after cardiac surgery. This review summarizes the current evidence on
depression as a risk factor and possible treatment options in patients
undergoing cardiac surgery, and highlights future perspectives for
clinical research. Methods This narrative review was based on a selection
of key papers, identified through collegial expert discussions rather than
a systematic literature search. Results Depression is often underdiagnosed
and undertreated in patients undergoing cardiac surgery, significantly
affecting recovery and increasing the risk of adverse outcomes.
Implementing systematic psychological screening for depression and anxiety
preoperatively and during follow-up is crucial for identifying at-risk
patients. Psychological interventions, especially cognitive behavioral
therapy have been shown to offer substantial benefits. Adopting a
multidisciplinary approach integrating cardiovascular and psychological
care is essential for improving recovery and long-term outcomes.
Incorporating psychological screening and interventions into standard care
can enhance postoperative outcomes, reduce complications, and provide
comprehensive support for cardiac surgery patients. Conclusions Depression
is often overlooked in cardiac surgery patients, despite its significant
impact on recovery and long-term outcomes. Systematic psychological
screening before and after surgery together with a multidisciplinary
approach integrating cardiovascular and psychological care can improve
patient outcomes. Future research should clarify how depression and
cardiovascular disease are linked, assess treatment effectiveness, and
identify appropriate intervention strategies.<br/>Copyright &#xa9; 2025
The Author(s). Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery.

<110>
Accession Number
648367112
Title
Management Strategies Following Recurrent Stroke in Patients on Direct
Oral Anticoagulants: A Meta-Analysis of Treatment Decisions.
Source
Neurology. Conference: Annual Meeting of the American Academy of
Neurology, AAN 2025. San Diego, CA United States. 104(7 Supplement 1) (no
pagination), 2025. Date of Publication: 01 Apr 2025.
Author
Mau C.Z.; Razavi M.; Khurana M.; Gabadadze M.; Sandhu D.
Institution
(Mau, Razavi, Khurana, Gabadadze, Sandhu) University of South Dakota,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: This meta-analysis aims to assess which strategies yield better
outcomes in reducing recurrent stroke and intracranial hemorrhage (ICH) in
patients with atrial fbrillation (AF) who have experienced ischemic stroke
despite anticoagulation. <br/>Background(s): Stroke management in AF
patients typically involves anticoagulation therapy with vitamin K
antagonists (VKA) or direct oral anticoagulants (DOACs). However,
recurrent ischemic strokes remain a signifcant clinical challenge, with
high mortality risk. Current management options include continuing or
switching DOACs, adding antiplatelet therapy, or left atrial appendage
closure, but limited data make it diffcult to recommend a preferred
approach. Design/Methods: A systematic literature search was conducted in
PubMed, Cochrane, and Web of Science, yielding 9987 studies. After
screening, 13 relevant studies were selected based on their focus on
recurrent stroke in anticoagulated patients. The studies included data on
stroke recurrence and ICH rates and explored interventions such as
switching from a DOAC to a VKA, switching between DOACs, or adjusting
medication dosage. The study was registered in PROSPERO (ID:
CRD42024523312). <br/>Result(s): A total of 13,635 patients with a mean
age of 77.5 years were included, 47% of whom were female. The follow-up
period averaged 11.3 months. Among the patients analyzed, the recurrent
stroke rate was 7.1%, and the ICH rate was 6.0%. Management strategies
varied, with some patients switching to VKAs or other DOACs, increasing
the dose, or maintaining their current anticoagulation. The full results
of the meta-analysis will be presented at the conference, offering deeper
insights into the effectiveness of each strategy. <br/>Conclusion(s):
Despite extensive research, no defnitive consensus has been reached on the
optimal approach for recurrent stroke in anticoagulated patients. This
meta-analysis aims to offer further insight, but the need for
individualized treatment and larger studies remains essential.

<111>
Accession Number
2035836025
Title
Multidisciplinary strategies to reduce radiotherapy-induced cardiotoxicity
in breast cancer: surgical and technological innovations.
Source
Frontiers in Oncology. 15 (no pagination), 2025. Article Number: 1647080.
Date of Publication: 2025.
Author
Lu K.; Sun Z.; Yi Y.
Institution
(Lu, Sun) Department of Thyroid and Breast Surgery, Affiliated Hospital of
Jiangsu University, Zhenjiang, China
(Yi) Institute of Medical Imaging and Artificial Intelligence of Jiangsu
University, Affiliated Hospital of Jiangsu University, Zhenjiang, China
Publisher
Frontiers Media SA
Abstract
Radiotherapy remains essential in breast cancer management, yet its
long-term cardiotoxicity, driven primarily by radiation-induced myocardial
fibrosis, threatens survivorship, particularly in left-sided tumors.
Surgical refinements, including breast-conserving surgery with sentinel
lymph node biopsy and total mastectomy, effectively reduce radiation
fields and cardiac exposure. Intraoperative radiotherapy with lead
shielding markedly lowers left anterior descending artery dose from 5.2 Gy
to 0.07 Gy. Technological advances-such as deep-inhalation breath-hold,
proton therapy exploiting the Bragg peak, and intensity-modulated
radiotherapy, further optimize cardiac sparing while preserving oncologic
efficacy. Integrating intraoperative image guidance, pharmacological
cardioprotection, and AI-assisted planning facilitates precise dose
delivery tailored to individual anatomy and risk. This review synthesizes
multidisciplinary strategies to mitigate cardiac injury through surgical
and technological innovation, underscoring a paradigm shift toward
organ-sparing precision radiotherapy. Future directions include the
application of degradable shielding materials, senescence-targeted
therapies, and predictive modeling to balance therapeutic efficacy with
long-term cardiovascular safety in breast cancer care.<br/>Copyright
&#xa9; 2025 Lu, Sun and Yi.

<112>
Accession Number
2035842431
Title
Incidence and risk factors of intraoperative acquired pressure injury in
open heart surgical patients: a meta-analysis of prospective studies.
Source
European Journal of Medical Research. 30(1) (no pagination), 2025. Article
Number: 814. Date of Publication: 01 Dec 2025.
Author
Fang Z.; Chen T.; Zheng W.; Chen Q.; Chen P.; Zhuo Q.
Institution
(Fang, Chen, Zhuo) Department of Operating Room, Fujian Children's
Hospital (Fujian Branch of Shanghai Children's Medical Center), Fujian,
Fuzhou, China
(Chen) Department of Anesthesiology, Fujian Children's Hospital (Fujian
Branch of Shanghai Children's Medical Center), Fujian, Fuzhou, China
(Zheng, Chen) Department of Operating Room, Fujian Maternity and Child
Health Hospital, Fujian, Fuzhou, China
(Fang, Chen, Zheng, Chen, Chen, Zhuo) College of Clinical Medicine for
Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian,
Fuzhou, China
Publisher
BioMed Central Ltd
Abstract
Purpose: This meta-analysis aimed to evaluate the incidence and risk
factors of intraoperative acquired pressure injuries (IAPIs) in open heart
surgical patients, focusing exclusively on prospective studies to address
gaps in the existing literature. <br/>Method(s): A systematic search was
conducted across PubMed, Embase, and Web of Science up to January 2025.
Data on incidence and risk factors were extracted, and statistical
analyses were performed using random-effects models. Heterogeneity was
assessed using I² statistics; publication bias was assessed by
funnel plot and Egger's test. <br/>Result(s): Ten prospective studies
involving 1311 patients were included. The pooled incidence of IAPIs was
25% (95% CI 16%-35%), with high heterogeneity (I² = 94%).
Sensitivity analysis confirmed stable results. Significant risk factors
included prolonged surgical duration (SMD: 1.76, 95% CI 0.10-3.42,
I² = 98%), advanced age (SMD: 0.30, 95% CI 0.14-0.46,
I² = 0%), female sex (RR: 1.36, 95% CI 1.03-1.80, I²
= 53%), and perioperative corticosteroid use (RR: 3.63, 95% CI 1.64-8.06,
I² = 0%). <br/>Conclusion(s): This study assessed the incidence
of IAPIs in open heart surgical patients and identifies key risk factors,
including prolonged surgical duration, advanced age, female sex, and
perioperative corticosteroid use. However, the results should be
interpreted with caution due to the high heterogeneity observed across
studies. Future research should focus on larger, multicenter prospective
studies to provide more robust evidence.<br/>Copyright &#xa9; The
Author(s) 2025.

<113>
Accession Number
2035827902
Title
Surgical Management of Substernal Goiters: A Systematic Review and
Meta-Analysis.
Source
Laryngoscope. (no pagination), 2025. Date of Publication: 2025.
Author
Cheung M.H.; Walker A.M.; Nguyen S.A.; Butehorn H.; Albergotti W.G.
Institution
(Cheung, Walker, Nguyen, Butehorn, Albergotti) Medical University of South
Carolina, Department of Otolaryngology-Head and Neck Surgery, Charleston,
SC, United States
(Cheung) SUNY Upstate Medical University, School of Medicine, Syracuse,
NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: Defining indication for intervention in substernal goiter, and
secondarily define when thoracic intervention may be required. <br/>Data
Sources: PubMed, Scopus, CINAHL. <br/>Method(s): A systematic review and
meta-analysis were performed on studies employing thyroidectomy for
substernal goiters. Meta-analysis of continuous measures, proportions, and
comparison of weighted proportions was performed for patient
characteristics, symptoms, and outcomes. <br/>Result(s): Data from 102
studies were included, with a total study population of 15,719 patients
undergoing substernal thyroidectomies. Criteria for classifying substernal
goiter were heterogeneous across studies, with a plurality (21/102)
defining diagnosis by > 50% of the goiter mass located below the thoracic
inlet. There was a female predominance at 67% (CI 64.2-69.9) with a mean
age of 58 years old (10-94). Most common preoperative symptoms were a
described "neck mass" (71.1%, CI 57.6-82.9) and overall compressive
symptoms (64.8%, CI 52.4-76.2). 27.6% (CI 22.4-33.1) of the population
remained asymptomatic. On radiologic imaging, tracheal deviation and
compression were identified in 60.6% (CI 52.5-68.5) and 48.6% (CI
37.6-59.6) of the population, respectively. Cervical approach alone was
performed in 88.7% (CI 86.0-91.1) of the population, while 10.4% (CI
8.2-12.8) required additional thoracic intervention. Malignancy was
moderate and seen in 12.4% (CI 10.4-14.6) of cases. <br/>Conclusion(s):
Results highlight the indication for substernal surgery is largely due to
the presence of clinical symptoms or compressive findings on imaging;
however, over a quarter of the population is asymptomatic and over 50% are
without compressive findings on imaging. When surgery is undertaken, a
cervical approach is often adequate, suggesting that only a minority of
the population may require thoracic intervention.<br/>Copyright &#xa9;
2025 The Author(s). The Laryngoscope published by Wiley Periodicals LLC on
behalf of The American Laryngological, Rhinological and Otological
Society, Inc.

<114>
Accession Number
2035832909
Title
Phenotype characterization of heart failure with preserved ejection
fraction in medical device and surgical trials.
Source
ESC Heart Failure. (no pagination), 2025. Date of Publication: 2025.
Author
Araz K.; Fioretti F.; Ladak S.; Obaidan M.; Butler J.; Hameed A.
Institution
(Araz, Ladak) School of Medicine, RCSI University of Medicine and Health
Sciences, Dublin, Ireland
(Fioretti, Butler) Baylor Scott & White Research Institute, Dallas, TX,
United States
(Obaidan) UCD School of Medicine, UCD Health Sciences Centre, University
College Dublin, Dublin, Ireland
(Butler) University of Mississippi, Jackson, MS, United States
(Hameed) Tissue Engineering Research Group (TERG), Department of Anatomy
and Regenerative Medicine, RCSI University of Medicine and Health
Sciences, Dublin, Ireland
(Hameed) Trinity Centre for Biomedical Engineering (TCBE), Trinity College
Dublin (TCD), Dublin, Ireland
Publisher
John Wiley and Sons Inc
Abstract
Aims: Heart failure with preserved ejection fraction (HFpEF) prevalence is
nearing 50% of all heart failure cases and is often associated with
advanced age, obesity, atrial fibrillation and hypertension, and medical
approaches are limited. This review aims to determine the potential of
medical devices or surgical interventions in treating HFpEF and to propose
specific phenotypes of HFpEF. <br/>Methods and Results: A systematic
review was conducted using various clinical trial databases and the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) guidelines followed by descriptive analysis and methodology
quality assessment. Inclusion criteria included a medical device or
surgical intervention involving HFpEF patients defined by a left
ventricular ejection fraction (LVEF) >=50% and signs of diastolic
dysfunction. Twenty-four novel trials were identified involving n = 1752
participants: 17 medical device trials [3 interatrial shunt device trials
(n = 1069), 1 atrial flow regulator trial (n = 41), 3 vagal nerve
stimulation trials (n = 112), 1 baroreflex activation therapy trial (n =
21), 1 cardiac contractility modulator trial (n = 47), 6 cardiac
resynchronization therapy trials (n = 178) and 2 functional electrical
stimulation therapy trials (n = 89)] and 7 surgical intervention trials [1
renal denervation trial (n = 25), 3 greater splanchnic nerve ablation
trials (n = 111), 2 catheter ablation trials (n = 55) and 1 pericardiotomy
procedure trial (n = 4)]. One trial completed phase 3 trials, 20 trials
completed phase 1 trials with further trials, and 5 trials completed phase
1 trials without further trials. <br/>Conclusion(s): Overall, 16 out of 24
trials have at least demonstrated safety and feasibility. However, despite
many trials of a medical device or surgical procedure showing proof of
concept to treat HFpEF phenotypes, they do not provide sufficient evidence
of long-term benefit. More robust and phenotype-based clinical trials are
needed to ensure evidence-based solutions are developed in
HFpEF.<br/>Copyright &#xa9; 2025 The Author(s). ESC Heart Failure
published by John Wiley & Sons Ltd on behalf of European Society of
Cardiology.

<115>
Accession Number
2040174307
Title
From pioneering to innovation: A comprehensive review of acupuncture
anesthesia in cardiothoracic surgeries.
Source
Journal of Integrative Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Wu X.-D.; Wei X.-Q.; Chen T.-Y.; Zhou W.-X.; Wang K.; Zhou J.
Institution
(Wu, Wei, Wang, Zhou) Department of Clinical Research Institute of
Acupuncture and Anesthetic, Yueyang Hospital of Integrated Traditional
Chinese and Western Medicine, Shanghai University of Traditional Chinese
Medicine, Shanghai, China
(Wu, Zhou) Department of Intensive Care Unit, Yueyang Hospital of
Integrated Traditional Chinese and Western Medicine, Shanghai University
of Traditional Chinese Medicine, Shanghai, China
(Chen, Zhou) Department of Cardiothoracic Surgery, Yueyang Hospital of
Integrated Traditional Chinese and Western Medicine, Shanghai University
of Traditional Chinese Medicine, Shanghai, China
(Wang) Office of National Clinical Research Base of Traditional Chinese
Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western
Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai,
China
Publisher
Elsevier (Singapore) Pte Ltd
Abstract
The evolution of acupuncture anesthesia (AA) has spanned six decades.
Cardiothoracic surgery serves as a representative case study to illustrate
this evolution. Reflecting on its historical development, the use of AA in
cardiothoracic surgery has advanced from basic AA procedures in the 1960s
to combined acupuncture and drug anesthesia techniques in the early 1980s.
Since 2005, the innovative use of non-intubation AA combined anesthesia
has been implemented extensively in cardiothoracic surgery. As the medical
industry continues to evolve, the techniques applied in AA have expanded
to encompass the entire perioperative period in cardiothoracic surgery,
leading to the introduction of the concept of modern AA. The use of AA in
cardiothoracic surgery exemplifies the ongoing advances and integration of
traditional Chinese and Western medicine. Moving forward, it is imperative
to enhance the theoretical framework of AA through the execution of
rigorous multicenter clinical trials, to further strengthen the body of
evidence supporting evidence-based medicine, and to finally explore the
underlying mechanisms of AA. Please cite this article as: Wu XD, Wei XQ,
Chen TY, Zhou WX, Wang K, Zhou J. From pioneering to innovation: A
comprehensive review of acupuncture anesthesia in cardiothoracic
surgeries. J Integr Med. 2025; Epub ahead of print.<br/>Copyright &#xa9;
2025 Shanghai Yueyang Hospital Affiliated to Shanghai University of
Traditional Chinese Medicine

<116>
Accession Number
2035833154
Title
Intravenous methadone for pain management in cardiac surgery: a randomised
controlled trial with plasma concentration analysis*.
Source
Anaesthesia. (no pagination), 2025. Date of Publication: 2025.
Author
Wong H.M.K.; Lai V.K.W.; Chiu S.L.C.; Wong W.T.; Wo S.K.; Zuo J.Z.; Liu
X.; Wong R.H.L.; Ho K.M.
Institution
(Wong, Chiu, Wong, Liu, Ho) Department of Anaesthesia and Intensive Care,
The Chinese University of Hong Kong, Hong Kong
(Lai) Child Health Evaluative Sciences, The Hospital for Sick Children
Research Institute, Toronto, ON, Canada
(Wo, Zuo) School of Pharmacy, Faculty of Medicine, The Chinese University
of Hong Kong, Hong Kong
(Wong) Division of Cardiothoracic Surgery, Department of Surgery, Prince
of Wales Hospital, New Territories, Hong Kong
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Postoperative pain after cardiac surgery remains significant
despite the administration of opioids. Methadone may improve pain control
and decrease the need for postoperative opioids. Randomised controlled
trials, however, are limited and the effects of cardiopulmonary bypass on
methadone pharmacokinetics are unclear. The aims of this study were to
compare methadone and morphine in cardiac surgery, measuring methadone
concentrations and correlating them with pain control. <br/>Method(s):
Patients undergoing cardiac surgery that required cardiopulmonary bypass
were allocated randomly to receive either 0.2 mg.kg^-1 methadone
or 0.2 mg.kg^-1 morphine (based on actual body weight, maximum
20 mg for both drugs). Postoperative pain was assessed at 15 min and 8 h,
12 h, 24 h, 48 h and 72 h after tracheal extubation, by analysis of
morphine consumption and pain scores. Opioid-related adverse events were
evaluated. Postoperative blood samples were collected for 96 h to measure
plasma methadone concentrations. <br/>Result(s): In total, 80 patients
were analysed (40 allocated to the methadone group, 40 allocated to the
morphine group). Patients allocated to the methadone group had
significantly reduced 24-h and total postoperative morphine requirements
compared to those allocated to the morphine group (median (IQR [range]) 9
(5-16 [0-40]) mg vs. 24 (17-43 [4-54]) mg (p < 0.001) at 24 h and 35
(23-52 [5-66]) mg vs. 11 (7-20 [0-44]) mg (p < 0.001) total). Patients
allocated to the methadone group had lower pain scores at rest (beta
-2.24, standard error 0.49, p < 0.001) and on coughing (beta -2.16,
standard error 0.50, p < 0.001). There was no difference in the incidence
of opioid-related adverse effects between the two groups. Plasma methadone
concentration decreased during cardiopulmonary bypass but remained above
the minimum effective analgesic concentration for approximately 24 h after
administration (mean (SD) 51 (24.7) ng.ml^-1 at baseline to 30
(10.7) ng.ml^-1 at 24 h). <br/>Discussion(s): Intra-operative
methadone reduces postoperative analgesia requirements without increasing
the incidence of opioid-related adverse events.<br/>Copyright &#xa9; 2025
The Author(s). Anaesthesia published by John Wiley & Sons Ltd on behalf of
Association of Anaesthetists.

<117>
Accession Number
2040157762
Title
Incidence, Risk Factors, and Clinical Impact of Intra-Stent Graft
Thrombosis in the Thoracic Aorta.
Source
European Journal of Cardio-thoracic Surgery. 67(8) (no pagination), 2025.
Article Number: ezaf272. Date of Publication: 01 Aug 2025.
Author
Hasami N.A.; Been M.; De Kort J.F.; Geuzebroek G.S.C.; Gelpi G.; De
Vincentiis C.; Patel H.J.; Czerny M.; Heijmen R.H.; Van Herwaarden J.A.;
Trimarchi S.
Institution
(Hasami, Been, De Kort, Trimarchi) Department of Vascular Surgery,
Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
(Hasami, Geuzebroek, Heijmen) Department of Cardiothoracic Surgery,
Radboud University Medical Centre, Nijmegen, Netherlands
(Hasami, De Kort, Van Herwaarden) Department of Vascular Surgery,
University Medical Centre Utrecht, Utrecht, Netherlands
(Gelpi) Department of Cardiac Surgery, Fondazione IRCCS Ca'Granda Ospedale
Maggiore Policlinico, Milan, Italy
(De Vincentiis) Department of Cardiac Surgery, IRCCS Policlinico San
Donato, Milan, Italy
(Patel) Department of Cardiac Surgery, University of Michigan, Ann Arbor,
MI, United States
(Czerny) Department of Cardiovascular Surgery, University Heart Centre
Freiburg, Freiburg, Germany
(Czerny) Faculty of Medicine, Albert Ludwig University, Freiburg, Germany
(Trimarchi) Department of Clinical Sciences and Community Health,
Universita degli Studi di Milano, Milan, Italy
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives: Stentgrafts in the thoracic aorta, whether placed during the
frozen elephant trunk procedure or thoracic endovascular repair, have been
associated with thrombosis. This study aimed to evaluate its incidence,
risk factors, and clinical consequences. <br/>Method(s): PubMed, Web of
Science, and SCOPUS were systematically searched for relevant studies.
Quality assessment was performed using the Risk of Bias in Non-Randomized
Studies of Interventions tool for cohort studies and the Joanna Briggs
Institute checklist for case reports. Certainty of evidence was evaluated
using the Grading of Recommendations Assessment, Development, and
Evaluation approach. <br/>Result(s): Seventeen studies were included: 4
cohort studies (825 patients) and 3 case reports on frozen elephant trunk,
3 cohort studies (142 patients), and 12 case reports on thoracic
endovascular repair. The pooled incidence of intra-stent graft thrombosis
after frozen elephant trunk was 8.6% (95% CI: 5.7-12.9), typically
occurring within 1 week and significantly associated with older age,
female sex, aneurysmal disease, and higher rates of dialysis (43% vs 16%)
and mortality (25% vs 8%). Thoracic endovascular repair cohorts were
heterogeneous and could not be pooled; therefore, findings were
synthesized narratively. One trauma cohort reported an incidence of 20.6%.
All 12 case reports involved patients treated for trauma, with a mean time
to diagnosis of 12 +/- 6.3 months; 8 presented with spinal cord injury; 11
underwent an intervention to address the thrombosis. <br/>Conclusion(s):
Intra-stent graft thrombosis is relatively common after frozen elephant
trunk and may be underrecognized after thoracic endovascular repair,
particularly in trauma patients. Structured imaging follow-up and
individualized treatment strategies are warranted.<br/>Copyright &#xa9;
2025 The Author(s). Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<118>
Accession Number
2040165946
Title
Comparative Effectiveness of Vascular Closure Device Strategies in
Transcatheter Aortic Valve Replacement: A Network Meta-Analysis.
Source
Annals of Vascular Surgery. 122 (pp 358-368), 2026. Date of Publication:
01 Jan 2026.
Author
Deng Y.; Feng Y.; He S.; Zhou W.; Zhang J.
Institution
(Deng, Feng, He, Zhang) Department of Cardiology, Northern Jiangsu
People's Hospital, Yangzhou, China
(Deng, Feng) Medical College of Yangzhou University, Yangzhou, China
(Zhou) Department of Rheumatology, Yangzhou University Affiliated
Hospital, Yangzhou, China
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) has become the
preferred treatment for high-risk patients with severe aortic stenosis.
However, the management of vascular complications associated with
large-bore femoral arterial access sheaths remains challenging for
clinicians. Traditional manual compression exhibits limited efficacy in
homeostasis, while the clinical outcomes of vascular closure devices
(VCDs) remain controversial. To conduct a systematic evaluation on the
differences among various types of VCDs in preventing vascular
complications and achieving device success rates post-TAVR.
<br/>Method(s): Systematic searches were conducted in PubMed, Web of
Science, and Cochrane for clinical studies on VCD application post-TAVR.
Two independent researchers performed study selection, data extraction,
and quality assessment. A network meta-analysis (NMA) was conducted using
STATA 16.0; device ranking was assessed via surface under the cumulative
ranking curve (SUCRA). <br/>Result(s): A total of 28 studies (21,029
patients, 7 types of VCD) were included. NMA revealed FemoSeal-ProGlide
was associated with lower risks of major vascular complications (odds
ratio (OR) = 0.28, 95% confidence interval (CI): 0.09-0.86) and major
bleeding events (OR = 0.20, 95% CI: 0.06-0.63). Prostar demonstrated a
higher risk of nonmajor vascular complications (OR = 1.61, 95% CI:
1.14-2.29). AngioSeal-ProGlide showed the lowest device failure rate (OR =
0.21, 95% CI: 0.10-0.48). No significant differences were observed among
other closure methods. SUCRA rankings indicated FemoSeal-ProGlide
demonstrated best efficacy in reducing major vascular complications
(89.7%), 30-day mortality (94.5%), and major bleeding events (75.4%).
AngioSeal-ProGlide demonstrated best efficacy in minimizing nonmajor
vascular complications (80.8%) and device failure (89.6%).
<br/>Conclusion(s): Based on current evidence, the combined use of
small-bore collagen plug-based and suture-mediated VCDs may represent the
safest and most effective strategy for TAVR-related vascular closure.
However, its clinical applicability requires further validation through
large-scale randomized controlled trials.<br/>Copyright &#xa9; 2025
Elsevier Inc.