EPICORE Embase Updates: EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
2035943213
Title
Effect of peri-operative pharmacological interventions on postoperative
delirium in patients having cardiac surgery: a systematic review and
Bayesian network meta-analysis.
Source
Anaesthesia. (no pagination), 2025. Date of Publication: 2025.
Author
Queiroz I.; Barbosa L.M.; Gallo Ruelas M.; Araujo B.; Defante M.L.R.;
Tavares A.H.; Florencio de Mesquita C.; Pimentel T.; Ximenes Mendes B.;
Ferreira Felix I.; Rivera A.; Oliva Morgado Ferreira R.; de Oliveira H.M.;
Righetto B.B.; Smischney N.J.; Tong G.; Ma D.
Institution
(Queiroz) Department of Medicine, APAMI Hospital, Vitoria de Santo Antao,
Brazil
(Barbosa) Department of Medicine, Federal University of Minas Gerais, Belo
Horizonte, Brazil
(Gallo Ruelas) Department of Nutrition Sciences, Instituto de
Investigacion Nutricional, Lima, Peru
(Araujo, Rivera) Department of Medicine, Nove de Julho University, Sao
Bernardo do Campo, Brazil
(Defante) Department of Medicine, Redentor University Center, Rio de
Janeiro, Brazil
(Tavares) Department of Medicine, University of Pernambuco, Recife, Brazil
(Florencio de Mesquita, Pimentel) Department of Medicine, Federal
University of Pernambuco, Recife, Brazil
(Ximenes Mendes) Department of Medicine, Unichristus, Fortaleza, Brazil
(Ferreira Felix, Smischney) Department of Medicine, Mayo Clinic,
Rochester, MN, United States
(Oliva Morgado Ferreira) Department of Medicine, Federal University of
Santa Catarina, Florianopolis, Brazil
(de Oliveira) Department of Medicine, Federal University of Mato Grosso,
Sinop, Brazil
(Righetto) Department of Medicine, University Positivo, Valinhos, Brazil
(Tong) Department of Medicine, Yale School of Medicine, New Haven, CT,
United States
(Tong) Department of Statistics, Yale School of Public Health, New Haven,
CT, United States
(Ma) Department of Anesthesiology, Zhejiang University School of Medicine
Children's Hospital, Hangzhou, China
(Ma) Department of Anaesthetics, Imperial College London Chelsea and
Westminster Hospital, London, United Kingdom
(Ma) Department of Anesthesiology, The First Affiliated Hospital of Ningbo
University, Ningbo, China
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Postoperative delirium is a common complication following
cardiac surgery. Despite its known impact on patient outcomes, effective
preventative strategies remain elusive. We aimed to perform a
comprehensive Bayesian network meta-analysis of randomised controlled
trials assessing the effect of pharmacological interventions on the
incidence of postoperative delirium. Method(s): Databases were
searched from inception to September 2024. Our search was updated in
January 2025. Eligible studies included randomised controlled trials
reporting the incidence of postoperative delirium in patients having
cardiac surgery treated with pharmacological interventions. Bayesian
models were used to estimate risk ratios (RR) and mean differences with
95%CrI through Markov chain Monte Carlo. Interventions were ranked using
the surface under the cumulative ranking curve. Sensitivity analyses and
grading of recommendations, assessment, development and evaluation
assessment were conducted to evaluate the robustness and certainty of
evidence. Result(s): Seventy-nine randomised controlled trials
comprising 24,827 patients were included, with 29 pharmacological
interventions compared. Dexmedetomidine combined with melatonin was the
most effective intervention, reducing the incidence of postoperative
delirium compared with placebo (risk ratio 0.31, 95%CrI 0.13-0.69; low
certainty). Dexmedetomidine with melatonin also significantly decreased
intensive care unit stay (2.4 days, 95%CrI -3.50-1.10) and hospital stay
(1.32 days, 95%CrI -2.09 to -0.57). Other interventions, including
ketamine and risperidone, showed potential efficacy but with low or very
low certainty of evidence. Discussion(s): We identified
dexmedetomidine with melatonin as the most effective pharmacological
strategy for preventing postoperative delirium following cardiac surgery.
Whilst these findings highlight potential benefits, the low certainty of
evidence underscores the need for more high-quality primary
evidence. Copyright © 2025 The Author(s). Anaesthesia published
by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.

<2>
Accession Number
2035930810
Title
Cardiac arrest during peri-anesthetic systemic induction and maintenance
in valvular heart disease: proceed or abandon? Clinical validation of a
modified cardiopulmonary bypass strategy in 21 patients.
Source
European Journal of Medical Research. 30(1) (no pagination), 2025. Article
Number: 818. Date of Publication: 01 Dec 2025.
Author
Wang H.; Yang H.; Liu J.; Zhang H.; Feng Y.; Lei Z.
Institution
(Wang) School of Nursing, University of South China, Hunan, Hengyang,
China
(Yang, Liu, Feng, Lei) Department of Cardiothoracic and Vascular Surgery,
The First Affiliated Hospital of Hengyang Medical School, University of
South China, Hunan, Hengyang, China
(Zhang) Department of Hepatobiliary Surgery, The First Affiliated Hospital
of Hengyang Medical School, University of South China, Hunan, Hengyang,
China
Publisher
BioMed Central Ltd
Abstract
Background: Critical gaps persist in clinical guidelines and resuscitation
strategies for induction and maintenance phase peri-anesthetic cardiac
arrest (IM-PACA), urgently necessitating exploration of feasible solutions
during anesthesia induction and maintenance periods. This study evaluates
a modified cardiopulmonary bypass (CPB) strategy for managing IM-PACA in
valvular heart disease (VHD) surgical patients. Method(s): A
retrospective analysis was performed on IM-PACA patients (n = 21) from
1,043 cardiac valve surgeries between March 2019 and January 2022 as the
cardiac arrest-resuscitation group (CAR group). Patients who completed
normal cardiac valve surgery (n = 84) were randomly selected from the
medical record database as the Routine Surgery group (RS group), serving
as a benchmark control for the standard efficacy of routine surgery. The
CAR group completed surgery after modified cardiopulmonary bypass
strategy; the RS group completed surgery as planned. This study reviewed
the possible causes of cardiac arrest in the CAR group and performed
statistical analysis on surgical time-related metrics (total surgical
duration, cardiopulmonary bypass duration, etc.) and postoperative
follow-up data (paravalvular leak, cardiac-related complications, etc.)
using SPSS 26.0. Result(s): The short-term postoperative survival
rate was 95.24% in the CAR group and 100% in the RS group. Baseline
characteristics including gender, age, and smoking history showed no
significant differences between the two groups (P > 0.05). The CAR group
showed a significantly shorter pericardiotomy-to-CPB time (250.00
(205.00-269.50) vs. 512.50 (459.25-563.00) s; P < 0.001), but longer
rewarming time (68.00 (63.50-74.50) vs. 48.00 (35.25-61.75) min; P <
0.001), ventilator duration (980.00 (619.00-1106.50) vs. 900.00
(630.00-1103.75) min; P = 0.002), and higher day 2 drainage (190
(157.50-215.00) vs. 105 (71.25-150.00) ml; P < 0.001) compared to the RS
group. Other intraoperative and postoperative parameters revealed no
statistically significant differences when compared with the RS group (P >
0.05). Conclusion(s): For IM-PACA patients undergoing cardiac valve
surgery, the modified cardiopulmonary bypass strategy is an effective
rescue method, and the strategy of continuing surgery after resuscitation
is completely feasible. Copyright © The Author(s) 2025.

<3>
Accession Number
2040229992
Title
The effect of postoperative hypotension on surgical patients' adverse
clinical outcomes: A systematic review and meta-analysis.
Source
Journal of Clinical Anesthesia. 107 (no pagination), 2025. Article Number:
111987. Date of Publication: 01 Nov 2025.
Author
Han S.; Zeng T.; Xie Y.; Liu C.; Yang L.; Yang M.
Institution
(Han, Zeng, Xie, Yang) School of Clinical Medicine, Southwest Medical
University, Luzhou, China
(Han, Zeng, Xie) Department of Anesthesiology, Qionglai Medical Center
Hospital, Chengdu, China
(Liu) Department of Anesthesiology, Wenjiang District People's Hospital,
Chengdu, China
(Yang, Yang) Department of Anesthesiology, Sichuan Academy of Medical
Sciences & Sichuan Provincial People's Hospital, Chengdu, China
Publisher
Elsevier Inc.
Abstract
Introduction: Postoperative hypotension (POH) represents an independent
predictor of multiorgan morbidity. Emerging evidence indicates its risks
exceed those associated with intraoperative hypotension (IOH). Considering
the ubiquitous presence of this pathophysiological disturbance across
surgical settings, our meta-analysis evaluates associations between POH
and major adverse outcomes. Method(s): We systematically searched
PubMed, Web of Science, Cochrane Library, and Embase for clinical studies
investigating POH and adverse outcomes, with literature coverage through 7
February 2025. Mortality during follow-up was designated as the primary
outcome. Secondary outcomes included acute kidney injury (AKI), myocardial
injury, delirium, stroke, and postoperative length of stay (LOS).
Publication bias was assessed using Egger's test and trim-and-fill
analysis; sensitivity analyses employed the leave-one-out method; and
subgroup analysis was performed to explore heterogeneity. Result(s):
This meta-analysis incorporated 23 studies involving 262,435 patients.
Significant associations were identified between POH and adverse outcomes,
including mortality (OR = 2.51, 95 % confidence interval [CI] 1.86-3.38),
AKI (OR = 1.72, 95 % CI 1.25-2.36), myocardial injury (OR = 2.52, 95 % CI
1.71-3.69), and stroke (OR = 1.82, 95 % CI 1.09-3.05). However,
publication bias detected by the trim-and-fill method compromised the
robustness of AKI findings, while the stroke association demonstrated
instability in leave-one-out sensitivity analyses. Subgroup analyses
identified multiple POH thresholds as the primary source of heterogeneity.
 Conclusion(s): These findings establish POH as a clinically
significant correlate of postoperative mortality and myocardial injury.
However, POH associations with AKI and stroke exhibit limited robustness,
requiring further investigation. Future studies must delineate the impact
of POH depth, duration, and measurement method. Copyright © 2025
Elsevier Inc.

<4>
Accession Number
643372179
Title
A systematic review and meta-analysis on outcomes of valvular heart
surgery in Africa.
Source
World journal of surgery. 48(1) (pp 228-239), 2024. Date of Publication:
01 Jan 2024.
Author
Akintoye O.; Musa A.; Gyau-Ampong C.; Usamah B.; Olakanmi D.
Institution
(Akintoye, Musa, Gyau-Ampong, Usamah, Olakanmi) Cardiothoracic Surgery,
Surgery Interest Group of Research, Lagos, Nigeria
Abstract
INTRODUCTION: The prevalence of valvular heart diseases remain
considerably high in Africa, largely but not solely due to rheumatic heart
disease. Valvular heart surgeries have emerged as the cornerstone in their
management. While several studies have reported data on outcomes following
heart valve surgery in many developed countries, there is a staggering
paucity of data and evidence reporting the outcomes in the Africa
population. The aim of this study is to report the perioperative outcomes
following valvular heart surgery in Africa. METHOD(S): The Preferred
Reporting Items for Systematic Reviews and Meta-analysis guideline was
utilized. Electronic searches were performed using PubMed, African journal
online, and Research gate from inception to June 2023. The primary
endpoints were overall mortality and 30-day mortality, and secondary
endpoints included postoperative complications, length of hospital, and
intensive care stays. The outcome data were pooled together and analyzed
with the random effect model for proportions and mean for meta-analysis
using the R software. RESULT(S): This systematic review identified 31
studies that fulfilled the study eligibility criteria and all were
observational studies. The countries in which these studies were carried
out include South Africa, Ethiopia, Egypt, Mali, Rwanda, Nigeria,
Cameroon, Ghana, Senegal, Tanzania, and Kenya. Statistical analysis
reported a pooled overall mortality of 10.48% and a pooled 30-day
mortality of 4.59%. CONCLUSION(S): Several obstacles, such as lack of
financial resources and inadequate infrastructure, continue to impede
valvular heart surgery practice in many parts of Africa. Future studies
need to focus on identifying factors associated with this poor early
mortality. Copyright © 2023 International Society of
Surgery/Societe Internationale de Chirurgie (ISS/SIC).

<5>
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.
 Objective(s): To evaluate the safety of performing DCCV without
systemic anticoagulation in patients with prior LAAO. 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. 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. 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. Copyright © 2025
Elsevier Inc.

<6>
Accession Number
2035900514
Title
The application of machine learning in predicting post-cardiac surgery
acute kidney injury in pediatric patients: a systematic review.
Source
Frontiers in Pediatrics. 13 (no pagination), 2025. Article Number:
1581578. Date of Publication: 2025.
Author
Cheong S.C.; So S.L.; Lal A.; Coveliers-Munzi J.
Institution
(Cheong, So, Lal) School of Medicine and Population Health, University of
Sheffield, Sheffield, United Kingdom
(Coveliers-Munzi) School of Health and Medical Sciences, St. George's,
University of London, London, United Kingdom
Publisher
Frontiers Media SA
Abstract
Introduction: Acute kidney injury (AKI) frequently complicates pediatric
cardiac surgery with high incidence and outcomes. Conventional markers
(KDIGO criteria) often fall short for pediatric patients undergoing
cardiac surgery. Emerging machine learning models offer improved early
detection and risk stratification. This review evaluates ML models'
feasibility, performance, and generalizability in predicting pediatric
AKI. Method(s): This systematic review adheres to PRISMA-DTA
guidelines. Search was conducted on PubMed and Medline (Ovid/Embase) on
March 24, 2024, using PICOTS-based keywords. Titles, abstracts, and full
texts were screened for eligibility. Data on study characteristics and
best-performing ML models' AUROC, sensitivity, and specificity were
extracted. PROBAST evaluated risk of bias and applicability
comprehensively. A narrative synthesis approach was employed to summarize
findings due to heterogeneity in study designs and outcome measures.
 Result(s): Nine unique studies were identified and included, eight
focused on post-cardiac surgery, and one on both PICU admissions and
post-cardiac surgery patients. PROBAST demonstrated high risk of bias and
low applicability amongst the studies, with notably limited external
validation. Conclusion(s): While ML models predicting AKI in
post-cardiac surgery pediatric patients show promising discriminatory
ability with prediction lead times up to two days, outperforming
traditional biomarkers and KDIGO criteria, findings must be interpreted
cautiously. High risk of bias across studies, particularly lack of
external validation, substantially limits evidence strength and clinical
applicability. Variations in study design, patient populations, and
outcome definitions complicate direct comparisons. Robust external
validation through multicenter cohorts using standardized guidelines is
essential before clinical implementation. Current evidence, though
promising, is insufficient for widespread adoption without addressing
these methodological limitations. Systematic Review Registration: PROSPERO
CRD420250604781. Copyright 2025 Cheong, So, Lal and Coveliers-Munzi.

<7>
Accession Number
2032184884
Title
Postoperative bleeding outcome of fresh frozen plasma prime in pediatric
cardiac surgery: A systematic review & meta-analysis.
Source
Perfusion (United Kingdom). 40(6) (pp 1305-1316), 2025. Date of
Publication: 01 Sep 2025.
Author
Kesumarini D.; Widyastuti Y.; Boom C.E.; Laurentius A.; Dinarti L.K.
Institution
(Kesumarini, Boom) Department of Anesthesia and Intensive Care, National
Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(Widyastuti) Department of Anesthesia and Intensive Therapy, University of
Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
(Laurentius) National Cardiovascular Center Harapan Kita, Jakarta,
Indonesia
(Dinarti) Department of Cardiology and Vascular Medicine, University of
Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
Publisher
SAGE Publications Ltd
Abstract
Introduction: Bleeding after cardiac surgeries holds risk of mortality and
morbidity in pediatrics. This systematic review aimed to evaluate
postoperative blood loss and blood transfusion requirements for pediatric
patients undergoing cardiac surgery with fresh frozen plasma (FFP)
priming. Method(s): In 2024, the search reviewed four databases on
randomized trials (RCTs) examining the impact of FFP prime intervention on
24-h postoperative blood loss and transfusion requirements in pediatric
cardiac surgeries. The journals were appraised using Grading of
Recommendation Assessment, Development, and Evaluation checklists, and
random effects models estimated the effect size with a 95% confidence
interval. Significance and study heterogeneity were indicated by p-values
and I2. Result(s): Of the screened 2070 articles, one
high-quality and four moderate-quality RCTs involving 354 children were
identified. No significant reduction in 24-h mean postoperative blood loss
was found following FFP priming (mean difference MD: -0.78, 95% CI [-3.3
to 1.75], p = .55) in general pediatric cardiac surgeries. However,
subgroup analysis showed significant decrease in blood loss for younger
children (<7 months) or those with lower body weight (<6 kg). There was no
significant difference between groups in FFP (MD: -0.19, 95% CI [-0.42 to
0.05], p = .13) or red blood cell transfusion (MD: -0.25, 95% CI [-0.51 to
0.02], p = .07). Conclusion(s): Administering FFP as prime fluid in
cardiac surgery did not reduce postoperative bleeding in general pediatric
patients, but younger children (<7 months) and those with lower weight (<6
kg) were the subjects who benefited from the FFP priming before
surgery. Copyright © The Author(s) 2024

<8>
Accession Number
2035123986
Title
Transcatheter Versus Surgical Approach for the Treatment of Aortic
Stenosis in Patients With Concomitant Coronary Artery Disease: A
Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 106(3) (pp 1661-1673),
2025. Date of Publication: 01 Sep 2025.
Author
Bacha Z.; Javed J.; Khattak F.; Qadri M.; Shoaib M.; Shah I.M.; Khan N.A.;
Ali M.A.; Mattumpuram J.; Tariq M.D.; Fakhar M.; Afridi A.; Kakakhel M.Z.;
Rath S.; Henna F.
Institution
(Bacha, Khattak, Shoaib, Shah, Khan, Ali, Afridi) Khyber Medical College,
Peshawar, Pakistan
(Javed, Qadri) Jinnah Sindh Medical University, Karachi, Pakistan
(Mattumpuram) Department of Medicine, University of Louisville School of
Medicine, Louisville, KY, United States
(Tariq, Fakhar) Department of Medicine, Mary Washington Healthcare,
Fredericksburg, VA, United States
(Kakakhel) Rehman Medical College, Peshawar, Pakistan
(Rath) All India Institute of Medical Sciences, Bhubaneswar, India
(Henna) Dubai Medical College for Girls, Dubai, United Arab Emirates
Publisher
John Wiley and Sons Inc
Abstract
Aortic stenosis (AS) with concomitant coronary artery disease (CAD)
requires an approach that addresses both valvular and coronary pathology.
While surgical aortic valve replacement (SAVR) with coronary artery bypass
graft (CABG) has long been the standard treatment, transcatheter aortic
valve replacement (TAVI) with percutaneous coronary intervention (PCI) has
become a less invasive alternative. This meta-analysis compares the
clinical outcomes of TAVI + PCI versus SAVR + CABG in patients with AS and
concomitant CAD. A systematic review and meta-analysis were conducted
according to PRISMA guidelines. Fourteen studies, including two randomized
controlled trials (RCTs) and 12 observational studies, with a total of
187,189 patients (31,298 in the TAVI + PCI group and 155,891 in the SAVR +
CABG group) were included. Outcomes analyzed included 30-day mortality,
stroke, major adverse cardiovascular and cerebrovascular events (MACCE),
coronary reintervention, atrial fibrillation, major bleeding, vascular
complications, acute kidney injury (AKI), perioperative myocardial
infarction MI), permanent pacemaker implantation (PPI), length of hospital
stay, and long-term survival. Patients undergoing TAVI + PCI were
generally older (ranging from 76.3 +/- 3.7 to 83.6 +/- 3.7 years) and had
higher rates of chronic kidney disease (CKD) compared to the SAVR + CABG
group. Other comorbidities, such as diabetes and hypertension, were
comparable between groups. The EuroSCORE varied widely (3 +/- 2.2 to 36.1
+/- 18.1), reflecting a mix of surgical risk profiles. TAVI + PCI was
associated with a lower 30-day mortality rate (OR: 0.63, 95% CI:
0.37-1.07, p = 0.09), though the result was not statistically significant.
Stroke rates were comparable between the two groups (OR: 0.89, 95% CI:
0.70-1.14, p = 0.36). There was no significant difference in MACCE (OR:
0.96, 95% CI: 0.50-1.84, p = 0.91). However, coronary reintervention was
significantly higher in the TAVI + PCI group (OR: 4.32, 95% CI: 2.58-7.23,
p < 0.00001). TAVI + PCI was associated with an 82% lower risk of atrial
fibrillation (OR: 0.18, 95% CI: 0.11-0.30, p < 0.00001) but a similar risk
of major bleeding (OR: 0.71, 95% CI: 0.38-1.31, p = 0.27). Vascular
complications were significantly higher in the TAVI + PCI group (OR: 3.01,
95% CI: 1.52-5.93, p = 0.002), while perioperative AKI was lower (OR:
0.46, 95% CI: 0.21-0.99, p = 0.05). There was no significant difference in
perioperative MI (OR: 0.78, 95% CI: 0.34-1.78, p = 0.55). However, TAVI +
PCI was associated with a higher likelihood of PPI (OR: 2.14, 95% CI:
1.88-2.43, p < 0.00001). The length of hospital stay was significantly
shorter in the TAVI + PCI group (mean difference: -3.45 days, 95% CI:
-5.79 to -1.12, p = 0.004). Long-term survival favored TAVI + PCI (OR:
0.63, 95% CI: 0.49-0.80, p = 0.0002). TAVI + PCI appears to be a viable
alternative to SAVR + CABG, particularly in elderly or high-risk patients,
with advantages such as lower long-term mortality, reduced atrial
fibrillation, shorter hospital stays, and lower AKI rates. However, it
carries a higher risk of coronary reintervention, vascular complications,
and the need for PPI. These findings highlight the importance of
individualized patient selection to balance risks and
benefits. Copyright © 2025 Wiley Periodicals LLC.

<9>
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Accession Number
2038756851
Title
Is Intravascular Ultrasound-Guided Angiography a Better Choice Than
Angiography Alone for Patients with Acute Coronary Syndrome and Coronary
Artery Disease? Unveiling the Efficacy and Safety of This Modern Imaging
Method: A Systematic Review and Meta-Analysis.
Source
Critical Pathways in Cardiology. 24(3) (pp e0383), 2025. Date of
Publication: 01 Sep 2025.
Author
Harmouch K.M.; Haider M.; Hamza M.; Upreti P.; Bahar Y.; Turkmani M.;
Rrapo T.; Kumar N.; Kumar M.; Safdar W.; Sattar Y.; Zafrullah F.; Mhafouz
A.; Alraies M.C.
Institution
(Harmouch, Kumar) Wayne State University School of Medicine, Detroit
Medical Center, Detroit, MI, United States
(Haider) Department of Cardiology, West Virginia University, Morgantown,
WV, United States
(Hamza) Guthrie Medical Group, Cortland, NY, United States
(Upreti) Sand Constellation Heart Institute, Rochester Regional Health,
Rochester, NY, United States
(Bahar) Wayne State University, Detroit, MI, United States
(Turkmani) Department of Internal Medicine, McLaren Healthcare, Oakland,
MI, United States
(Rrapo) Oakland University, Rochester, MI, United States
(Kumar) John H. Stroger Jr. Hospital of Cook County, Chicago, IL, United
States
(Safdar) Albert Einstein College of Medicine/Montefiore Medical Center
(Wakefield), Bronx, NY, United States
(Sattar) Division of Cardiology, West Virginia University, Morgantown, WV,
United States
(Zafrullah) Division of Cardiology, Western Michigan University,
Kalamazoo, MI, United States
(Mhafouz, Alraies) Cardiovascular Institute, Detroit Medical Center,
Detroit, MI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Coronary angiography has been an established standard for
over 6 decades for percutaneous coronary interventions (PCIs), but its
role is limited to assessing vascular lumen and anterograde flow. In the
1980s, intravascular ultrasonography (IVUS) gained traction in
interventional cardiology for its advantages over angiography. Despite its
precise evaluation of plaque burden and vessel wall structure for
optimizing stent implantation, the literature reports varying outcomes on
the efficacy and safety of IVUS-guided angiography in patients presenting
with acute coronary syndrome or coronary artery disease. To address this
discrepancy, we conducted a comprehensive systematic review and
meta-analysis to assess the efficacy and safety of utilizing IVUS versus
angiography alone for PCI in these groups of patients. Method(s): We
conducted a comprehensive systematic review and meta-analysis to assess
the efficacy and safety of IVUS-guided angiography in these patients.
Electronic databases were searched, and 25 studies were included.
Inclusion criteria are given as follows: (1) patients aged >18 years, (2)
patients with acute coronary syndrome or coronary artery disease
undergoing IVUS-guided PCI or angiography-guided PCI, and (3) randomized
controlled trials. Exclusion criteria comprised observational,
nonrandomized studies, case reports, clinical spotlights, and review
articles. Studied outcomes included all-cause mortality, cardiac death,
myocardial infarction, target lesion revascularization (TLR), need for
coronary artery bypass graft, and stent thrombosis (ST). Result(s):
Compared with angiography alone, IVUS-guided PCI demonstrated a
significant reduction in cardiac death, TLR, and ST regardless of the
follow-up period. No significant difference was observed between the 2
groups concerning all-cause mortality, and myocardial infarction
regardless of the follow-up period, and the need for coronary artery
bypass graft at 1-year follow-up. Conclusion(s): Compared with
angiography-guided PCI, IVUS-guided PCI is associated with a lower
incidence of cardiac death, TLR, and ST. Copyright © 2025 Wolters
Kluwer Health, Inc. All rights reserved.

<10>
Accession Number
2040278628
Title
Completed and ongoing trials in minimally invasive cardiac surgery
coronary surgery.
Source
Current Opinion in Cardiology. (no pagination), 2025. Date of
Publication: 2025.
Author
Boskovski M.T.; Tseng E.E.
Institution
(Boskovski, Tseng) Division of Cardiac Surgery & Lung Transplantation,
University of California San Francisco, San Francisco Va Healthcare
System, San Francisco, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review Minimally invasive cardiac surgery (MICS) coronary
artery bypass grafting (CABG), first established two decades ago, offers
multivessel revascularization via a small left anterior thoracotomy and
without the need for cardiopulmonary bypass, potentially leading to lower
complication rates and faster recovery. However, adoption of MICS CABG has
been slow, in part due to lack of randomized trial data. Here, we review
important retrospective studies, as well as ongoing and completed MICS
CABG trials. Recent findings The majority of studies remain single-center
observational studies demonstrating that MICS CABG yields comparable
perioperative morbidity and mortality to conventional CABG, with excellent
angiographic graft patency, comparable long-term outcomes and faster
recovery times. There are two ongoing randomized controlled trials, the
MIST and MICS-CABG PRPP trials, both comparing quality of life and
recovery in the early postoperative period between patients undergoing
MICS CABG versus sternotomy CABG. Summary The MIST and MICS-CABG PRPP
trials will for the first time provide prospective, randomized data on the
benefits of MICS CABG. However, both trials involve highly experienced
MICS CABG surgeons. As such, the findings will likely not be generalizable
to the general cardiac surgery community and MICS CABG will remain a
boutique operation offered in highly specialized centers. Copyright
© 2025 Lippincott Williams and Wilkins. All rights reserved.

<11>
Accession Number
2040244606
Title
Short- and Long-Term Outcomes After Transcatheter or Surgical Aortic Valve
Replacement in Patients With Chronic Lung Disease: An Analysis From the
German Aortic Valve Registry.
Source
Interdisciplinary Cardiovascular and Thoracic Surgery. 40(8) (no
pagination), 2025. Article Number: ivaf189. Date of Publication: 01 Aug
2025.
Author
Boning A.; Balaban U.; Herrmann E.; Beckmann A.; Bekeredjian R.;
Bleiziffer S.; Ensminger S.; Frerker C.; Mollmann H.; Walther T.; Bauer T.
Institution
(Boning) Department of Cardiovascular Surgery, University Hospital
Giessen, Giessen, Germany
(Balaban, Herrmann) Goethe University Frankfurt, Institute of
Biostatistics and Mathematical Modelling, Frankfurt, Germany
(Balaban, Herrmann) German Center for Cardiovascular Research, DZHK
(Deutsches Zentrum fur Herz-Kreislaufforschung), Partner Site Rhine-Main,
Frankfurt am Main, Germany
(Beckmann) Department for Cardiac Surgery, Heart Center Duisburg,
Duisburg, Germany
(Bekeredjian) Department of Cardiology, Robert-Bosch Hospital Stuttgart,
Stuttgart, Germany
(Bleiziffer) Clinic for Thoracic and Cardiovascular Surgery, Herz-und
Diabeteszentrum Bad Oeynhausen, Bad Oeynhausen, Germany
(Ensminger) Department of Thoracic and Cardiovascular Surgery, University
Hospital Schleswig-Holstein, Lubeck, Germany
(Frerker) Department of Medicine, University Medical Center
Schleswig-Holstein, Lubeck, Germany
(Mollmann) Medizinische Klinik I, St.-Johannes-Hospital Dortmund,
Dortmund, Germany
(Walther) Department of Cardiac Surgery, Goethe University Hospital,
Frankfurt, Germany
(Bauer) Sana Klinikum Offenbach, Department of Cardiology, Offenbach,
Germany
Publisher
Oxford University Press
Abstract
Objectives: Data from the German Aortic Valve Registry (GARY) were
analysed to determine whether there are differences between patients with
and without chronic lung disease (CLD) undergoing transcatheter aortic
valve implantation (TAVI) and surgical aortic valve replacement (SAVR) and
whether TAVI or SAVR is more beneficial in patients with preexisting CLD.
 Method(s): Follow-up data from GARY registry patients treated from
2014 to 2015 and from 2018 to 2019 were incorporated in the analysis.
Demographic results for each of the 2 treatment modalities were evaluated,
and patients with and without CLD were compared. In a second step,
variables that would have influenced the treatment decision in CLD
patients in direction of either SAVR or TAVI were accounted for in the
adjusted analysis. This led to a subgroup of 1385 patients with CLD that
was subjected to propensity score weighted analysis to compare outcomes of
TAVI and SAVR. Result(s): After exclusion, 11 457 SAVR patients and
2378 TAVI patients were analysed. CLD patients were sicker than patients
without CLD, although the observed 30-day mortality was lower than
expected by 3 risk scores. Accordingly, long-term survival in CLD patients
was lower in both treatment groups than in patients without CLD.
Thirty-day mortality was similar in the 2 treatment groups (SAVR 2.3%,
TAVI 3.8%, P 1/4 .964) in spite of a possible selection bias in favour of
SAVR. During a 5-year follow-up, survival after TAVI (44.6%) was
significantly lower than after SAVR (56.7%), P 1/4 .029.
 Conclusion(s): Patients with CLD undergoing SAVR or TAVI are
generally at higher risk for complications or death after the procedure
than patients without CLD. After 5 years, patient-reported outcomes were
similar in TAVI and in SAVR patients. Copyright © 2025 Oxford
University Press. All rights reserved.

<12>
Accession Number
2035912155
Title
Efficacy and safety of hydromorphone caudal block combined with
intercostal nerve block during VATS: a single-center randomized controlled
study.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 433. Date
of Publication: 01 Dec 2025.
Author
Cao X.; Gui Q.; Li P.; Yan H.; Chen Z.; Wei Y.; Zhang S.; Yang W.; Li X.
Institution
(Cao, Gui, Li, Yan, Chen, Wei, Zhang, Yang, Li) Department of
Anesthesiology, Dongguan Tungwah Hospital, Dongguan, China
(Cao, Gui, Li, Yan, Chen, Wei, Zhang, Yang, Li) Dongguan Key Laboratory of
Anesthesia and Enhanced Recovery after surgery, Dongguan, China
Publisher
BioMed Central Ltd
Abstract
Background: The management of post-operative pain while minimizing opioid
use remains challenging in thoracic surgery. While intercostal nerve
blocks are commonly used, the optimal multimodal approach remains unclear.
 Objective(s): To evaluate whether adding hydromorphone caudal
blockade to intercostal nerve blocks improves post-operative recovery
outcomes in thoracic surgery patients. Design(s): A prospective,
double-blinded, randomized controlled trial. Setting(s): Dongguan
Tungwah Hospital. Patient(s): Eighty adult patients scheduled for
video-assisted thoracoscopic surgery (VATS) were enrolled.
 Intervention(s): Patients were randomized to receive either
ultrasound-guided caudal blockade with 1 mg hydromorphone (caudal group)
or normal saline (control group) in addition to standard intercostal nerve
blocks. Main Outcome Measure(s): The primary outcome was the Quality
of Recovery-40 (QoR-40) score at 48 h post-surgery. Secondary outcomes
included pain scores, nausea assessment, opioid consumption, vital signs,
chest tube drainage, pulmonary complications, inflammatory markers, and
length of hospital stay. Result(s): The median [IQR] total QoR-40
score showed a non-significant trend favoring the caudal group (189.50
[169-194.5] vs. 181 [170.25-189.50], P = 0.134). However, significant
improvements were observed in the caudal group for: nausea scores (5 [5-5]
vs. 5 [4-5], P = 0.011), moderate pain (4 [4-5] vs. 4 [3-5], P = 0.014),
and severe pain (5 [5-5] vs. 5 [4-5], P = 0.004). Conclusion(s):
While hydromorphone caudal blockade did not significantly improve overall
recovery scores, it demonstrated specific benefits in pain and nausea
control when combined with intercostal nerve blocks for VATS procedures.
Trial registration: Clinical Trial Registry of China (ChiCTR2400080726 /
02/ 2024). Copyright © The Author(s) 2025.

<13>
Accession Number
2035937041
Title
The impact of heated humidified circuits on arterial oxygenation during
one-lung ventilation in thoracic surgery: a randomized controlled trial.
Source
Journal of Anesthesia. (no pagination), 2025. Date of Publication: 2025.
Author
Park S.-K.; Lee J.; Kim M.H.; Park J.; Kim H.-C.
Institution
(Park, Lee, Kim, Kim) Department of Anesthesiology and Pain Medicine and
Anesthesia and Pain Research Institute, Yonsei University College of
Medicine, Seoul, South Korea
(Park) Department of Anesthesiology and Pain Medicine, Keimyung University
College of Medicine, Seoul, South Korea
Publisher
Springer
Abstract
Purpose: One-lung ventilation (OLV) during thoracic surgery often disturbs
systemic oxygenation. Hypoxic pulmonary vasoconstriction is influenced by
body temperature; however, the effect of heated humidified circuits on
hypoxic pulmonary vasoconstriction and arterial oxygenation during OLV
remains unclear. This study aimed to investigate the impact of heated
humidified circuits on arterial oxygenation during OLV for thoracic
surgery, compared with conventional non-heated circuits. Method(s):
Patients undergoing video-assisted thoracic surgery were randomly assigned
to the heated humidified circuit or conventional breathing circuit group.
During two-lung ventilation, tidal volume was set at 8 ml/kg with a
fraction of inspired oxygen (FiO<inf>2</inf>) of 0.5, and during OLV, it
was adjusted to 6 ml/kg with a FiO<inf>2</inf> of 1.0. Arterial blood gas
measurements were obtained preoperatively, during two-lung ventilation, at
15, 30, 45, and 60 min after initiating OLV. The primary outcome was the
partial pressure of oxygen in the arterial blood (PaO<inf>2</inf>) at 30
min after initiating OLV. Result(s): Ninety-seven patients were
included in the final analysis. The heated humidified circuit group had
significantly higher PaO2 at 30 min after initiating OLV than the control
group (estimated mean [standard error], 211.3 [13.4] vs. 146.2 [13.2]
mmHg; P = 0.004). The mean PaO<inf>2</inf> at 15 and 45 min was
significantly higher in the heated humidified circuit group.
 Conclusion(s): Using heated humidified circuits significantly
improves PaO<inf>2</inf> during OLV in patients undergoing thoracic
surgery compared to conventional circuits. These findings suggest that
heated humidified circuits can be considered as an option when hypoxemia
persists despite other interventions. Copyright © The Author(s)
under exclusive licence to Japanese Society of Anesthesiologists 2025.

<14>
Accession Number
2035899939
Title
Effect of intraoperative Electroencephalogram-guided anesthesia on
postoperative cognitive function in elderly patients: a systematic review,
meta-analysis, and trial sequential analysis of randomized controlled
trials.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 423. Date
of Publication: 01 Dec 2025.
Author
Yin Q.; Chen D.; Gu C.
Institution
(Yin, Chen, Gu) Department of Anesthesiology, Nantong Haimen People's
Hospital, No. 1201 Beijing Road, Haimen District, Jiangsu Province,
Nantong, China
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative cognitive dysfunction (POCD) is a common
complication in elderly surgical patients and has been associated with
excessive anesthetic depth. Electroencephalogram (EEG)-guided anesthesia
provides real-time cerebral monitoring (e.g., bispectral index [BIS]), but
its effect on POCD remains inconclusive across randomized controlled
trials (RCTs). Method(s): We conducted a systematic review and
meta-analysis following PRISMA guidelines, searching PubMed, Embase,
Cochrane Library, and Web of Science for RCTs evaluating EEG-guided
anesthesia versus standard care in elderly surgical patients. Primary
outcome was POCD incidence; secondary outcomes included cognitive scores
across acute (1-7 days), subacute (1-3 months), and chronic (>= 6 weeks)
phases. Risk of bias was assessed using the Cochrane Tool. Pooled odds
ratios (ORs) and standardized mean differences (SMDs) were calculated with
fixed/random-effects models. Trial sequential analysis (TSA) and
sensitivity analyses validated evidence robustness; funnel plots and
Egger's test evaluated publication bias. Result(s): Ten RCTs (4,367
patients) were included. EEG-guided anesthesia significantly reduced POCD
incidence by 22% (pooled OR = 0.78, 95% CI: 0.69-0.90, P < 0.001,
I2 = 0.0%), with TSA confirming conclusive evidence after
reaching the required information size (3,437 patients) and crossing the
efficacy boundary. Subacute follow-ups (1-3 months) showed improved verbal
fluency (WMD = 1.2, P = 0.009) and delayed recall (WMD = 0.8, P = 0.03) in
EEG-guided groups, primarily with BIS monitoring, while acute-phase scores
were heterogeneous and long-term (>= 6 weeks) global cognitive scores did
not differ. Sensitivity analyses and funnel plots indicated no significant
publication bias or result instability. Non-cardiac surgeries demonstrated
consistent benefits, whereas cardiac surgery data were limited.
 Conclusion(s): Intraoperative EEG-guided anesthesia-particularly
using BIS monitoring-reduces POCD incidence and improves subacute
cognitive outcomes in elderly patients, likely by avoiding excessive
anesthetic depth and optimizing hemodynamics. While long-term effects on
global cognition remain unproven, these findings support EEG monitoring as
a valuable adjunct in high-risk populations, particularly for major
non-cardiac surgery. Standardized POCD assessment, personalized
strategies, and long-term follow-ups are needed to refine clinical
guidelines and understand persistent cognitive trajectories. Copyright
© The Author(s) 2025.

<15>
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. Copyright
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC
BY-NC. No commercial re-use. See rights and permissions. Published by BMJ
Group.

<16>
Accession Number
2035918795
Title
The multidisciplinary Heart Team in mitral valve transcatheter
edge-to-edge repair.
Source
Herz. (no pagination), 2025. Date of Publication: 2025.
Author
Mueller C.S.; Hagl C.; Hausleiter J.; Stocker T.J.
Institution
(Mueller, Hagl) Herzchirurgische Klinik und Poliklinik, LMU Klinikum, LMU
Munchen, Marchioninistrase 15, Munich, Germany
(Hausleiter, Stocker) Medizinische Klinik und Poliklinik I, LMU Klinikum,
LMU Munchen, Munich, Germany
(Hagl, Hausleiter, Stocker) German Center for Cardiovascular Research
(DZHK), Partner Site Munich, Heart Alliance, Munich, Germany
Publisher
Springer Medizin
Abstract
Treatment options for mitral regurgitation (MR) have markedly evolved over
the past few decades, with mitral valve transcatheter edge-to-edge repair
(M-TEER) expanding the clinical armamentarium of guideline-directed
medical therapy and surgical techniques. However, the variety of mitral
valve anatomies, the presence of heart failure (HF), and consideration of
the individual patient risk require a multidisciplinary Heart Team
approach to identify the optimal treatment for MR for each patient.
Despite the growing field of transcatheter mitral interventions and the
longstanding availability of surgical mitral valve repair and replacement,
evidence from randomized clinical trials comparing intervention with
surgery remains scarce. In the meantime, the increasing safety and
experience of surgical and interventional procedures have shifted the
perspective on mitral valve disease in terms of when and how to treat it.
Therefore, the multidisciplinary Heart Team discussion has become of
paramount importance in the evaluation and treatment decisions for
patients with mitral valve disease. Copyright © The Author(s),
under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von
Springer Nature 2025.

<17>
Accession Number
2035905329
Title
Effect of radical resection of lung cancer combined with breathing
training on lung cancer patients in thoracic surgery: a meta-analysis.
Source
BMC Pulmonary Medicine. 25(1) (no pagination), 2025. Article Number: 410.
Date of Publication: 01 Dec 2025.
Author
Lu B.; Li X.; Jiang H.
Institution
(Lu, Li, Jiang) Department of Cardiothoracic Surgery, Shaoxing Central
Hospital, Zhejiang Province, Shaoxing, China
Publisher
BioMed Central Ltd
Abstract
Background: Its objective was to use meta-analysis (MA) to methodically
assess the impact of perioperative breathing exercises on the
postoperative rehabilitation of patients with lung cancer (LC) having
radical resection. Method(s): PubMed, and other databases were
searched for randomized controlled trials on radical resection of LC
combined with perioperative respiratory training from January 1995 to
January 2024. After quality assessment, MA was performed using Review
Manager 5.3 software. Result(s): A total of 14 studies involving 880
patients were included, of which 434 patients received perioperative
breathing training (Intervention group, IG). The differences between the
two groups in terms of MIP (MD = -13.31, 95% CI: [-24.43, -2.19]; Z =
2.35, P = 0.02), FVC (MD = -0.23, 95% CI = [-0.36, -0.11]; Z = 3.69, P =
0.0002), 6-minute walk test (6MWT) values (MD = 36.42, 95% CI: [4.37,
68.48]; Z = 2.23, P = 0.03), incidence of pneumonia (OR = 0.38, 95% CI =
0.20-0.72; Z = 2.95, P = 0.003), and complication rates (OR = 0.66, 95% CI
= 0.46-0.94; Z = 2.29, P = 0.02) were statistically significant. However,
there were no significant differences between the two groups in MEP (MD =
-6.10, 95% CI: [-12.10, -0.11]; Z = 2.00, P = 0.05), FEV1 (MD = -0.25, 95%
CI = [-0.58, 0.08]; Z = 1.47, P = 0.14), FEV1/FVC (MD = -3.78, 95% CI =
[-7.65, 0.09]; Z = 1.91, P = 0.06), PEF (MD = -15.02, 95% CI = [-45.88,
15.83]; Z = 0.95, P = 0.34), atelectasis (OR = 0.52, 95% CI = 0.24-1.12; Z
= 1.68, P = 0.09), pneumothorax (OR = 1.20, 95% CI = 0.63-2.29; Z = 0.57,
P = 0.57), and mechanical ventilation incidence (OR = 0.99, 95% CI =
0.34-2.91; Z = 0.01, P = 0.99). Conclusion(s): This MA demonstrates
that perioperative respiratory training significantly improves MIP, FVC,
and 6MWT in patients undergoing radical LC surgery, while effectively
reducing the incidence of postoperative pneumonia and overall
complications. However, its impact on MEP, certain pulmonary function
parameters (FEV1, FEV1/FVC, PEF), and specific complications (atelectasis,
pneumothorax, mechanical ventilation requirement) did not reach
statistical significance. The findings support the inclusion of
respiratory training in perioperative rehabilitation programs for LC
patients to optimize postoperative recovery outcomes. Copyright ©
The Author(s) 2025.

<18>
Accession Number
2035900363
Title
The significance of S100beta and neuron-specific enolase (NSE) in
postoperative cognitive dysfunction following cardiac surgery: a
systematic review and meta-analysis.
Source
European Journal of Medical Research. 30(1) (no pagination), 2025. Article
Number: 811. Date of Publication: 01 Dec 2025.
Author
Hassani Ahangar M.; Aghazadeh-Habashi K.; Rahi A.; Torabian A.; Alavi I.;
Amirian Shayesteh K.; Mozaffari S.M.; Khalaji A.; Rostami Ghezeljeh M.;
Sadat Rafiei S.K.; Mohebbi A.; Salehi S.; Fahami A.; Asadi Anar M.; Eini
P.; Sagharichi M.; Khosravi F.
Institution
(Hassani Ahangar) School of Medicine, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Aghazadeh-Habashi) Student Research Committee, Tabriz University of
Medical Sciences, Tabriz, Iran, Islamic Republic of
(Rahi) Student Research Committee, Isfahan University of Medical Science,
Isfahan, Iran, Islamic Republic of
(Torabian) Medical Faculty, Kazerun Branch, Islamic Azad University,
Kazerun, Iran, Islamic Republic of
(Alavi) Cardiovascular Division, University of Louisville, Kentucky,
United States
(Amirian Shayesteh) Student Research Committee, Faculty of Medicine,
Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran, Islamic
Republic of
(Mozaffari) Department of General Surgery, Loghman Hakim Hospital, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Khalaji) Faculty of Medicine, Tabriz University of Medical Sciences,
Tabriz, Iran, Islamic Republic of
(Rostami Ghezeljeh) School of Medicine, Kerman University of Medical
Sciences, Kerman, Iran, Islamic Republic of
(Sadat Rafiei) Student Research Committee, School of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Mohebbi) Students Research Committee, Ardabil University of Medical
Sciences, Ardabil, Iran, Islamic Republic of
(Salehi) School of Medicine, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Fahami) School of Medicine, Tehran Islamic Azad University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Asadi Anar, Sagharichi, Khosravi) School of Medicine, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Eini) Cardiovascular Research Center, Rajaie Cardiovascular Institute,
Tehran, Iran, Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative cognitive dysfunction (POCD) significantly
affects recovery, hospitalization duration, and quality of life following
cardiac surgery. Identifying reliable biomarkers for predicting POCD could
improve patient outcomes and perioperative care. Among these, S100
calcium-binding protein beta (S100beta) and neuron-specific enolase (NSE)
have emerged as promising indicators of cerebral injury and neurocognitive
dysfunction. Objective(s): This systematic review and meta-analysis
aimed to assess within-subject perioperative changes in S100beta and NSE
levels among patients who developed POCD after cardiac surgery, to
evaluate whether these biomarkers consistently rise in association with
POCD. Method(s): Following PRISMA guidelines, we searched PubMed,
Scopus, and Web of Science up to October 2024. Studies included
peer-reviewed articles evaluating S100beta and NSE levels in relation to
POCD in cardiac surgery patients. Two reviewers independently extracted
data and assessed the quality using the ROBINS-I tool. Meta-analyses were
conducted using a random-effects model. Result(s): Thirty studies
were included. Among patients who developed POCD, both S100beta and NSE
levels were significantly elevated postoperatively compared to
preoperative baselines. The pooled standardized mean difference (SMD) was
1.52 (95% CI 0.57-2.48; I2 = 93.1%) for S100beta and 1.19 (95%
CI 0.42-1.96; I2 = 88.7%) for NSE, indicating large effect
sizes. Sensitivity analyses confirmed the robustness of these findings
despite substantial heterogeneity. Conclusion(s): Among patients who
developed POCD, S100beta and NSE levels significantly increased from
preoperative to postoperative measurements, indicating a potential
association with cerebral injury. However, as non-POCD patients were not
analyzed for the same biomarker changes, causality or specificity to POCD
cannot be confirmed and future research should be directed toward between
group changes. Copyright © The Author(s) 2025.

<19>
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.
 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. 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%). 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. Copyright © 2025 by the
authors.

<20>
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. 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. 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. 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. Copyright © 2025 by
the authors.

<21>
Accession Number
2031924427
Title
Meta-analysis of improved mitral regurgitation after aortic valve
replacement.
Source
Perfusion (United Kingdom). 40(6) (pp 1325-1337), 2025. Date of
Publication: 01 Sep 2025.
Author
Naito N.; Takagi H.
Institution
(Naito, Takagi) Department of Cardiovascular Surgery, Shizuoka Medical
Center, Shizuoka, Japan
Publisher
SAGE Publications Ltd
Abstract
Background: This meta-analysis aimed to compare survival outcomes among
patients experiencing improvement in untreated significant mitral
regurgitation (MR) following surgical aortic valve replacement (SAVR) or
transcatheter aortic valve replacement (TAVR) for severe aortic stenosis,
in contrast to those without improvement. Method(s): We conducted a
comprehensive search through February 2024. Pooled hazard ratios (HR) with
95% confidence intervals (CI) were computed. Kaplan-Meier curves depicting
all-cause mortality were reconstructed using individual patient data
derived from the included studies. Result(s): A systematic review
identified twelve non-randomized studies encompassing 4040 patients. The
pooled all-cause mortality of the meta-analysis demonstrated a significant
reduction in patients whose MR improved compared to those with persistent
MR after aortic valve replacement (AVR) (HR [95% CI] = 0.55 [0.47-0.64], p
< .01). The hazard ratio, derived from reconstructed time-to-event data,
indicated lower all-cause mortality in patients with improved MR after AVR
relative to the other cohort (HR [95% CI] = 0.50 [0.40-0.62], p < .01 in
all patients, 0.48 [0.34-0.68], p < .01 in patients undergoing SAVR, and
0.58 [0.42-0.80], p < .01 in those receiving TAVR). Conclusion(s): In
conclusion, this meta-analysis revealed that improved MR after AVR,
whether surgically or by transcatheter approach, correlates with superior
survival. The benefits of simultaneous or staged intervention on the
mitral valve in individuals undergoing AVR warrant validation in future
investigations. Copyright © The Author(s) 2024

<22>
[Use Link to view the full text]
Accession Number
2037183027
Title
Heart transplantation performance in China: Five-year experience after
transplantation system reform.
Source
Chinese Medical Journal. 138(5) (pp 589-591), 2025. Date of Publication:
05 Mar 2025.
Author
Lin S.; Chen S.; Zheng S.; Liu S.; Huang J.; Shi Y.; Wang H.; Zheng Z.
Institution
(Lin, Zheng, Liu, Zheng) Department of Cardiovascular Surgery, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences, Peking Union Medical College, Beijing, China
(Chen) Department of Information Center, Fuwai Hospital, National Center
for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking
Union Medical College, Beijing, China
(Huang) Department of Heart Failure and Heart Transplant, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences, Peking Union Medical College, Beijing, China
(Shi, Wang) China Organ Transplantation Response System, Guangdong,
Guangzhou, China
(Wang) Clinical Trial Unit, First Affiliated Hospital of Sun Yat-Sen
University, Guangdong, Guangzhou, China
(Zheng) National Clinical Research Center for Cardiovascular Diseases,
Fuwai hospital, Chinese Academy of Medical Sciences, Bejing, China
Publisher
Lippincott Williams and Wilkins

<23>
Accession Number
2040260244
Title
Preoperative Rectus Femoris Muscle Characteristics as Predictors of
Postoperative Walking Ability in Elderly Cardiac Surgery Patients: A
Prospective Observational Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Abe R.; Shiotsuka J.; Aida K.; Tani N.; Ono S.; Kimura N.; Uchino S.;
Sanui M.
Institution
(Abe, Aida, Tani) Department of Rehabilitation, Jichi Medical University,
Saitama Medical Center, Saitama, Japan
(Shiotsuka, Sanui) Department of Anesthesiology and Critical Care
Medicine, Jichi Medical University, Tochigi, Shimotsuke, Japan
(Ono, Uchino) Department of Anesthesiology and Critical Care Medicine,
Jichi Medical University, Saitama Medical Center, Saitama, Japan
(Kimura) Division of Cardiovascular Surgery, Department of Surgery, Jichi
Medical University, Tochigi, Shimotsuke, Japan
Publisher
W.B. Saunders
Abstract
Objective: Postoperative walking ability has been identified as a crucial
prognostic indicator for older patients undergoing major cardiac
surgeries. This study was designed to investigate the predictive value of
preoperative lower extremity muscle mass and muscle echo intensity for
postoperative walking ability in older patients undergoing cardiac
surgeries. Design(s): A prospective observational study.
 Setting(s): A single-center study conducted at a university hospital.
 Participant(s): A total of 109 elective cardiac surgery patients, 65
years of age or older, were prospectively enrolled. Intervention(s):
Preoperative muscle mass and quality of the rectus femoris were assessed
using muscle cross-sectional area and echo intensity on ultrasound images,
respectively. Measurements and Main Results: The primary outcome of
interest was the walking distance achieved in a 6-minute walk test after
cardiac surgery. Multiple regression analysis was performed to identify
factors independently associated with 6-minute walk distance after
surgery. Higher muscle cross-sectional area and lower echo intensity of
the rectus femoris, measured by ultrasonography, were associated with a
significantly longer 6-minute walk distance upon discharge. Higher muscle
mass and lower echo intensity were also significantly associated with
shorter hospital length of stay. Conclusion(s): The preoperative
measurement of cross-sectional area and echo intensity of the quadriceps
muscles can be used as a predictor of postoperative 6-minute walk distance
in elderly patients undergoing cardiac surgery. Copyright © 2025
Elsevier Inc.

<24>
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. Copyright ©
2025 Tessari, Lucertini, Addonizio, Geatti, Bacich, Pradegan, Fabozzo,
Bianco, Toscano, Tarzia and Gerosa.

<25>
Accession Number
2032490562
Title
Hemoadsorption during cardiopulmonary bypass to absorb plasma-free
hemoglobin in patients with acute type a aortic dissection: A randomized
controlled trial.
Source
Perfusion (United Kingdom). 40(6) (pp 1477-1486), 2025. Date of
Publication: 01 Sep 2025.
Author
Bao Y.; Wang X.; Zi Y.; Qian X.; Li Y.; Li S.; Wang Z.
Institution
(Bao, Wang, Zi, Qian, Li, Li, Wang) Department of Cardiovascular Surgery,
Yan'an Affiliated Hospital of Kunming Medical University, Kunming, China
(Bao, Wang, Zi, Qian, Li, Li, Wang) Key Laboratory of Cardiovascular
Disease of Yunnan Province, China
Publisher
SAGE Publications Ltd
Abstract
Aims: This study aimed to investigate the effect of hemoadsorption (HA) on
plasma-free hemoglobin (pfHb) levels during cardiopulmonary bypass (CPB)
and the clinical outcomes in patients with acute type A aortic dissection
(ATAAD). Method(s): In this single-center randomized trial, patients
were assigned to either a group using the HA380 device or a control group
without it. The primary outcome was changes in pfHb levels during CPB and
within the first 48 hours after surgery. The study concentrated on
comparing compared the data between the two groups using analysis of
variance for repeated measures. Concurrently, both correlation and linear
regression analyses were employed to identify the factors influencing pfHb
levels. Result(s): The mean pfHb concentration was lower in the HA380
group than in the control group,but there were no significant differences
between the two groups (F = 2.883, 95% confidence interval CI: -0.006 to
0.072, p = .093) using a repeated measures analysis of covariance model.
Linear regression analysis identified body mass index (BMI) as the primary
factor influencing the adsorption effect (B = 0.01, 95% CI: 0.36-1.24, p =
.001). Additionally, the major postoperative complications within the
first 48 hours did not show significant differences between the groups,
including acute kidney injury (AKI) (25% HA380 group vs 36% control group,
p = .261) and postoperative liver dysfunction (PLD) (5% HA380 group vs 16%
control group, p = .106). Conclusion(s): The use of the HA380 device
in CPB during cardiac operations may contribute to reduced pfHb levels.
However, the difference was statistically non-significant because pfHb
adsorption was notably influenced by the patient's BMI. Consequently, BMI
should be considered when deploying HA380 in prolonged CPB procedures,
including ATADD repair. Enhancing either the number of devices or the
duration of HA in patients with overweight or obesity may potentially
improve postoperative clinical outcomes. Copyright © The
Author(s) 2024

<26>
Accession Number
2035931007
Title
Advances in the Application of Three-Dimensional Reconstruction in
Thoracic Surgery: A Comprehensive Review.
Source
Thoracic Cancer. 16(17) (no pagination), 2025. Article Number: e70159.
Date of Publication: 01 Sep 2025.
Author
Lin G.; Li R.; Li X.; Wang D.; Chen X.
Institution
(Lin, Li, Li, Chen) Department of Thoracic Surgery, Peking University
People's Hospital, Beijing, China
(Lin, Li, Li, Chen) Thoracic Oncology Institute, Peking University
People's Hospital, Beijing, China
(Lin, Li, Li, Chen) Research Unit of Intelligence Diagnosis and Treatment
in Early Non-Small Cell Lung Cancer, Chinese Academy of Medical Sciences,
Peking University People's Hospital, Beijing, China
(Lin, Li, Li, Chen) Institute of Advanced Clinical Medicine, Peking
University, Beijing, China
(Lin, Li, Li, Chen) Beijing Key Laboratory of Innovative Application of
Big Data in Lung Cancer, Peking University People's Hospital, Beijing,
China
(Wang) Institute of Advanced Research, Infervision Medical Technology Co.
Ltd, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
This review presents a comprehensive overview of recent advancements and
clinical applications of three-dimensional (3D) reconstruction technology
in thoracic surgery, with a focus on lung cancer surgery. The widespread
adoption of chest computed tomography (CT) screening has increased the
detection rates of early-stage lung cancers, facilitating a transition
from traditional lobectomy to parenchymal-sparing sublobar resections,
such as segmentectomy, which demand higher anatomical precision. 3D
reconstruction technology significantly improves tumor localization, as
well as vascular and bronchial visualization, thereby enhancing surgical
accuracy and safety. Its key applications encompass preoperative planning,
intraoperative navigation, real-time localization, vascular and airway
visualization, and postoperative pulmonary function assessment,
collectively contributing to improved surgical outcomes and patient
prognosis. Recent innovations in artificial intelligence have streamlined
and automated the reconstruction process, leading to reduced operative
times and increased accuracy. However, challenges persist, including image
quality limitations, algorithm robustness, and limited high-quality
clinical evidence. Future integration with emerging technologies such as
virtual reality and augmented reality holds promise for achieving
personalized, intelligent thoracic surgical procedures. This review aims
to systematically evaluate the clinical value of 3D reconstruction
technology and explore its future development directions. Copyright
© 2025 The Author(s). Thoracic Cancer published by John Wiley & Sons
Australia, Ltd.

<27>
[Use Link to view the full text]
Accession Number
2038971724
Title
Evaluation of Bioprosthetic Valve Dysfunction in the SMART Randomized
Clinical Trial.
Source
Circulation: Cardiovascular Interventions. 18(8) (pp e015202), 2025. Date
of Publication: 01 Aug 2025.
Author
Herrmann H.C.; Blackman D.J.; Attizzani G.F.; Abdel-Wahab M.; Batchelor
W.B.; Gillam L.D.; Rogers T.; Oh J.K.; Althouse A.D.; Mehran R.; Tchetche
D.
Institution
(Herrmann) Perelman School of Medicine, University of Pennsylvania,
Philadelphia, United States
(Blackman) Leeds Teaching Hospitals, United Kingdom
(Attizzani) Harrington Heart and Vascular Institute, University Hospitals
Cleveland Medical Center, OH, United States
(Abdel-Wahab) Heart Center Leipzig, University of Leipzig, Germany
(Batchelor) Inova Schar Heart and Vascular, Falls Church, VA, United
States
(Gillam) Morristown Medical Center/Atlantic Health System, NJ, United
States
(Rogers) MedStar Washington Hospital Center, DC, United States
(Oh) Echocardiography Core Laboratory, Mayo Clinic, Rochester, MN, United
States
(Althouse) Medtronic, Minneapolis, MN, United States
(Mehran) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Tchetche) Clinique Pasteur, Toulouse, France
Publisher
Lippincott Williams and Wilkins

<28>
Accession Number
2035472642
Title
Clinical effectiveness and safety of preoperative oral carbohydrate
loading in patients with diabetes: A systematic review.
Source
Diabetes and Metabolic Syndrome: Clinical Research and Reviews. 18(10) (no
pagination), 2024. Article Number: 103140. Date of Publication: 01 Oct
2024.
Author
Zhao C.; Shi J.; Zhu N.; Yang P.; Xiang B.; Dai Y.; Wang S.
Institution
(Zhao) Department of Critical Care Medicine, The Third People's Hospital
of Chengdu, The Affiliated Hospital of Southwest Jiao Tong University,
China
(Shi, Zhu, Yang, Dai, Wang) Department of Anesthesiology, Clinical Medical
College and the First Affiliated Hospital of Chengdu Medical College,
Sichuan, Chengdu, China
(Xiang) Department of Anesthesiology, West China Hospital, Sichuan
University, Chengdu, China
Publisher
Elsevier Ltd
Abstract
Background: The effectiveness and safety of preoperative oral carbohydrate
(POC) for people with diabetes remain controversial. Method(s): We
systematically reviewed studies comparing POC to fasting or placebo in
elective surgery for diabetic adults, focusing on gastric volume,
postoperative complications, hospital stay, and glycemic control.
 Result(s): Fourteen studies (n = 1870 patients) were included. POC
did not significantly increase gastric volume or aspiration risk in
well-controlled type 2 diabetes. Effects on perioperative glucose control
varied. POC improved patient comfort and reduced preoperative hypoglycemia
in gestational diabetes. Limited evidence suggested potential benefits in
cardiac surgery patients. Conclusion(s): POC is safe for
well-controlled type 2 diabetics, enhancing comfort and reducing
preoperative hypoglycemia without increasing aspiration risk. However, its
effects on glucose control and postoperative outcomes vary. Personalized
approaches are crucial, particularly for poorly controlled
diabetes. Copyright © 2024 Research Trust of DiabetesIndia
(DiabetesIndia) and National Diabetes Obesity and Cholesterol Foundation
(N-DOC)

<29>
Accession Number
2034135052
Title
Mitral Valve Transcatheter Edge-to-Edge Repair With PASCAL Vs MitraClip: A
Systematic Review and Meta-analysis.
Source
Journal of Invasive Cardiology. 35(11) (no pagination), 2023. Date of
Publication: 01 Nov 2023.
Author
Oliveri F.; Amri I.A.; Cabezas J.M.; Bingen B.; Van Der Kley F.; Arslan
F.; Scherptong R.; Mazzarotto P.; Bollati M.; Pepe A.; Tua L.; Bongiorno
A.; Fasolino A.; Gentile F.R.; Colombo D.; Ghio S.; Ferlini M.; Munafo A.
Institution
(Oliveri, Pepe, Tua, Bongiorno, Fasolino, Gentile, Colombo, Munafo)
Department of Molecular Medicine, Division of Cardiology, University of
Pavia, Pavia, Italy
(Oliveri, Amri, Cabezas, Bingen, Van Der Kley, Arslan, Scherptong)
Department of Cardiology, Leiden University Medical Center, Leiden,
Netherlands
(Mazzarotto, Bollati) Cardiology Unit, Ospedale Maggiore, Lodi, Italy
(Tua) Interventional Cardiology, Policlinico San Donato, Milan, Italy
(Ghio, Ferlini) Division of Cardiology, Fondazione IRCCS Policlinico San
Matteo, Pavia, Italy
Publisher
Cliggott Publishing Co.
Abstract
Background. Transcatheter edge-to-edge repair (TEER) using the MitraClip
(Abbott Vascular) system has emerged as a standard treatment for patients
with symptomatic severe secondary or inoperable primary mitral
regurgitation (MR). The relatively recent approval of the PASCAL
Transcatheter Valve Repair System (Edwards Lifesciences) has expanded the
options of TEER devices. However, evidence comparing PASCAL with MitraClip
systems is still limited. Methods. We conducted a systematic literature
research and meta-analysis in PubMed, Medline, and EMBASE databases for
studies comparing PASCAL and MitraClip systems. Results. Four
observational studies and 1 randomized controlled trial, involving 1315
patients total, were eligible for inclusion. All patients exhibited
symptomatic (NYHA II-IV) MR grades 3+ or 4+. Baseline characteristics were
comparable across all included studies. The clinical outcomes were
assessed according to the Mitral Valve Academic Research Consortium
consensus. The procedural success rates for the 2 devices were comparable
in terms of achieving post-procedural MR grades of less than or equal to
2+ and less than or equal to 1+. Furthermore, most patients improved their
clinical status, with no significant differences between patients treated
with PASCAL and those treated with MitraClip. In terms of safety, both
procedures exhibited low overall mortality rates and occurrence of major
adverse events (MAE), without significant difference between the 2
devices. These findings remained consistent in both short- and long-term
follow-up assessments. Conclusions. Our study revealed similar
effectiveness and safety profiles between the PASCAL and MitraClip devices
in patients experiencing significant symptomatic MR. Copyright ©
2023 Cliggott Publishing Co.. All rights reserved.

<30>
Accession Number
2028602421
Title
Fractional Flow Reserve and Angiography Guided Complete Revascularization
in Primary Percutaneous Coronary Intervention: A Systematic Review and
Network Meta-Analysis.
Source
Angiology. 76(8) (pp 720-733), 2025. Date of Publication: 01 Sep 2025.
Author
Hyasat K.; Hasche E.; Almafragy H.; Chiha J.; Asrress K.; Liou K.
Institution
(Hyasat, Hasche, Almafragy, Chiha, Asrress, Liou) Department of
Cardiology, Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia
(Hyasat, Asrress) Department of Cardiology, Liverpool Hospital, Liverpool,
NSW, Australia
(Hyasat, Asrress, Liou) University of New South Wales, Sydney, NSW,
Australia
Publisher
SAGE Publications Inc.
Abstract
Using a network meta-analysis, this study compared fractional flow reserve
(FFR) guided with angiography-guided revascularization of non-culprit
lesions in ST elevation myocardial infarction (STEMI). We also assessed if
early complete revascularization is superior to delayed revascularization.
We conducted a network meta-analysis using Net Meta XL of trials of STEMI
patients with multivessel disease and compared revascularization
strategies. The primary outcomes of interest were rate of
revascularization, myocardial infarction, and all-cause mortality. Ten
studies were included in our analysis comprising 7981 patients with 4484
patients undergoing complete revascularization and 3497 patients with
culprit-only revascularization. There was no significant reduction in
all-cause death, myocardial infarction, or revascularization using FFR
guidance. There was significant reduction in repeat revascularization with
complete revascularization irrespective of timing of percutaneous coronary
intervention (PCI) compared with the culprit-only group. There was an
overall trend favoring earlier revascularization. For patients with
multivessel disease presenting with ST-elevation MI, complete
revascularization significantly reduces repeat revascularization compared
with culprit-only treatment. FFR guidance is non-superior to
angiography-guided revascularization. Furthermore, there was significant
reduction in repeat revascularization irrespective of timing of PCI to
non-culprit vessels. Copyright © The Author(s) 2024

<31>
Accession Number
2035821559
Title
Cardiac Contractility Modulation Therapy in a Transplant Candidate Patient
with Advanced Heart Failure to Improve Cardiac Function and Restore Sinus
Rhythm.
Source
Hearts. 6(1) (no pagination), 2025. Article Number: 1. Date of
Publication: 01 Mar 2025.
Author
Rodio G.; Ludovico M.; Angelini A.; Alfeo M.; Andrenucci D.; Pugliese G.;
Luvera W.; Luzzi G.
Institution
(Rodio, Alfeo, Andrenucci) Electrophysiology Unit, Cardiology Department,
Ospedale SS Annunziata, Taranto, Italy
(Ludovico, Angelini) Echocardiography Unit, Cardiology Department,
Ospedale SS Annunziata, Taranto, Italy
(Pugliese) New Medical Solution Srl, Potenza, Italy
(Luvera) Impulse Dynamics GmbH, Frankfurt am Main, Germany
(Luzzi) Coronary and Cardiac Intensive Care Unit, Cardiology Department,
Ospedale SS Annunziata, Taranto, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Cardiac Contractility Modulation (CCM) is an electrical therapy based on
an implantable device. This device is approved for patients with heart
failure with reduced ejection fraction (HFrEF). Randomized clinical trials
and thousands of described cases and studies have shown how CCM can
improve exercise tolerance, quality of life, re-hospitalization for HF,
and cardiac function by reverse left ventricular modelling. In this case
report, we describe a patient candidate for a cardiac transplant based on
dilated cardiomyopathy with severe LV dysfunction and narrow QRS. The
patient had frequent heart failure-related hospitalizations, despite the
optimal medical therapy. The strategy was to adopt the Cardiac
Contractility Modulation (CCM) therapy while waiting for a cardiac
transplant. During a consultation on all prospective therapy options, the
patient refused the LVAD therapy, and was more confident in adopting a
less invasive device therapy like CCM. This strategy had a very fast and
beneficial impact on the patient's health; the CCM improved heart failure
symptoms, hemodynamics flow and cardiac functionality. Moreover, after a
relatively short time, the patient went from persistent AF to Sinus
Rhythm, although he started with a severe bi-atrial dilatation. These
parameters were stable during an extended follow-up of 18
months. Copyright © 2025 by the authors.

<32>
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. Copyright © Author(s) (or their employer(s) 2025.

<33>
Accession Number
2029409422
Title
Mortality Rates in Patients Undergoing Urgent Versus Elective
Transcatheter Aortic Valve Replacement: A Meta-analysis.
Source
Angiology. 76(8) (pp 784-795), 2025. Date of Publication: 01 Sep 2025.
Author
Apostolos A.; Ktenopoulos N.; Chlorogiannis D.-D.; Katsaros O.;
Konstantinou K.; Drakopoulou M.; Tsalamandris S.; Karanasos A.; Synetos
A.; Latsios G.; Aggeli C.; Panoulas V.; Tsioufis C.; Toutouzas K.
Institution
(Apostolos, Ktenopoulos, Katsaros, Drakopoulou, Tsalamandris, Karanasos,
Synetos, Latsios, Aggeli, Tsioufis, Toutouzas) First, Department of
Cardiology, Medical School, Hippokration General Hospital, National and
Kapodistrian University of Athens, Athens, Greece
(Chlorogiannis) Department of Radiology, Brigham and Women's Hospital,
Boston, MA, United States
(Konstantinou, Panoulas) Department of Cardiology, Royal Brompton and
Harefield Hospitals, Guy's, St Thomas' NHS Foundation Trust, London,
United Kingdom
Publisher
SAGE Publications Inc.
Abstract
Patients with severe aortic stenosis (AoS) often present with acute heart
failure and compensation, frequently leading to cardiogenic shock.
Transcatheter Aortic Valve Replacement (TAVR) has been recently performed
as a bailout treatment in such patients. The aim of our meta-analysis is
to compare urgent TAVR with elective procedures. We systematically
screened three databases searching for studies comparing urgent vs
elective TAVR. Primary endpoint is the 30-days mortality. Secondary
endpoints included in-hospital mortality, device success, periprocedural
vascular complications, 30-days stroke, 30-days acute kidney injury (AKI),
permanent pacemaker implantation (PPM), moderate or severe paravalvular
leakage, and 30-days bleeding. Seventeen studies were included, with a
total of 84,495 patients. Urgent TAVR was associated with an increased
risk for 30-days mortality [Risk Ratio (RR): 2.53, 95% Confidence
Intervals (CI): 1.81-3.54)], in-hospital mortality (RR: 2.67, 95% CI:
1.94-3.68), periprocedural vascular complications (RR: 1.91, 95% CI:
1.28-2.85) and AKI (RR: 2.83, 95% CI: 1.93-4.14), compared with elective
procedure. No differences were observed in the other secondary endpoints.
Urgent TAVR was associated with higher in-hospital and 30-days mortality,
possibly driven by the increased incidence of AKI and vascular
complications in urgent TAVR. The results highlight the importance of
early TAVR in stable AoS patients. Copyright © The Author(s) 2024

<34>
[Use Link to view the full text]
Accession Number
2040107620
Title
Dual antiplatelet therapy in GI-bleed patients with extensive coronary
artery disease history: a systematic review.
Source
Annals of Medicine and Surgery. 87(6) (pp 3715-3735), 2025. Date of
Publication: 01 Jun 2025.
Author
Abdulrahim A.O.; Abd-Alhadi M.J.Y.; Mahmoud H.A.H.; Sarwar A.; Akram A.;
Alvarado W.J.; Sadik O.; Kesireddy S.R.; Mumtaz H.
Institution
(Abdulrahim) Gastroenterology Specialist. Fellowship NPMCN, King Fahd
Specialist Hospital Buraydah, Al Qassim province, Saudi Arabia
(Abd-Alhadi) AbdulHadi Hospital, Amman, Jordan
(Mahmoud) Diagnostic Radiology Fellowship Heliopolis Hospital, Cairo,
Egypt
(Sarwar) Dr. V.R.K. Women's Medical College, Hyderabad, India
(Akram) Jinnah Sindh Medical University, Karachi, Pakistan
(Alvarado) Universidad Nacional Autonoma de Honduras, Tegucigalpa,
Honduras
(Sadik) Richmond Gabriel University, St. Vincent and the Grenadines, Saint
Vincent and the Grenadines
(Mumtaz) SVS Medical College, Mahabubnagar, India
(Kesireddy) BPP University, London, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Extensive coronary artery disease whether at initial
presentation or after percutaneous coronary intervention (PCI), involves
the use of dual antiplatelet therapy (DAPT) as a very significant
therapeutic option. There are many reasons why clinicians should weigh the
risks of bleeding and cardiovascular thrombosis when deciding whether to
maintain or discontinue DAPT in such patients. Method(s): This
comprehensive review systematically analyzed via electronic databases, a
total of 39 papers most of which were on countries in Southeast Asia. The
focus was on randomized control designs (RCTs) and observational studies.
Results and discussion: PCI with drug eluting stents was the most common
method of treating acute coronary syndrome. The study found more
independent predictors of gastrointestinal (GI) bleeding in young and
elderly patients from Southeast Asia. The precise DAPT score was more
readily used among various bleeding risk prediction models for patients on
antiplatelet therapy. Conclusion(s): The use of DAPT in the setting
of the GI bleeding risk in patients with coronary artery disease has been
studied extensively, but there are still no clearly defined strategies and
very definite answers to the risk of bleeding versus cardiac event
envisaged during the management of an extensive acute coronary disease
mostly in southeast Asia. More studies using good study designs and
statistics and establishing clinical prediction rules, are needed to fill
this knowledge gap most especially in Southeast Asia and Middle
East. Copyright © 2025 The Author(s)

<35>
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. 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.
 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.
 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). 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. Copyright © 2025 by
the authors.

<36>
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. Copyright © The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2025.

<37>
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. 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. 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. 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. Copyright ©
2025 The Author(s). Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<38>
Accession Number
2035237876
Title
Management of analgesia in cardiac surgery.
Source
Pain Management. 15(9) (pp 595-609), 2025. Date of Publication: 2025.
Author
Strumia A.; Lusini M.; Costa F.; Stefani E.; Cipollone E.; Cusimano L.;
Libri F.; Ricci M.; Ruggiero A.; Sarubbi D.; Mattei A.; Schiavoni L.;
Barbato R.; Mastroianni C.; Jawabra M.; Agro F.E.; Chello M.; Cataldo R.;
Carassiti M.; Pascarella G.
Institution
(Strumia, Costa, Sarubbi, Mattei, Schiavoni, Agro, Cataldo, Carassiti,
Pascarella) Operative Research Unit of Anesthesia and Intensive Care,
Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
(Lusini, Jawabra, Chello) Research Unit of Cardiac Surgery, Department of
Cardiovascular Surgery, University Campus Bio-Medico di Roma, Roma, Italy
(Lusini, Barbato, Mastroianni, Chello) Operative Research Unit of Cardiac
Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Roma,
Italy
(Stefani, Cipollone, Cusimano, Libri, Ricci, Ruggiero, Agro, Cataldo,
Carassiti) Research Unit of Anaesthesia and Intensive Care, Department of
Medicine, University Campus Bio-Medico di Roma, Roma, Italy
Publisher
Taylor and Francis Ltd.
Abstract
Background: Pain management in cardiac surgery remains a critical
component of perioperative care, influencing recovery, patient
satisfaction, and outcomes. Traditional opioid-based analgesia is
associated with significant adverse effects, prompting the exploration of
multimodal strategies, including regional anesthesia (RA), non-opioid
analgesics, and enhanced recovery after surgery (ERAS) protocols. This
review evaluates the evolution of cardiac surgery pain management, from
conventional opioid-based regimens to multimodal approaches with regional
anesthesia. Method(s): A comprehensive analysis of existing
literature was conducted, assessing the efficacy, safety, and integration
of different pain management strategies in cardiac surgery on PubMed,
Google Scholar, MEDLINE, UpToDate, Embase and Web of Science until 1
November 2024. Studies on opioids, adjunct analgesics (e.g. NSAIDs,
acetaminophen, ketamine, dexmedetomidine), RA techniques, and ERAS
frameworks were reviewed to provide a comparative perspective.
 Result(s): Multimodal analgesia significantly reduces opioid
consumption, enhances pain control, and minimizes complications such as
respiratory depression and postoperative nausea. RA techniques, including
fascial plane blocks, offer promising opioid-sparing benefits. ERAS
protocols further optimize recovery, yet challenges remain in
standardizing approaches across institutions. Conclusion(s): The
future of cardiac surgery pain management lies in individualized,
multimodal strategies following ERAS principles. Standardized guidelines
and further research are needed to refine these protocols for widespread
adoption. Copyright © 2025 Informa UK Limited, trading as Taylor
& Francis Group.

<39>
Accession Number
2039883759
Title
COMPARISON OF POSTOPERATIVE INFLAMMATION, OXIDATIVE STRESS, PAIN AND
COGNITIVE IMPAIRMENT IN PROPOFOL AND SEVOFLURANE: A RANDOMIZED CLINICAL
TRIAL.
Source
Bulletin of Pharmaceutical Sciences. Assiut. 48(1) (pp 421-442), 2025.
Date of Publication: 01 Jun 2025.
Author
Elwan H.H.; Kassem A.B.; Shaat A.M.; Salahuddin A.; Werida R.H.
Institution
(Elwan) Department of Clinical Pharmacy, Damanhour Teaching Hospital,
General Organization for Teaching Hospitals and Institutes, Damanhour,
Egypt
(Kassem, Werida) Department of Clinical Pharmacy and Pharmacy Practice,
Faculty of Pharmacy, Damanhour University, Damanhour, Egypt
(Shaat) Department of Anesthesia, Intensive Care, and Pain Management,
Damanhour Teaching Hospital, General Organization for Teaching Hospitals
and Institutes, Damanhour, Egypt
(Salahuddin) Department of Biochemistry, Faculty of Pharmacy, Damanhour
University, Damanhour, Egypt
(Salahuddin) Department of Biochemistry, College of Pharmacy, Al-Ayen
University, Thi Qar, Iraq
Publisher
Assiut University
Abstract
Background: The choice of anesthetics is critical to guard brain
functions, reduce complications associated with surgical operations, and
provide superior-standard care and better patients' quality of life.
 Objective(s): To compare postoperative inflammatory response,
oxidative stress, cognitive dysfunction and pain index in patients
undergoing elective, non-cardiac, abdominal surgery using propofol or
sevoflurane anesthesia. Method(s): A prospective, parallel,
randomized, double-blinded clinical trial was conducted from December 2021
to April 2023 on 44 patients undergoing elective abdominal surgeries and
anesthetized with either infusion of propofol or inhalational sevoflurane
at Damanhour Teaching Hospital, El-Beheira, Egypt., Blood samples were
drawn from the patients before surgery, 1 and 24 hours after surgery.
Inflammatory response was measured by using matrix metalloproteinase-9
(MMP-9), oxidative stress by utilizing superoxide dismutase (SOD),
cognitive dysfunction by using S100 calcium-binding protein beta
(S100-beta), neuron-specific enolase (NSE) levels and Montreal Cognitive
Assessment score (MoCA-B), pain by applying the numerical pain rating
scale (NPRS). Result(s): Propofol group showed significantly higher
SOD enzyme activities and lower MMP-9 levels 1hour, and 24 hours
postoperatively compared to sevoflurane group, (P=0.03, 0.04)
respectively. Time to emerge from anesthesia and NPRS scores were
significantly lower in propofol compared to sevoflurane group, (P<0.001).
Postoperative nausea and vomiting were significantly lower in propofol
group compared to sevoflurane group. Conclusion(s): Propofol infusion
lowered postoperative pain scores, inflammatory response, and oxidative
stress, shortened the time to emerge from anesthesia, and decreased
incidence rates of vomiting and nausea in patients scheduled for elective,
abdominal operations under the effect of general anesthetics Copyright
© 2005 Bulletin of Pharmaceutical Sciences Assiut University. All
Rights Reserved.

<40>
Accession Number
2034789568
Title
Effect of Initial Opening Morphology of Polymeric Valves on Hemodynamic
Performance.
Source
Cardiovascular Engineering and Technology. 16(4) (pp 481-492), 2025. Date
of Publication: 01 Aug 2025.
Author
Liu S.; Zheng X.; Cao Y.; Wang W.; Wei L.; Wang S.
Institution
(Liu, Zheng, Wang) Institute of Biomechanics, Department of Aeronautics
and Astronautics, Fudan University, Shanghai, China
(Cao, Wang) Institute of Biomedical Engineering and Technology, Academy of
Engineering and Technology, Fudan University, Shanghai, China
(Wang, Wei) Department of Cardiovascular Surgery, Zhongshan Hospital,
Fudan University, Shanghai, China
(Wang) Zhuhai Fudan Innovation Institute, Shanghai, China
Publisher
Springer
Abstract
Purpose: In order to explore the correlation between the initial
morphology of the valve and hemodynamic and valve dynamic performance,
this study is based on the fact that polymeric prostheses are more
convenient to manufacture, and have the possibility of preparing complex
geometric shapes and directly obtaining the initial morphologies of
different valves, aims to research the effect of different initial opening
morphologies of polymeric valves on hemodynamic performance.
 Method(s): Valve models with different opening shapes were
established. Polyurethane materials were used to manufacture the valve
samples by dip-coating molding. The stress distribution of three different
initial opening shapes was compared by finite element simulation. The
hemodynamics and the leaflets dynamic performance of the three polymeric
valves were analyzed by in vitro pulsatile flow experiments and particle
image velocity measurement experiments. Result(s): The valve
morphology at 0.025s, 0.053s, and 0.079s was selected as the initial shape
and was recorded as PHV1, PHV2, and PHV3. Finite element analysis found
that during the systolic phase, the stress concentration area of PHV1 was
the highest among the three types of valves, while during the diastolic
phase, the stress concentration area of PHV1 was the lowest. Similarly,
the maximum principal strain of PHV1, PHV2, and PHV3 decreased in turn at
the time of peak systole but increased in turn at the time of peak
diastole. In vitro testing results showed that valves with smaller opening
areas had smaller regurgitant volume, while valves with larger opening
areas had larger EOA, as well as smaller vorticity and viscous shear
stress. Conclusion(s): Valves with a smaller initial opening area
have a better effect in preventing regurgitation, whereas valve with a
larger initial opening area has a larger opening area and a lower risk of
thrombosis. Therefore, comprehensive considerations are needed when
designing the initial morphology of the polymeric artificial heart
valve. Copyright © The Author(s) under exclusive licence to
Biomedical Engineering Society 2025.

<41>
Accession Number
643875479
Title
Cabrol procedure and its modifications: a systematic review and
meta-analysis.
Source
Journal of cardiothoracic surgery. 19(1) (pp 153), 2024. Date of
Publication: 26 Mar 2024.
Author
Yang S.; Zhang Y.-Y.; Zi Y.-F.; Pu L.; Qian X.; Ren L.; Li Y.-B.; Jin
Z.-H.; Liu J.-F.; Yuan Z.; Li Y.-X.
Institution
(Yang, Zhang, Zi, Pu, Qian, Ren, Li, Jin, Liu, Yuan) Department of
Cardiovascular Surgery, Yan'an Affiliated Hospital of Kunming Medical
University, Kunming, Yunnan, China
(Zhang, Zi, Pu, Qian, Ren, Li, Liu) Key Laboratory of Cardiovascular
Disease of Yunnan Province, Yan'an Affiliated Hospital of Kunming Medical
University, Kunming, Yunnan, China
(Li) Department of Cardiovascular Surgery, Yan'an Affiliated Hospital of
Kunming Medical University, Kunming, Yunnan, China
(Li) Key Laboratory of Cardiovascular Disease of Yunnan Province, Yan'an
Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
Abstract
BACKGROUND: The Cabrol procedure has undergone various modifications and
developments since its invention. However, there is a notable gap in the
literature regarding meta-analyses assessing it. METHOD(S): A
systematic review and meta-analysis was conducted to evaluate the
effectiveness and long-term outcomes of the Cabrol procedure and its
modifications. Pooling was conducted using random effects model. Outcome
events were reported as linearized occurrence rates (percentage per
patient-year) with 95% confidence intervals. RESULT(S): A total of 14
studies involving 833 patients (mean age: 50.8 years; 68.0% male) were
included in this meta-analysis. The pooled all-cause early mortality was
9.0% (66 patients), and the combined rate of reoperation due to bleeding
was 4.9% (17 patients). During the average 4.4-year follow-up (3,727.3
patient-years), the annual occurrence rates (linearized) for complications
were as follows: 3.63% (2.79-4.73) for late mortality, 0.64% (0.35-1.16)
for aortic root reoperation, 0.57% (0.25-1.31) for hemorrhage events,
0.66% (0.16-2.74) for thromboembolism, 0.60% (0.29-1.26) for endocarditis,
2.32% (1.04-5.16) for major valve-related adverse events, and 0.58%
(0.34-1.00) for Cabrol-related coronary graft complications.
 CONCLUSION(S): This systematic review provides evidence that the
outcomes of the Cabrol procedure and its modifications are acceptable in
terms of mortality, reoperation, anticoagulation, and valve-related
complications, especially in Cabrol-related coronary graft complications.
Notably, the majority of Cabrol procedures were performed in reoperations
and complex cases. Furthermore, the design and anastomosis of the Dacron
interposition graft for coronary reimplantation, considering natural
anatomy and physiological hemodynamics, may promise future advancements in
this field. Copyright © 2024. The Author(s).

<42>
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. Copyright © 2025 Dolor Investigacion, Clinica &
Terapeutica.

<43>
Accession Number
2035790658
Title
Tricuspid transcatheter edge-to-edge repair versus surgery for tricuspid
regurgitation: a systematic review and meta-analysis.
Source
Expert Review of Cardiovascular Therapy. 23(9) (pp 567-575), 2025. Date of
Publication: 2025.
Author
Penteris M.; Lampropoulos K.
Institution
(Penteris) Department of Medicine, Democritus University of Thrace,
Alexandroupolis, Greece
(Lampropoulos) School of Medicine, European University of Cyprus, Nicosia,
Cyprus
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: To perform a systematic review and meta-analysis to compare
the safety, early and late mortality, morbidity and long-term function of
the tricuspid valve (TV) following tricuspid transcatheter edge-to-edge
repair (T-TEER) compared to surgical tricuspid valve (TV)
repair/replacement (TVR) for tricuspid regurgitation (TR). Method(s):
This review investigates through two different databases for original
studies that evaluated patients with TR who underwent either T-TEER or TVR
was until December 2024. The outcomes of interest were safety, morbidity,
mortality and long-term function following T-TEER vs TVR. Result(s):
We identified three retrospective observational studies, including a total
of 1612 patients with TR. Short-term (OR, 0.36; 95% CI, 0.13-1.04; p =
0.06) and long-term mortality was similar between T-TEER and TVR. There
was a lower risk of acute kidney injury (AKI) (OR, 0.31; 95% CI,
0.23-0.43; p < 0.00001) and permanent pacemaker implantation (PPI) (OR,
0.19; 95% CI, 0.10-0.35; p < 0.00001) with T-TEER, while there was no
significant difference in terms of stroke events (OR, 1.17; 95% CI,
0.68-2.01; p = 0.58) and risk of bleeding (OR, 0.81; 95% CI, 0.45-1.44; p
= 0.47) compared to TVR. Conclusion(s): In conclusion, T-TEER appears
to have a comparable safety profile to TVR with a lower risk of AKI and
PPI. However, these findings are based on limited observational data and
should be interpreted as hypothesis-generating rather than conclusive.
Registration: This systematic review and meta-analysis was prospectively
registered on the international prospective register of systematic reviews
(PROSPERO; CRD42024622555). Copyright © 2025 Informa UK Limited,
trading as Taylor & Francis Group.

<44>
Accession Number
2037298829
Title
Home-based physical symptom management for family caregivers: systematic
review and meta-analysis.
Source
BMJ Supportive and Palliative Care. 15(5) (pp 586-599), 2025. Date of
Publication: 01 Sep 2025.
Author
Schoth D.E.; Holley S.; Johnson M.; Stibbs E.; Renton K.; Harrop E.;
Liossi C.
Institution
(Schoth, Holley, Stibbs, Liossi) Pain Research Laboratory, School of
Psychology, University of Southampton, Southampton, United Kingdom
(Johnson) Patient and Public Representative, Great Ormond Street Hospital
for Children NHS Foundation Trust, London, United Kingdom
(Renton) University Hospital Southampton NHS Foundation Trust,
Southampton, United Kingdom
(Renton) Naomi House & Jacksplace, Winchester, United Kingdom
(Harrop) Helen & Douglas House, Oxford, United Kingdom
(Harrop) Oxford University Hospitals NHS Foundation Trust, John Radcliffe
Hospital, Oxford, United Kingdom
(Liossi) Great Ormond Street Hospital for Children NHS Foundation Trust,
London, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Background Patients with life-limiting conditions are often cared for at
home by family, typically without adequate training to carry out the
challenging tasks performed. This systematic review assessed the efficacy
of interventions designed to help family caregivers manage pain and other
symptoms in adults and children with life-limiting conditions at home.
Methods A systematic search was performed on seven databases. A narrative
synthesis was conducted, along with a meta-analysis comparing outcomes in
those who received an intervention to those who did not, or to
preintervention scores. Results 84 eligible studies were identified.
Significant improvements in pain and fatigue in patients with cancer were
found compared with patients in the control group and baseline. Caregivers
of patients with cancer receiving an intervention, compared with the
control group caregivers, showed significant improvements in self-efficacy
and active coping and lower avoidant coping. This group also showed
significant improvements in burden, self-efficacy, anxiety and depression,
and decreases in avoidant coping pre- to post intervention. Patients with
dementia whose caregivers received an intervention showed significantly
reduced pain intensity and improvements in quality of life pre- to post
intervention. Caregivers of patients with dementia showed significantly
reduced distress pre- to post intervention. No beneficial effects were
found for caregivers of patients with Parkinson's disease or heart
failure, although only limited analyses could be performed. Conclusions
Interventions targeting family caregivers can improve both patient
symptoms and caregiver outcomes, as demonstrated in cancer and dementia
care. Future mixed-methods research should collect data from caregiver and
patient dyads, identifying key intervention components. There is also need
for more studies on caregivers of paediatric patients. Copyright
© Author(s) (or their employer(s)) 2025. No commercial re-use. See
rights and permissions. Published by BMJ Group.

<45>
[Use Link to view the full text]
Accession Number
2040076395
Title
Surgical closure versus transcatheter closure for ventricular septal
defect post-infarction: A meta-analysis.
Source
Annals of Medicine and Surgery. 86(9) (pp 5276-5282), 2024. Date of
Publication: 01 Sep 2024.
Author
Aramin M.A.S.; Abuhashem S.; Faris K.J.; Omar B.M.M.; Burhanuddin M.; Teja
P.S.; Ibraheim M.
Institution
(Aramin, Abuhashem, Faris, Omar) Faculty of Medicine, Al-Quds University,
Jerusalem, Palestine
(Burhanuddin, Teja) Department of Internal Medicine, Bhaskar Medical
college, Telangana, India
(Ibraheim) Department of Cardiothoracic Surgery, Alexandria University
Hospitals, Alexandria, Egypt
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Surgical correction of post-infarct ventricular septal defect
(PIVSD) is associated with a significant incidence of morbidity and
mortality. The authors aimed to evaluate the effectiveness and safety of
surgical versus transcatheter approaches in the management of PIVSD.
 Method(s): A systematic review and meta-analysis of retrospective
from five databases including the Cochrane Library, PubMed, Web of
Science, Ovid, and Scopus) until 9 March 2024 was conducted. Risk ratio
(RR) for dichotomous outcomes was used and data with a 95% CI are
presented. Result(s): A total of 7 retrospective observational
studies with 603 patients were included in the analysis. Surgical closure
was associated with a significantly lower short-term mortality and lower
number of residual shunt or re-intervention rate compared to percutaneous
closure, with a relative risk (RR) of 1.21 (95% CI:1:00-1.46, P = 0.05)
and 2.68 (95% CI: 1.46-4.91, P = 0.001), respectively. Surgical closure
was associated with a non-significantly lower long-term mortality rate
compared to percutaneous closure, with a relative risk (RR) of 1.10 (95%
CI: 0.82-1.48, P = 0.52). No difference is reported when time from acute
myocardial infarction (AMI) or PIVSD to intervention is compared groups,
with a relative risk (RR) of -0.24 (95% CI: -4.49 to 4.2, P = 0.91).
 Conclusion(s): Our meta-analysis shied the light on the significance
of surgical closure in terms of short-term mortality and the need for
re-intervention. However, no significant difference was observed in terms
of long-term mortality and time to intervention. Copyright © 2024
The Author(s).

<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. Copyright ©
2025 Informa UK Limited, trading as Taylor & Francis Group.

<47>
Accession Number
2035921694
Title
Rotational Atherectomy for Coronary Chronic Total Occlusion With Severe
Calcification: A Preliminary Study.
Source
Journal of Interventional Cardiology. 2025(1) (no pagination), 2025.
Article Number: 5574643. Date of Publication: 2025.
Author
Zhang B.; Sun Y.; Tian Z.; Luan B.
Institution
(Zhang, Luan) Department of Cardiology, The People's Hospital of Liaoning
Province, The People's Hospital of China Medical University, Liaoning,
Shenyang, China
(Sun) Department of Cardiology, The Second Hospital of Dalian Medical
University, Liaoning, Dalian, China
(Tian) Department of Endocrinology, Shenyang Liaozhong District People's
Hospital, Liaoning, Shenyang, China
Publisher
John Wiley and Sons Inc
Abstract
Objective: The aim of this study was to investigate the therapeutic
effects and 1-year outcomes of RA in patients with severe calcified
coronary artery CTO. Method(s): Data were collected from 395
individuals with severe calcified CTO who received treatment at Liaoning
Provincial People's Hospital. These patients were categorized into two
groups: those receiving RA and those receiving non-RA. The association
between RA and the incidence of MACCEs within the 1-year postoperative
period was evaluated via the Cox proportional hazards model.
 Result(s): In patients with CTO exhibiting severe calcification, we
compared various factors, including age, BMI, history of diabetes, left
ventricular ejection fraction, low-density lipoprotein levels, hemoglobin,
creatinine, the glomerular filtration rate, and family history of coronary
heart disease, between those who underwent RA and those who did not. In
addition, we assessed medical history, cardiac bypass surgery,
cerebrovascular disease, coronary interventions, the number of CTO
lesions, operation time, irradiation time, contrast agent usage, and the
incidence rates of MACCEs, all of which were found to be statistically
significant (p < 0.05). These significant indicators and the occurrence of
MACCEs within 1 year were incorporated into the Cox survival regression
analysis, which revealed that the use of RA (p = 0.010, HR: 0.457, 95% CI:
0.251-0.830) was independently correlated with a lower MACCE rate.
Furthermore, the survival curve of the non-RA group was significantly
lower than that of the RA group. Conclusion(s): Intervention with RA
is associated with a lower MACCE rate in patients with severely calcified
CTO. These findings imply that the potential of RA could be an alternative
treatment modality in these patients. However, more evidence and further
randomized controlled studies are needed to verify these
findings. Copyright © 2025 Bin Zhang et al. Journal of
Interventional Cardiology published by John Wiley & Sons Ltd.

<48>
Accession Number
643172937
Title
The efficacy of pregabalin for pain control after thoracic surgery: a
meta-analysis.
Source
Journal of cardiothoracic surgery. 19(1) (pp 4), 2024. Date of
Publication: 03 Jan 2024.
Author
Zhang L.; Zhang H.
Institution
(Zhang) Anesthesia Department Operating Room, Chongqing Liangjiang New
Area People's Hospital, Chongqing, China
(Zhang) Anesthesia Department Operating Room, Chongqing Liangjiang New
Area People's Hospital, Chongqing, China
Abstract
BACKGROUND: Pregabalin may have some potential in alleviating pain after
thoracic surgery, and this meta-analysis aims to explore the impact of
pregabalin on pain intensity for patients undergoing thoracic surgery.
 METHOD(S): PubMed, EMbase, Web of science, EBSCO and Cochrane library
databases were systematically searched, and we included randomized
controlled trials (RCTs) assessing the effect of pregabalin on pain
intensity after thoracic surgery. RESULT(S): Five RCTs were finally
included in the meta-analysis. Overall, compared with control intervention
for thoracic surgery, pregabalin was associated with significantly reduced
pain scores at 0 h (mean difference [MD]=-0.70; 95% confidence interval
[CI]=-1.10 to -0.30; P = 0.0005), pain scores at 24 h (MD=-0.47; 95%
CI=-0.75 to -0.18; P = 0.001) and neuropathic pain (odd ratio [OR] = 0.24;
95% CI = 0.12 to 0.47; P < 0.0001), but demonstrated no obvious impact on
the incidence of dizziness (OR = 1.07; 95% CI = 0.15 to 7.46; P = 0.95),
headache (OR = 1.00; 95% CI = 0.30 to 3.35; P = 1.00) or nausea (OR =
1.24; 95% CI = 0.46 to 3.35; P = 0.68). CONCLUSION(S): Pregabalin may
be effective to alleviate the pain after thoracic surgery. Copyright
© 2023. The Author(s).

<49>
Accession Number
2035241685
Title
A novel dura splitting technique for surgical resection of anterior spinal
meningioma: a case series and systematic review of the literature.
Source
European Spine Journal. 34(8) (pp 3481-3489), 2025. Date of Publication:
01 Aug 2025.
Author
Elashaal A.; Ibdah A.; Hulliel A.; Almomani A.
Institution
(Elashaal) Windsor Regional Hospital, Windsor, Canada
(Ibdah) Hashemite University, Zarqa, Jordan
(Hulliel, Almomani) Jordan University of Science and Technology, Irbid,
Jordan
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Introduction: Recent research indicates that the extent of tumor resection
impacts the recurrence rate of spinal meningiomas, with Simpson grade II
resection potentially being inadequate. Simpson grade I resection, which
involves full-thickness dura resection, carries a high risk of
cerebrospinal fluid (CSF) leak and neurological complications. To mitigate
these issues, Saito et al. introduced the dura split (DS) technique in
2001. This method separates the dura into inner and outer layers, allowing
the tumor to be removed with the inner layer while preserving the outer
layer for primary closure. This approach reduces the risk of CSF leaks and
avoids the need for dural graft reconstruction. The DS technique's safety
and efficacy have been validated by subsequent studies. Method(s): We
retrospectively reviewed medical records for six patients with spinal
meningiomas who underwent dura-splitting technique surgeries between 2018
and 2022. A systematic literature review was conducted following the
Preferred Reporting Items for Systematic Reviews and Meta-Analysis
guidelines. Result(s): The case series included six patients treated
between 2018 and 2022 for ventral or ventrolateral spinal meningiomas,
predominantly in the thoracic region (4 thoracic, 2 cervical). Surgical
approaches included posterior laminectomy in five cases and anterior
cervical corpectomy (C4-5) in one. No perioperative complications were
reported. The systematic review encompassed nine studies involving 69
patients, with a mean age of 63 years (range: 36-82) and 80.4% female
predominance. Most tumors were thoracic (75-82.5%), followed by cervical
(15-17.5%) and lumbar (2.5%). The dural splitting technique was the most
common surgical approach, minimizing complications and preserving dura
integrity. CSF leakage occurred in 1.4% of cases, while tumor recurrence
was reported in 5.8%. Neurological recovery was observed in multiple
studies, with follow-up durations ranging from 4 months to 19 years.
 Conclusion(s): Our study confirms the dura-splitting technique as an
effective alternative to Simpson grade I and II resections, providing a
safer method for radical resection with reduced CSF leak
risk. Copyright © The Author(s), under exclusive licence to
Springer-Verlag GmbH Germany, part of Springer Nature 2025.

<50>
Accession Number
2035891228
Title
Giant Left Atrial Appendage Aneurysm in a 6-Year-Old Girl with a
Prothrombotic Genetic Predisposition: A Case Report and Literature Review.
Source
Diagnostics. 15(16) (no pagination), 2025. Article Number: 2070. Date of
Publication: 01 Aug 2025.
Author
Suciu H.; Anitei E.-D.; Stroe V.I.; Brudan E.E.; Capilna T.; Al Hussein
H.; Ghiragosian S.; Calburean P.; Veres M.; Harpa M.M.
Institution
(Suciu, Harpa) Department of Surgery IV, George Emil Palade University of
Medicine, Pharmacy, Science and Technology of Targu Mures, Targu Mures,
Romania
(Suciu, Anitei, Stroe, Brudan, Capilna, Harpa) Department of
Cardiovascular Surgery, Emergency Institute for Cardiovascular Diseases
and Transplantation Targu Mures, Targu Mures, Romania
(Al Hussein) Department of Anatomy and Embriology, George Emil Palade
University of Medicine, Pharmacy, Science and Technology of Targu Mures,
Targu Mures, Romania
(Ghiragosian) Department of Pediatrics III, George Emil Palade University
of Medicine, Pharmacy, Science and Technology of Targu Mures, Targu Mures,
Romania
(Calburean) Department of Biostatistics and Medical Informatics, George
Emil Palade University of Medicine, Pharmacy, Science and Technology of
Targu Mures, Targu Mures, Romania
(Veres) Department of Anesthesia and Intensive Care, Emercency Institute
for Cardiovascular Diseases and Transplantation of Targu Mures, Targu
Mures, Romania
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: The term 'left atrial appendage aneurysm' (LAAA) has been
recognized since 1962, when it was first described. It is an exceedingly
rare pathology that can affect both adults and children. Often
asymptomatic, it may be discovered incidentally. The anomaly consists of
an exaggerated dilation of the primitive portion of the left atrium,
resulting from pectinate muscle dysplasia or as a consequence of an
obstructive lesion between the left atrium and the mitral valve. Surgical
intervention represents a reliable strategy for preventing catastrophic
complications such as stroke, thromboembolism, and rupture. This is a very
rare condition, which is why we aimed to present a case report along with
a review of the literature. Case presentation: We report the case of a
6-year-old asymptomatic girl in whom a giant left atrial appendage
aneurysm was incidentally detected during a routine transthoracic
echocardiogram, associated with a small atrial septal defect and a
prothrombotic genetic profile. The aneurysm was successfully excised, and
the atrial septal defect was closed. The postoperative course was
uneventful, and the patient was discharged home on the 8th postoperative
day. Conclusion(s): Left atrial appendage aneurysm is rare in
children and often asymptomatic, yet it may be life-threatening due to
stroke or thromboembolism. Fetal echocardiography may be considered in
selected high-risk pregnancies, and routine postnatal assessment is
advised, with surgical intervention recommended particularly for patients
with risk factors for thrombus formation in the left atrium or its
appendage. Copyright © 2025 by the authors.

<51>
Accession Number
2038972068
Title
Differential cardiovascular impact of omega-3 fatty acid in patients at
high cardiovascular risk in Asians versus non-Asians: Sub-analysis of the
strength randomized clinical trial.
Source
Atherosclerosis. 408 (no pagination), 2025. Article Number: 120228. Date
of Publication: 01 Sep 2025.
Author
Wang T.K.M.; Nicholls S.J.; St John J.; Wolski K.; Nissen S.E.
Institution
(Wang, St John, Wolski, Nissen) C5 Research, Department of Cardiovascular
Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic,
Cleveland, OH, United States
(Nicholls) Monash Cardiovascular Research Centre, Melbourne, VIC,
Australia
Publisher
Elsevier Ireland Ltd
Abstract
Background/Aims: Racial differences in lipid and cardiovascular risk
profiles are well-established, including for Asians. We compared
cardiovascular treatment effects of omega-3 carboxylic acid (CA) between
Asians and non-Asians in this post-hoc analysis of the STRENGTH trial.
 Method(s): The STRENGTH trial was a double-blinded randomized
controlled trial of 13,078 high cardiovascular risk patients enrolled at
675 global centers. Efficacy and interactions of omega-3 CA for Asians (n
= 1355) and non-Asians (n = 11,723) were assessed. The primary endpoint is
a 5-point composite of cardiovascular death, non-fatal myocardial
infarction, non-fatal stroke, coronary revascularization, and unstable
angina hospitalizations. Result(s): In Asians, omega-3 CA was
associated with significantly reduction in the primary endpoint during 3.6
+/- 0.7 years follow-up with 81/698 (Kaplan-Meier estimate (KME): 14.8 %)
events in the omega-3 CA group, 103/657 (KME: 20.4 %) events in the corn
oil group, hazard ratio (HR) 0.72, 95 %CI 0.54-0.96, p = 0.03. In
non-Asians, there was not a significant difference in primary endpoint
rates, 704/5841 (KME: 15.6 %) events in the omega-3 CA group, 692/5882
(KME: 15.9 %) events in the corn oil group, HR 1.03 95 %CI 0.93-1.14, p =
0.60. There were significant interactions between race (Asian vs
non-Asian) and treatment group for the primary endpoint (p = 0.02) and
non-fatal stroke (p = 0.02). Conclusion(s): In this exploratory
analysis from the neutral STRENGTH trial, omega-3 CA was associated with
significant reduction in the primary endpoint in Asians but not in
non-Asian patients with high cardiovascular risk. Further, ideally
randomized, research is necessary to assess these hypothesis-generating
findings and elucidate potential mechanisms for beneficial effects of
omega-3 CA in Asians. Copyright © 2025 The Authors

<52>
Accession Number
2034687511
Title
Role of strain imaging by echocardiography in pericardial diseases; a
scoping review.
Source
International Journal of Cardiovascular Imaging. 41(8) (pp 1477-1486),
2025. Date of Publication: 01 Aug 2025.
Author
Behjati M.; Mansouri P.; Mirshafiee S.; Samiei N.
Institution
(Behjati) Cardiac Rehabilitation Research Center, Cardiovascular Research
Institute, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic
Republic of
(Mansouri) Tehran Heart Center, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Mirshafiee) Department of Cardiology, School of Medicine, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Samiei) Heart Valve Disease Research Center, Rajaie Cardiovascular
Research Center, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
Publisher
Springer Science and Business Media B.V.
Abstract
Normal pericardium plays a fundamental role in the maintenance of left
ventricular (LV) twists. Pericardial diseases are among the important
causes of morbidity and mortality in cases with cardiovascular diseases.
The thorough management of suspected pericardial diseases requires early
diagnosis using optimal imaging modalities for each patient. Strain and
strain rate could be calculated using two-dimensional speckle-tracking
echocardiography (STE) through tracking frame-to-frame movements of
myocardial tissue. This modality could also determine the LV torsion and
rotation. Ultrasonic strain imaging can evaluate LV function without being
influenced by the whole heart motion or even tethering forces. This
imaging modality could also identify the disease at earlier stages. This
report reviews the role of strain imaging by echocardiography in the
assessment of pericardial diseases including acute pericarditis,
perimyocarditis, chronic constrictive pericarditis, effusive constrictive
pericarditis, and transient constriction, pericardial tamponade, post
pericardiectomy, pericardial cysts, masses, diverticula and congenital
absence of the pericardium. Being familiar with obtaining data from strain
imaging using STE could help pericardial specialists working in
established pericardial centers of excellence. Copyright © The
Author(s), under exclusive licence to Springer Nature B.V. 2025.

<53>
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. Method(s): In this
secondary analysis, data from NCT03145441, a prospective, single-center,
open-label, randomized controlled trial were used. 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. 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. Copyright © 2025 Katona,
Soltesz, Kovacs, Szakal-Toth, Tamaska, Racz, Radovits, Fintha, Kovacs,
Hurler, Prohaszka, Merkely and Nemeth.

<54>
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.
 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. 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.
 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. Copyright © 2025 by the authors.

<55>
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.
 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). 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%).
 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. Copyright © 2025
Elsevier Inc.

<56>
[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. 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. 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). 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. Copyright © 2025 the Author(s).

<57>
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. 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. 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. 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. Copyright © 2025, Colegio Brasileiro de Cirurgioes.
All rights reserved.

<58>
Accession Number
647595782
Title
Single-stage pulmonary vein isolation combined with percutaneous
implantation of left atrial appendage occluder in patients with recent
onset ischemic stroke and atrial fibrillation (PILOS-AF): A study protocol
of randomized controlled trial.
Source
Cardiology journal. 32(4) (pp 416-424), 2025. Date of Publication: 2025.
Author
Wybraniec M.T.; Hoffmann A.; Bochenek T.; Lelek M.; Wita M.; Szydlo K.;
Lasek-Bal A.; Gasior M.; Kalarus Z.; Ptaszynski P.; Kazmierczak J.;
Mizia-Stec K.; Wita K.
Institution
(Wybraniec, Hoffmann, Bochenek, Lelek, Wita, Szydlo, Mizia-Stec, Wita) 1st
Department of Cardiology School of Medicine in Katowice, Medical
University of Silesia, Katowice, Poland
(Wybraniec, Hoffmann, Bochenek, Lelek, Wita, Szydlo, Lasek-Bal,
Mizia-Stec, Wita) Upper-Silesian Medical Center, Katowice, Poland
(Wybraniec, Mizia-Stec) European Reference Network on Heart Diseases-ERN
GUARD-HEART, Amsterdam, Netherlands
(Lasek-Bal) Department of Neurology, School of Health Sciences, Medical
University of Silesia in Katowice
(Gasior) 3rd Department of Cardiology, Faculty of Medical Sciences in
Zabrze, Medical University of Silesia in Katowice, Poland, Silesian Center
for Heart Diseases in Zabrze, Poland 6Department of Cardiology, Congenital
Heart Diseases and Electrotherapy, Faculty of Medical Sciences in Zabrze,
Medical University of Silesia, Katowice, Silesian Center for Heart
Diseases in Zabrze, Zabrze, Poland
(Kalarus) Department of Cardiology, Congenital Heart Diseases and
Electrotherapy, Faculty of Medical Sciences in Zabrze, Medical University
of Silesia, Katowice, Silesian Center for Heart Diseases in Zabrze,
Zabrze, Poland
(Ptaszynski) Department of Electrocardiology, Medical University of Lodz,
Lodz, Poland
(Kazmierczak) Department of Cardiology, Pomeranian Medical University,
Szczecin, Poland

<59>
Accession Number
648177105
Title
The Effect of Parental Active Participation on Pain and Anxiety in
Supporting Children With Cancer Experiencing a Venipuncture: A Randomized
Controlled Study.
Source
Journal of pediatric hematology/oncology nursing. 42(4) (pp 155-164),
2025. Date of Publication: 01 Jul 2025.
Author
Erkul M.; Bekar P.; Efe E.
Institution
(Erkul) Faculty of Health Sciences, Antalya Bilim University, Antalya,
Turkey
(Bekar) Department of Child Health and Diseases Nursing, Bucak School of
Health, Burdur Mehmet Akif Ersoy University, Turkey
(Efe) Department of Child Health and Diseases Nursing, Faculty of Nursing,
Akdeniz University, Antalya, Turkey
Abstract
BackgroundDuring cancer treatment, children are exposed to many painful
procedures. In some areas of the world, the most common exposure may be
the venipuncture procedure. This painful process causes increased anxiety
in children. Studies have reported that sometimes pain procedures are more
traumatic than the disease itself. In general pediatrics, parent support
is effective in reducing pain and anxiety during venipuncture. This study
aimed to evaluate the effect of parental involvement on relieving pain and
anxiety in children with cancer during venipuncture compared to children
whose parents were present but not involved.MethodThis randomized
controlled trial included 60 participants receiving hospitalized in the
pediatric oncology clinic. Through randomization, 30 children had parents
coached in supportive behaviors (parental involvement) and 30 children had
parents present but without coaching as a usual care control
group.ResultsCompared to children in the control group, children in the
parental involvement group had significantly lower pain (p < .001) and
anxiety (p < .001) scores reported after the procedure and lower heart
rates during the procedure (p < .05).DiscussionResults support the
efficacy of parental involvement compared to routine procedures such as
venipuncture. Building on these results, future research is needed on how
to involve the parent during the procedure and for which types of children
and parental presence have the best effect.

<60>
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. Copyright © 2025

<61>
Accession Number
2037041238
Title
Sugammadex versus neostigmine for neuromuscular blockade reversal after
surgery in pediatric patients: a systematic review and meta-analysis of
randomized clinical trials.
Source
Anaesthesia, Pain and Intensive Care. 29(5) (pp 393-404), 2025. Date of
Publication: 01 Aug 2025.
Author
Waren K.; Fuadi I.; Lestari A.P.
Institution
(Waren, Fuadi, Lestari) Department of Anaesthesiology and Intensive
Therapy, Faculty of Medicine, Padjajaran University, Bandung, Indonesia
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Background & objective: The use of muscle relaxants is a routine in most
of the pediatric surgeries. At the end of the surgery, the residual effect
of the muscle relaxants needs to be reversed. In most of the countries the
reversal agents used are neostigmine plus atropine. In the previous few
decades sugammadex has been introduced for this purpose. We reviewed the
available research regarding efficacy and safety of sugammadex compared
with neostigmine in reversing rocuronium-induced neuromuscular blockade
(NMB) among pediatric patients. Methodology: Using specific keywords, we
comprehensively went through the potential articles, comparing efficacy
and safety of sugammadex with neostigmine in reversing rocuronium-induced
neuromuscular blockade (NMB) among pediatric patients. We searched Europe
PMC, Cochrane Library, Scopus, Medline, and ClinicalTrials.gov sources
until September 22, 2022. Outcomes were expressed in risk ratio (RR) and
mean difference (MD). Result(s): A total of 17 randomized controlled
trials (RCTs) were included. Our pooled analysis revealed that the use of
sugammadex as NMB agent in pediatric population was associated with faster
time to reach train of four (TOF) > 0.9 [MD-10.32 min (95%
CI-12.42,-8.23), P < 0.00001] and shorter time of extubation [MD-9.40 min
(95% CI-11.84,-6.96), P < 0.00001] compared with neostigmine + atropine.
Regarding safety, incidence of post-operative nausea vomiting (PONV) [RR
0.44 (95% CI 0.25 - 0.78), P = 0.005] and tachycardia [RR 0.13 (95% CI
0.04 - 0.42), P = 0.0006] was significantly lower among children receiving
sugammadex than those who received neostigmine + atropine. Incidence of
other adverse events did not differ significantly between the two groups.
 Conclusion(s): Based upon the results of our research, we conclude
that sugammadex possesses higher efficacy and better safety than
neostigmine to reverse rocuronium-induced NMB among pediatric
populations. Copyright © 2025, Faculty of Anaesthesia, Pain and
Intensive Care, AFMS. All rights reserved.

<62>
Accession Number
2040056872
Title
Rationale and design of SCOPE trial: a prospective, multicentre,
open-label, randomised controlled trial to evaluate the overall efficacy
and safety of a shortterm anticoagulation strategy versus conventional
single antiplatelet therapy in patients with severe aortic stenosis
without indications for anticoagulation or dual antiplatelet therapy
posttranscatheter aortic valve replacement.
Source
BMJ Open. 15(8) (no pagination), 2025. Article Number: e098551. Date of
Publication: 16 Aug 2025.
Author
Yan Y.; Liu R.; Zhang L.; Liu X.; Yuan F.; Jiang Z.; Luo T.; Lu Z.; Wang
Y.; Zhu Y.; Tang Y.-D.; Zhang H.; Wu W.; Li Y.; Guo L.; Pocock S.; Song G.
Institution
(Yan, Li, Liu, Liu, Yuan, Jiang, Luo, Lu, Song) Interventional Center of
Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical
University, Beijing, China
(Zhang) National Clinical Research Center for Cardiovascular Diseases, NHC
Key Laboratory of Clinical Research for Cardiovascular Medications, State
Key Laboratory of Cardiovascular Disease Fuwai Hospital, Chinese Academy
of Medical Sciences, Peking Union Medical College, National Center for
Cardiovascular Diseases, Beijing, China
(Wang, Zhu) Medical Research and Biometrics Center, National Clinical
Research Center for Cardiovascular Diseases, Fuwai Hospital, National
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences,
Peking Union Medical College, Beijing, China
(Tang) Department of Cardiology, Institute of Vascular Medicine, Peking
University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular
Biology and Regulatory Peptides, Key Laboratory of Molecular
Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of
Cardiovascular Receptors Research, Beijing, China
(Zhang) Cardiology Department, Beijing Hospital, National Center of
Gerontology, Beijing, China
(Wu) Department of Cardiology, Peking Union Medical College Hospital,
Chinese Academy of Medical Science, Peking Union Medical College, Beijing,
China
(Li) Department of Cardiology, Tangdu Hospital, Airforce Medical
University, Beijing, China
(Guo) Department of Cardiovascular Medicine, The First Hospital of China
Medical University, Shenyang, China
(Pocock) EPH, London School of Hygiene and Tropical Medicine, London,
United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction While transcatheter aortic valve replacement (TAVR) has
become a well-established standard of care for patients with symptomatic
severe aortic stenosis, the optimal antithrombotic strategy post-TAVR
remains a subject of debate, particularly in patients without clear
indications for anticoagulation or dual antiplatelet therapy. This study
aims to investigate the safety and efficacy of rivaroxaban compared with
antiplatelet monotherapy in this specific patient population. Methods and
analysis This study is designed as a prospective, multicentre, open-label,
randomised controlled trial. A total of 454 patients, who have
successfully undergone TAVR and do not have indications for long-term
anticoagulation or dual antiplatelet therapy, will be consecutively
enrolled from seven centres across China. Participants will be randomly
assigned to receive either anticoagulation with rivaroxaban (20/15 mg) or
conventional antiplatelet therapy (aspirin or clopidogrel) for 1 month.
Follow-up evaluations are scheduled at 1, 3, 6 and 12 months
post-procedure. After the initial 1-month antithrombotic therapy, the
regimen may be adjusted by the investigator based on the patient's
clinical and imaging follow-up results. The primary endpoint is a
hierarchical composite of cardiovascular death, first occurrence of
myocardial infarction or stroke, first occurrence of life-threatening,
disabling or major bleeding, and grade 3 or higher hypo-attenuated leaflet
thickening and reduced leaflet motion at 12 months post-TAVR. The win
ratio method will be employed to analyse the primary
endpoint. Copyright © Author(s) (or their employer(s)) 2025.

<63>
Accession Number
2040111795
Title
Incidence of Coronary Obstruction During Aortic Valve Implantation:
Meta-Analysis and Mixt-Treatment Comparison of Self-Expandable Versus
Balloon-Expandable Valve Prostheses.
Source
Reviews in Cardiovascular Medicine. 26(7) (no pagination), 2025. Article
Number: 36208. Date of Publication: 01 Jul 2025.
Author
Wang Y.F.; Liu Z.Q.; Ma X.T.; Yang L.X.; Wang Z.J.; Zhou Y.J.
Institution
(Wang) Cardiology Division, Beijing Jishuitan Hospital, Capital Medical
University, Beijing, China
(Liu, Ma, Yang, Wang, Zhou) Department of Cardiology, Beijing Anzhen
Hospital, Capital Medical University, Beijing, China
(Wang, Zhou) Beijing Institute of Heart Lung and Blood Vessel Disease, The
Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of
Education, Beijing, China
Publisher
IMR Press Limited
Abstract
Background: Recently, the transcatheter aortic valve replacement (TAVR)
indications have expanded meanwhile, valve systems have continuously
evolved and improved. However, coronary occlusion (CO), a rare but
catastrophic consequence of TAVR surgery, limits the expansion of
indications for TAVR. Moreover, comparisons between different systems
remain scarce. This study aimed to evaluate the incidence of CO associated
with TAVR, specifically comparing self-expanding valves (SEVs) and
balloon-expandable valves (BEVs), and further assess the safety profile of
these valve subtypes. Method(s): The primary outcome of interest was
the incidence of CO during TAVR using BEVs or SEVs. Electronic databases
were searched from January 2009 to June 2023, and this study included
randomized controlled trials, observational studies, and propensity
pair-matched studies. Heterogeneity and inter-study variance were assessed
using Cochran's Q, I2, and tau2 (Sidik-Jonkman
estimator). Random effects models were used based on the Bayesian theory
framework. The node-splitting approach was generated to determine study
network inconsistency. The convergence of the model was evaluated using
the trajectory map, density map, and the potential scale reduction factor
(PSRF). Rank sort graphs illustrate the best valve deployment techniques
or valve types. Result(s): A total of 830 articles were searched
referring to the incidence of CO using the valve deployment system of SEVs
or BEVs during the TAVR procedure, from which 51 were included (27,784
patients). The procedure incidence of coronary obstruction was 0.4% for
the SEVs and 0.6% for the BEVs. Treatment ranking based on network
analysis revealed SAPIEN 3 (Edwards Lifesciences (Irvine, CA, USA))
possessed the best procedural CO incidence (0.05%) performance, whereas
SAPIEN (Edwards Lifesciences (Irvine, CA, USA)) produced the worst
(1.04%). Conclusion(s): Our study indicates that CO incidence was not
reduced during TAVR with BEVs compared to SEVs. SAPIEN 3 and SAPIEN had
the lowest and highest TAVR-associated CO rates, respectively. These
findings suggest that the SAPIEN 3 valve may be the best choice for
reducing CO risk, and future studies should focus on its applicability in
different populations. More randomized controlled trials with head-to-head
comparisons of SEVs and BEVs are needed to address this open question. The
PROSPERO registration: CRD42024528269,
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024528269. Copyright
© 2025 The Author(s). Published by IMR Press.

<64>
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. 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.
 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. 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. Copyright © 2025 The Obesity
Society.

<65>
Accession Number
2037041359
Title
FFRangio-guided versus pressure wire-guided PCI: design and rationale of
the multicentre, randomised ALL-RISE trial.
Source
EuroIntervention. 21(16) (pp 961-970), 2025. Date of Publication: 2025.
Author
Redfors B.; Madhavan M.V.; Kirtane A.J.; Fearon W.F.; Yeh R.W.; Cohen
D.J.; Al-Lamee R.; Jeremias A.; Witberg G.; Sharma R.P.; Popma A.; Kaki
A.; Froimovich A.; Leon M.B.
Institution
(Redfors, Madhavan, Kirtane, Cohen, Jeremias, Popma, Leon) Cardiovascular
Research Foundation, New York, NY, United States
(Redfors) Department of Population Health Sciences, Weill Cornell
Medicine, New York, NY, United States
(Redfors) Department of Molecular and Clinical Medicine, Gothenburg
University, Gothenburg, Sweden
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Madhavan, Kirtane, Leon) NewYork-Presbyterian Hospital, Columbia
University Irving Medical Center, New York, NY, United States
(Fearon, Sharma) Division of Cardiovascular Medicine and Stanford
Cardiovascular Institute, Stanford University, Stanford, CA, United States
(Fearon) Veterans Affairs Palo Alto Health Care System, Palo Alto, CA,
United States
(Yeh) Division of Cardiovascular Medicine, Smith Center for Outcomes
Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard
Medical School, Boston, MA, United States
(Cohen, Jeremias) Department of Cardiology, St. Francis Hospital and Heart
Center, Rosyln, NY, United States
(Al-Lamee) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Al-Lamee) Imperial College Healthcare NHS Trust, London, United Kingdom
(Witberg) Department of Cardiology, Rabin Medical Centre, Petah Tikva,
Israel
(Witberg) Faculty of Medical and Health Sciences, Tel Aviv University, Tel
Aviv, Israel
(Kaki) Interventional Cardiology Department, Ascension St. John Hospital
and Center, Detroit, MI, United States
(Froimovich) CathWorks, Inc., Newport Beach, CA, United States
Publisher
Europa Group
Abstract
Wire-based indices of coronary physiology are the gold standard for
guiding revascularisation decisions in patients with coronary artery
disease and angiographically intermediate coronary stenoses. FFRangio is a
novel angiography-based technology for assessing the functional
significance of epicardial coronary stenoses without pressure wires or
hyperaemic stimulus. The primary objective of the Advancing Cath Lab
Results with FFRangio Coronary Physiology Assessment trial (ALL-RISE;
ClinicalTrials.gov: NCT05893498) is to compare clinical outcomes in
patients with chronic coronary syndromes or non-ST-segment elevation acute
coronary syndromes undergoing coronary angiography with >=1 coronary
lesion suitable for physiological assessment. Patients will be randomised
to FFRangio-guided or to pressure wire-guided treatment. The primary
endpoint is the occurrence of major adverse cardiovascular events (MACE)
at 1 year (a composite of all-cause death, myocardial infarction, or
unplanned clinically driven revascularisation), assessed for
non-inferiority of FFRangio-based versus pressure wire-based guidance. If
non-inferiority is met, reflex superiority guidance will be tested.
Secondary endpoints include periprocedural and early complications up to
30 days, individual components of MACE at 1 year, patient-reported health
status, procedural resource utilisation and healthcare-related costs, and
operator-assessed usability of the FFRangio and pressure wire systems.
With a sample size of 1,924 patients, the study has 82.7% power to assess
non-inferiority with a non-inferiority margin of 3.5%. The ALL-RISE trial
will provide prospective clinical outcomes data on the relative safety,
efficacy, and cost-effectiveness of a workflow using FFRangio as compared
with pressure wire-based approaches for coronary lesion assessment among
patients being considered for percutaneous coronary
intervention. Copyright © 2025, Europa Group. All rights
reserved.

<66>
Accession Number
2040145522
Title
Comparative outcomes of robotic surgery vs conventional sternotomy for
cardiac myxoma excision: A meta-analysis.
Source
World Journal of Cardiology. 17(8) (no pagination), 2025. Article Number:
111159. Date of Publication: 26 Aug 2025.
Author
Khawar M.M.H.; Ejaz H.; Jaffar M.S.; Kashif M.; Habib M.; Mukhtar A.; Riaz
H.; Shah S.A.; Muhammad A.; Ali U.; Saeed H.; Buhadur Ali M.K.; Chhetri R.
Institution
(Khawar, Ejaz, Jaffar, Kashif, Habib, Mukhtar, Riaz) Department of
Cardiology, Services Institute of Medical Sciences, Punjab, Lahore,
Pakistan
(Chhetri) Department of Cardiology, Nepalgunj Medical College, Kohal,
Nepal
(Shah, Muhammad, Ali, Saeed, Buhadur Ali) Department of Cardiology, King
Edward Medical University, Punjab, Lahore, Pakistan
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Cardiac myxoma, a benign intracardiac tumor, is traditionally
excised via conventional sternotomy, which is invasive and associated with
longer recovery times. Minimally invasive robotic surgery has emerged as a
potential alternative, offering reduced trauma and faster recovery. This
meta-analysis compares the efficacy and safety of robotic surgery vs
conventional sternotomy for cardiac myxoma excision. We hypothesized that
robotic surgery would provide comparable safety outcomes with improved
postoperative recovery, such as shorter hospital stays and reduced
transfusion rates, despite potentially longer operative times. AIM To
assess robotic surgery vs sternotomy for cardiac myxoma regarding
operative times, hospital stay, transfusions, and complications. METHODS A
systematic review was performed using EMBASE, OVID, Scopus, PubMed,
Cochrane, and ScienceDirect databases to identify studies comparing
robotic surgery and sternotomy for cardiac myxoma excision. Continuous
outcomes were analyzed using mean differences (MDs), and categorical
outcomes with odds ratios (ORs) and 95% confidence intervals (95%CIs). A
random-effects model was used to pool data, accounting for study
heterogeneity. RESULTS Six studies involving 425 patients (180 robotic,
245 conventional) were included. Robotic surgery significantly increased
cross-clamp time (MD = 12.03 minutes, 95%CI: 2.14-21.92, P = 0.02) and
cardiopulmonary bypass time (MD = 28.37 minutes, 95%CI: 11.85-44.89, P =
0.001). It reduced hospital stay (MD = -1.86 days, 95%CI: -2.45 to -1.27,
P < 0.00001) and blood transfusion requirements (OR = 0.30, 95%CI:
0.13-0.69, P = 0.007). No significant differences were observed in atrial
arrhythmia (OR = 0.55, 95%CI: 0.27-1.12) or ventilation time (MD = -1.72
hours, 95%CI: -5.27 to 1.83, P = 0.34). CONCLUSION Robotic surgery for
cardiac myxoma excision prolongs operative times but shortens hospital
stays and reduces transfusion needs, suggesting enhanced recovery without
compromising safety. Copyright ©The Author(s) 2025. Published by
Baishideng Publishing Group Inc. All rights reserved.

<67>
Accession Number
2033116576
Title
Reproducibility of the Motor Optimality Score-Revised in infants with an
increased risk of adverse neurodevelopmental outcomes.
Source
Developmental Medicine and Child Neurology. 67(9) (pp 1176-1185), 2025.
Date of Publication: 01 Sep 2025.
Author
Luke C.; Bos A.F.; Jackman M.; Ware R.S.; Gordon A.; Finn C.; Baptist
D.H.; Benfer K.A.; Bosanquet M.; Boyd R.N.
Institution
(Luke, Finn, Benfer, Boyd) Queensland Cerebral Palsy and Rehabilitation
Research Centre, Child Health Research Centre, The University of
Queensland, Brisbane, Australia
(Luke, Finn) Queensland Paediatric Rehabilitation Service, Children's
Health Queensland Hospital and Health Service, Brisbane, Australia
(Bos, Baptist) Beatrix Children's Hospital, Division of Neonatology,
University of Groningen, Groningen, Netherlands
(Jackman) John Hunter Children's Hospital, Newcastle, Australia
(Jackman) Cerebral Palsy Alliance, University of Sydney, NSW, Australia
(Ware) Griffith Biostatistics Unit, Griffith University, Brisbane,
Australia
(Gordon) Department of Physiotherapy, Townsville Hospital and Health
Service District, Townsville, Australia
(Bosanquet) Department of Health and Wellbeing, Townsville Hospital and
Health Service District, Townsville, Australia
Publisher
John Wiley and Sons Inc
Abstract
Aim: To determine reproducibility of the Motor Optimality Score-Revised
(MOS-R) to assess infants at high risk of adverse neurodevelopmental
outcomes, including cerebral palsy (CP), autism, and developmental delays.
 Method(s): Thirty infants (18 males, 12 females, gestational age mean
[range] = 32.5 [23-41] weeks) were randomly selected, according to 2-year
outcome (typically developing; CP; or adverse neurodevelopmental outcome
[ad-NDO]) from a prospective cohort. Participants had two General
Movements videos between 12 weeks and 15 + 6 weeks corrected age. Six
assessors, masked to history and outcomes, independently scored the MOS-R
from videos. Assessors scored either one (Group 1; n = 3) or two videos
for each infant (Group 2; n = 3). Intraclass correlation coefficient
(ICC), Gwet's agreement coefficient, and limits of agreement were
calculated. Result(s): Combined interassessor reliability (IRR) over
six assessors for total MOS-R was 'fair' (ICC = 0.56, 95% confidence
interval [CI] 0.41-0.72), and 'excellent' with consensus agreement (ICC =
0.99, 95% CI 0.98-0.99). Analyses demonstrated a mean interrater
difference of 0.316 (95% limits of agreement -11.51, 12.14) over 450
comparisons (15 pairs). IRR was 'moderate' to 'almost perfect' across
subcategories, with the highest reliability 'movement patterns' (Gwet's
agreement coefficient = 0.73-1.00) and the lowest 'postural patterns'
(0.45-0.73). Assessors who scored two videos (Group 2) demonstrated higher
reproducibility. IRR for total MOS-R was 'excellent' when infants were
typically developing (ICC = 0.90), and 'good' for CP (0.74) and ad-NDO
(0.68). Interpretation(s): The MOS-R is a highly reproducible tool
for assessing infants at high risk of ad-NDOs and is feasible for
implementation in clinical settings. Reproducibility is best when the tool
is used by experienced assessors to gain consensus
agreement. Copyright © 2025 The Author(s). Developmental Medicine
& Child Neurology published by John Wiley & Sons Ltd on behalf of Mac
Keith Press.

<68>
Accession Number
2035729881
Title
Comparison of different timings of percutaneous coronary intervention in
patients with transcatheter aortic valve implantation: a network
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1596208. Date of Publication: 2025.
Author
Wen Q.; Yang J.; Xu G.; Wang D.
Institution
(Wen) Cardiovascular Medicine Department, Hulunbuir People's Hospital,
Inner Mongolia, Hulunbuir, China
(Yang, Xu, Wang) Department of Cardiovascular and Structural Heart
Disease, Inner Mongolia Forestry General Hospital, Inner Mongolia,
Yakeshi, China
Publisher
Frontiers Media SA
Abstract
Background: The combination of selective percutaneous coronary
intervention (PCI) and transcatheter aortic valve implantation (TAVI) is a
safe and feasible therapy and has become our preferred treatment option
for patients with severe aortic stenosis and high-risk coronary heart
disease. However, the timing of staged PCI is uncertain. The purpose of
this meta-analysis is to compare the benefits and risks of TAVI alone, PCI
before TAVI, simultaneous TAVI and PCI, and PCI after TAVI in TAVI
patients, and to provide guidance for clinical decision-making on the
timing of PCI in TAVI patients. Method(s): We searched Pubmed,
Embase, the Cochrane Library and Web of Science as of April 2025. By
employing Bayesian network meta-analysis, with the aid of R software
(V4.3.2) and in combination with Stata (V15), the analysis included
outcomes such as all-cause mortality, cardiovascular mortality, stroke,
bleeding and myocardial infarction (MI). Pooled analysis was performed
utilizing risk ratios (RR) and 95% confidence intervals (CI).
 Result(s): A total of 13 studies involving 304,181 patients were
included in the analysis. The research findings showed that the
application of TAVI alone significantly reduced the all-cause mortality
compared to PCI after TAVI (RR = 0.35, 95% CrI: 0.13, 0.88), and the
lowest all-cause mortality rate was observed in the cumulative ranking
(SUCRA = 75.89%). Compared with PCI after TAVI (RR = 0.57, 95% CrI: 0.41,
0.79) and TAVIplus PCI (RR = 0.72, 95% CrI: 0.54, 0.97), PCI before TAVI
significantly reduced cardiovascular mortality and was found the lowest
cardiovascular mortality in the cumulative ranking (SUCRA = 98.37%). In
comparison to TAVIplus PCI (RR = 0.44, 95% CrI: 0.27, 0.71), PCI after
TAVI significantly reduced the stroke rate and found the lowest stroke
rate in the cumulative ranking (SUCRA = 97.21%). The application of TAVI
alone significantly reduced the bleeding rate compared to TAVIplusPCI (RR
= 0.61, 95% CrI: 0.60, 0.62), and the lowest bleeding rate was observed in
the cumulative ranking (SUCRA = 88.14%). Compared with PCI before TAVI (RR
= 0.12, 95% CrI: 0.04, 0.29) and TAVI (RR = 0.21, 95% CrI: 0.12, 0.34),
TAVIplusPCI significantly reduced the incidence of myocardial infarction
and was found the lowest incidence of myocardial infarction in the
cumulative ranking (SUCRA = 96.44%). Conclusion(s): The timing of
application of TAVI combined with PCI affects mortality and the incidence
of cardiovascular events. Among them, PCI after TAVI may effectively
reduce all-cause mortality, cardiovascular mortality, and stroke, but the
interval between the two procedures remains uncertain. Future studies
should investigate the optimal interval between PCI and TAVI to maximize
clinical benefits. Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/, PROSPERO. Copyright 2025 Wen,
Yang, Xu and Wang.

<69>
Accession Number
2035770429
Title
Pulmonary protective and antiinflammatory effects of dexmedetomidine in
cardiac surgery with cardiopulmonary bypass: a systematic review and
metaanalysis.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 414. Date
of Publication: 01 Dec 2025.
Author
Liu J.; Gao R.; Ma J.; Han J.; Guo Z.
Institution
(Liu, Gao, Han) Department of Anesthesiology, chest hospital, Tianjin
University, Tianjin, China
(Liu, Gao, Ma, Han, Guo) Tianjin Key Laboratory of Cardiovascular
Emergency and Critical Care, Tianjin Municipal Science and Technology
Bureau, Tianjin, China
(Liu, Gao, Ma, Han, Guo) Tianjin Cardiovascular Institute, Tianjin, China
(Guo) Department of Cardiovascular Surgery, Tianjin Chest Hospital,
Tianjin, China
Publisher
BioMed Central Ltd
Abstract
Objective: This study aims to investigate pulmonary protective and
antiinflammatory effects of dexmedetomidine (DEX) in patients undergoing
cardiac surgery with cardiopulmonary bypass (CPB) by meta-analysis.
 Method(s): Six databases were searched to collect trials on the
pulmonary protective and anti-inflammatory effects of DEX in cardiac
surgery with CPB. The search period was from the establishment of each
database to August 1, 2024. Alveolar arterial oxygen partial pressure
difference (AaDO2), Oxygenation index (OI), respiratory index (RI), IL-6,
TNF-alpha, and CRP values were collected in CPB progress, end of
operation, postoperative 6 h(POH6), and postoperative 24 h(POH24). The
control group was treated with normal saline after anesthesia induction,
while the experimental group with DEX. Result(s): A total of 9
articles were included. In the overall analysis, AaDO2 (SMD=-1.03,
95%CI:-1.62 to -0.44) and RI (SMD=-1.03, 95%CI:-1.90 to -0.16) in the DEX
group were significantly lower than those in the control group, whereas OI
was significantly increased (SMD = 0.44, 95%CI: 0.29-0.60). For
inflammatory markers, levels of IL-6 (SMD= -1.96, 95%CI: -2.31-1.62) and
TNF-alpha (SMD= -1.81, 95%CI: -2.36-1.26) were significantly decreased in
the DEX group. Subgroup analyses based on the course of surgery presented
a significant reduction in AaDO2 at the end of operation. At the end of
operation, OI was significantly increased, while IL-6 and TNF-alpha were
significantly decreased at POH6 and POH12. At POH24, no significant
difference was found in CRP between the two groups (P > 0.05).
 Conclusion(s): DEX has pulmonary protective and anti-inflammatory
effects in patients undergoing cardiac surgery with CPB. Copyright
© The Author(s) 2025.

<70>
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. 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. 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%). 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. Copyright © The
Author(s) 2025.

<71>
Accession Number
643102905
Title
Effect of Prewarming on Perioperative Hypothermia in Patients Undergoing
Loco-Regional or General Anesthesia: A Randomized Clinical Trial.
Source
Medicina (Kaunas, Lithuania). 59(12) (no pagination), 2023. Date of
Publication: 27 Nov 2023.
Author
Recio-Perez J.; Miro Murillo M.; Martin Mesa M.; Silva Garcia J.;
Santonocito C.; Sanfilippo F.; Asunsolo A.
Institution
(Recio-Perez, Miro Murillo, Martin Mesa) Department of Anesthesia,
Torrejon University Hospital, 28850 Torrejon de Ardoz, Spain
(Silva Garcia) Department of Anesthesia, 12 Octubre Hospital, Madrid,
Spain
(Santonocito, Sanfilippo) Department of Anesthesia and Intensive Care,
University Hospital "Policlinico-San Marco", Catania, Italy
(Sanfilippo) Department of Surgery and Medical-Surgical Specialties,
University of Catania, Catania, Italy
(Asunsolo) Department of Public Health, Alcala University, Alcala de
Henares, Spain
Abstract
Background and Objectives: Redistribution hypothermia occurs during
anesthesia despite active intraoperative warming. Prewarming increases the
heat absorption by peripheral tissue, reducing the central to peripheral
heat gradient. Therefore, the addition of prewarming may offer a greater
preservation of intraoperative normothermia as compared to intraoperative
warming only. Material(s) and Method(s): A single-center clinical
trial of adults scheduled for non-cardiac surgery. Patients were
randomized to receive or not a prewarming period (at least 10 min) with
convective air devices. Intraoperative temperature management was
identical in both groups and performed according to a local protocol. The
primary endpoint was the incidence, the magnitude and the duration of
hypothermia (according to surgical time) between anesthetic induction and
arrival at the recovery room. Secondary outcomes were core temperature on
arrival in operating room, surgical site infections, blood losses,
transfusions, patient discomfort (i.e., shivering), reintervention and
hospital stay. Result(s): In total, 197 patients were analyzed: 104
in the control group and 93 in the prewarming group. Core temperature
during the intra-operative period was similar between groups (p = 0.45).
Median prewarming lasted 27 (17-38) min. Regarding hypothermia, we found
no differences in incidence (controls: 33.7%, prewarming: 39.8%; p =
0.37), duration (controls: 41.6% (17.8-78.1), prewarming: 45.2%
(20.6-71.1); p = 0.83) and magnitude (controls: 0.19 degreeC . h-1
(0.09-0.54), prewarming: 0.20 degreeC . h-1 (0.05-0.70); p = 0.91).
Preoperative thermal discomfort was more frequent in the prewarming group
(15.1% vs. 0%; p < 0.01). The interruption of intraoperative warming was
more common in the prewarming group (16.1% vs. 6.7%; p = 0.03), but no
differences were seen in other secondary endpoints. Conclusion(s): A
preoperative prewarming period does not reduce the incidence, duration and
magnitude of intraoperative hypothermia. These results should be
interpreted considering a strict protocol for perioperative temperature
management and the low incidence of hypothermia in controls.

<72>
Accession Number
2035211197
Title
Firesorb bioresorbable scaffold for de novo coronary artery disease:
1-year clinical outcomes.
Source
BMC Medicine. 23(1) (no pagination), 2025. Article Number: 419. Date of
Publication: 01 Dec 2025.
Author
Jiang J.; Li C.; Chen D.; Song L.; Cui Z.; Li P.; Gan L.; Chen Y.; Li H.;
Jia S.; He S.; Lu W.; Gao R.; Wang J.
Institution
(Jiang, Li, Chen, Wang) Department of Cardiology, The Second Affiliated
Hospital, Zhejiang University School of Medicine, Hangzhou, China
(Jiang, Li, Chen, Wang) State Key Laboratory of Transvascular Implantation
Devices, Hangzhou, China
(Jiang, Li, Chen, Wang) Heart Regeneration and Repair Key Laboratory of
Zhejiang Province, Hangzhou, China
(Jiang, Li, Chen, Wang) Transvascular Implantation Devices Research
Institute, Binjiang District, Hang Zhou, China
(Song, Gao) Department of Cardiology, National Center for Cardiovascular
Diseases, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking
Union Medical College, Beijing, China
(Cui) Department of Cardiology, Inner Mongolia Autonomous Region People's
Hospital, Hohhot, China
(Li) Department of Cardiology, The First People's Hospital of Yulin,
Yulin, China
(Gan) Department of Cardiology, Affiliated Hospital of Jining Medical
University, Jining, China
(Chen) Department of Cardiology, Chinese PLA General Hospital, Beijing,
China
(Li) Department of Cardiology, Daqing Oilfield General Hospital, Daqing,
China
(Jia) Department of Cardiology, General Hospital of Ningxia Medical
University, Ningxia, China
(He) Department of Cardiology, Northern Jiangsu People's Hospital,
Yangzhou, China
(Lu) Department of Cardiology, Xuzhou Central Hospital, Xuzhou, China
Publisher
BioMed Central Ltd
Abstract
Background: The first-generation bioresorbable scaffolds (BRS) have been
associated with higher rates of device-related adverse outcomes in
comparison to everolimus-eluting stents. We aimed to evaluate the efficacy
and safety of the thinner-strut (100/125 mum) poly-L-lactic acid-based
sirolimus-eluting Firesorb BRS in patients with de novo coronary lesions.
 Method(s): Patient-level data derived from 1205 patients in the
FUTURE-II RCT (n = 215) and FUTURE-III registry (n = 990) were
prospectively collected, pooled, and analyzed. The primary endpoint of
1-year target lesion failure (TLF) was defined as a composite of cardiac
death, target vessel myocardial infarction, or ischemia-driven target
lesion revascularization. The patient-oriented composite endpoint (POCE)
of all-cause death, any myocardial infarction, or any revascularization
was also analyzed. Result(s): At 1-year follow-up, the cumulative
rate of TLF was 1.67%, with an upper 95% confidence interval of 2.57%,
significantly lower than the objective performance criterion goal of 6.6%
(P < 0.001). The rate of single TLF components was 0.42% for cardiac
death, 0.92% for target vessel myocardial infarction, and 0.42% for
ischemia-driven target lesion revascularization. The cumulative rate of
POCE at 1 year was 3.34%. No patient experienced definite or probable
device thrombosis during 1-year follow-up. Conclusion(s): This
pooled, patient-level analysis indicates that the thinner strut Firesorb
BRS exhibits promising 1-year efficacy and safety profiles with regard to
TLF. However, our findings are only applicable to non-complex lesions;
large-scale randomized clinical trials powered to assess clinical
endpoints are necessary to evaluate the strategy of Firesorb BRS compared
to drug-eluting stents. Trial registration: ClinicalTrials.gov Identifier:
NCT02890160 and NCT03660202. Copyright © The Author(s) 2025.

<73>
Accession Number
2035996147
Title
Technical performance assessment of robotic surgery: a systematic scoping
review.
Source
Journal of Robotic Surgery. 19(1) (no pagination), 2025. Article Number:
554. Date of Publication: 01 Dec 2025.
Author
Kalantar Motamedi S.M.; Fatima S.; Zhang Q.; Foster M.J.; Kolman J.M.;
Bageshwar R.; Lilly J.L.; Lin P.K.; Lopez A.; Jones S.L.; Lee G.I.;
Sankaranarayanan G.; Sasangohar F.; Stefanidis D.; Steadman R.H.
Institution
(Kalantar Motamedi, Stefanidis) Department of Surgery, Indiana University
School of Medicine, Indianapolis, IN, United States
(Fatima, Sasangohar, Steadman) Department of Anesthesiology and Critical
Care, Houston Methodist, 6565 Fannin St, B452, Houston, TX, United States
(Zhang, Lopez, Jones, Sasangohar) Center for Health Data Science and
Analytics, Houston Methodist, Houston, TX, United States
(Zhang) Department of Engineering, College of Charleston, Charleston, SC,
United States
(Foster) Department of Medical Education, School of Medicine, and Center
for Systematic Reviews and Research Syntheses, University Libraries, Texas
A & M University, College Station, TX, United States
(Kolman) Academic Affairs, Houston Methodist, Houston, TX, United States
(Kolman, Sasangohar) Wm Michael Barnes '64 Department of Industrial and
Systems Engineering, Texas A & M University, College Station, TX, United
States
(Bageshwar, Lilly, Lin) School of Engineering Medicine (EnMed), Texas A &
M University College of Medicine, Texas A & M College of Engineering and
Houston Methodist Hospital, Houston, TX, United States
(Lee) Division of Education, American College of Surgeons, Chicago, IL,
United States
(Sankaranarayanan) Department of Surgery, The University of Texas
Southwestern Medical Center, Dallas, TX, United States
Publisher
Springer Nature
Abstract
Defining performance errors in robotic surgery is critical for the
assessment of robotic surgery skill. Our goal was to identify and
categorize explicitly defined intraoperative technical errors in robotic
surgery, how skill assessment was performed, and how ratings were
conducted either manually by experts or via automated ratings. This
scoping review included studies involving general, urologic,
obstetrics/gynecologic, and thoracic surgery, and general skills as
practiced in inanimate, virtual reality, in vivo/ex vivo animal, cadaver,
and human operations. Primary empirical and consensus-building studies
were included if they addressed intraoperative performance assessment or
error definition and identification. MEDLINE (Ovid), Embase (Ovid), and
Compendex were queried for results from 2012 to May 19, 2022. Of 2642
studies screened, 185 were included. The majority (n = 109, 60%) were
US-based and involved either simulated surgical procedures using inanimate
models (n = 88), virtual reality (n = 72), or intraoperative performance
assessments of robotic surgeries in humans (n = 44); 36 studies combined
two or more of these settings. Performance errors were explicitly defined
in 104 articles (56%), and 64 used previously defined performance rating
scales. The method of rating was split between manual (n = 137) and
automated ratings (n = 85). Measures of performance vary considerably.
More conceptual work is warranted to explicitly define errors that can
inform robotic skill assessment. This is important given the growing
interest in developing efficient and reliable objective measures of
performance which are likely to rely on automated assessment
methods. Copyright © The Author(s), under exclusive licence to
Springer-Verlag London Ltd., part of Springer Nature 2025.

<74>
Accession Number
648429788
Title
Left Atrial Appendage Occlusion in Patients with End-Stage Renal Disease:
An Individual Patient-Level Meta-Analysis.
Source
Europace : European pacing, arrhythmias, and cardiac electrophysiology :
journal of the working groups on cardiac pacing, arrhythmias, and cardiac
cellular electrophysiology of the European Society of Cardiology. (no
pagination), 2025. Date of Publication: 29 Aug 2025.
Author
Rodriguez-Riascos J.F.; Vemulapalli H.S.; Akin I.; Areiza L.A.; Della
Rocca D.G.; Eitel I.; Fink T.; Genovesi S.; Kefer J.; Zweiker D.;
Prajapati P.; Srivathsan K.
Institution
(Rodriguez-Riascos, Vemulapalli, Prajapati, Srivathsan) Division of
Cardiovascular Diseases, Mayo Clinic, Phoenix, AZ, United States
(Akin) Department of Invasive Cardiology and Electrophysiology, Deputy
Director of the First Department of Medicine, Head of Cardiovascular
Research, University Medical Center Mannheim, Medical Faculty Mannheim,
Heidelberg University, Mannheim, Germany
(Areiza) Department of Invasive Cardiology, Hospital Universitario Mayor,
Mederi, Bogota, Colombia
(Della Rocca) Texas Cardiac Arrhythmia Institute, St.David's Medical
Center, Austin, TX, United States
(Della Rocca) Heart Rhythm Management Centre, Postgraduate Program in
Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis
Brussel-Vrije Universiteit Brussel, European Reference Networks
Guard-Heart, Jette, Brussels, Belgium
(Eitel) Department of Cardiology, Angiology and Intensive Care
Medicine-Division of Electrophysiology, University Heart Center Lubeck,
Lubeck, Germany
(Fink) Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr
University Bochum, Bad Oeynhausen, Germany
(Genovesi) School of Medicine and Surgery, Nephrology Clinic, University
of Milano-Bicocca, Milan, Italy
(Genovesi) Istituto Auxologico Italiano, IRCCS, Milan, Italy
(Kefer) Division of Cardiology, Cliniques universitaires Saint-Luc et Pole
de Recherche Cardiovasculaire, Institut de Recherche Experimentale et
Clinique, (IREC) ,Universite Catholique de Louvain (UCLouvain), Brussels,
Belgium
(Zweiker) Department of Cardiology, Medical University of Graz, Graz,
Austria
(Zweiker) 12: Third Medical Department for Cardiology and Intensive Care,
Vienna, Austria
Abstract
BACKGROUND: Patients with end-stage renal disease (ESRD) and atrial
fibrillation (AF) present a challenge for thromboembolic prevention, given
their elevated risks of both thromboembolism and bleeding. Anticoagulants
carry a higher bleeding risk in this population without clear evidence of
thromboembolic benefit. This study aims to define the role of left atrial
appendage occlusion (LAAO) as a preventive strategy for patients with
ESRD. METHOD(S): A systematic literature review was conducted to
identify studies reporting outcomes in patients with ESRD who underwent
LAAO. Meta-analyses of aggregate and individual patient data were
performed to evaluate acute and long-term outcomes and compare them with
those of patients without ESRD. RESULT(S): Seventeen studies
reporting data from 24,127 patients, including 1,047 with ESRD, were
included. Procedural complications were more common in patients with ESRD
(RR 2.23; P = 0.02), with a pooled rate of 4% (95%CI, 1-9%). There was no
significant difference in thromboembolic event rates during follow-up
between the groups (IRR 1.44; P = 0.16), but major bleeding incidence was
higher among patients with ESRD (IRR 1.84; P < 0.01). Individual
patient-level data from seven studies comprising 4,745 patients (268 with
ESRD) were obtained and analyzed. Similarly, there was no significant
association between ESRD and stroke/TIA incidence (HR 1.22 95% CI
0.66-2.26), but major bleeding was higher on patients with ESRD (HR 1.65
95% CI 1.01-2.69). CONCLUSION(S): LAAO represents a feasible option
for thromboembolic prevention in patients with ESRD, although these
patients have an increased risk of complications and
bleeding. Copyright © The Author(s) 2025. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<75>
Accession Number
2040332173
Title
Ultrasound-guided bilateral serratus plane block versus thoracic
paravertebral block following minimally invasive pectus excavatum repair
in children: A randomized controlled non-inferiority study.
Source
Journal of Clinical Anesthesia. 107 (no pagination), 2025. Article Number:
112003. Date of Publication: 01 Nov 2025.
Author
He Y.; Xu M.; Li Z.; Yu J.; Li Q.; Zuo Y.; Kang Y.; Du B.
Institution
(He, Xu, Li, Zuo, Du) Department of Anesthesiology, West China Hospital,
Sichuan University & The Research Units of West China (2018RU012), Chinese
Academy of Medical Sciences. Chengdu, Sichuan, China
(Li) Department of Critical Care Medicine, Cheng Du Shang Jin Nan Fu
Hospital, West China Hospital of Sichuan University, Chengdu, China
(Yu) West China School of Medicine, West China Hospital of Sichuan
University, Chengdu, China
(Kang) Department of Anesthesiology and Translational Neuroscience Center,
Laboratory of Anesthesia and Critical Care Medicine, West China Hospital,
Sichuan University, Chengdu, China
Publisher
Elsevier Inc.
Abstract
Study objective: This study evaluated whether ultrasound-guided serratus
anterior plane block (SAPB) provided non-inferior analgesic effects for
minimally invasive pectus excavatum repair surgery compared with thoracic
paravertebral block (TPVB). Design(s): A noninferiority randomized
trial. Setting(s): West China Hospital of Sichuan University.
 Patient(s): Seventy-four children aged 7-16 years who underwent
minimally invasive pectus excavatum repair surgery were enrolled.
 Intervention(s): Patients were randomly assigned to receive bilateral
SAPB (n = 37) or TPVB (n = 37) after induction of anesthesia (0.5 mL
kg-1 0.25 % of ropivacaine per side). Measurements: Pain scores
assessed via numerical rating scale (NRS) postoperatively; opioid
consumption, block-related complications; and plasma ropivacaine
concentrations were measured. Main Result(s): Median (IQR) pain
scores for SAPB were 1 (1.0-2.0) and 1 (0.5-2.0) for those with TVPB 24 h
postoperatively (effect size = 0.027; 95 % confidence interval, -0.42 to
0.47, P = 0.905), meeting the non-inferiority criterion with a
pre-specified margin of 0.5. The TPVB group exhibited a greater incidence
of hypotension (29.7 % vs. 8.1 %, p = 0.018). The ropivacaine
concentrations were lower in the SAPB group at all measured time points
(SAPB: 0.44 (0.21), 0.56 (0.23), and 0.66 (0.29) mug mL-1 vs.
TPVB: 1.18 (0.39), 1.17 (0.30), and 1.13 (0.26) mug mL-1 at 10,
30, and 60 min post-injection, respectively). Conclusion(s): Compared
with TPVB, SAPB provides non-inferior analgesia for children undergoing
minimally invasive pectus excavatum repair surgery. Moreover, SAPB is
associated with less intraoperative hemodynamic instability and lower
plasma concentrations, suggesting it is a safe and valid alternative.
Trial registration: Chinese Clinical Trial Registry, identifier: ChiCTR
2,200,056,596. Copyright © 2025

<76>
Accession Number
648427269
Title
Redefining preoperative care in cardiac surgery: The multifaceted impact
of holistic and technological advances.
Source
European Journal of Cardiovascular Nursing. Conference: Association of
Cardiovascular Nursing and Allied Professions Congress, ACNAP 2025. Sophia
Antipolis France. 24(Supplement 1) (pp i158), 2025. Date of Publication:
01 Jul 2025.
Author
Sigala E.; Pikoula V.; Dogka V.; Parisi M.; Tsompou M.; Stamatopoulou E.;
Argyriou M.; Mandraveli A.; Pistolas D.
Institution
(Sigala, Pikoula, Dogka, Parisi, Tsompou, Argyriou, Mandraveli, Pistolas)
Evangelismos Hospital, Athens, Greece
(Stamatopoulou) Attikon University Hospital, Hemodynamic Laboratory
Department, Athens, Greece
Publisher
Oxford University Press
Abstract
Background: Cardiac surgery is a high-stress procedure often associated
with significant physical and psychological burdens. Preoperative
education plays a crucial role in improving postoperative recovery.
 Aim(s): Our aim was to evaluate the impact of holistic preoperative
patient education on postoperative outcomes after cardiac surgery and to
explore recent advancements in the field. Methodology: A systematic review
was conducted following PRISMA guidelines. Included studies were
randomized controlled, cohort studies and qualitative research, published
between 2010 and 2025. Databases searched were PubMed, Scopus and CINAHL
with the following keywords: "preoperative education", "cardiac surgery",
"postoperative outcomes", "holistic care", "new advancements",
"technology". Result(s): A total of 22 studies met the inclusion
criteria (17 quantitative and 5 qualitative studies), comprising 2.630
participants. Preoperative education was delivered through various
methods, including simulations, videos, questionnaires, and structured
interviews. Most participants were patients who undergone coronary artery
bypass grafting (CABG). Quantitative information showed that preoperative
education had a significant impact on decreasing postoperative anxiety and
enhancing markers of recovery, including improved pain management, shorter
ICU stays, and decreased readmission rates. Qualitative investigations
brought forth themes of heightened patient self-determination, effective
coping mechanisms, and the value of culturally sensitive communication.
Some studies also describe prehabilitation activities as part of their
holistic preoperative approach. Based on our findings, a thematic guide
was developed in which all important steps are described to ensure
patient-oriented preoperative information in cardiac surgery (figure 1).
 Conclusion(s): The holistic preoperative patient education is an
effective strategy to improve postoperative results. The results could
build a national protocol for the leadership of the patients before
cardiac surgery to improve the quality of care and to minimize the costs
of hospitalization..

<77>
Accession Number
2040312580
Title
Scoping Review of Operative Management of Thoracic Malignancies in
Patients With Psychiatric Comorbidities.
Source
Journal of Surgical Research. 314 (pp 671-689), 2025. Date of Publication:
01 Oct 2025.
Author
Rosenbaum J.J.; Varma S.; Kirkpatrick M.; Udelsman B.V.
Institution
(Rosenbaum, Varma) Keck School of Medicine of USC, Los Angeles,
California, United States
(Kirkpatrick) Department of Preventive Medicine, Keck School of Medicine
of USC, Los Angeles, California, United States
(Udelsman) Department of Surgery, Keck School of Medicine of USC, Los
Angeles, California, United States
Publisher
Academic Press Inc.
Abstract
Introduction: Psychiatric comorbidities are increasingly recognized in
patients with thoracic malignancies. We undertook this scoping review to
characterize the management of thoracic malignancies in patients with
psychiatric illness and uncover any disparities in operative treatment or
perioperative outcomes. Method(s): We conducted a scoping review
following the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guidelines. Full-text English articles were identified in
PubMed, Embase, and APA PsycInfo published between January 01, 2000, and
August 01, 2024. Eligible articles included experimental,
quasiexperimental, and observational studies that involved adult patients
with psychiatric conditions, thoracic malignancies, and surgical
interventions. Data on diagnostic stage, guideline-based interventions,
and patient health outcomes were extracted and analyzed. Result(s): A
total of 5050 studies were identified and screened by two reviewers: 235
met the criteria for full-text review and 31 were included for data
extraction. Among the included articles, 26 assessed lung cancer and seven
assessed esophageal cancer. The most frequently investigated psychiatric
comorbidities were substance use disorder (n = 13), alcohol use disorder
(n = 12), depression (n = 11), anxiety (n = 8), psychotic disorders (n =
7), and cognitive disorders (n = 7). Although the nature of the observed
disparities varied by specific conditions, the presence of a psychiatric
comorbidity was associated with delayed diagnoses, lower rates of surgical
intervention, longer length of stay, increased perioperative morbidity,
and higher mortality rates. Conclusion(s): Psychiatric illness is
common in patients with thoracic malignancy with heterogeneous effects on
treatment and outcomes. There is a need for targeted treatment plans to
alleviate the identified disparities and optimize care. Copyright
© 2025 Elsevier Inc.

<78>
Accession Number
2040319742
Title
Long-term cardiovascular outcomes and mortality following Kawasaki
disease: A systematic review and meta-analysis.
Source
Paediatrics and Child Health (Canada). 30(5) (pp 406-413), 2025. Date of
Publication: 01 Aug 2025.
Author
Lao F.; Robinson C.H.; Borovsky D.; Ewusie J.; Beattie K.; Batthish M.
Institution
(Lao, Borovsky) Michael G. DeGroote School of Medicine, McMaster
University, Hamilton, ON, Canada
(Lao) Department of Pediatrics, Hospital for Sick Children, University of
Toronto, Toronto, ON, Canada
(Robinson) Division of Nephrology, Department of Pediatrics, Hospital for
Sick Children, Toronto, ON, Canada
(Robinson) Institute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, ON, Canada
(Ewusie) Research Institute, St Joseph's Healthcare Hamilton, Hamilton,
ON, Canada
(Beattie, Batthish) Division of Rheumatology, Department of Pediatrics,
McMaster University, Hamilton, ON, Canada
Publisher
Oxford University Press
Abstract
Objectives To determine if children with Kawasaki disease (KD) are at an
increased long-term risk of cardiovascular disease and mortality. Methods
A systematic review and meta-analysis was performed. A systematic search
of MEDLINE, EMBASE, CINAHL, Cochrane, and Web of Science databases was
performed through 2022. English-language publications, patients 0 to 18
years at KD diagnosis, minimum follow-up >1 year, and >=10 patients
included. Of 5072 articles, 181 were included. Cardiovascular events and
mortality were extracted and pooled for analysis. Meta-analyses and
meta-regression analyses were performed. The primary outcome of interest
was the incidence of specific cardiovascular events (composite of
myocardial infarction, heart failure or cardiac arrest) and all-cause
mortality. Secondary outcomes included the incidence of occlusive coronary
events, myocardial infarction, heart failure, cardiac arrest, non-coronary
artery bypass grafting (CABG) coronary revascularization procedures, and
CABG. Results Cardiovascular events occurred in 0.85% of children during
study follow-up. The incidence rate of cardiovascular events was 370 per
100,000 person-years. Mortality occurred in 0.24% of children during study
follow-up. The incidence rate of mortality was 117 per 100,000
person-years. Conclusions There is a low incidence of cardiovascular
events and mortality following childhood KD diagnosis. Further studies are
needed to better define this long-term risk. Copyright © 2025 The
Author(s).

<79>
Accession Number
2040325709
Title
Neurocognitive outcomes and memory transfer in heart transplantation.
Source
Global Cardiology Science and Practice. 4 (no pagination), 2025. Article
Number: 43. Date of Publication: 2025.
Author
Ashinze P.; Salawu W.; Akande E.; Banerjee S.; Idris-Agbabiaka A.; Chukwu
B.; Mafua N.; Ngirigwa F.; Okeoyo T.; Olowookere S.; Adeleye V.M.;
Olajuwon J.T.; Aboderin C.; Olasemo A.; Musa L.A.
Institution
(Ashinze, Akande, Chukwu, Olasemo) Faculty of Clinical Sciences,
University of Ilorin Teaching Hospital, Ilorin, Nigeria
(Salawu) St John's Hospital, Livingston, (NHS Lothian), United Kingdom
(Banerjee) Burdwan Medical College and Hospital, Department of Health and
Family Welfare, Government of West Bengal, India
(Idris-Agbabiaka) Georgetown Public hospital, Guyana
(Mafua) Faculty of Clinical Sciences, Madonna University, Anambra, Nigeria
(Ngirigwa) Federal Medical Centre, Delta, Asaba, Nigeria
(Okeoyo) The Balfour Hospital, NHS Scotland, United Kingdom
(Olowookere, Aboderin) Obafemi Awolowo University Teaching Hospital
Complex, Osun state, Ife, Nigeria
(Adeleye) Department of Community Medicine and Public Health, Ekiti State
University Teaching Hospital, Ekiti, Nigeria
(Olajuwon) Mersey and West Lancashire Teaching Hospital NHS Trust, United
Kingdom
(Musa) Emergency Department, Aberdeen Royal Infirmary, Foresterhill,
Aberdeen, United Kingdom
Publisher
HBKU Press
Abstract
Introduction: Cardiac transplantation remains a life-saving intervention
for end-stage cardiac disease, substantially improving survival and
quality of life. While physiological and immunological challenges, such as
graft rejection and immunosuppression, are well-characterized, emerging
evidence underscores complex neurocognitive and psychological
transformations in recipients. These include debated phenomena such as
shifts in memory, behavior, and personality, which challenge conventional
paradigms of transplantation outcomes. Methodology: This scoping review
was conducted by performing comprehensive literature searches of databases
including PubMed, Scopus, Google Scholar, Cochrane Library, and PsycINFO
using MeSH keywords : "heart transplant," "neurocognitive outcomes,"
"cellular memory," AND "personality transfer." The timeline spanned 1990
through June 2025. Inclusion criteria: (1) peer-reviewed clinical studies;
(2) case reports providing detailed narrative descriptions relevant to
memory/personality changes; (3) manuscripts written in English; (4)
reports including >=5 participants/patients. Exclusion criteria: (1)
non-transplant cardiac studies; (2) animal research; (3)
editorials/opinions/gray literature; (4) non-English manuscripts. Study
quality was assessed through manual review of documented accounts
alongside corresponding peer-reviewed manuscripts. Result(s): This
review synthesizes theories, case studies, and mechanistic hypotheses from
published reports, exploring neurocognitive trajectories and purported
memory-behavioral transfer between donors and recipients. Epigenetic
modifications-such as DNA methylation and histone remodeling-are
hypothesized to alter gene expression in donor-derived cells, potentially
influencing recipient cognition and behavior. Concurrently, immune-brain
crosstalk, mediated by cytokines and neuroinflammatory pathways, may
exacerbate psychological distress, including identity dissonance and
anxiety. Cognitive-behavioral interventions and psychosocial support
emerge as critical tools for post-transplant adaptation.
 Conclusion(s): Current evidence on memory transfer remains
inconclusive, yet its implications for biological-psychological
interconnectedness warrant rigorous interdisciplinary inquiry. By
integrating neuroscientific, immunological, and psychological frameworks,
future research can elucidate the mechanisms underlying post-transplant
neurocognitive phenomena, optimizing therapeutic strategies and patient
counseling. Copyright COPYRIGHT: 2025 The Author(s)

<80>
Accession Number
2040304895
Title
Patient selection in robotic mitral valve surgery.
Source
Current Opinion in Cardiology. (no pagination), 2025. Article Number: 40.
Date of Publication: 2025.
Author
Gillinov M.; Malas T.; Rabbani M.; Wierup P.
Institution
(Gillinov, Malas, Rabbani, Wierup) Department of Thoracic and
Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review National databases reveal increased application of the
surgical robot to facilitate mitral valve repair. Single-center and
multiinstitutional studies confirm that excellent results are achievable
with robotic mitral valve repair. However, not all patients with
degenerative mitral valve disease are appropriate candidates for robotic
mitral valve repair. Recent findings With increased experience, surgeons
have successfully applied the surgical robot to perform mitral valve
repair in conjunction with concomitant procedures. Concurrently, selection
criteria have expanded, enabling more patients to enjoy the benefits of a
less invasive approach. A small group of patient-related and anatomic
factors are best managed via a standard sternal approach. Summary
Approaching 15% of all mitral valve repairs for degenerative disease,
robotic mitral valve repair has reached an inflection point in its growth.
Well tolerated application of this technology requires understanding of
both its advantages and its limitations. Copyright © 2025 Wolters
Kluwer Health, Inc. Unauthorized reproduction of this article is
prohibited.

<81>
Accession Number
2040304966
Title
Advancements in Computed Tomography Analysis for Thoracic Aortic Surgery:
The Expanding Role of Automation.
Source
Heart Surgery Forum. 28(8) (pp E644-E655), 2025. Date of Publication: 20
Aug 2025.
Author
Chatterjee D.; Singh S.; Shou B.L.
Institution
(Chatterjee) Department of Cardiothoracic Surgery, University of Maryland
School of Medicine, Baltimore, MD, United States
(Singh) Department of Biomedical Engineering, Johns Hopkins University,
Baltimore, MD, United States
(Shou) Department of Cardiothoracic Surgery, Stanford University, Palo
Alto, CA, United States
Publisher
Forum Multimedia Publishing LLC
Abstract
Computed tomography (CT) is crucial for evaluating complex aortic anatomy,
facilitating surgical planning, and improving patient outcomes in thoracic
aortic surgery. Recent advancements in artificial intelligence (AI)-driven
tools offer potential improvements in diagnostic accuracy and
interventional planning through automated segmentation and feature
extraction. We conducted a systematic review of AI-based tools for aortic
CT imaging, focusing on machine learning and deep learning algorithms used
in segmentation and feature extraction. Databases searched included
PubMed, Embase, and IEEE Xplore, using terms such as "Thoracic Aortic
Surgery", "CT Imaging", "Segmentation", and "Outcome Prediction". This
review identified high-performance segmentation models, including U-Net
and convolutional neural network (CNN) architectures. Radiomic analyses
and automated features demonstrated correlations with surgical outcomes,
such as aneurysm growth rates and thrombus assessment. AI-driven
automation in CT imaging is an expanding field with potential to improve
diagnosis, operative planning, and prognostication in aortic pathologies.
Further refinement and integration of these tools in clinical practice
could improve diagnostics and management for patients with thoracic aortic
disease. Copyright © 2025 The Author(s).

<82>
Accession Number
2040260277
Title
Left atrial appendage closure vs oral anticoagulation for stroke
prevention in atrial fibrillation: Long-term outcomes from 4 randomized
trials.
Source
Heart Rhythm. (no pagination), 2025. Date of Publication: 2025.
Author
Kaisaier W.; Xu Z.; Guo L.; Dong Y.; Chen Y.; Lip G.Y.H.; Zhu W.
Institution
(Kaisaier, Dong, Chen, Zhu) Department of Cardiology, First Affiliated
Hospital of Sun Yat-Sen University, Guangzhou, China
(Xu) Department of Emergency, Third Affiliated Hospital of Sun Yat-sen
University, Guangzhou, China
(Guo) Department of Cardiology, Jiangxi Provincial People's Hospital,
First Affiliated Hospital of Nanchang Medical College, Nanchang, China
(Lip) Liverpool Centre for Cardiovascular Science at University of
Liverpool, Liverpool John Moores University and Liverpool Heart & Chest
Hospital, Liverpool, United Kingdom
(Lip) Department of Clinical Medicine, Danish Center for Health Services
Research, Aalborg University, Aalborg, Denmark
Publisher
Elsevier B.V.
Abstract
Background: Left atrial appendage closure (LAAC) is primarily indicated
for stroke prevention in patients with atrial fibrillation (AF) who have
contraindications to long-term oral anticoagulants (OACs). However, the
long-term comparative benefits of LAAC vs OACs in the broader AF
population remain unclear. Objective(s): To study aimed to assess the
long-term efficacy and safety of LAAC compared with OACs in patients with
AF, we conducted a meta-analysis of randomized controlled trials (RCTs).
 Method(s): We systematically searched PubMed, Embase, and Cochrane
Library for eligible RCTs. Risk ratios (RRs) with 95% confidence intervals
(CIs) were calculated using fixed-effects models. Result(s): Four
RCTs involving 3116 patients with AF (1736 assigned to LAAC and 1380 to
OACs) and follow-up durations ranging from 36 to 49.6 months were
included. Compared with OACs, LAAC was associated with reduced risks of
all-cause death (RR = 0.78; 95% CI: 0.64-0.95) and cardiovascular or
unexplained death (RR = 0.69; 95% CI: 0.51-0.94). There were no
significant differences between the 2 groups in stroke or systemic
embolism, ischemic stroke, or systemic embolism, and non-cardiovascular
death. LAAC was associated with significantly lower risk of hemorrhagic
stroke (RR = 0.34; 95% CI: 0.16-0.76) and non-procedural clinically
relevant bleeding (RR = 0.49; 95% CI: 0.40-0.61). Major bleeding
(including procedural and non-procedural) risk did not differ
significantly between groups. Conclusion(s): In this meta-analysis of
RCTs, LAAC was associated with significantly lower risks of all-cause and
cardiovascular death, hemorrhagic stroke, and non-procedural clinically
relevant bleeding compared with OACs, without increasing the risk of
thromboembolic events or major bleeding. These findings support the
consideration of LAAC as an alternative to OAC in selected patients with
AF. Copyright © 2025 Heart Rhythm Society

<83>
Accession Number
2037070220
Title
Implementation of Uniportal Video-Assisted Thoracoscopic Surgery to Treat
Pericardial Effusion: A Review.
Source
Heart Surgery Forum. 28(8) (pp E635-E643), 2025. Date of Publication: 20
Aug 2025.
Author
Aleem M.U.; Alsultan B.S.; Chahine R.O.; Nardini M.; Migliore M.
Institution
(Aleem, Alsultan, Chahine, Migliore) College of Medicine, Alfaisal
University, Riyadh, Saudi Arabia
(Nardini) Department of Thoracic Surgery, University Hospital of Leeds,
West Yorkshire, Leeds, United Kingdom
(Migliore) Thoracic Surgery & Lung Transplant, Lung Health Centre, Organ
Transplant Center of Excellence (OTCoE), King Faisal Specialist Hospital &
Research Center, Riyadh, Saudi Arabia
(Migliore) Department of General Surgery & Medical Specialties, University
Polyclinic Hospital, University of Catania, Catania, Italy
Publisher
Forum Multimedia Publishing LLC
Abstract
Pericardial effusion is the pathological accumulation of fluid in the
pericardial cavity and can lead to life-threatening complications such as
cardiac tamponade. While pericardiocentesis and surgical pericardial
window creation remain the mainstay of treatment, uniportal video-assisted
thoracoscopic surgery (UVATS) has emerged as a minimally invasive
alternative with potential advantages over conventional approaches. This
study comprehensively reviewed the existing literature to evaluate the
safety, efficacy, and clinical outcomes of UVATS in managing pericardial
effusion. A comprehensive search across the PubMed, Cochrane, and Google
Scholar databases identified studies published from 2000 onward, focusing
on the application of UVATS in thoracic surgery. The findings indicate
that UVATS is associated with shorter hospital stays, reduced
postoperative pain, and lower recurrence rates compared to multiportal
VATS and the subxiphoid approach. Additionally, since UVATS is a
single-incision technique, this method minimizes intercostal trauma,
instead enhancing postoperative recovery. However, challenges remain,
including a steep learning curve, technical limitations, and the
requirement for specialized instrumentation. Despite these concerns, UVATS
continues to evolve with advancements in instrumentation, imaging, and
robotic assistance, further improving its feasibility and outcomes. As the
adoption of UVATS grows, future research should focus on long-term
efficacy, standardization of techniques, and expanded indications to
optimize its role in thoracic surgery. Copyright © 2025 The
Author(s).

<84>
Accession Number
2035320706
Title
Predicting the depth of insertion of central venous catheters using a
bronchoscopy-based carinal measurement technique or the Peres'
formula-based method in adults undergoing cardiac surgery: A randomised
comparative double-blind study.
Source
Indian Journal of Anaesthesia. 68(11) (pp 978-984), 2024. Date of
Publication: 01 Nov 2024.
Author
Misra S.; Das P.K.; Behera B.K.; Das D.; Patra T.K.
Institution
(Misra, Das, Behera, Das, Patra) Department of Anesthesiology and Critical
Care, AIIMS, Odisha, Bhubaneswar, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Various methods are used to predict the depth of
insertion of central venous catheters (CVCs). We evaluated a
bronchoscopy-based carinal measurement technique to predict this depth.
 Method(s): We randomised adults undergoing cardiac surgery into a
bronchoscopy group or the Peres' formula-based method group. CVCs were
inserted through the right internal jugular vein. The skin insertion
reference point was at the level of the cricoid cartilage lateral to the
carotid artery. In the bronchoscopy group, the depth of insertion was
determined by the total length from the carina to the proximal end of the
tracheal tube (TT) (measured with a flexible bronchoscope) minus (the sum
of the distances from the skin insertion reference point to the TT and the
length of the TT outside the mouth). In the Peres' group, height (cm)/10
determined the depth of insertion. Confirmation of CVCs' distal tip
position was done with transoesophageal echocardiography. The area from 2
cm proximal to 1 cm distal to the superior vena cava-right atrium junction
was considered ideal. The primary outcome was the proportion of correct
CVC placements. The secondary outcome was the alignment of the CVCs.
 Result(s): Forty-one patients in the bronchoscopy group and 40
patients in the Peres' group were enroled. A greater proportion of CVCs
was placed correctly in the bronchoscopy group (87.8% vs. 37.5%; P =
0.001). A more significant proportion of CVC tips was abutting the vessel
wall in the Peres' group (45% vs. 19.5%; P = 0.014). Conclusion(s):
Bronchoscopy-based carinal measurement technique results in more accurate
placement of CVCs compared to the Peres' method. Copyright © 2024
Indian Journal of Anaesthesia.

<85>
Accession Number
2040260187
Title
The effectiveness and side effects of anti-coagulant drugs in pregnant
women with mechanical or bio-prosthetic heart valves: A systematic review
and meta-analysis study.
Source
Journal of Cardiology. (no pagination), 2025. Date of Publication: 2025.
Author
Shishesaz M.I.; Eshraghi R.; Bahrami A.; Farzan M.; Hajibeygi R.; Fathi
M.; Yaghoobpoor S.; Tavasol A.; Gorjizad M.; Dehghani M.; Akbari A.;
Rafiei N.; Roostaie M.; Eslami S.; Taherkhani M.; Movahed M.R.
Institution
(Shishesaz) School of Medicine, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Eshraghi) Social Determinants of Heath Research Center, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Bahrami) Student Research Committee, Kashan University of Medical
Sciences, Kashan, Iran, Islamic Republic of
(Farzan, Farzan) Medical Plants Research Center, Basic Health Sciences
Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran,
Islamic Republic of
(Farzan) Student Research Committee, Shahrekord University of Medical
Sciences, Shahrekord, Iran, Islamic Republic of
(Hajibeygi) School of Medicine, Tehran University of Medical Science,
Tehran, Iran, Islamic Republic of
(Fathi, Yaghoobpoor, Tavasol, Gorjizad, Akbari) School of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Dehghani, Rafiei) School of Medicine, Isfahan University of Medical
Sciences, Isfahan, Iran, Islamic Republic of
(Roostaie) School of Medicine, Islamic Azad University Tehran Medical
Branch, Tehran, Iran, Islamic Republic of
(Eslami) Firoozgar Hospital, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Taherkhani) Clinical Research Development Unit (CRDU) of Loghman Hakim
Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Movahed) University of Arizona Sarver Heart Center, Tucson, AZ, United
States
(Movahed) University of Arizona College of Medicine, Phoenix, AZ, United
States
(Hajibeygi) Department of Radiology and Biomedical Imaging, Yale School of
Medicine, CT, United States
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background and objectives: Patients with pregnancy and mechanical or
bio-prosthetic heart valves (BHVs) need tailored antithrombotic therapy to
prevent thromboembolism. The goal of this study was to evaluate the
effects and complications of various anticoagulation strategies used
during pregnancy in these patients using a meta-analysis. Method(s):
We searched PubMed, Google Scholar, Scopus, EMBASE, and Web of Science
databases and discovered 24 articles. We also discarded some articles when
evaluating them in detail due to inadequate information. Finally, 24
studies were included in the systematic review. We compared pregnancy
outcomes in three groups of pregnant women: 1) Those taking warfarin; 2)
Those taking LMWH (Low Molecular Weight Heparin) or UFH (Unfractionated
Heparin); 3) Those on no anticoagulant therapy. The authors would like to
thank the Clinical Research Development Unit (CRDU) of Loghman Hakim
Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran for
their support, cooperation and assistance throughout the period of study.
The ethic code is: IR.SBMU.RETECH.REC.1403.831. Result(s): The
incidence of maternal thromboembolic events was higher in the UFH or LMWH
group, but fetal complications (FC) were lower in this group. Using
warfarin during the first trimester was associated with a higher abortion
rate, embryopathies, and FCs overall. Using <5 mg of warfarin daily to
maintain their targeted INR had a lower risk of developing. Preterm labor
and spontaneous abortion were observed in 0.09 (95 % CI = 0.04-0.14) and
0.08 (95 % CI = 0.01-0.14) of cases in the LMWH/UFH subgroup. In terms of
maternal complications (MCs) in Warfarin subgroup, maternal hemorrhagic
complications, maternal thromboembolic events, and valve thrombosis were
respectively observed in 2.0 (95 % CI = 0-3), 0.01 (95 % CI = 0.00-0.03),
0.01 (95 % CI = 0.00-0.03); in LMWH subgroup the rates were 0.18 (95 % CI
= 0.09-0.27), 0.03 (95 % CI = 0.00-0.06), and 0.28 (95 % CI = 0.15-0.71);
and finally in those taking no anticoagulant therapy, the rates were 0.02
(95 % CI = 0.03-0.06), 0.07 (95 % CI = 0.06-0.19). Conclusion(s):
According to the results, preterm labor is a significant fatal
complication in pregnant women on warfarin. Maternal hemorrhagic
complications and thromboembolic events occur in the LMWH subgroup. There
are no significant differences in other complications between the three
subgroups. Copyright © 2025 Elsevier Ltd

<86>
Accession Number
2035652501
Title
Timing of coronary angiography in high-risk non-ST-elevation acute
coronary syndrome: results from the Portuguese Registry for Acute Coronary
Syndromes (ProACS).
Source
Coronary Artery Disease. 36(2) (pp 166-172), 2025. Date of Publication: 01
Mar 2025.
Author
Ribeiro Carvalho C.; Bernardo M.C.; Martins Moreira I.; Mateus P.;
Baptista A.; Moreira I.
Institution
(Ribeiro Carvalho, Bernardo, Martins Moreira, Mateus, Baptista, Moreira)
Department of Cardiology, Unidade Local de Saude de Tras-os-Montes e Alto
Douro, Vila Real, Portugal
Publisher
Lippincott Williams and Wilkins
Abstract
Background Current guidelines recommend an early invasive coronary
angiography (ICA) within 24 h of admission for high-risk patients with
non-ST-elevation acute coronary syndrome (NSTE-ACS). Nevertheless,
meta-analyses failed to demonstrate a clear advantage of this strategy in
reducing hard endpoints such as death or nonfatal myocardial infarction
compared to a delayed approach. Thus, the optimal timing of ICA in
high-risk NSTE-ACS remains undetermined. Objective This study aimed to
determine the optimal timing for ICA in high-risk NSTE-ACS, regarding
1-year all-cause mortality and cardiovascular rehospitalizations. Methods
We conducted a national multicenter retrospective study of high-risk
NSTE-ACS patients included in the Portuguese Registry for Acute Coronary
Syndromes. Patients were divided into three groups according to the time
of ICA: within the first 24 h, between 24 and 48 h, and between 48 and 72
h. The incidence of in-hospital complications and mortality, 1-year
mortality, and cardiovascular rehospitalizations were assessed. Results Of
the 9949 patients included, 46.7% underwent early ICA. This was associated
with a lower incidence of acute heart failure (8.5% vs. 11.1% vs. 11.5%, P
< 0.001) and shorter length of stay (3 vs. 4 vs. 6 days, P = 0.012). It,
however, did not reduce in-hospital complications or mortality (1.2 vs.
0.7 vs. 0.8%, P = 0.066). We also found no significant association with
the composite endpoint of 1-year mortality or cardiovascular
rehospitalization (15.1 vs. 15.9 vs. 15.7%, P = 0.887). Conclusions Early
ICA was associated with a lower incidence of acute heart failure and
shorter length of stay, without a significant impact on 1-year mortality
risk or cardiovascular rehospitalizations. Copyright © 2024
Wolters Kluwer Health, Inc. All rights reserved.

<87>
Accession Number
2040293634
Title
Meta-analysis of poultry organ weights and their relationship with meat
yield.
Source
Poultry Science. 104(11) (no pagination), 2025. Article Number: 105634.
Date of Publication: 01 Nov 2025.
Author
Richardson N.T.; Jahnel R.E.; Makanjuola B.O.; Bai X.; Barbut S.; Ellis
J.L.; Baes C.F.; Leishman E.M.
Institution
(Richardson, Jahnel, Makanjuola, Baes, Leishman) Centre for Genetic
Improvement of Livestock, Department of Animal Biosciences, University of
Guelph, Guelph, ON, Canada
(Bai) Hybrid Turkeys, Kitchener, ON, Canada
(Ellis, Leishman) Centre for Nutrition Modelling, Department of Animal
Biosciences, University of Guelph, Guelph, ON, Canada
(Barbut) Food Science Department, University of Guelph, United States
(Leishman) Department of Animal and Veterinary Sciences, Aarhus
University, Blichers Alle 20, DK, Tjele, Denmark
Publisher
Elsevier Inc.
Abstract
Late-stage mortality is a significant challenge for the poultry industry,
leading to substantial economic losses, concerns about animal welfare, and
operational sustainability. Heart-related conditions, including ascites
syndrome, pulmonary hypertension syndrome, hypertrophic cardiomyopathy,
and sudden death syndrome, contribute significantly to this issue. The
increasing prevalence of these conditions is potentially linked to intense
selection pressure aimed at maximizing meat yield, particularly breast
meat. However, the precise relationship between meat yield, heart size and
cardiovascular health remains unclear. To address this, a systematic
literature review and meta-analysis were conducted to explore the
relationship between breast meat yield and organ size (heart, lungs,
liver), in which 91 publications meeting specific inclusion criteria were
identified. Data extracted included variables such as live weight, portion
yields (breast, leg, wing), organ weights (heart, lungs, liver), and the
prevalence of heart-related conditions (pulmonary hypertension syndrome,
ascites syndrome). A backward selection modeling approach was used to
develop linear mixed models, treating the study as a random effect, to
examine the relationship between organ weights as a percentage of body
weight (% BW), meat yield and other animal attributes. The best heart
weight model (% BW) included the effects of sex, species (chicken or
turkey), bird purpose (meat or egg), breast meat yield (%), and live
weight (g). The best liver weight model (% BW) included species, bird
purpose, breast meat yield (%), and live weight (g). The best lung weight
(% BW) model included heart weight (g). Model performance was evaluated
using residuals analysis, root mean squared prediction error, and the
concordance correlation coefficient. Findings suggest that laying hens
have larger hearts relative to body weight compared to broiler chickens
and turkeys. The liver and lung models revealed that broiler chickens had
larger livers (% BW) compared to laying hens, and that lung weight (% BW)
was negatively correlated to heart weight (g). These results highlight the
potential need to consider organ health in breeding programs focused on
meat yield. Copyright © 2025

<88>
Accession Number
2035959602
Title
Safety of pericardiocentesis in pulmonary arterial hypertension: a
systematic review.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1610419. Date of Publication: 2025.
Author
Cabada-Garcia M.J.; Rodriguez-Rivera J.; Jerjes-Sanchez C.; Castillo-Perez
M.; Gutierrez-Gallegos P.; Martinez-Rodriguez A.L.; Paredes-Gutierrez E.;
Quevedo-Salazar R.C.; De Leon-Gutierrez H.; Lopez-Cortes O.D.; Panneflek
J.; Monjaras-Alvarado R.; Moron-Mosso J.A.; Gonzalez-Medina J.G.
Institution
(Cabada-Garcia, Rodriguez-Rivera, Jerjes-Sanchez, Castillo-Perez,
Gutierrez-Gallegos, Martinez-Rodriguez, Paredes-Gutierrez,
Quevedo-Salazar, De Leon-Gutierrez, Lopez-Cortes, Panneflek,
Monjaras-Alvarado, Moron-Mosso, Gonzalez-Medina) Tecnologico de Monterrey,
Escuela de Medicina y Ciencias de la Salud, Nuevo Leon, Monterrey, Mexico
(Cabada-Garcia) Fellow of the General Directorate of Quality and Health
Education, Ministry of Health, Mexico City, Mexico
(Jerjes-Sanchez, Panneflek) Instituto de Cardiologia y Medicina Vascular,
TecSalud, Escuela de Medicina y Ciencias de la Salud, Tecnologico de
Monterrey, Nuevo Leon, San Pedro Garza Garcia, Mexico
Publisher
Frontiers Media SA
Abstract
Introduction: Controversy persists regarding the use of pericardial
effusion drainage in patients with pulmonary arterial hypertension (PAH),
as several studies report high rates of post-procedure morbidity and
mortality. Method(s): We conducted a systematic review to evaluate
the safety of pericardiocentesis (PC) in patients with PAH and a large or
hemodynamically significant pericardial effusion. We focused on studies
involving patients with PAH who presented with a large or hemodynamically
significant pericardial effusion and underwent PH. Our primary objective
was to evaluate the incidence of major periprocedural complications, and
our secondary objectives were to identify the clinical presentation and
echocardiographic findings. Result(s): We identified 35 patients
across 16 studies. Connective tissue disease was the most common etiology
of PAH. Drainage strategies during PC differed across studies. The overall
mortality rate was 20%, and we identified pericardial decompression
syndrome in 14% of patients. Dyspnea and peripheral edema dominated the
clinical presentation. Echocardiographic findings of cardiac tamponade,
particularly left-sided chamber collapse, appeared more frequently.
 Discussion(s): PC in patients with PAH carries a heightened risk of
pericardial decompression syndrome and mortality. However, careful patient
selection, echocardiographic guidance, gradual decompression, and
continuous hemodynamic monitoring during the procedure may help improve
outcomes. Systematic Review Registration: PROSPERO 585310. Copyright
2025 Cabada-Garcia, Rodriguez-Rivera, Jerjes-Sanchez, Castillo-Perez,
Gutierrez-Gallegos, Martinez-Rodriguez, Paredes-Gutierrez,
Quevedo-Salazar, De Leon-Gutierrez, Lopez-Cortes, Panneflek,
Monjaras-Alvarado, Moron-Mosso and Gonzalez-Medina.

<89>
Accession Number
648421636
Title
Sex-specific outcomes after transcatheter or surgical treatment of aortic
valve stenosis: the DEDICATE-DZHK6 trial.
Source
European heart journal. (no pagination), 2025. Date of Publication: 03
Sep 2025.
Author
Bleiziffer S.; Leuschner F.; Rudolph T.K.; Vonthein R.; Meyer A.L.;
Haeusler K.G.; Hofmann U.; Gorski A.; Hagendorff A.; Kim W.-K.;
Baumgartner H.; Borger M.A.; Choi Y.-H.; Cremer J.; Falk V.; Frey N.; Hagl
C.; Konig I.R.; Landmesser U.; Massberg S.; Reichenspurner H.; Renker M.;
Thiele H.; Walther T.; Ziegler A.; Blankenberg S.; Dreger H.; Arif R.;
Unbehaun A.; Seiffert M.
Institution
(Bleiziffer) Department of Thoracic and Cardiovascular Surgery, Herz- und
Diabeteszentrum NRW, Ruhr-Universitat Bochum, Bad Oeynhausen, Germany
(Leuschner, Frey) Department of Cardiology, Angiology, Pneumology,
Heidelberg University Hospital, Heidelberg, Germany
(Leuschner, Frey, Arif) DZHK (German Centre for Cardiovascular Research)
Partner Site Heidelberg/Mannheim, Heidelberg, Germany
(Rudolph) Department of General and Interventional Cardiology/Angiology,
Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Bad Oeynhausen,
Germany
(Vonthein, Konig) Institute of Medical Biometry and Statistics, University
of Lubeck, Lubeck, Germany
(Meyer, Arif) Department of Cardiac Surgery, University Hospital
Heidelberg, Heidelberg, Germany
(Haeusler) Department of Neurology, University Hospital Ulm, Ulm, Germany
(Hofmann) Department of Internal Medicine I, University Hospital Wurzburg
(UKW), Wurzburg, Germany
(Gorski) Department of Cardiac Surgery, Hamburg, Germany
(Hagendorff) Department of Cardiology, University of Leipzig, Leipzig,
Germany
(Kim) University of Giessen, Campus Kerckhoff and Medical Clinic I,
Giessen, Germany
(Kim, Renker, Walther) DZHK (German Centre for Cardiovascular Research)
Partner Site Rhine-Main, Rhine-Main, Germany
(Baumgartner) Department of Cardiology III-Adult Congenital and Valvular
Heart Disease, University Hospital Muenster, Muenster, Germany
(Borger) Department of Cardiac Surgery, Heart Center Leipzig at University
of Leipzig, Leipzig, Germany
(Choi) Department of Cardiac Surgery, Kerckhoff-Clinic GmbH, Bad Nauheim,
Germany
(Cremer) Department of Cardiovascular Surgery, University Hospital of
Schleswig-Holstein, Kiel, Germany
(Cremer, Konig, Reichenspurner, Blankenberg, Seiffert) DZHK (German Centre
for Cardiovascular Research) Partner Site Hamburg/Kiel/Lubeck, Germany
(Falk, Unbehaun) Department of Cardiothoracic and Vascular Surgery,
Berlin, Germany
(Falk) Department of Health Sciences and Technology, ETH Zurich,
Translational Cardiovascular Technology, Zurich, Switzerland
(Falk, Landmesser, Dreger, Unbehaun) DZHK (German Centre for
Cardiovascular Research) Partner Site Berlin, Berlin, Germany
(Hagl) Department of Cardiac Surgery, University Hospital Munich,
Ludwig-Maximilians-University Munich, Munich, Germany
(Hagl, Massberg) DZHK (German Centre for Cardiovascular Research) Partner
Site Munich Heart Alliance, Munich, Germany
(Landmesser, Dreger) Department of Cardiology, Angiology and Intensive
Care Medicine, Berlin, Germany
(Landmesser, Dreger) Charite Universitatsmedizin Berlin, Berlin, Germany
(Massberg) Department of Cardiology, University Hospital Munich,
Ludwig-Maximilians-University Munich, Munich, Germany
(Reichenspurner) Department of Cardiovascular Surgery, University Heart
and Vascular Center Hamburg, Hamburg, Germany
(Renker) Department of Cardiology, Kerckhoff-Clinic, Bad Nauheim, Germany
(Thiele) Department of Cardiology, Heart Center Leipzig at University of
Leipzig, Leipzig, Germany
(Thiele) Leipzig Heart Science, Leipzig, Germany
(Walther) Department of Cardiac and Vascular Surgery, University Hospital
Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
(Ziegler, Blankenberg) Department of Cardiology, University Heart and
Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf,
Hamburg, Germany
(Ziegler, Blankenberg) Centre for Population Health Innovation (POINT),
University Heart and Vascular Center Hamburg, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany
(Ziegler) Medizincampus Davos, Davos, Switzerland
(Ziegler) School of Mathematics, Statistics and Computer Science,
University of KwaZulu-Natal, Pietermaritzburg, South Africa
(Seiffert) Department of Cardiology and Angiology, BG University Hospital
Bergmannsheil, Ruhr University Bochum, Burkle de la Camp-Platz 1, Bochum,
Germany
Abstract
BACKGROUND AND AIMS: Aortic stenosis may be managed differently in women
and men, but evidence remains limited. Sex-specific characteristics and
outcomes of low- to intermediate-risk patients assigned to transcatheter
aortic valve implantation (TAVI) or surgical aortic valve replacement
(SAVR) from the DEDICATE-DZHK6 trial are described. METHOD(S): The
DEDICATE-DZHK6 trial demonstrated non-inferiority for the primary outcome
of all-cause death or stroke at 1 year. Sex-specific effects were
evaluated in this predefined descriptive subgroup analysis.
 RESULT(S): A total of 1394 patients (43.3% women) were included.
Women were older (women: 74.8 +/- 4.6 years vs men: 74.2 +/- 4.2 years, P
= .020) and at higher operative risk [median Society of Thoracic Surgeons
risk score 2.1% (1.5-2.7) vs 1.5% (1.0-2.2), P < .001]. All-cause death or
stroke at 1 year was 5.2% in the TAVI vs 11.5% in the SAVR group [hazard
ratio (HR) 0.46; 95% confidence interval (CI) 0.25-0.82] in women and 5.4%
vs 9.0% (HR 0.61; 95% CI 0.35-1.03) in men. At 1 year after TAVI vs SAVR,
all-cause death occurred in 2.6% vs 6.7% (HR 0.41; 95% CI 0.17-0.90) in
women and 2.6% vs 5.9% (HR 0.44; 95% CI 0.20-0.88) in men. Stroke occurred
in 2.6% vs 6.2% (HR 0.43; 95% CI 0.18-0.93) in women and 3.1% vs 3.6% (HR
0.89; 95% CI 0.41-1.90) in men. CONCLUSION(S): Among patients with
severe aortic stenosis at low to intermediate risk, TAVI was non-inferior
to SAVR for the primary outcome in women and men with lower event rates in
patients assigned to TAVI. Women were at particular risk for early
complications irrespective of the assigned treatment and at increased
stroke risk after SAVR. Copyright © The Author(s) 2025. 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

<90>
Accession Number
2035320711
Title
Efficacy and safety of a generic remifentanil formulation versus fentanyl
and Ultiva during general anaesthesia: A phase III, prospective,
multi-centric, observer-blind, randomised controlled trial.
Source
Indian Journal of Anaesthesia. 68(11) (pp 985-995), 2024. Date of
Publication: 01 Nov 2024.
Author
Hemantkumar I.; Swain A.K.; Mishra M.; Singh S.; Gurudatt C.L.; Giridhar
J.B.
Institution
(Hemantkumar) Department of Anaesthesia, Seth GS Medical College, KEM
Hospital, Parel East, Maharashtra, Mumbai, India
(Swain) Medical Services, Themis Medicare Limited, Goregaon West,
Maharashtra, Mumbai, India
(Mishra) Department of Anaesthesia, Institute of Medical Sciences, Banaras
Hindu University, Uttar Pradesh, Varanasi, India
(Singh) Department of Anaesthesia, Indira Gandhi Institute of Medical
Sciences, Sheikhupura, Bihar, Patna, India
(Gurudatt) Department of Anaesthesia, JSS Hospital, Karnataka, Mysuru,
India
(Giridhar) Department of Anaesthesia, Panimalar Medical College Hospital
and Research Institute, Poonamallee, Tamil Nadu, Chennai, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Remifentanil and fentanyl are potent opioid
analgesics commonly used during surgery due to their distinct
pharmacological profiles. This study aimed to compare the efficacy and
safety of a generic remifentanil (test drug) with fentanyl and Ultiva
(innovator formulation) during general anaesthesia in the Indian
population. Method(s): This phase III, multi-centre (n = 13),
randomised, three-arm, comparative study was conducted from 24 November
2021 to 31 March 2022. Eligible subjects scheduled for elective
therapeutic and diagnostic surgical procedures (n = 314) were randomised
into generic remifentanil, Ultiva, and fentanyl groups. An independent
anaesthetist blinded to treatment allocation assessed efficacy and safety
parameters. The primary efficacy endpoint was haemodynamic response during
specific activities (endotracheal intubation, skin incision, skin closure,
and extubation). Result(s): The study groups exhibited no significant
differences in demographic and baseline characteristics. Heart rate was
similar between the remifentanil and Ultiva groups measured during
laryngeal intubation, skin incision, skin closure, and extubation (P >
0.05 in all four procedures). Heart rate was significantly higher in the
fentanyl group in comparison to the remifentanil group during laryngeal
intubation (P = 0.035), skin incision (P = 0.017), skin closure (P =
0.001), and extubation (P = 0.026). The need for vasopressor and
anti-cholinergic drugs was similar between groups, and no subject required
naloxone administration. Conclusion(s): Our study's findings
demonstrated that generic remifentanil is non-inferior to fentanyl and
equivalent to Ultiva for general anaesthesia in Indian patients undergoing
various surgical and diagnostic procedures. Remifentanil offers advantages
in terms of optimum haemodynamic stability, fast equilibrating analgesia,
and rapid emergence from sedation, making it a suitable alternative to
fentanyl. Copyright © 2024 Indian Journal of Anaesthesia.

<91>
Accession Number
2040299145
Title
Cardiac prehabilitation: Is there a role in cardiac surgery.
Source
Best Practice and Research: Clinical Anaesthesiology. (no pagination),
2025. Date of Publication: 2025.
Author
Di Giambattista C.; Buyck K.; Shepherd S.
Institution
(Di Giambattista, Buyck, Shepherd) Department of Anaesthesia and Intensive
Care Medicine, St. Bartholomew's Hospital, West Smithfield, London, United
Kingdom
Publisher
Bailliere Tindall Ltd
Abstract
Background: Cardiac surgery presents significant perioperative risks,
particularly for high-risk populations such as elderly and frail patients.
Prehabilitation, a preoperative strategy focusing on patient optimization,
has emerged as a promising intervention to enhance recovery and reduce
complications. Objective(s): This review explores the evidence
supporting prehabilitation programs, which integrate exercise, nutritional
optimization, psychological support, and patient education to improve
cardiac surgical outcomes. Method(s): A review of current literature
highlights the benefits, challenges, and emerging multidisciplinary
approaches in cardiac prehabilitation, including inspiratory muscle
training and tailored nutritional support. Result(s): While
prehabilitation is well-established in other surgical specialties, its
implementation in cardiac surgery remains limited due to protocol
heterogeneity, time constraints, and patient-specific factors. Early data
suggest improved recovery, reduced hospital stays, and better
perioperative outcomes. Conclusion(s): Standardized prehabilitation
protocols and additional research are necessary to improve patient
selection, increase adherence, and assess long-term effects. With around
one million cardiac surgeries conducted worldwide annually, incorporating
structured prehabilitation programs may enhance patient outcomes and
refine perioperative care. Copyright © 2025 Elsevier Ltd

<92>
Accession Number
2035956441
Title
Effectiveness of Active Cycle of Breathing Technique in Improving
Physiological and Functional Outcomes Following Coronary Artery Bypass
Graft Surgery: A Narrative Review.
Source
Journal of Multidisciplinary Healthcare. 18 (pp 5431-5439), 2025. Date of
Publication: 2025.
Author
Nazir A.
Institution
(Nazir) Department of Physical Medicine and Rehabilitation, Dr. Hasan
Sadikin General Hospital, Jl. Pasteur No. 38, West Java, Bandung,
Indonesia
(Nazir) Department of Physical Medicine and Rehabilitation, Faculty of
Medicine Universitas Padjadjaran, West Java, Bandung, Indonesia
Publisher
Dove Medical Press Ltd
Abstract
Coronary artery bypass grafting (CABG) is a common surgical approach for
advanced coronary artery disease unresponsive to conservative or
percutaneous treatments. Despite its benefits in symptom relief and
long-term outcomes, CABG is associated with notable postoperative
respiratory complications. As such, respiratory physiotherapy plays a
crucial role in recovery. The active cycle of breathing technique (ACBT)
is a non-invasive, evidence-based method that promotes lung ventilation,
secretion clearance, and respiratory function. This review aimed to
describe the effectiveness of the ACBT in enhancing physiological and
functional outcomes following CABG surgery. A review of PubMed and Google
Scholar studies was conducted, with relevant articles analyzed for study
design, patient profiles, intervention protocols, and clinical outcomes.
Fifteen articles were included, encompassing studies on pulmonary
complications following CABG, dosage and application of ACBT, its
preventive role in postoperative pulmonary complications (PPCs), and its
effects on respiratory and functional outcomes. The results of this review
are expected to enhance clinicians' insight into selecting physical
therapy to prevent PPCs. Pulmonary complications, including atelectasis
and impaired gas exchange, are common after CABG and are primarily
associated with anesthesia, surgical trauma, systemic inflammatory
response, and impaired airway clearance. ACBT, consisting of breathing
control, thoracic expansion, and forced expiration techniques, is a
structured, non-invasive intervention designed to mobilize secretions and
improve ventilation. It is typically applied 2-3 times per day over 2-5
days and often combined with incentive spirometry and conventional chest
physiotherapy. The reviewed studies suggest that ACBT enhances
oxygenation, improves lung volumes, and increases functional capacity.
Additionally, ACBT helps reduce postoperative pain and dyspnea,
contributing to overall recovery without reported adverse events. To
conclude, ACBT is a safe, practical, and effective physiotherapeutic
approach to support postoperative pulmonary recovery in CABG patients.
Further well-designed trials are needed to validate and standardize its
clinical use. Copyright © 2025 Nazir.

<93>
Accession Number
2040290288
Title
Remimazolam besylate versus propofol as sedative agents in cardiac
surgery: A randomized noninferiority clinical trial.
Source
Surgery (United States). 187 (no pagination), 2025. Article Number:
109661. Date of Publication: 01 Nov 2025.
Author
Shen J.; Wang L.; Liu Y.; Li T.; Zhu L.; Li Z.; Shi J.; Lv H.
Institution
(Shen, Wang, Liu, Li, Shi, Lv) Department of Anesthesiology, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing, China
(Zhu) Department of Anesthesiology, Gansu Provincial People's Hospital,
Gansu, Lanzhou, China
(Li) Department of Anesthesiology, Shandong Provincial Third Hospital,
Shandong, Jinan, China
Publisher
Elsevier Inc.
Abstract
Background: Remimazolam besylate, despite being widely used in various
clinical settings, lacks evidence in cardiac anesthesia. This trial
compared its efficacy with propofol in elective cardiac surgery.
 Method(s): A total of 320 adult patients undergoing elective cardiac
surgery via cardiopulmonary bypass between December 2024 and March 2025
were randomized 1:1 to either propofol (1 mg/kg for induction and 1-1.5
mg/kg/h for maintenance) or remimazolam besylate (0.3 mg/kg for induction
and 1 mg/kg/h for maintenance) groups. The primary outcome was the
sedation success rate (ie, bispectral index 40-60 throughout surgery with
predefined dosages and without rescue sedatives), with an absolute
difference of 3% as a noninferiority margin. Secondary outcomes included
time from drug administration to bispectral index <60 (minute) and
bispectral index variation within 15 minutes after drug withdrawal.
Application of vasoactive drugs during induction, time to extubation
(hour), length of stay in intensive care unit (hour), and hospital (day)
were recorded. Result(s): Of 320 enrolled patients, all patients
completed the trial and 318 patients were analyzed eventually. The
sedation success rate of the whole surgery was significantly higher in the
remimazolam besylate group (159; 99.4%) than in the propofol group (130;
82.3%) (absolute difference 17.1%, 95% confidence interval 11.6%-23.9%; P
< .001). No significant differences in time from drug administration to
bispectral index <60 (P = .119), bispectral index variation after drug
withdrawal (P = .658), time to extubation (P = .824), and length of stay
in intensive care unit (P = .898) and hospital (P = .294) were observed.
 Conclusion(s): Remimazolam besylate is noninferior to propofol in
terms of sedation efficacy during elective cardiac
procedures. Copyright © 2025 Elsevier Inc.

<94>
Accession Number
2040286311
Title
The Endo-Bentall Procedure in the Treatment of Ascending Aorta
Pathologies: A Scoping Review.
Source
European Journal of Vascular and Endovascular Surgery. (no pagination),
2025. Date of Publication: 2025.
Author
Shehab M.; Prendes C.F.; Wanhainen A.; Lindblom R.; James S.; Mani K.
Institution
(Shehab, Prendes, Wanhainen, Mani) Department of Surgical Sciences,
Vascular Surgery, Uppsala University, Uppsala, Sweden
(Wanhainen) Department of Surgical and Peri-operative Sciences, Surgery,
Umea University, Umea, Sweden
(Lindblom) Department of Surgical Sciences, Cardiothoracic Surgery,
Uppsala University, Uppsala, Sweden
(James) Department of Medical Sciences, Cardiology, Uppsala University,
Uppsala, Sweden
Publisher
W.B. Saunders Ltd
Abstract
Objective: The ascending aorta remains a challenging area for endovascular
repair, with limited anatomical suitability of current stent grafts due to
proximal landing zone constraints. This scoping review summarised,
existing experiences with the Endo-Bentall procedure, evaluated its use
across pathologies, identified obstacles, and proposed future advances.
 Data Sources: PubMed, Cochrane, and Embase were systematically
searched (English language, up to 30 November 2024) for studies evaluating
the Endo-Bentall procedure in treating ascending aortic pathologies.
Review Methods: The Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) protocol extension for scoping reviews was
followed, and data were reported as descriptive narratives or tables.
 Result(s): Twenty studies were included, comprising case reports,
anatomical feasibility analyses, reviews, expert opinions, and technical
notes. Proof of concept studies in ex vivo (n = 30) and in vivo (n = 20)
models achieved 95 - 100% technical success rates, with sustained coronary
patency. Five cases were reported; indications included aortic dissection
(n = 2), aneurysm (n = 1), and post-surgical complications (n = 2).
Balloon expandable transcatheter aortic valve implantation (TAVI)
platforms were used in three cases (one used single stage and two used two
stage procedures), while self expanding platforms were used in two cases
(single stage). Technical success was achieved in all cases. Early follow
up showed favourable outcomes in two of three balloon expandable cases and
two of two self expanding cases. One patient died at 5 months (non-aortic
cause). Anatomical feasibility studies for aortic dissection (n = 547) and
aortic aneurysm (n = 80) demonstrated a median suitability rate of 68% (31
- 80%) for various device designs. The Grading of Recommendations
Assessment, Development, and Evaluation (GRADE) methodology suggested a
very low certainty regarding clinical outcomes. Conclusion(s): The
Endo-Bentall procedure is an emerging endovascular approach for ascending
aortic pathologies, particularly for patients at high surgical risk. Early
experience suggests feasibility. However, the current literature is
significantly limited by publication bias and methodological
heterogeneity. Further research is required, with systematic evaluation to
optimise device development, surgical technique, bailout strategies, and
long term outcomes. Copyright © 2025 The Author(s)

<95>
Accession Number
2040286516
Title
Effects of Preoperative Oral Carbohydrates on Insulin Resistance and
Postoperative Recovery in Diabetic Patients Undergoing Coronary Artery
Bypass Grafting: A Preliminary Prospective, Single-Blinded, Randomized
Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Zhang S.; He L.; Yu Y.; Yuan X.; Yang T.; Yan F.; Xu F.; Zhang Y.; Pan S.;
Zhang H.; Chen Z.; Xie L.; Wu R.; Feng W.; Yao Y.
Institution
(Zhang, Yuan, Yang, Xu, Zhang, Pan, Zhang, Xie, Feng) Department of
Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular
Diseases, Peking Union Medical College and Chinese Academy of Medical
Sciences, Beijing, China
(Yan, Yao) Department of Anesthesiology, Fuwai Hospital, National Center
for Cardiovascular Diseases, Peking Union Medical College and Chinese
Academy of Medical Sciences, Beijing, China
(Chen, Wu) The Department of Intensive Care Unit, Chinese Academy of
Medical Sciences and Peking Union Medical College, Fuwai Hospital,
Beijing, China
(He) Department of Anesthesiology, Fuwai Yunnan Hospital, Chinese Academy
of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical
University
(Yu) Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital
Medical University, Beijing, China
(Yao) Center of Outcomes Research, Department of Anesthesiology, Critical
Care and Pain Medicine, University of Texas, Houston, TX, United States
(Yao) Outcomes Research Consortium, Houston, TX, United States
Publisher
W.B. Saunders
Abstract
Objective: Previous studies have demonstrated that preoperative oral
carbohydrates (CHO) can alleviate postoperative insulin resistance (IR)
and enhance recovery in non-diabetic patients undergoing cardiac surgery.
However, the potential benefits in diabetic patients remain unclear. This
study aimed to investigate the effects of preoperative CHO on IR and
postoperative recovery in diabetic patients undergoing off-pump coronary
artery bypass grafting (OPCAB). Design(s): A prospective,
single-center, single-blind, randomized controlled trial. Setting(s):
The study was conducted in the Adult Cardiac Surgery Ward 6 of a
large-volume cardiovascular center. Participant(s): A total of 62
consecutive diabetic patients scheduled for isolated OPCAB were
prospectively enrolled between July 8, 2022, and April 28, 2023.
Participants were randomized in a 1:1 ratio to the CHO group or the
control (CTRL) group using computer-generated random numbers.
 Intervention(s): Patients in the CHO group received 335 mL of a
carbohydrate drink containing 50 g of carbohydrates 8 to 12 hours before
surgery, while those in the CTRL group followed routine fasting protocols.
 Measurements and Main Results: The primary endpoint was postoperative
IR, assessed by the homeostasis model assessment. Secondary endpoints
included postoperative inflammatory markers and stress responses (e.g.,
serum cortisol levels), while exploratory endpoints focused on in-hospital
clinical outcomes. Baseline characteristics were comparable between
groups. CHO administration significantly reduced postoperative
inflammatory markers but did not significantly improve IR. Stress response
was attenuated in the CHO group, though the difference was not
statistically significant. Postoperative drainage was higher in the CHO
group, but no differences were observed in other clinical outcomes.
 Conclusion(s): Preoperative CHO may attenuate inflammatory and stress
responses without increasing perioperative risk in diabetic patients
undergoing OPCAB, although its effect IR remains uncertain. Copyright
© 2025 Elsevier Inc.

<96>
Accession Number
2035972990
Title
Revascularization strategies in Non-ST segment elevation myocardial
infarction: the clash continues.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1614843. Date of Publication: 2025.
Author
Zuccarelli V.; Giunti F.; Chiarito M.; Pivato C.A.; Stefanini G.G.
Institution
(Zuccarelli) Department of Cardiology, Hopital Prive Saint-Martin, Caen,
France
(Giunti, Chiarito, Pivato, Stefanini) Department of Cardiovascular
Medicine, IRCCS Humanitas Research Hospital, Milan, Italy
(Giunti, Chiarito, Pivato, Stefanini) Department of Biomedical Sciences,
Humanitas University, Milan, Italy
Publisher
Frontiers Media SA
Abstract
For patients presenting with Non-ST-Elevation Myocardial Infarction
(NSTEMI), the choice and timing of revascularization remain complex and
debated. This decision is influenced by clinical factors such as
hemodynamic stability, comorbidities and surgical risk profile, as well as
anatomical considerations like coronary lesion complexity and feasibility
of achieving complete revascularization. Randomized controlled trials
directly comparing CABG and PCI in NSTEMI are limited, making
evidence-based comparisons challenging. However, data suggest that while
PCI is less invasive and offers rapid revascularization, CABG often
achieves more comprehensive revascularization, particularly in high-risk
patients with multivessel coronary artery disease, especially diabetic
patients, or unprotected left main coronary artery disease. Over the last
two decades, the adoption of CABG in NSTEMI has declined, driven by the
advantages of PCI's minimally invasive nature and advancements in stent
technology. Nevertheless, CABG remains essential in cases of complex
coronary anatomy or where PCI fails to achieve adequate revascularization.
Available outcome data indicate that CABG offers significant long-term
benefits, including lower rates of myocardial infarction and repeat
revascularization, although it is associated with an increased short-term
risk of stroke, and surgical related bleeding. This review critically
analyzes clinical scenarios in NSTEMI, examining the risks and benefits of
CABG and PCI. It highlights the importance of individualized
decision-making, guided by multidisciplinary Heart Teams, to balance
procedural risks and long-term outcomes for optimal patient
care Copyright 2025 Zuccarelli, Giunti, Chiarito, Pivato and
Stefanini.

<97>
Accession Number
2035952955
Title
Paravertebral Block versus Erector Spinae Plane Block for Postoperative
Analgesia and Recovery: A Systematic Review and Meta-Analysis.
Source
Journal of Pain Research. 18 (pp 4509-4526), 2025. Date of Publication:
2025.
Author
Ren D.; Wang D.; Zhang W.; Lei L.; He X.; Yue H.
Institution
(Ren, Wang, Zhang, Lei, He) Department of Anesthesiology, Gansu Provincial
Hospital, Gansu, Lanzhou, China
(Yue) Department of Orthopaedics, Lanzhou University Second Hospital,
Gansu, Lanzhou, China
(Yue) Orthopaedic Clinical Research Center of Gansu Province, Gansu,
Lanzhou, China
(Yue) Intelligent Orthopaedic Industry Technology Center of Gansu
Province, Gansu, Lanzhou, China
Publisher
Dove Medical Press Ltd
Abstract
Background: This systematic review and meta-analysis was performed to
assess the relative efficacy of paravertebral block (PVB) and erector
spinae plane block (ESPB) for postoperative analgesia and recovery.
 Method(s): Randomized controlled trials (RCTs) evaluating PVB and
ESPB for postoperative analgesia and recovery were retrieved from
databases, including PubMed, Embase, MEDLINE, Cochrane Library,
Science-Direct, and Google Scholar, from inception to January 2025. The
primary outcome included resting Visual Analogue Scale (VAS) at 6 h and
quality of recovery (QoR) score in first 24 h. The meta-analysis was
conducted using Stata 15.1 software. The certainty of the evidence was
assessed utilizing the risk of bias and GRADE frameworks. Result(s):
We included 33 RCTs with 2256 patients. For resting VAS at 6 h, there was
no significant difference between PVB and ESPB (mean difference [MD] =
-0.08, 95% confidence interval [CI]: -0.44 to 0.27). For QoR, there was no
significant difference between PVB and ESPB (MD = -0.44, 95% CI: -2.64 to
1.76). For resting VAS at 12 h, ESPB had a lower VAS than PVB. For resting
VAS at 24 h, movement VAS at 6 h, 12 h, 24 h, time of first rescue
analgesia, LOS, and postoperative nausea and vomiting (PONV), there were
no significant differences between PVB and ESPB. However, PVB had a lower
morphine consumption than ESPB. Conclusion(s): There were no
significant clinical differences between PVB and ESPB in terms of the VAS,
QoR, time of first rescue analgesia, LOS, and PONV. Based on existing
evidences, we recommended the application of ESPB in thoracic surgery,
breast surgery, kidney surgery, and abdominal surgery. Limitation(s):
The included studies showed considerable variability in postoperative
analgesia protocols, which increased heterogeneity in the results. There
was a lack of data on long-term analgesia and functional
outcomes. Copyright © 2025 Ren et al.

<98>
Accession Number
2040267980
Title
Optimal medical care and coronary flow capacity-guided myocardial
revascularization vs usual care for chronic coronary artery disease: the
CENTURY trial.
Source
European Heart Journal. 46(33) (pp 3273-3286), 2025. Date of Publication:
01 Sep 2025.
Author
Gould K.L.; Johnson N.P.; Roby A.E.; Kirkeeide R.; Haynie M.; Nguyen T.;
Bui L.; Patel M.B.; Kitkungvan D.; Mendoza P.; Lai D.; Li R.; Sdringola
S.; McPherson D.; Narula J.
Institution
(Gould, Johnson, Roby, Kirkeeide, Haynie, Nguyen, Bui, Patel, Kitkungvan,
Mendoza, Sdringola, McPherson, Narula) Weatherhead PET Center for
Preventing and Reversing Atherosclerosis, Division of Cardiology,
Department of Medicine, Memorial Hermann Hospital, University of Texas,
McGovern Medical School, 6431 Fannin St., Room MSB 4.256, Houston, TX,
United States
(Lai, Li) Department of Biostatistics and Data Science, University of
Texas, School of Public Health, Houston, TX, United States
Publisher
Oxford University Press
Abstract
Background and Aims The randomized CENTURY trial tested the hypothesis
that a comprehensive strategy integrating intense lifestyle modification
and aggressive medical management to goals with revascularization reserved
for severely reduced coronary flow capacity (CFC) by positron emission
tomography (PET) would reduce risk factors, subsequent revascularization,
death and myocardial infarction (MI) compared with standard of care in
chronic stable coronary artery disease (CAD). Methods Participants were
randomly assigned to standard or comprehensive care groups. Rest-stress
PET quantified CFC for physiological CAD severity at baseline, 2, 5, and
up to 11 years. The comprehensive care group reviewed PET results with
frequent clinic visits and open 24/7 phone/email support. Standard care
lacked supportive contact with blinded PET results that were unblinded
only for severely reduced CFC with high mortality risk for potential
revascularization. Results Between 2009-2017, 515 patients were assigned
to comprehensive care and 513 to standard care and followed for 5 or more
years. Comprehensive vs standard care decreased risk factors and summed
5-year risk score (DELTA-1.1 vs + 0.33; 95% confidence interval -1.84 to
-0.97; P < .0001), decreased cumulative 11-year all-cause death (4.7% vs
8.2%; P = .023), death or MI (7.0% vs 11.1%; P = .024) late
revascularization (9.5% vs 14.8%; P = .021) and major adverse cardiac
events (20.5% vs 29.9%; P = .0006). Only 56 of 1028 (5.4%) CENTURY
patients with chronic CAD had revascularization within 90 days
predominantly guided by CFC severity. Conclusions The randomized CENTURY
trial demonstrates that comprehensive integrated lifestyle modification
and medical management towards goals with revascularization reserved for
severely reduced CFC, significantly reduced risk factor scores, death,
death or MI, and revascularization. Copyright © The Author(s)
2025. Published by Oxford University Press on behalf of the European
Society of Cardiology.

<99>
Accession Number
2035464894
Title
The Effects of Angiotensin II versus Norepinephrine on Pulmonary Vascular
Resistance in Cardiac Surgery: Post Hoc Analysis of a Randomized
Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(12) (pp 2950-2958),
2024. Date of Publication: 01 Dec 2024.
Author
Lim J.; Zhang K.; Miles L.; Bellomo R.; Coulson T.G.
Institution
(Lim, Coulson) Department of Anaesthesiology and Perioperative Medicine,
Alfred Health and Monash University, Victoria, Melbourne, Australia
(Lim) Department of Anaesthesia and Pain Medicine, Fiona Stanley Hospital,
WA, Australia
(Zhang, Miles) Department of Anaesthesia, Austin Hospital, Heidelberg,
VIC, Australia
(Miles, Bellomo, Coulson) Department of Critical Care, Melbourne Medical
School, University of Melbourne, Parkville, VIC, Australia
(Bellomo) Department of Intensive Care, Austin Hospital, Heidelberg, VIC,
Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Victoria, Melbourne, Australia
(Bellomo) Data Analytics Research and Evaluation, Austin Hospital,
Melbourne, Australia
Publisher
W.B. Saunders
Abstract
Objectives: To assess whether angiotensin II infusion increases pulmonary
vascular resistance (PVR) relative to norepinephrine. Design(s):
Secondary analysis of a double-blinded randomized feasibility study.
 Setting(s): Two tertiary metropolitan hospitals in Melbourne,
Australia. Participant(s): Fifty-eight adult patients undergoing
cardiac surgery using cardiopulmonary bypass with an elevated risk of
acute kidney injury (AKI). Intervention(s): Angiotensin II infusion
compared with norepinephrine infusion. Measurements and Main Results:
There was no significant difference in the primary outcome of PVR both
intraoperatively and postoperatively between the angiotensin II group and
the norepinephrine group. The study drug (angiotensin II or
norepinephrine) infusion rate was associated with a small increase in PVR
(beta = 0.08; p = 0.01). The strongest association with PVR was the random
effect (ie, patient effect) (p < 0.001). This effect was consistent across
secondary outcomes. Randomization to norepinephrine instead of to
angiotensin II was associated with reduced mean systemic arterial to mean
pulmonary arterial pressure ratio postoperatively (beta = -0.65; p =
0.01). Conclusion(s): The results of this study suggest that in
cardiac surgery patients and at doses used in the prior feasibility study,
angiotensin II did not have significant effects on the pulmonary
vasculature compared with norepinephrine. Moreover, at doses used in this
study, neither drug appeared to have a substantial effect on the pulmonary
circulation relative to surgical and patient factors. Copyright ©
2024 Elsevier Inc.

<100>
Accession Number
2035396393
Title
Postoperative delirium in patients undergoing TAVI versus SAVR - A
systematic review and meta-analysis.
Source
IJC Heart and Vasculature. 55 (no pagination), 2024. Article Number:
101544. Date of Publication: 01 Dec 2024.
Author
Stavridis D.; Runkel A.; Starvridou A.; Fischer J.; Fazzini L.; Kirov H.;
Wacker M.; Wippermann J.; Doenst T.; Caldonazo T.
Institution
(Stavridis, Wacker, Wippermann) Department of Cardiothoracic Surgery,
University Clinic Magdeburg, Magdeburg, Germany
(Runkel, Fischer, Kirov, Doenst, Caldonazo) Department of Cardiothoracic
Surgery, Jena University Hospital, Friedrich-Schiller-University Jena,
Germany
(Starvridou) European University Cyprus, School of Medicine, Nicosia,
Cyprus
(Fazzini) Department of Medical Sciences and Public Health, Clinical
Cardiology Unit, University of Cagliari, Cagliari, Italy
(Fazzini) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Caldonazo) Department of Cardiothoracic Surgery, Weill Medical College of
Cornell University, New York, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Transcatheter Aortic Valve Implantation (TAVI) and Surgical
Aortic Valve Replacement (SAVR) have different levels of invasiveness
which can result in different levels of functional status after the
procedure. Method(s): We performed a systematic review and
meta-analysis to detect studies showing direct comparison between TAVI and
SAVR regarding postoperative functional status. The primary endpoint was
the incidence of postoperative delirium (POD) after TAVI or SAVR, assessed
using the Confusion Assessment Method (CAM). Secondary endpoints included
30-day mortality, stroke, major bleeding, and hospital length of stay
(LOS). Result(s): We identified 1,161 manuscripts, of which 10
studies (12,015 patients) were analyzed. TAVI patients had a significantly
lower incidence of POD (OR: 0.35, 95 % CI, 0.26-0.48, p < 0.01) compared
to SAVR patients. No significant differences were found in secondary
outcomes between the groups. Conclusion(s): TAVI is associated with a
lower incidence of postoperative delirium compared to SAVR without
compromising length of stay or other major clinical outcomes. Further
research is needed to understand the impact of postoperative delirium on
short and long-term outcomes. Copyright © 2024 The Authors

<101>
Accession Number
2035900547
Title
Clinical outcomes of transcatheter aortic valve replacement in patients
with radiation-induced aortic stenosis: a systematic review and
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1537220. Date of Publication: 2025.
Author
Ameen D.; Thakker N.; Contreras R.; Hashemi S.M.; Nasrollahizadeh A.;
Saberian P.; Kuriyakose D.; Amini-Salehi E.; Keetha N.R.; Nayak S.S.
Institution
(Ameen, Thakker, Contreras, Nayak) Department of Internal Medicine, Yale
New Heaven Health Bridgeport Hospital, Bridgeport, CT, United States
(Hashemi, Saberian) Cardiovascular Research Center, Hormozgan University
of Medical Sciences, Bandar Abbas, Iran, Islamic Republic of
(Nasrollahizadeh) Tehran Heart Center, Cardiovascular Diseases Research
Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Kuriyakose) St. Joseph's Mission Hospital, Kerala, Anchal, India
(Amini-Salehi) Gastrointestinal and Liver Diseases Research Center, Guilan
University of Medical Sciences, Rasht, Iran, Islamic Republic of
(Keetha) Ohio Kidney and Hypertension Center, Middleburg Heights, OH,
United States
Publisher
Frontiers Media SA
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is an effective
treatment for severe aortic stenosis, particularly in high-risk patients
unsuitable for surgical aortic valve replacement (SAVR). However, the
efficacy of TAVR in patients with radiation-induced aortic stenosis
remains uncertain and controversial. This meta-analysis evaluates clinical
outcomes of TAVR in patients with prior chest radiation (C-XRT).
 Method(s): A comprehensive literature search of PubMed, Scopus, and
Web of Science databases was conducted through September 15, 2024. Studies
comparing TAVR outcomes in patients with and without prior chest radiation
were included. Statistical analysis used STATA software with a
random-effects model, incorporating Knapp-Hartung correction and
prediction intervals. Publication bias was assessed using funnel plots,
Egger's test, Begg's test, and the trim-and-fill method. Result(s):
The meta-analysis found no significant differences in short-term outcomes
between patients with and without C-XRT. In-hospital mortality (OR: 0.81;
95% CI: 0.14-4.69), 30-day mortality (OR: 1.59; 95% CI: 0.71-3.55), and
1-year mortality (OR: 1.15; 95% CI: 0.52-2.54) were comparable. Similarly,
rates of in-hospital myocardial infarction, stroke, and major bleeding
showed no significant differences. The GRADE assessment indicated very
low-quality evidence for most outcomes, including in-hospital mortality
and stroke, and low-quality evidence for outcomes like 30-day stroke and
acute kidney injury. Conclusion(s): TAVR appears effective in
patients with prior chest radiation, with comparable short-term outcomes
to non-C-XRT patients. However, due to significant heterogeneity across
the included studies and the low to very low quality of evidence, these
findings should be interpreted with caution. The current data remains
inconclusive, and further high-quality, prospective studies with longer
follow-up periods are essential to better understand the long-term risks
and confirm the safety and efficacy of TAVR in this patient population.
Systematic Review Registration: PROSPERO CRD42024593497. Copyright
2025 Ameen, Thakker, Contreras, Hashemi, Nasrollahizadeh, Saberian,
Kuriyakose, Amini-Salehi, Keetha and Nayak.

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