EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
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.<br/>Copyright &#xa9; The Author(s)
2025. Published by Oxford University Press on behalf of the European
Society of Cardiology.

<2>
Accession Number
2040385646
Title
Comparative Effectiveness of TAVI Platforms and Surgical Aortic Valve
Replacement: A Network Meta-Analysis of Randomized Controlled Trials.
Source
Circulation: Cardiovascular Interventions. (no pagination), 2025. Date of
Publication: 2025.
Author
Moroni F.; Lamelas P.; Izcovich A.; Foroutan F.; Fremes S.E.; Alba A.C.;
Agoritsas T.; Whitlock R.; Denicolai M.; Mendiz O.; Mamas M.A.; Bagur R.
Institution
(Moroni) Division of Cardiology, Berne Cardiovascular Research Center and
Heart and Vascular Center, School of Medicine, University of Virginia,
Charlottesville, United States
(Lamelas, Foroutan, Agoritsas) Department of Health Research Methods,
Evidence, and Impact, McMaster University, Hamilton, ON, Canada
(Whitlock) Department of Surgery, McMaster University, Hamilton, ON,
Canada
(Lamelas, Mendiz) Fundacion Favaloro, Buenos Aires, Argentina
(Izcovich) Faculty of Medicine, Universidad Del Salvador, Buenos Aires,
Argentina
(Foroutan) Ted Rogers Centre for Heart Research, University Health
Network, Toronto, ON, Canada
(Fremes) Division of Cardiac Surgery, Department of Surgery, Schulich
Heart Centre, Sunnybrook HSC, University of Toronto, Canada
(Alba) Peter Munk Cardiac Centre, University Health Network, Toronto, ON,
Canada
(Agoritsas) Division General Internal Medicine, Department of Medicine,
University Hospitals of Geneva, Switzerland
(Agoritsas) MAGIC Evidence Ecosystem Foundation, Oslo, Norway
(Whitlock) Population Health Research Institute, Hamilton, ON, Canada
(Denicolai) Interventional Cardiology Division, Hospital Italiano de
Buenos Aires, Argentina
(Mamas, Bagur) Keele Cardiovascular Research Group, Keele University,
United Kingdom
(Mamas) National Institute for Health and Care Research (NIHR), Birmingham
Biomedical Research Centre, United Kingdom
(Bagur) London Health Sciences Centre Division of Cardiology, Department
of Medicine, Western University, Ontario, Canada
(Bagur) Department of Epidemiology and Biostatistics, Western University,
ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Evidence informing clinical guidelines assumes that all
transcatheter aortic valve implantation (TAVI) devices have similar
effectiveness, in other words, displaying a class effect across TAVI
valves. We aimed to assess the comparative effectiveness of different TAVI
platforms relative to other TAVI counterparts or surgical aortic valve
replacement (SAVR). <br/>METHOD(S): MEDLINE/Embase/CENTRAL were searched
from inception until April 2025, for randomized controlled trials
comparing outcomes with different commercially available TAVI devices
relative to other TAVI counterparts or SAVR. The certainty of the evidence
was assessed following the Grading of Recommendations, Assessment,
Development, and Evaluations approach. We performed a frequentist network
meta-analysis to generate treatment effect estimates. All-cause,
cardiovascular mortality, and stroke were considered critically important
patient-centered outcomes. <br/>RESULT(S): We identified 11 randomized
controlled trials with 9946 participants and reporting outcomes between 1
to 10 years. TAVI with CoreValve-Evolut was associated with a similar risk
of all-cause (absolute risk difference [ARD], 31/1000 from -12 to 79), and
cardiovascular mortality (ARD, -8/1000 from -39 to 28) compared with SAVR
(moderate certainty). Compared with SAVR, TAVI with SAPIEN and ACURATE neo
were associated with an increased risk of all-cause (ARD, 109/1000 from 56
to 169, high certainty and ARD, 123/1000 from 9 to 277, moderate
certainty, respectively) and cardiovascular mortality (ARD, 58/1000 from
18 to 105, high certainty and ARD, 105 from 7 to 247, moderate certainty,
respectively). Moderate and high-certainty evidence showed that all TAVI
platforms were associated with an increased risk of reinterventions and
pacemaker implant versus SAVR. Compared with TAVI with CoreValve-Evolut,
SAPIEN was associated with higher all-cause (ARD, 75/1000 from 13 to 147,
high certainty) and cardiovascular mortality (ARD, 66/1000 from 15 to 130,
high certainty), same scenario for ACURATE neo (ARD 113/1000 from 13 to
259, high certainty). TAVI with SAPIEN was associated with a higher risk
of stroke compared with CoreValve-Evolut (ARD, 31/1000 from 5 to 65, high
certainty), whereas CoreValve-Evolut showed higher rates of pacemaker
implant compared with SAPIEN, ACURATE neo. <br/>CONCLUSION(S): TAVI with
CoreValve-Evolut is probably associated with similar mortality to SAVR.
TAVI with SAPIEN and ACURATE neo were associated with increased risk of
mortality compared with SAVR and CoreValve-Evolut. The current body of
evidence from randomized controlled trials goes against the hypothesis of
a class effect across TAVI valves.<br/>Copyright &#xa9; 2025 American
Heart Association, Inc.

<3>
[Use Link to view the full text]
Accession Number
2039637760
Title
Gabapentin for Pain Management after Major Surgery: A Placebo-controlled,
Double-blinded, Randomized Clinical Trial (the GAP Study).
Source
Anesthesiology. 143(4) (pp 851-861), 2025. Date of Publication: 01 Oct
2025.
Author
Baos S.; Lui M.; Walker-Smith T.; Pufulete M.; Messenger D.; Abbadi R.;
Batchelor T.; Casali G.; Edwards M.; Goddard N.; Hilal M.A.; Alzetani A.;
Vaida M.; Martinovsky P.; Saravanan P.; Cook T.; Malhotra R.; Simpson A.;
Little R.; Wordsworth S.; Stokes E.; Jiang J.; Reeves B.; Culliford L.;
Collett L.; Maishman R.; Chauhan N.; McCullagh L.; McKeon H.; Abbs S.;
Lamb J.; Gilbert A.; Hughes C.; Wynick D.; Angelini G.; Grocott M.;
Gibbison B.; Rogers C.A.
Institution
(Baos, Lui, Walker-Smith, Reeves, Culliford, Collett, Maishman, McKeon,
Abbs, Lamb, Gilbert, Hughes, Rogers) Bristol Trials Centre, University of
Bristol, Bristol, United Kingdom
(Pufulete) Bristol Medical School, University of Bristol, Bristol, United
Kingdom
(Messenger, Abbadi, Batchelor, Casali) Department of Surgery, University
Hospitals Bristol, Weston NHS Foundation Trust, Bristol, United Kingdom
(Edwards) Department of Anaesthesia, University of Southampton,
Southampton, United Kingdom
(Goddard) Department of Anaesthesia, University Hospital Southampton NHS
Foundation Trust, Southampton, United Kingdom
(Hilal, Alzetani) Department of Surgery, University Hospital Southampton
NHS Foundation Trust, Southampton, United Kingdom
(Vaida) Department of Anaesthesia, Somerset Hospitals Foundation NHS
Trust, Taunton, United Kingdom
(Martinovsky, Saravanan) Department of Anaesthesia, University Hospitals
Blackpool NHS Trust, Blackpool, United Kingdom
(Cook) Department of Anaesthesia, Royal United Hospitals, Bath NHS Trust,
Bath, United Kingdom
(Malhotra, Little) Department of Anaesthesia, University Hospitals
Liverpool NHS Trust, Liverpool, United Kingdom
(Simpson, Chauhan) Department of Anaesthesia, University Hospitals
Bristol, Weston NHS Foundation Trust, Bristol, United Kingdom
(Wordsworth, Stokes, Jiang) Nuffield Deaprtment of Population Health,
University of Oxford, Oxford, United Kingdom
(McCullagh) Department of Pharmacy, University Hospitals Bristol, Weston
NHS Foundation Trust, Bristol, United Kingdom
(Wynick) University of Bristol, University Hospitals Bristol, Weston NHS
Foundation Trust, Bristol, United Kingdom
(Angelini) Department of Cardiac Surgery, University of Bristol,
University Hospitals Bristol, Weston NHS Foundation Trust, Bristol, United
Kingdom
(Grocott) Department of Anaesthesia, University of Southampton, Upper
Shirley, United Kingdom
(Gibbison) Bristol Medical School, University of Bristol, Department of
Anaesthesia, University Hospitals Bristol, Weston NHS Foundation Trust,
Bristol, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Gabapentin is an anticonvulsant medication with approval for
use in neuropathic pain and epileptic disorders. It is frequently added to
multimodal analgesic regimens during and after surgery to reduce opioid
use while controlling pain effectively. There is little evidence to show
its effectiveness in major surgery. <br/>Method(s): In this multicenter,
double-blinded randomized controlled trial, adults undergoing major
cardiac, thoracic, or abdominal surgery were randomized to receive either
gabapentin (600 mg before surgery, 300 mg twice daily for 2 days after
surgery) or placebo. The primary outcome was length of hospital stay.
Secondary outcomes included acute and chronic pain, total opioid use,
adverse health events, and health-related quality of life. Patients were
followed up daily in-hospital until discharge and then at 4 weeks and 4
months after surgery. <br/>Result(s): A total of 1,196 participants were
randomized (500 underwent cardiac, 346 thoracic, and 350 abdominal
surgery); 596 were allocated to placebo, and 600 were allocated to
gabapentin. Median length of hospital stay was similar in the two groups
(gabapentin, 5.94 [interquartile range (IQR), 4.08 to 8.04] days; placebo,
6.15 [IQR, 4.22 to 8.97] days; hazard ratio, 1.07; 95% CI, 0.95 to 1.20; P
= 0.26). Overall, 384 participants experienced one or more serious adverse
events (gabapentin, 189 of 596 [31.7%]; placebo, 195 of 599 [32.6%]), with
some variation across surgical specialties. <br/>Conclusion(s): Among
patients undergoing major cardiac, thoracic, and abdominal surgery, adding
gabapentin to multimodal analgesic regimes did not alter the length of
hospital stay or the number of serious adverse events.<br/>Copyright
&#xa9; 2025 The Author(s)

<4>
[Use Link to view the full text]
Accession Number
2040266005
Title
Unifying FALD assessment-A call to arms.
Source
Hepatology Communications. 9(9) (no pagination), 2025. Article Number:
e0789. Date of Publication: 01 Sep 2025.
Author
Cao J.Y.; Cordina R.; Majumdar A.
Institution
(Cao, Cordina) Department of Cardiology, Royal Prince Alfred Hospital,
Sydney, Australia
(Cao, Cordina) Sydney Medical School, University of Sydney, Sydney,
Australia
(Majumdar) Victorian Liver Transplant Unit, Austin Health, Melbourne,
Australia
(Majumdar) Melbourne Medical School, University of Melbourne, Melbourne,
Australia
Publisher
Lippincott Williams and Wilkins

<5>
Accession Number
2040356137
Title
Assessing the risk factors of permanent pacemaker implantation following
mitral valve surgery A systematic review and meta-analysis.
Source
Medicine (United States). 104(36) (no pagination), 2025. Article Number:
e44232. Date of Publication: 05 Sep 2025.
Author
Qureshi M.A.; Amir M.; Bakht D.; Ali K.; Asif A.; Bakht K.; Sarmad M.;
Tahir M.; Shahid A.; Rehmani M.; Awais M.N.; Haseeb S.; Bokhari S.F.H.;
Ali M.K.B.
Institution
(Qureshi) Henry Ford Jackson Hospital, Jackson, MI, United States
(Amir, Bakht, Ali, Asif, Sarmad, Tahir, Rehmani, Bokhari, Ali) King Edward
Medical University, Mayo Hospital, Punjab, Lahore, Pakistan
(Bakht) Sheikh Zayed Medical College, Punjab, Rahim Yar Khan, Pakistan
(Shahid) Allama Iqbal Medical College, Jinnah Hospital, Punjab, Lahore,
Pakistan
(Awais) Shaheed Ziaur Rahman Medical College & Hospital, Bogura,
Bangladesh
(Haseeb) Northwell Health System, New York, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Mitral valve surgery is a widely performed intervention for
the treatment of various mitral valve pathologies. Postoperative
conduction disturbances may necessitate permanent pacemaker (PPM)
implantation. This study aims to identify and quantify patient-related,
cardiovascular, procedural risk factors, and risk score-based predictors
of PPM implantation following mitral valve surgery. <br/>Method(s): The
conduct of this systematic review and meta-analysis followed the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses reporting
guidelines. A systematic literature search was performed across PubMed,
Cochrane Library, Google Scholar, and Embase, including studies published
from inception until September 2024. Statistical analyses were conducted
using RevMan 5.4 software. <br/>Result(s): The meta-analysis included 8
studies totaling 39,634 patients (PPM: 3417; no PPM: 36,217) and revealed
multiple significant predictors of postoperative PPM implantation. Among
demographics, advanced age (mean difference [MD] 3.54; P < .00001) and
female sex (odds ratio [OR] 1.19; P < .00001) were found as independent
risk factors. Comorbidities included hypertension (OR 1.71, P < .00001),
diabetes (OR 1.96, P < .00001), renal disease (OR 1.96, P < .00001),
preexisting atrial fibrillation (OR 1.82, P < .00001), prior stroke (OR
1.57, P < .00001), chronic lung disease (OR 1.38, P < .00001), peripheral
vascular disease (OR 2.03, P = .01), and smoking history (OR 1.19, P <
.0001). Cardiovascular predictors comprised mitral stenosis (OR 1.77, P
<.00001), prior cardiac surgery (OR 1.48, P = .0002), New York Heart
Association class III/IV (OR 1.38, P = .005), and New York Heart
Association class I (OR 0.64, P = .03). Procedural factors showed longer
cardiopulmonary bypass time (MD 9.89, P < .00001) and aortic cross-clamp
duration (MD 11.96, P < .00001) increasing risk, along with concomitant
atrial fibrillation ablation (OR 1.34, P = .002). Increased society of
thoracic surgeons' mortality risk (MD 1.14%, P = .04) and EuroScore (MD
2.16, P = .0005), both effectively predicted PPM need. <br/>Conclusion(s):
This meta-analysis represents the first comprehensive evaluation of risk
factors associated with PPM implantation in patients undergoing mitral
valve surgery. Several significant risk factors have been identified,
warranting further research to validate and expand upon these
findings.<br/>Copyright &#xa9; 2025 the Author(s).

<6>
Accession Number
2040355994
Title
Comparison between lumbar plexus block and fascia iliaca block in hip
surgery: A systematic review and meta-analysis.
Source
Medicine (United States). 104(36) (pp e43744), 2025. Date of Publication:
05 Sep 2025.
Author
Wu J.; Mou H.; Luo X.
Institution
(Wu, Mou, Luo) Department of Anesthesiology, The First Affiliated Hospital
of Traditional Chinese Medicine of Chengdu Medical College, XinDu Hospital
of Traditional Chinese Medicine, Chengdu, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: With ultrasound-guided nerve block technology being
increasingly used in hip surgery, the choice between fascia iliaca block
(FIB) and lumbar plexus block (LPB) is still inconclusive. This study aims
to evaluate the advantages and disadvantages of FIB and LPB in hip
surgery. <br/>Method(s): PubMed, Web of Science, Cochrane Library, Embase,
and CNKI were searched from inception to October 4, 2022. Two authors
independently screened literature, extracted data, assessed study quality,
and conducted meta-analysis using Review Manager 5.4.1. The heterogeneity
was assessed by I2, and the fixed-effects model was applied when P>.05 and
I2<50%; otherwise, the random-effects model was applied. For dichotomous
variables, relative risk (RR) with 95% confidence interval (CI) was
calculated. For the measured data, the standardized mean difference (SMD)
with 95% CI were calculated, and statistical significance was set at
P<=.05. Sensitivity analysis was performed by comparing results between
fixed- and random-effects models. <br/>Result(s): In this comparative
study of 639 patients (FIB group, n=323; LPB group, n=316) undergoing
general anesthesia, 21 indices were analyzed via meta-analysis, with 12
showing heterogeneity and 7 lacking stability. FIB demonstrated
superiority in ultrasound imaging time [SMD=-1.53, 95% CI (-1.93 to
-1.13), P<.001], puncture time [SMD=-3.02, 95% CI (-4.12 to -1.91),
P<.001], and length of stay [SMD=-0.43, 95% CI (-0.78 to -0.08), P=.02].
LPB outperformed in time to take effect [SMD=1.76, 95% CI (0.13-3.39),
P=.03], end-of-operation heart rate [SMD=0.55, 95% CI (0.18-0.91), P=.03]
and blood pressure [SMD=0.88, 95% CI (0.51-1.26), P<.001], intraoperative
sufentanil dose [SMD=2.22, 95% CI (0.84-3.59), P=.002], 24-hour
postoperative sufentanil dose [SMD=1.80, 95% CI (0.17-3.42), P=.03], and
postoperative 1-hour visual analogue scale (VAS) score [SMD=0.48, 95% CI
(0.16-0.80), P=.003]. No significant differences were observed in
hemodynamics during laryngeal mask implantation or skin incision,
remifentanil dose, patient-controlled analgesia (PCA) usage time,
postoperative VAS scores at 6, 8, 12, 24, 48 hours, or adverse event
incidence. <br/>Conclusion(s): LPB significantly reduced intraoperative
and postoperative opioid doses, and provided more stable hemodynamics at
the end of surgery. FIB showed higher efficiency and shortened hospital
stay. Anesthesiologists should select appropriate block techniques based
on the unique advantages of different nerve blocks and patients' specific
conditions.<br/>Copyright &#xa9; 2025 the Author(s).

<7>
Accession Number
2036046527
Title
beta-blocker and clinical outcomes in patients after myocardial
infarction: a systematic review and meta-analysis.
Source
European Journal of Clinical Pharmacology. (no pagination), 2025. Date of
Publication: 2025.
Author
Yang W.; Sun X.; Zhang Y.; Lu Z.; Shu Z.; Zhang K.
Institution
(Yang) Department of Physiology, West China School of Basic Medical
Sciences & Forensic Medicine, Sichuan University, Chengdu, China
(Sun, Zhang, Lu, Shu, Zhang) Department of Forensic Pathology, West China
School of Basic Medical Sciences & Forensic Medicine, Sichuan University,
Chengdu, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background and objective: While current clinical guidelines generally
advocate for beta-blocker therapy following acute myocardial infarction
(AMI), conflicting findings have surfaced through large-scale
observational studies and meta-analyses. We conducted this systematic
review and meta-analysis of published observational studies to quantify
the long-term therapeutic impact of beta-blocker across heterogeneous AMI
populations. <br/>Method(s): We conducted comprehensive searches of the
PubMed, Embase, Cochrane, and Web of Science databases for articles
published from 2000 to 2025 that examine the link between beta-blocker
therapy and clinical outcomes (last search update: March 1, 2025). We used
the odds ratio (OR) with its 95% confidence interval (95% CI) to evaluate
the effect of beta-blocker therapy on all-cause mortality, cardiac death,
or major adverse cardiac events (MACE) in AMI patients. Our analysis
stratified these effects by study type, ejection fraction (EF), sample
size, follow-up duration, and patient characteristics including primary
coronary revascularization, ST-segment elevation status, and
comorbidities. <br/>Result(s): This meta-analysis incorporated 34
observational studies covering 233,303 AMI patients. Our results showed
beta-blockers reduced all-cause (OR = 0.73, 95% CI = 0.64-0.82) and
cardiac mortality (OR = 0.79, 95% CI = 0.70-0.89) in post-AMI patients,
with no significant effect on MACE. In these patients, post-PCI and STEMI
patients, beta-blockers lowered all-cause mortality but not MACE risk.
Subgroup analysis revealed that beta-blockers decreased all-cause death in
post-AMI patients with diabetes and COPD, but not in those with
hypertension and AF. Stratified by EF, beta-blockers were beneficial for
all-cause death (OR = 0.75, 95% CI = 0.60-0.93), cardiac death (OR = 0.72,
95% CI = 0.56-0.92), and MACE (OR = 0.85, 95% CI = 0.76-0.96) in post-AMI
patients with reduced EF and only decreased all-cause death in those with
preserved EF. <br/>Conclusion(s): Our meta-analysis suggests beta-blockers
may offer long-term clinical benefits to AMI patients, particularly those
with reduced EF. However, this is not conclusive for AMI patients with
comorbidities or preserved EF.<br/>Copyright &#xa9; The Author(s), under
exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature
2025.

<8>
Accession Number
2037073617
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, Poland
(Gasior) 3rdDepartment of Cardiology, Faculty of Medical Sciences in
Zabrze, Medical University of Silesia in Katowice, Poland, Silesian Center
for Heart Diseases in Zabrze, Poland
(Kalarus) Department of Cardiology, Congenital Heart Diseases and
Electrotherapy, Faculty of Medical Sciences in Zabrze, Medical University
of Silesia, Silesian Center for Heart Diseases in Zabrze, Zabrze,
Katowice, Poland
(Ptaszynski) Department of Electrocardiology, Medical University of Lodz,
Poland
(Kazmierczak) Department of Cardiology, Pomeranian Medical University,
Szczecin, Poland
Publisher
Via Medica

<9>
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). <br/>Design(s): A noninferiority randomized
trial. <br/>Setting(s): West China Hospital of Sichuan University.
<br/>Patient(s): Seventy-four children aged 7-16 years who underwent
minimally invasive pectus excavatum repair surgery were enrolled.
<br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9; 2025

<10>
Accession Number
646817974
Title
Does the surgical approach affect the incidence of postoperative atrial
fibrillation after thoracic surgery? A systematic review and
meta-analysis.
Source
Updates in surgery. 77(5) (pp 1279-1288), 2025. Date of Publication: 01
Sep 2025.
Author
Brascia D.; Mangiameli G.; Giudici V.M.; Re Cecconi E.; Luppichini M.;
Marulli G.
Institution
(Brascia, Mangiameli, Marulli) Department of Biomedical Sciences,
Humanitas University, Via Rita Levi Montalcini 4Pieve Emanuele, Milan,
Italy
(Brascia, Mangiameli, Giudici, Re Cecconi, Luppichini, Marulli) Division
of Thoracic Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56,
20089, Rozzano, Milan, Italy
Abstract
Postoperative atrial fibrillation (PAF) is a common complication after
lung resection, since surgical stress may act as a trigger. The VATS
approach reduces surgical stress and alleviates inflammation and oxidative
stress commonly associated with open lung surgery. However, only a few
studies have investigated the possible impact of the surgical approach on
the incidence of PAF. A literature review was performed through PubMed,
EMBASE, and Google Scholar in March 2024, to identify any study published
since 2000 evaluating the role of the VATS vs the open approach to perform
lung resections as a risk factor for postoperative atrial fibrillation.
Pooled odds ratio (OR) estimates with 95% confidence intervals (CIs) were
calculated. Twenty-one studies, including 59,101 patients, met the
criteria for inclusion. Both propensity-matched and non-matched data
showed that VATS was associated with a significant reduction in PAF
compared to open thoracotomy (OT) (OR 0.73; 95% CI 0.58-0.91; I2 = 10.1%,
p = 0.349). A meta-regression was conducted to explore contributing
factors, showing the geographic regions in which the studies were
conducted may be a significant source of heterogeneity. Subgroup analyses
revealed less heterogeneity in studies conducted in Europe and on those
focused solely on lobectomy. Postoperative atrial fibrillation risk
following VATS is significantly lower than OT. Further prospective
randomized controlled trials with large sample sizes are needed to confirm
these findings.<br/>Copyright &#xa9; 2025. Italian Society of Surgery
(SIC).

<11>
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.<br/>Copyright
&#xa9; 2025 The Author(s). Thoracic Cancer published by John Wiley & Sons
Australia, Ltd.

<12>
Accession Number
2040418748
Title
Delivery of oxygen during cardiopulmonary bypass and associated clinical
outcomes among adult cardiac surgery patients: A systematic review.
Source
Perfusion (United Kingdom). (no pagination), 2025. Article Number:
02676591251380659. Date of Publication: 2025.
Author
Dias R.D.; Borges P.; Rance G.; Srey R.; Kennedy Metz L.R.; Martinez-Rioux
A.; Arney D.; Paladugu P.; Gikandi A.; Miccile C.; Harari R.; Iwai K.;
Fitzgerald J.; O'Gara P.; Shann K.; Gombolay M.; Zenati M.A.
Institution
(Dias, Borges, Paladugu, Miccile, Harari) Medical AI & Cognitive
Engineering (MAICE) Lab, Department of Emergency Medicine, Mass General
Brigham, Boston, MA, United States
(Dias, Borges, Arney, Gikandi, Harari, Zenati) Harvard Medical School,
Boston, MA, United States
(Rance) Cape Cod Healthcare, Hyannis, MA, United States
(Srey) InvoCirc, Inc, Sudbury, MA, United States
(Kennedy Metz) Psychology Department, Roanoke College, Salem, VA, United
States
(Martinez-Rioux, Fitzgerald, O'Gara, Zenati) Division of Cardiac Surgery,
Veterans Healthcare System, Boston, MA, United States
(Paladugu, Gombolay) Sidney Kimmel Medical College, Thomas Jefferson
University, Philadelphia, PA, United States
(Harari) Department of Radiology, Mass General Brigham, Boston, MA, United
States
(Iwai, Shann, Zenati) Division of Cardiac Surgery, Mass General Brigham,
Boston, MA, United States
Publisher
SAGE Publications Ltd
Abstract
Purpose: Oxygen delivery (DO<inf>2</inf>) during cardiopulmonary bypass
(CPB) is critical in preventing postoperative complications in adult
cardiac surgery. This systematic review aimed to assess the relationship
between intraoperative DO<inf>2</inf>during CPB, particularly within
Goal-directed Perfusion (GDP) strategies, and associated clinical
outcomes. <br/>Method(s): A systematic search of MEDLINE, Embase, Web of
Science, PsycINFO, CINAHL, PROSPERO, and Cochrane was conducted from
database inception through December 2024, adhering to PRISMA 2020
guidelines. Studies reported intraoperative DO<inf>2</inf>measurements and
their relationship with clinical outcomes among adults undergoing cardiac
surgery with CPB. Data extraction and quality assessment were performed
independently by two reviewers. <br/>Result(s): Thirty-nine studies
(71,050 patients) were included, with acute kidney injury (AKI) being the
most frequently studied outcome (84.6% of studies). A consistent
association was found between lower intraoperative DO<inf>2</inf>and
increased risk of AKI, intraoperative lactate elevations, and prolonged
mechanical ventilation. Five randomized controlled trials (RCTs)
demonstrated that maintaining DO<inf>2</inf>levels, indexed to body
surface area (iDO<inf>2</inf>), above a threshold of 270-300
mL/min/m²significantly reduced the risk of postoperative AKI.
However, evidence linking DO<inf>2</inf>management directly to reductions
in mortality or neurologic complications remains limited, as well as
studies reporting compliance with GDP strategies. <br/>Conclusion(s):
Maintaining adequate iDO<inf>2</inf>during CPB significantly reduces
postoperative complications, especially AKI. These findings underscore the
clinical relevance of GDP strategies, highlighting the importance of
individualized perfusion management to optimize outcomes. Further
large-scale RCTs are needed to confirm these benefits, standardize
specific iDO<inf>2</inf>threshold levels that are beneficial, and to
explore strategies that impact mortality and neurologic outcomes, as well
as investigate the role that temperature management plays in
DO<inf>2</inf>threshold determination.<br/>Copyright &#xa9; The Author(s)
2025

<13>
Accession Number
2040330084
Title
Single Leaflet Device Attachment After Pascal Implantation for
Transcatheter Edge-to-Edge Repair: Systematic Review and Meta-Analysis.
Source
Structural Heart. 9(10) (no pagination), 2025. Article Number: 100698.
Date of Publication: 01 Oct 2025.
Author
Gupta S.; Aggarwal D.; Gao M.; Bhatia K.; Petrovic M.; Dominguez A.C.;
Lerakis S.; Argulian E.
Institution
(Gupta) Department of Internal Medicine, Mount Sinai Morningside/West, New
York, NY, United States
(Aggarwal, Petrovic, Dominguez, Argulian) Division of Cardiology, Mount
Sinai Fuster Heart, Mount Sinai Morningside Hospital, New York, NY, United
States
(Gao) Department of Medicine, Icahn School of Medicine at Mount Sinai, New
York, NY, United States
(Bhatia) Division of Cardiology, Montefiore Medical Center/Albert Einstein
College of Medicine, Bronx, NY, United States
(Lerakis) Division of Cardiology, Mount Sinai Fuster Heart, Mount Sinai
Hospital, New York, NY, United States
Publisher
Cardiovascular Research Foundation

<14>
Accession Number
2036014040
Title
Mortality Outcomes of Combined Heart and Liver Transplantation and
Isolated Heart Transplantation Following Fontan Procedures: A Systematic
Review and Meta-Analysis.
Source
Pediatric Transplantation. 29(7) (no pagination), 2025. Article Number:
e70174. Date of Publication: 01 Nov 2025.
Author
Holmvard O.; Povoa-Correa M.; Macintyre Innocenzi A.; Pacheco L.F.;
Parente D.B.; Luiz R.R.; de Lima Moreira J.P.; de Mello Perez R.;
Fernandes F.P.; Moll-Bernardes R.
Institution
(Holmvard, Povoa-Correa, Macintyre Innocenzi, Pacheco, Parente, Luiz, de
Lima Moreira, de Mello Perez, Fernandes, Moll-Bernardes) D'Or Institute
for Research and Education (IDOR), RJ, Rio de Janeiro, Brazil
(Povoa-Correa) Maternal and Child Health Department, Federal University of
Rio de Janeiro (UFRJ), RJ, Macae, Brazil
(Macintyre Innocenzi) Pediatric Cardiology Department, National Institute
of Cardiology (INC), RJ, Rio de Janeiro, Brazil
(Pacheco) Liver Transplant Surgery Department, Rede D'Or, RJ, Rio de
Janeiro, Brazil
(Parente) Radiology Department, Federal University of Rio de Janeiro
(UFRJ), RJ, Rio de Janeiro, Brazil
(Luiz) Institute for Studies in Public Health-IESC, Federal University of
Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
(de Lima Moreira) Fluminense Federal University, RJ, Niteroi, Brazil
(de Mello Perez) Internal Medicine Department, Federal University of Rio
de Janeiro (UFRJ), RJ, Rio de Janeiro, Brazil
(Fernandes) Pediatric Cardiac Transplantation, National Institute of
Cardiology (INC), RJ, Rio de Janeiro, Brazil
Publisher
John Wiley and Sons Inc
Abstract
Background: Fontan-associated liver disease can progress to advanced
fibrosis, raising the potential need for combined heart-liver
transplantation (CHLT) in selected patients. However, the benefits of CHLT
over isolated orthotopic heart transplantation (HT), particularly in terms
of mortality, remain uncertain. In this systematic review, we compared
mortality outcomes following CHLT versus HT in patients with Fontan
circulation, with the aim of supporting clinical decision-making.
<br/>Method(s): This systematic review was conducted according to the 2020
PRISMA guidelines and registered in PROSPERO. PubMed, Scopus, and Embase
were searched. Studies examining HT or CHLT in patients with Fontan
circulation that provided information about total and/or 1-year mortality
were included. Bias risks were assessed using the Newcastle-Ottawa Scale.
We used random- and fixed-effect models, depending on heterogeneity, to
estimate pooled effects. <br/>Result(s): Sixteen studies were included in
this analysis. CHLT was associated with a lower mortality rate per
patient-year compared to HT (0.03 vs. 0.09; p < 0.01). However, after
excluding studies in which transplantations were performed before the year
2000, the difference between groups was no longer statistically
significant. One-year mortality rates were also not significantly
different between CHLT and HT (0.09 vs. 0.14; p = 0.28), with similar
results observed after excluding pre-2000 studies. <br/>Conclusion(s):
Overall, this systematic review suggests that CHLT may result in mortality
rates comparable to those of isolated HT. These findings support the
consideration of CHLT in patients with concomitant liver disease and
reinforce the importance of comprehensive liver evaluation in transplant
candidates.<br/>Copyright &#xa9; 2025 The Author(s). Pediatric
Transplantation published by Wiley Periodicals LLC.

<15>
Accession Number
2035396194
Title
Bioadaptor implant versus contemporary drug-eluting stent in percutaneous
coronary interventions in Sweden (INFINITY-SWEDEHEART): a single-blind,
non-inferiority, registry-based, randomised controlled trial.
Source
The Lancet. 404(10464) (pp 1750-1759), 2024. Date of Publication: 02 Nov
2024.
Author
Erlinge D.; Andersson J.; Frobert O.; Tornerud M.; Hamid M.; Kellerth T.;
Grimfjard P.; Winnberg O.; Jurga J.; Wagner H.; Zwackman S.; Adielsson M.;
Alstrom P.; Masoe E.; Ulvenstam A.; Millgard J.; Bohm F.; Held C.; Renlund
H.; Oldgren J.; Smits P.C.; Elek C.; Abizaid A.; James S.
Institution
(Erlinge, Wagner) Department of Cardiology, Clinical Sciences, Lund
University, Skane University Hospital, Lund, Sweden
(Andersson) Department of Cardiology, Umea University, Umea, Sweden
(Frobert) Department of Cardiology, Faculty of Health, Orebro University,
Orebro, Sweden
(Frobert) Department of Clinical Medicine, Faculty of Health, Aarhus
University, Aarhus, Denmark
(Tornerud, Bohm) Department of Cardiology, Karolinska Institute and
Danderyd Hospital, Stockholm, Sweden
(Hamid) Department of Cardiology, Malarsjukhuset, Eskilstuna, Sweden
(Kellerth) Department of Cardiology, Central Hospital, Karlstad, Sweden
(Grimfjard) Department of Cardiology, Vasteras Hospital, Vasteras, Sweden
(Grimfjard, Held, Oldgren, James) Department of Medical Sciences,
Cardiology, Uppsala University, Uppsala, Sweden
(Winnberg) Department of Clinical Science and Education, Sodersjukhuset,
Karolinska Institute, Stockholm, Sweden
(Winnberg) Department of Cardiology, Capio St Goran's Hospital, Stockholm,
Sweden
(Jurga) Department of Cardiology, Karolinska Institutet and Karolinska
University Hospital, Stockholm, Sweden
(Wagner) Department of Cardiology, Helsingborg Lasarett, Helsingborg,
Sweden
(Zwackman) Department of Health, Medicine and Caring Sciences and
Department of Cardiology, Linkoping University, Linkoping, Sweden
(Adielsson) Department of Cardiology, Halmstad Hospital, Halmstad, Sweden
(Alstrom) Department of Clinical Science and Education, Division of
Cardiology, Sodersjukhuset, Karolinska Institutet, Stockholm, Sweden
(Masoe) Department of Cardiology, Sundsvall Hospital, Sundsvall, Sweden
(Ulvenstam) Department of Cardiology, Ostersund Hospital, Ostersund,
Sweden
(Millgard) Department of Cardiology, Sunderby Hospital, Lulea, Sweden
(Held, Renlund, Oldgren, James) Uppsala Clinical Research Center, Uppsala
University, Uppsala, Sweden
(Smits) European Cardiovascular Research Center (CERC), Massy, France
(Elek, Abizaid) Elixir Medical Corporation, Milpitas, CA, United States
Publisher
Elsevier B.V.
Abstract
Background: Persistent non-plateauing adverse event rates in patients who
underwent percutaneous coronary intervention (PCI) remain a challenge. A
bioadaptor is a novel implant that addresses this issue by restoring the
haemodynamic modulation of the artery, allowing cyclic pulsatility,
vasomotion, and adaptative remodelling, by unlocking and providing dynamic
support to the artery. We aimed to assess outcomes with the device versus
a contemporary drug-eluting stent (DES) in a representative PCI
population. <br/>Method(s): INFINITY-SWEDEHEART is a single-blind,
non-inferiority, registry-based, randomised controlled study conducted in
20 hospitals in Sweden. Patients aged 18-85 years, with chronic or acute
coronary syndrome ischaemic heart disease, with an indication for PCI,
with up to three de novo lesions suitable for implantation with one single
device per lesion, and successful pre-dilatation were identified via the
Swedish Coronary Angiography and Angioplasty Registry and eligible for
enrolment. Participants were randomly assigned (1:1), using block
randomisation with random variation in block size and stratified by site,
to either the DynamX bioadaptor (Elixir Medical, Milpitas, CA, USA) or a
zotarolimus-eluting DES (Resolute Onyx and Onyx Trustar, Medtronic,
Minneapolis, MN, USA). The primary endpoint was the device-oriented
clinical endpoint of target lesion failure at 12 months (a composite of
cardiovascular death, target vessel myocardial infarction, and
ischaemia-driven target lesion revascularisation), assessed in the
intention-to-treat (ITT) population (ie, all patients randomly assigned to
treatment, regardless of treatment received) who had either experienced an
event up to 12 months or completed the trial up to 12 months.
Non-inferiority was established if the upper limit of the two-sided 95% CI
for the absolute risk difference was less than 4.2%. Powered secondary
endpoints were landmark analyses from 6 months onwards for target lesion
failure, target vessel failure (composite of cardiovascular death, target
vessel myocardial infarction, and ischaemia-driven target vessel
revascularisation), and target lesion failure for patients with acute
coronary syndrome assessed in the ITT population). This study is
registered with ClinicalTrials.gov, NCT04562805, and follow-up to 5 years
is ongoing. <br/>Finding(s): Between Sept 30, 2020, and July 11, 2023,
2399 patients were randomly assigned to receive the bioadaptor (n=1201) or
DES (n=1198; ITT population). Median age was 69.5 years (IQR 61.2-75.6),
575 (24.0%) of 2399 patients were female, and 1824 (76.0%) were male (data
on race and ethnicity were not collected), and 1838 (76.6%) patients
presented with acute coronary syndrome. The primary endpoint of 12-month
target lesion failure occurred in 28 (2.4%) of 1189 assessable patients in
the bioadaptor group versus 33 (2.8%) of 1192 assessable patients in the
DES group, with a risk difference of -0.41% (95% CI -1.94 to 1.11;
p<inf>non-inferiority</inf><0.0001). In the prespecified landmark analysis
from 6 months to 12 months, the Kaplan-Meier estimates of target lesion
failure were 0.3% (with events in three of 1170 patients) in the
bioadaptor group versus 1.7% (with events in 16 of 1176 patients) in the
DES group (hazard ratio 0.19 [95% CI 0.06 to 0.65]; p=0.0079), of target
vessel failure were 0.8% (events in eight of 1167) versus 2.5% (events in
23 of 1174; 0.35 [0.16 to 0.79]; p=0.011), and of target lesion failure in
patients with acute coronary syndrome were 0.3% (events in two of 906)
versus 1.8% (events in 12 of 895; 0.17 [0.04 to 0.74]; p=0.018). The rate
of definite or probable device thrombosis, which was recorded as a safety
outcome, was low and did not differ between groups (eight [0.7%] of 1201
in the bioadaptor group vs six [0.5%] of 1198 in the DES group; difference
in event rates of 0.16% [95% CI -0.50 to 0.83]). <br/>Interpretation(s):
Among patients with coronary artery disease, including those with acute
coronary syndrome, treatment with the bioadaptor was non-inferior to
contemporary DES, showing potential to mitigate non-plateauing
device-related events and improving outcomes in patients undergoing PCI.
The additional planned follow-up will help to reinforce the clinical
significance of the 1-year findings. <br/>Funding(s): Elixir
Medical.<br/>Copyright &#xa9; 2024 Elsevier Ltd

<16>
Accession Number
2040356672
Title
Outcomes and complications among nonagenarians undergoing cardiac surgery:
A scoping review.
Source
PLOS ONE. 20(9 September) (no pagination), 2025. Article Number: e0331755.
Date of Publication: 01 Sep 2025.
Author
Weinberg L.; Ludski J.; Carp B.; Suh J.M.; Koshy A.N.; Haywood C.;
Churilov B.; Lee D.-K.; Yii M.
Institution
(Weinberg, Ludski, Carp, Suh, Churilov) Department of Anaesthesia, Austin
Health, Heidelberg, Australia
(Weinberg, Haywood) Department of Critical Care, The University of
Melbourne, Parkville, VIC, Australia
(Koshy) Department of Cardiology, Austin Health, Melbourne, VIC, Australia
(Koshy) Department of Medicine, The University of Melbourne, Parkville,
VIC, Australia
(Haywood) Department of Aged Care, Austin Health, Heidelberg Heights, VIC,
Australia
(Lee) Department of Anaesthesiology and Pain Medicine, Dongguk University
Ilsan Hospital, Goyang, South Korea
(Yii) Department of Cardiac Surgery, Epworth Eastern Hospital, Box Hill,
VIC, Australia
Publisher
Public Library of Science
Abstract
Introduction This review was aimed at understanding the scope of evidence
regarding outcomes and complications in nonagenarians (90-99 years of age)
undergoing open cardiac surgery. Methods The review was conducted in
accordance with the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) Extension for Scoping Review Protocol guidelines. A
search of three databases, MEDLINE, EMBASE, and the Cochrane Central
Register of Controlled Trials, identified articles pertaining to
nonagenarians undergoing various open cardiac surgical procedures. No
restrictions were applied to study design or publication date. Results
From the initial 1826 articles identified, we included 28 studies from
eight countries in a total of 6411 nonagenarians. The median 30-day
mortality rate was 10.5% (IQR 7.2-14.6). Postoperative complication rates
were reported in 20 studies (71%), and the median major complication rate
was 71.4%. Respiratory, cardiac, renal, neurologic, gastrointestinal,
and/or infectious complications were reported in 19%, 20%, 14%, 18%, 5%,
and 9% of cases, respectively. The median length of hospital stay was 12.5
days (IQR 10.4-18.0). No studies reported unplanned readmissions to the
intensive care unit or detailed patient-centered outcome measures.
Conclusions Although age alone should not preclude nonagenarians from
undergoing cardiac surgery, the procedure is associated with a
significantly elevated risk of morbidity and a relatively high mortality
rate. The review findings emphasize the need for international registry
data to identify risk factors associated with adverse outcomes, explore
strategies to decrease the risk of major complications, and improve
postoperative quality of life. Moreover, creating and implementing uniform
preoperative frailty assessments, and correlating them with surgical
outcomes, will be crucial. Developing standardized patient-reported
experience and outcome measures will also be imperative. Scoping review
registered on OSF registries (https://osf.io/4mg7n).<br/>Copyright &#xa9;
2025 Weinberg et al. This is an open access article distributed under the
terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided
the original author and source are credited.

<17>
Accession Number
2038497820
Title
Effect of PCSK9 inhibitor usage on coronary endothelial dysfunction in
patients with hypercholesterolemia after coronary stenting: The CuVIC-2
trial.
Source
Journal of Cardiology. 86(3) (pp 230-237), 2025. Date of Publication: 01
Sep 2025.
Author
Akiyama Y.; Katsuki S.; Koga Y.; Yamamoto M.; Hironaga K.; Suematsu N.;
Miyata K.; Mukai Y.; Inoue S.; Nishi J.-I.; Tashiro H.; Nakano Y.;
Funakoshi K.; Tagawa K.; Ichi I.; Tsutsui H.; Abe K.; Matoba T.
Institution
(Akiyama, Koga) Department of Cardiovascular Medicine, Oita Prefectural
Hospital, Oita, Japan
(Akiyama, Katsuki, Nakano, Abe, Matoba) Department of Cardiovascular
Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka,
Japan
(Yamamoto) Department of Cardiovascular Medicine, Harasanshin Hospital,
Fukuoka, Japan
(Hironaga) Department of Cardiovascular Medicine, Fukuoka City Hospital,
Fukuoka, Japan
(Suematsu) Department of Cardiovascular Medicine, Saiseikai Fukuoka
General Hospital, Fukuoka, Japan
(Miyata) Department of Cardiovascular Medicine, Japan Community Health
Care Organization, Kyushu Hospital, Fukuoka, Japan
(Mukai) Department of Cardiovascular Medicine, Japanese Red Cross Fukuoka
Hospital, Fukuoka, Japan
(Inoue) Department of Cardiovascular Medicine, National Hospital
Organization Kyushu Medical Centre, Fukuoka, Japan
(Nishi) Department of Cardiovascular Medicine, Iizuka Hospital, Fukuoka,
Japan
(Tashiro) Department of Cardiovascular Medicine, St. Mary's Hospital,
Fukuoka, Japan
(Funakoshi, Tagawa) Center for Clinical and Translational Research of
Kyushu University Hospital, Fukuoka, Japan
(Ichi) of Humanities and Science, Ochanomizu University, Tokyo, Japan
(Tsutsui) School of Medicine and Graduate School, International University
of Health and Welfare, Fukuoka, Japan
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background: The effects of evolocumab on coronary endothelial dysfunction
(CED), a hallmark of atherogenesis, are unknown. The aim of this study was
to investigate whether evolocumab, in combination with high-dose statins,
could ameliorate CED in patients who underwent coronary stenting.
<br/>Method(s): The CuVIC-2 trial was a multicenter randomized controlled
trial. CED was defined as intracoronary acetylcholine (ACh)-induced
contractile responses with signs of myocardial ischemia. We originally
intended to enroll 160 participants but altered the study design due to
the COVID-19 pandemic and then recruited 41 participants. The revised
primary endpoint was the coronary contraction rate in response to ACh
assessed in a core laboratory, ensuring a statistical power of over 80 %
using the mixed model for repeated measures. <br/>Result(s): The
evolocumab in combination with high-dose statins with or without ezetimibe
(EV + S) group included 19 males and 4 females aged 62 +/- 13 years. The
high-dose statins with or without ezetimibe (S) group included 13 males
and 5 females aged 64 +/- 11 years. Compared with the S group, the EV + S
group presented a significantly greater decrease in low-density
lipoprotein cholesterol at 28 weeks; 83 +/- 17 to 20 +/- 16 mg/dL (-76 %
from the baseline) in the EV + S group and 88 +/- 16 to 81 +/- 20 mg/dL
(-7 % from the baseline) in the S group (p < 0.0001). At 28 weeks, there
was no difference between the two groups in terms of the coronary artery
constriction rate across all doses [mean difference: 4.8 % (95 % CI: -13.6
to 23.2); p = 0.6]. <br/>Conclusion(s): Amelioration of CED by evolocumab
was not observed in this trial with several limitations.<br/>Copyright
&#xa9; 2025 The Authors

<18>
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. <br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9; The Author(s) 2024

<19>
Accession Number
2040302403
Title
Efficacy of botulinum toxin type A injections in improving hypertrophic
scarring and keloid formation: A systematic review and meta-analysis of
randomized controlled trials.
Source
Journal of Cutaneous and Aesthetic Surgery. 18(3) (pp 161-174), 2025. Date
of Publication: 01 Jul 2025.
Author
Mortada H.; Alowais F.A.; Alassaf H.; Jabbar I.A.; Albalawi I.A.S.;
Alshomer F.; Alawirdhi B.
Institution
(Mortada) Division of Plastic Surgery, Department of Surgery, King Saud
University Medical City, King Saud University, Saudi Arabia
(Alowais) Department of Plastic and Reconstructive Surgery, Security
Forces Hospital, Saudi Arabia
(Alassaf) Department of Surgery, Division of Plastic Surgery, Prince
Sultan Military Medical City, Riyadh, Saudi Arabia
(Jabbar) College of Medicine, King Khalid University, Abha, Saudi Arabia
(Albalawi) Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia
(Alshomer) Department of Surgery, Division of Plastic Surgery, King Saud
bin Abdulaziz University for Health and Sciences, Saudi Arabia
(Alawirdhi) Department of Plastic Surgery, Prince Sultan Military Medical
City, Riyadh, Saudi Arabia
Publisher
Scientific Scholar LLC
Abstract
Introduction: This article aims to provide a systematic review of the use
of botulinum toxin type A (BTA) in the prevention and treatment of
hypertrophic scars and keloids. These types of scars pose significant
challenges in clinical practice, and alternative treatment approaches are
being explored. BTA has shown promise in its potential to modulate scar
formation and improve outcomes. <br/>Material(s) and Method(s): Following
the guidelines set forth by the preferred reporting items for systematic
reviews and meta-analyses, a thorough examination of the available
literature was conducted, encompassing the period from the inception of
relevant databases until September 2023. The electronic databases utilized
for this review included CENTRAL, MEDLINE, Google Scholar, and EMBASE.
<br/>Result(s): Our review evaluated 1001 articles, ultimately including
12 randomized controlled trials that fulfilled our inclusion criteria. The
visual analog scale (VAS) scores revealed a significant improvement in the
cosmetic outcomes for the BTA group (mean difference [MD] 1.03, 95%
confidence interval [CI] 0.01-2.05, P < 0.0001). Similarly, the vancouver
scar scale (VSS) scores indicated superior scar quality in the BTA group
(MD = -1.18, 95% CI -1.94 to -0.42, P = 0.001). Adverse events were
minimal and included instances such as mild eyelid drooping and the
development of an abscess requiring surgical intervention.
<br/>Conclusion(s): Our systematic review and meta-analysis indicate that
BTA significantly improves hypertrophic scars and keloids, as shown by
better VAS and VSS scores. Adverse events were minimal. Further
large-scale studies are needed for validation.<br/>Copyright &#xa9; 2025
Published by Scientific Scholar.

<20>
Accession Number
2035873276
Title
Treatment Strategies for Patients with Mitral Regurgitation: A
Meta-Analysis of Randomized Controlled Trials.
Source
Journal of Personalized Medicine. 15(8) (no pagination), 2025. Article
Number: 383. Date of Publication: 01 Aug 2025.
Author
Carassia C.; Simonetti F.; Alvarez Covarrubias H.A.; Wolf B.; Pellegrini
C.; Rheude T.; Fuchs P.; Roski F.; Kuhlein M.; Blum E.; Ndrepepa G.;
Trenkwalder T.; Joner M.; Kastrati A.; Cassese S.; Xhepa E.
Institution
(Carassia) Cardiology Department, Busto Arsizio Hospital, ASST Valle
Olona, Busto Arsizio, Italy
(Carassia, Simonetti, Alvarez Covarrubias, Wolf, Pellegrini, Rheude,
Fuchs, Roski, Kuhlein, Blum, Ndrepepa, Trenkwalder, Joner, Kastrati,
Cassese, Xhepa) Klinik fur Herz- und Kreislauferkrankungen, TUM Klinkum
Deutsches Herzzentrum, Technische Universitat Munchen, Munich, Germany
(Simonetti) Department of Advanced Biomedical Sciences, University of
Naples Federico II, Naples, Italy
(Alvarez Covarrubias) Departamento de Cardiologia, Hospital de
Cardiologia, Centro Medico Nacional Siglo XXI, Instituto Mexicano del
Seguro Social (IMSS), Mexico City, Mexico
(Joner, Kastrati) DZHK (German Center for Cardiovascular Research),
Partner Site Munich Heart Alliance, Munich, Germany
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Several treatment strategies are available for patients with
mitral valve regurgitation (MR). However, evidence regarding their
comparative effectiveness remains limited. We sought to compare the
performance of different treatment strategies for personalized treatment
of patients with MR. <br/>Method(s): We performed a pairwise and network
meta-analyses of randomized trials comparing treatment strategies for
patients with MR. Patients were divided in two groups: transcatheter
mitral valve repair (TMVR, including edge-to-edge repair and indirect
percutaneous annuloplasty) and control (surgery or optimal medical
therapy). The primary outcome of this analysis was all-cause death. Main
secondary outcomes were re-hospitalization for heart failure and
re-intervention. <br/>Result(s): A total of seven trials with 2324
participants, with mainly functional MR (TMVR, n = 1373-control, n = 951)
were available for the quantitative synthesis. The median follow-up
duration was 14 months. Compared to control therapy, TMVR significantly
reduced all-cause death (RR 0.77, 95% CI 0.65-0.91, p = 0.002) and
re-hospitalization for heart failure (RR 0.67, 95% CI 0.49-0.91, p =
0.01). Among TMVR strategies, the edge-to-edge repair with MitraClip
ranked as possibly the best option to reduce all-cause death.
<br/>Conclusion(s): In symptomatic patients with significant MR, TMVR is
associated with a significant reduction of all-cause death, and
re-hospitalization for heart failure, mainly in patients with functional
MR. Additional comparative studies are needed to investigate the best TMVR
treatment option, for patients with degenerative MR.<br/>Copyright &#xa9;
2025 by the authors.

<21>
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. <br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9;
The Author(s) 2025.

<22>
Accession Number
2035999120
Title
Efficacy and safety of different proprotein convertase subtilisin/kexin
type 9 inhibitors in the general population and solid organ transplant
recipients: a network meta-analysis.
Source
Frontiers in Pharmacology. 16 (no pagination), 2025. Article Number:
1584612. Date of Publication: 2025.
Author
Luo B.; Sun Z.; Luo H.
Institution
(Luo) School of Medicine, University of Electronic Science and Technology
of China, Chengdu, China
(Sun) Qianwan Institute, Ningbo Institute of Materials Technology and
Engineering (NIMTE), Chinese Academy of Sciences, Ningbo, China
(Luo) Department of Hepatobiliary Surgery, Zigong Fourth People's
Hospital, Zigong, China
Publisher
Frontiers Media SA
Abstract
Introduction: We conducted a network meta-analysis (NMA) to compare the
efficacy (primarily assessed by low-density lipoprotein cholesterol
(LDL-C) reduction and cardiovascular event (CVE) incidence) and safety
(total adverse events (AEs), neurocognitive events (NCEs), injection site
reactions, infections, and all-cause mortality (ACM)) of different
Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors versus
placebo in the general population and solid organ transplant (SOT)
recipients. <br/>Material(s) and Method(s): A total of 16 randomized
controlled trials (RCTs) involving 79,615 patients were included. Cochrane
risk of bias assessment tool evaluated the literature quality. Data
analysis and graph generation were conducted employing RevMan5.3 and
Stata20.0. The cumulative ranking probability curve (SUCRA) compared
impact of different treatment regimens (DTRs) on patient efficacy, safety,
and ACM. <br/>Result(s): Evolocumab ranked highest for LDL-C reduction
(SUCRA 67.2%) and CVE reduction (SUCRA 69.5%). Ongericimab had the lowest
total AEs (SUCRA 91.3%), while Alirocumab ranked best for NCEs (SUCRA
89.5%) and infections (SUCRA 74.1%). Placebo had the fewest injection site
reactions (SUCRA 89.8%). No PCSK9 inhibitor significantly reduced ACM
(Alirocumab SUCRA 69.0%, highest but non-significant). LDL-C reduction was
significant in both general and SOT populations, but CVE and ACM
reductions were non-significant. Inclisiran increased risks of total AEs
and injection site reactions (RR > 1.2). <br/>Conclusion(s): Evolocumab is
optimal for LDL-C and CVE reduction, while Ongericimab and Alirocumab
offer better safety profiles. PCSK9 inhibitors did not increase acute
rejection or infection risk in SOT recipients. Long-term mortality
benefits remain uncertain.<br/>Copyright &#xa9; 2025 Luo, Sun and Luo.

<23>
Accession Number
2036654743
Title
Fractional flow reserve-guided complete revascularization versus
culprit-only percutaneous coronary intervention in patients with
myocardial infarction: A meta-analysis of randomized controlled trials.
Source
Cardiovascular Revascularization Medicine. 78 (pp 31-40), 2025. Date of
Publication: 01 Sep 2025.
Author
Ezenna C.; Krishna M.M.; Joseph M.; Pereira V.; Ramesh P.; Ismayl M.;
Nanna M.G.; Goldsweig A.M.
Institution
(Ezenna, Ramesh) Department of Medicine, University of Massachusetts -
Baystate Medical Center, Springfield, MA, United States
(Krishna, Joseph) Department of Medicine, Medical College
Thiruvananthapuram, India
(Pereira) Faculty of Medicine, Universidad Austral, Pilar, Argentina
(Ismayl) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Nanna) Section of Cardiovascular Medicine, Yale School of Medicine, New
Haven, CT, United States
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center
and Division of Cardiovascular Medicine, University of
Massachusetts-Baystate, Springfield, MA, United States
Publisher
Elsevier Inc.
Abstract
Introduction: The optimal revascularization strategy for patients with
myocardial infarction (MI) and multivessel coronary artery disease (CAD)
remains an area of research and debate. Fractional flow reserve
(FFR)-guided complete revascularization (CR) by percutaneous coronary
intervention (PCI) has emerged as an alternative to traditional
culprit-only PCI. <br/>Objective(s): To investigate the outcomes of
FFR-guided CR versus culprit-only PCI in patients with MI and multivessel
CAD. <br/>Method(s): We systematically searched PubMed, Scopus and
Cochrane Central databases for randomized controlled trials (RCTs)
comparing FFR-guided CR versus culprit-only PCI in MI patients with
multivessel CAD. Outcomes included a composite of all-cause death, MI,
stroke and repeat revascularization, these individual outcomes, cardiac
death, stent thrombosis (definite or probable), and contrast-induced acute
kidney injury (CIAKI). Random effects models were used to generate risk
ratios (RRs) with 95 % confidence intervals (CIs). <br/>Result(s): The
search identified 5 RCTs including 4618 patients with a median follow-up
duration of 3 years. Compared with culprit-only PCI, FFR-guided CR was
associated with less composite adverse events (RR 0.73; 95%CI 0.57-0.92; p
= 0.009), cardiac death (RR 0.73; 95%CI 0.55-0.97; p = 0.03), and repeat
revascularization (RR 0.61; 95%CI 0.44-0.84; p = 0.003). Both strategies
were similar in terms of all-cause death, MI, stroke, stent thrombosis,
and CIAKI. <br/>Conclusion(s): FFR-guided complete revascularization
appears to be superior to culprit-only PCI in reducing composite adverse
events, cardiac death, and the need for repeat revascularization in
patients with MI and multivessel CAD without a significant impact on
recurrent myocardial infarction rates. Social media abstract: 4618-patient
meta-analysis: in MI w/ multivessel #CAD, #FFR-guided complete
revascularization yields less composite adverse events, cardiac death &
repeat revascularization than culprit-only #PCI.<br/>Copyright &#xa9; 2024
Elsevier Inc.

<24>
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. <br/>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). <br/>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. <br/>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.<br/>Copyright &#xa9; 2024 The Authors

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

<26>
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.<br/>Copyright &#xa9; 2025 Wiley Periodicals LLC.

<27>
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.
<br/>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. <br/>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.
<br/>Conclusion(s): Remimazolam besylate is noninferior to propofol in
terms of sedation efficacy during elective cardiac
procedures.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<28>
Accession Number
2021973905
Title
Edoxaban Monotherapy in Nonvalvular Atrial Fibrillation Patients with
Coronary Artery Disease.
Source
Journal of Interventional Cardiology. 2022 (no pagination), 2022. Article
Number: 5905022. Date of Publication: 2022.
Author
Fukamachi D.; Okumura Y.; Matsumoto N.; Tachibana E.; Oiwa K.; Ichikawa
M.; Haruta H.; Nomoto K.; Arima K.; Hirayama A.
Institution
(Fukamachi, Okumura) Division of Cardiology, Nihon University Itabashi
Hospital, Tokyo, Japan
(Matsumoto) Department of Cardiology, Nihon University Hospital, Tokyo,
Japan
(Tachibana) Kawaguchi Municipal Medical Center, Saitama, Japan
(Oiwa) Yokohama Central Hospital, Kanagawa, Yokohama, Japan
(Ichikawa) Sekishindo Hospital, Saitama, Japan
(Haruta) Tmg Asaka Hospital, Saitama, Japan
(Nomoto) Tokyo Rinkai Hospital, Tokyo, Japan
(Arima) Kasukabe Municipal Hospital, Saitama, Japan
(Hirayama) Osaka Police Hospital, Osaka, Japan
Publisher
Hindawi Limited
Abstract
Background. Current guidelines recommend an oral anticoagulant (OAC)
monotherapy in patients with nonvalvular atrial fibrillation (NVAF) and
stable coronary artery disease (CAD) 1 year postpercutaneous coronary
intervention (PCI). It might be possible to shorten the time for
de-escalation from a dual therapy to monotherapy, but data regarding
de-escalation to an edoxaban monotherapy are lacking. This study aimed to
assess the clinical safety of an edoxaban monotherapy in patients with
NVAF and stable CAD. Methods. A multicenter, prospective, randomized,
open-label, and parallel group study was established to investigate the
safety of an edoxaban monotherapy in patients with NVAF and stable CAD
including over 6 months postimplantation of a third-generation DES and 1
year postimplantation of other stents (PRAEDO AF study). Between March
2018 and June 2020, 147 patients from 8 institutions in Japan were
randomized to receive either an edoxaban monotherapy (n = 74) or
combination therapy (edoxaban plus clopidogrel, n = 73). The primary study
endpoint was the composite incidence of major bleeding and clinically
significant bleeding, defined according to the ISTH criteria. Results.
Major or clinically significant bleeding occurred in 2 patients in the
monotherapy group (1.67% per patient-year) and in 5 patients in the
combination therapy group (4.28% per patient-year) (hazard ratio, 0.39;
95% confidence interval, 0.08-2.02). There was no incidence of a
myocardial infarction, stent thrombosis, unstable angina requiring
revascularization, ischemic stroke, systemic stroke, or hemorrhagic stroke
in either of the groups. Conclusions. The edoxaban monotherapy was shown
to have acceptable clinical safety in patients with NVAF and stable CAD.
The study was registered with the Japan Registry of Clinical Trials
(jRCTs031180119).<br/>Copyright &#xa9; 2022 Daisuke Fukamachi et al.

<29>
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.<br/>Copyright &#xa9; 2025

<30>
Accession Number
2036906160
Title
Impact of pulmonary hypertension on short and long-term outcome after
mitral transcatheter edge-to-edge repair: A meta-analysis.
Source
Cardiovascular Revascularization Medicine. 78 (pp 88-96), 2025. Date of
Publication: 01 Sep 2025.
Author
Neppala S.; Chigurupati H.D.; Fath A.; Jagirdhar G.S.K.; Sandhyavenu H.;
Bolte J.; Muhammad A.N.; Sattar Y.; Desai R.; Defronzo R.A.; Paul T.K.;
Prasad A.
Institution
(Neppala, Bolte, Defronzo) Department of Medicine, University of Texas
Health Sciences Center, San Antonio, TX, United States
(Chigurupati, Jagirdhar) Department of Medicine, New York Medical College
at Saint Michael's Medical Center, Newark, NJ, United States
(Fath, Sandhyavenu, Prasad) Division of Cardiology, Department of
Medicine, University of Texas Health Sciences Center, San Antonio, TX,
United States
(Muhammad) Dow University of Health Sciences, Karachi, Pakistan
(Sattar) Department of Internal medicine and Cardiovascular disease, West
Virginia University, Morgantown, WV, United States
(Desai) Independent Outcomes Researcher, Atlanta, GA, United States
(Paul) Department of Cardiovascular Sciences, Ascension St. Thomas
Hospital/University of Tennessee Health Sciences Center, Nashville, TN,
United States
Publisher
Elsevier Inc.
Abstract
Background: Pulmonary hypertension (pHTN) has been associated with
increased morbidity and mortality after mitral Transcatheter Edge-to-Edge
Repair (TEER), but the association remains uncertain. This study aims to
evaluate the impact of pHTN on cardiovascular outcomes following TEER.
<br/>Method(s): We searched PubMed, Scopus, and Medline to identify
studies reporting outcomes after TEER in individuals with pHTN. Utilizing
a random-effects model, we ascertained a pooled odds ratio (OR) of
clinical outcomes in patients with pulmonary artery systolic pressure
(PASP >50 mmHg) vs. without (PASP <50 mmHg) severe pHTN. <br/>Result(s):
We included seven studies with 27,965 patients. The mean age was 79.9
(+/-5.2) years; 53 % were male, and 75 % were New York Heart Association
(NYHA) class-III/IV with a median follow-up of 360 days. Patients with
severe pHTN had higher odds of in-hospital all-cause mortality (OR: 1.99,
95 % CI: 1.69-2.34, p < 0.00001) and Major adverse cardiovascular events
(MACE) (OR: 1.38, 95 % CI: 1.22-1.56, p < 0.00001) compared to patients
without severe pHTN. <br/>Conclusion(s): Severe pHTN is associated with
increased risks of all-cause mortality, MACE, and higher heart failure
rehospitalizations in patients undergoing mitral TEER. Prospective trials
are necessary to validate the findings and determine if early intervention
improves clinical outcomes.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<31>
Accession Number
2039516632
Title
Effects of Increased Cardiopulmonary Bypass Pump Flow on Renal Filtration,
Perfusion, Oxygenation, and Tubular Injury in Cardiac Surgical Patients: A
Randomized Controlled Trial.
Source
Anesthesiology. 143(4) (pp 906-916), 2025. Date of Publication: 01 Oct
2025.
Author
Wijk J.; Cordefeldt-Keiller A.; Bragadottir G.; Redfors B.; Ricksten
S.-E.; Lannemyr L.
Institution
(Wijk, Cordefeldt-Keiller, Bragadottir, Redfors, Ricksten, Lannemyr)
Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska
Academy, University of Gothenburg, Section of Cardiothoracic Anesthesia
and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Cardiac surgery with cardiopulmonary bypass (CPB) is
associated with impaired renal oxygenation and acute kidney injury. The
authors investigated whether an amount higher than their standard blood
flow during CPB could improve renal blood flow, the oxygen demand-supply
relationship, and function and attenuate tubular injury. <br/>Method(s):
After ethical approval and informed consent, 36 adult patients undergoing
cardiac surgery received either high flow (2.9 l . min^-1.
m^-2, n = 19) or standard flow (2.4 l . min^-1.
m^-2, n = 17) during CPB in this randomized, nonblinded,
parallell-arm study. Systemic hemodynamics and renal variables were
measured before and during CPB. Glomerular filtration rate was measured by
infusion clearance of iohexol and renal blood flow by infusion clearance
of para-aminohippuric acid, corrected for renal extraction of
para-aminohippuric acid, using a renal vein catheter. Renal oxygen
demand-supply relationship was estimated from renal oxygen extraction and
tubular injury assessed by urinary N-acetyl-beta-d-glucosaminidase.
<br/>Result(s): During CPB, high flow led to a larger increase in systemic
oxygen delivery (100 [95% CI, 60 to 141] vs. 31 [1.9 to 65] ml .
min^-1. m^-2]; between-group P < 0.001; effect size
Cohen's dz, 0.59) and target mean arterial pressure was maintained at a
lower norepinephrine dose (0.03 [-0.01 to 0.06] microg . kg^-1.
min^-1] vs. 0.10 [0.02 to 0.19] microg . kg^-1.
min^-1; P = 0.048; Cohen's dz, 0.62) compared with standard
flow. There were no differences in renal blood flow or oxygen extraction
between groups. Glomerular filtration rate increased during high-flow CPB
(6.4 [1.9 to 10.9] ml . min^-1. 1.73 m^-2), but not in
the standard-flow group (-2.3 [-10.9 to 6.2] ml . min^-1. 1.73
m^-2; between-group P = 0.044; Cohen's dz, 0.66). The peak
urinary excretion of N-acetyl-beta-d-glucosaminidase was 1.42 (0.87 to
3.6) versus 3.74 (1.5 to 7.7) units/micromol creatinine in the high-flow
and standard-flow groups, respectively (P = 0.049). No perfusion-related
adverse events were seen in either group. <br/>Conclusion(s): A 20%
higher-than-standard CPB flow during cardiac surgery improved renal
function, whereas no change in renal blood flow or oxygen demand-supply
relationship could be detected. Higher CPB flow was associated with a less
pronounced tubular injury marker release compared with standard
flow.<br/>Copyright &#xa9; 2025 Lippincott Williams and Wilkins. All
rights reserved.

<32>
Accession Number
2035996698
Title
Optimizing equine standing sedation: continuous infusion of detomidine and
butorphanol enhances stability but prolongs ataxia.
Source
Frontiers in Veterinary Science. 12 (no pagination), 2025. Article Number:
1606585. Date of Publication: 2025.
Author
Arantes J.D.A.; Rabelo I.P.; Bermudes L.; Lacerenza M.D.; Mendes R.P.;
Correa R.R.; Yamada D.I.; Valadao C.A.D.A.; Doria R.G.S.
Institution
(Arantes, Rabelo, Bermudes, Lacerenza, Mendes, Doria) Department of
Veterinary Medicine, Faculty of Animal Sciences and Food Engineering
(FZEA), University of Sao Paulo (USP), SP, Pirassununga, Brazil
(Correa) Department of Surgery, School of Veterinary Medicine and Animal
Science (FMVZ), University of Sao Paulo (USP), SP, Sao Paulo, Brazil
(Yamada, Valadao) Department of Veterinary Medicine and Surgery, Faculty
of Agricultural and Veterinary Sciences (UNESP), Sao Paulo State
University, Sao Paulo, Jaboticabal, Brazil
Publisher
Frontiers Media SA
Abstract
Objective: This study aimed to compare the sedation quality and
cardiorespiratory and behavioral effects of detomidine administered
intravenously, either in intermittent boluses or as a continuous rate
infusion, with butorphanol in horses pre-medicated with acepromazine for
odontoplasty procedures. <br/>Method(s): A prospective clinical study was
conducted with fifteen adult horses randomly assigned to two groups: Bolus
group (BG, n = 7) and Infusion group (IG, n = 8). Both groups received
acepromazine premedication, followed by detomidine administration (bolus
or infusion). Butorphanol was administered either as a bolus or continuous
infusion during oral cavity evaluation (after detomidine). When sedation
was inadequate, an additional bolus of detomidine combined with
butorphanol was given. Physiological, sedative, and behavioral parameters
were evaluated at multiple time points throughout the procedure. Data were
analyzed using statistical models to assess differences between groups and
across time points. <br/>Result(s): Continuous infusion of detomidine
resulted in superior sedation quality, greater stability, and a reduced
need for rescue sedation (p < 0.001) compared to bolus administration.
Horses in the BG total detomidine consumption was significantly influenced
by procedure duration and the number of readministrations (p = 0.004).
Despite improved sedation quality in IG, ataxia persisted longer
post-procedure. Cardiovascular parameters showed expected alpha2-agonist
effects, with transient reductions in heart rate and stable arterial
pressure. Conclusions and clinical relevance: Continuous infusion of
detomidine with butorphanol provided more stable sedation, reducing the
need for frequent redosing, but also led to prolonged ataxia. Future
studies should explore alternative drug combinations to optimize sedation
quality while minimizing ataxia and cardiorespiratory
effects.<br/>Copyright &#xa9; 2025 Arantes, Rabelo, Bermudes, Lacerenza,
Mendes, Correa, Yamada, Valadao and Doria.

<33>
Accession Number
2040386050
Title
Omega-3 fatty acid supplementation in solid organ transplant recipients: A
systematic review and meta-analysis of randomized controlled trials.
Source
Clinical Nutrition ESPEN. 69 (pp 809-820), 2025. Date of Publication: 01
Oct 2025.
Author
Samankan S.; Gharekhani A.; Khiali S.; Rezagholizadeh A.; Agabalazadeha
A.; Sarbakhsh P.; Alizadeh L.; Sharifi A.; Sadrazar A.
Institution
(Samankan, Rezagholizadeh) Department of Clinical Pharmacy
(Pharmacotherapy), Faculty of Pharmacy, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
(Gharekhani) Kidney Research Center, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
(Khiali) Cardiovascular Research Center, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
(Agabalazadeha) Student Research Committee, Faculty of Pharmacy, Tabriz
University of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Sarbakhsh) Department of Statistics and Epidemiology, Faculty of Public
Health, Tabriz University of Medical Sciences, Tabriz, Iran, Islamic
Republic of
(Alizadeh, Sadrazar) Liver and Gastrointestinal Diseases Research Center,
Tabriz University of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Sharifi) Hepatopancreaticobiliary and Organ Transplantation Surgery
Group, Department of General and Vascular Surgery, Imam Reza Hospital,
Tabriz University of Medical Science, Tabriz, Iran, Islamic Republic of
Publisher
Elsevier Ltd
Abstract
Background: Omega-3 polyunsaturated fatty acids are known for
anti-inflammatory and cardiovascular benefits, but their impact on solid
organ transplant outcomes is unclear. <br/>Objective(s): To assess the
effects of omega-3 supplementation on clinical outcomes in solid organ
transplant recipients. <br/>Method(s): A systematic review and
meta-analysis of randomized controlled trials was conducted according to
PRISMA guidelines. Databases including PubMed, Scopus, and Web of Science
were searched through May 2025. Eligible studies were evaluated for
transplant-related outcomes, with the primary outcome being graft
rejection at 30-day, 3-month, and 1-year post-transplant. Secondary
outcomes included changes in lipid profile, blood pressure, renal
function, and infection rates. <br/>Result(s): Sixteen trials involving
1,020 patients were included. Omega-3 supplementation did not result in a
statistically significant reduction in rejection rates at 30 days, 3
months, or 1 year post-transplant. Diastolic blood pressure decreased
significantly (Hedges' g = -0.72; 95 % CI: -1.31 to -0.13), and total
cholesterol levels also declined (Hedges' g = -0.64; 95 % CI: -1.04 to
-0.24), particularly in kidney transplant recipients. In heart transplant
recipients, systolic blood pressure decreased significantly (Hedges' g =
-1.03; 95 % confidence interval: -1.53 to -0.54). Effects on high- and
low-density lipoproteins, triglycerides, glomerular filtration rate, and
creatinine clearance were inconsistent and largely non-significant. A
single study reported reduced sepsis rates in kidney recipients (log odds
ratio = -1.16; 95 % confidence interval: -2.25 to -0.07). No significant
impact was seen on calcineurin inhibitor toxicity. <br/>Conclusion(s):
Omega-3 supplementation may have benefits for solid organ transplant
recipients in terms of improving lipid profiles and reducing blood
pressure. However, study heterogeneity and limited outcome data highlight
the need for larger, standardized trials.<br/>Copyright &#xa9; 2025
European Society for Clinical Nutrition and Metabolism

<34>
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).
<br/>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. <br/>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. <br/>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.<br/>Copyright
2025 Ameen, Thakker, Contreras, Hashemi, Nasrollahizadeh, Saberian,
Kuriyakose, Amini-Salehi, Keetha and Nayak.

<35>
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). <br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9; The
Author(s) 2024

<36>
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.<br/>Copyright &#xa9; 2025 The
Author(s).

<37>
Accession Number
2035871175
Title
Infective Endocarditis by Fusobacterium Species-A Systematic Review.
Source
Pathogens. 14(8) (no pagination), 2025. Article Number: 829. Date of
Publication: 01 Aug 2025.
Author
Ioannou P.; Mourati E.; Thalasseli Kazali S.; Bali C.; Baliou S.; Samonis
G.
Institution
(Ioannou, Mourati, Thalasseli Kazali, Bali, Baliou, Samonis) School of
Medicine, University of Crete, Heraklion, Greece
(Samonis) First Oncology Department, Metropolitan Hospital, Neon Faliron,
Athens, Greece
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Fusobacterium species are anaerobic Gram-negative bacilli that
are part of the normal oropharyngeal and gastrointestinal flora. Although
rare, they can cause infective endocarditis (IE), a severe condition with
high morbidity. The clinical characteristics, treatment strategies, and
outcomes of IE caused by Fusobacterium spp. remain incompletely defined.
This systematic review aimed to synthesize available data on Fusobacterium
IE and compare its features with IE caused by other pathogens.
<br/>Method(s): We conducted a systematic literature search in PubMed,
Scopus, and the Cochrane Library up to 27 February 2025, using the terms
"Fusobacterium" and "endocarditis." Eligible studies included case reports
or series describing adult or pediatric patients with
Fusobacterium-associated IE. Data were extracted on demographics, risk
factors, clinical features, microbiology, treatment, and outcomes.
<br/>Result(s): A total of 21 studies (all case reports) involving 21
patients were included. The median age was 48 years, and 85.7% were male.
Poor dental hygiene or recent dental work was the most common predisposing
factor (47.6%). The mitral valve was most frequently affected (44.4%).
Fever and sepsis were reported in nearly all cases, and embolic phenomena
occurred in 81%. The most commonly isolated species were F. necrophorum
(47.6%) and F. nucleatum (42.9%). Treatment commonly included
metronidazole (61.9%), while surgical management was required in 23.8%.
All-cause and infection-attributable mortality were both 9.5%.
<br/>Conclusion(s): Fusobacterium IE predominantly affects younger males
and is often linked to oral sources. This disease is associated with a
high risk of systemic complications but seems to have a lower mortality
compared to IE from other pathogens, including other anaerobic bacteria.
Early diagnosis and appropriate antimicrobial treatment are of utmost
importance for optimal outcomes. Further research is required to guide
evidence-based management of this rare but serious
infection.<br/>Copyright &#xa9; 2025 by the authors.

<38>
Accession Number
2040227924
Title
Diaphragmatic plication for diaphragmatic paralysis: A systematic review
and meta-analysis of surgical outcomes.
Source
Surgery (United States). 187 (no pagination), 2025. Article Number:
109640. Date of Publication: 01 Nov 2025.
Author
Rahouma M.; Al-Thani S.; Baudo M.; Khairallah S.; El-Kharbotly I.; Dabsha
A.; Mehta K.; El-Sherbiny M.; Port J.; Mick S.L.; Bertolaccini L.
Institution
(Rahouma, Al-Thani, Baudo, Khairallah, Dabsha, Mehta, Port, Mick)
Cardiothoracic Surgery Department, Weill Cornell Medicine, New York, NY,
United States
(Rahouma, Khairallah, El-Kharbotly, Dabsha, El-Sherbiny) Surgical Oncology
Department, National Cancer Institute, Cairo University, Cairo, Egypt
(Baudo) Department of Cardiac Surgery Research, Lankenau Institute for
Medical Research, Wynnewood, PA, United States
(El-Kharbotly) Department of General Surgery, Barts Health NHS Trust,
London, United Kingdom
(Bertolaccini) Department of Thoracic Surgery, IEO, European Institute of
Oncology IRCCS, Milan, Italy
Publisher
Elsevier Inc.
Abstract
Background: This systematic review and meta-analysis aims to investigate
the surgical approach and outcomes of diaphragmatic plication in the
setting of diaphragmatic paralysis after phrenic nerve injury. The
incidence of iatrogenic diaphragm paralysis varies across different
surgical procedures. <br/>Method(s): Six databases were searched from
inception until February 2023 for publications reporting on diaphragm
plication surgery for phrenic nerve injury. Hospital mortality was the
primary outcome. Pulmonary function, return to normal breathing, survival,
and radiographic or symptomatic recurrence were secondary outcomes.
Factors associated with mortality and return to normal breathing were
investigated. <br/>Result(s): Of 879 deduplicated papers, 96 studies were
included, and a total of 1,846 patients were included. Diaphragmatic
paralysis was found mostly to be unilateral and secondary to iatrogenic
causes, with dyspnea being the main presenting symptom, and generally
performed via a thoracotomy. Following surgical repair, our analysis
showed a positive improvement in forced vital capacity and forced
expiratory volume in 1 second, with more than 70% of patients returning to
normal breathing. In-hospital mortality was 0.51%, and the follow-up
mortality was 1.04% per person/year. With a median (interquartile range)
follow-up time of 1.6 (0.9-4.5) years, follow-up recurrence was reported
at a rate of 1.64% per person/year. There was a significant association
between diabetes and return to normal breathing (beta: 0.1103, P = .027).
However, type of surgical approach was not associated with differences in
outcomes. <br/>Conclusion(s): Repair of diaphragmatic paralysis is
associated with significant improvement in pulmonary function tests and
minimal morbidity and mortality, independent of the chosen surgical
approach.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<39>
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. <br/>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. <br/>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.
<br/>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.<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer-Verlag GmbH Germany, part of Springer Nature 2025.

<40>
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. <br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9; The Author(s) 2024

<41>
Accession Number
2036904960
Title
Percutaneous coronary intervention for stable late ST-elevation myocardial
infarction with symptoms onset between 12 and 72 h - A systematic review.
Source
Cardiovascular Revascularization Medicine. 78 (pp 1-9), 2025. Date of
Publication: 01 Sep 2025.
Author
Fatima S.; Harinstein M.E.; Hussain M.; Pacella J.J.
Institution
(Fatima) Harrington Heart and Vascular Institute, University Hospitals,
Case Western Reserve Medical University, United States
(Harinstein, Pacella) Heart and Vascular Institute, University of
Pittsburgh Medical Center, United States
(Hussain) Department of Medicine, Allied Hospital, Faisalabad, Pakistan
Publisher
Elsevier Inc.
Abstract
Background: There exists clinical equipoise regarding whether and when an
invasive approach should be preferred over conservative treatment in the
management of stable late ST-elevation myocardial infarction (STEMI)
presenting within 12 to 72 h of symptom onset. <br/>Objective(s): To
perform a systematic review to identify the most effective treatment
strategy between percutaneous coronary intervention (PCI) and medical
therapy in stable late STEMI presenters by comparing their respective
outcomes as well as determine the optimal timing of PCI by evaluating the
outcomes of urgent versus non-urgent PCI approach in this patient
population. <br/>Method(s): PubMed, Embase, and Cochrane databases were
queried from inception until March 2024 for studies comparing the outcomes
of PCI versus medical therapy, as well as urgent versus non-urgent PCI, in
stable late STEMI patients presenting with symptom onset within 12-72 h.
Quality of the studies and risk of bias were assessed using the Grading of
Recommendations, Assessment, Development, and Evaluations (GRADE) criteria
and the Cochrane Risk of Bias (ROBINS-I 2016) tool, respectively.
<br/>Result(s): A total of 8 studies were included in this systematic
review that met the inclusion criteria. Among these, 5 studies (1
randomized controlled trial (RCT), 1 post-hoc analysis, and 3
observational studies) with an aggregate of 3820 participants compared PCI
and medical therapy in stable late STEMI presenters. They found that PCI
was associated with statistically significant better short- and long-term
outcomes by lowering all-cause mortality, recurrent myocardial infarction
(MI), and infarct size, and by improving myocardial salvage index (P <
0.001). Similarly, a non-statistically significant improvement was seen in
the events of cardiac death, heart failure, and revascularization as well
as ejection fraction percentage with PCI (P > 0.05). The other 3 studies,
involving 1270 participants, were observational and compared urgent versus
non-urgent PCI and did not find any statistically significant difference
in clinical outcomes between the two approaches (P > 0.05). The included
studies were significantly heterogeneous in methodologies, follow-up
intervals, and reporting of outcomes. Most of the studies provided
moderate quality of evidence and had moderate to serious risk of bias.
Conclusions and relevance: Revascularization through PCI is associated
with superior short- and long-term outcomes compared to medical therapy in
stable late STEMI patients presenting within 12-72 h of symptom onset.
However, the optimal timing of PCI needs further
investigation.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<42>
[Use Link to view the full text]
Accession Number
2039288191
Title
Erector Spinae Plane Block versus Intercostal Nerve Blocks in Uniportal
Videoscopic-assisted Thoracic Surgery: A Multicenter, Double-blind,
Prospective Randomized Placebo-controlled Trial.
Source
Anesthesiology. 143(4) (pp 1015-1025), 2025. Date of Publication: 01 Oct
2025.
Author
Coppens S.; Hoogma D.F.; Dewinter G.; Neyrinck A.; Van Loon P.; Stessel
B.; Hassanin J.; Vandenbrande J.; Du Pont B.; Jansen Y.; Fieuws S.; Rex S.
Institution
(Coppens, Hoogma, Dewinter, Neyrinck, Van Loon, Rex) Department of
Anesthesiology, University Hospitals of Leuven, Leuven, Belgium
(Coppens, Hoogma, Dewinter, Neyrinck, Rex) Biomedical Sciences Group,
Department of Cardiovascular Sciences, University of Leuven, Leuven,
Belgium
(Stessel, Hassanin, Vandenbrande) Department of Anesthesiology and Pain
Medicine, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium
(Stessel, Vandenbrande) Faculty of Medicine and Life Sciences,
Universiteit Hasselt, Hasselt, Belgium
(Du Pont) Department of Cardiothoracic Surgery, Jessa Hospital Campus
Virga Jesse, Hasselt, Belgium
(Jansen) Department of Cardiothoracic Surgery, University Hospitals of
Leuven, Leuven, Belgium
(Fieuws) Biomedical Sciences Group, Leuven Biostatistics and Statistical
Bioinformatics Centre, University of Leuven, Leuven, Belgium
(Coppens) UZ Leuven, Herestraat 49, Leuven, Belgium
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Although intercostal nerve blocks are sometimes approached
with caution due to concerns about potentially high local anesthetic
uptake, they remain a valuable tool in specific clinical situations. On
the other hand, the erector spinae plane block is currently often favored
for its broader coverage and versatility. The hypothesis was that the
intercostal nerve block, applied directly by surgeons under direct vision
in patients undergoing uniportal video-assisted thoracoscopic surgery,
might offer superior analgesia and fewer complications compared to the
erector spinae plane block. <br/>Method(s): In this multicenter,
double-blind, placebo-controlled randomized trial, 100 patients undergoing
uniportal thoracoscopic surgery (wedge excision or lobectomy) within an
enhanced recovery program received either a surgical intercostal nerve
block under thoracoscopic guidance or an ultrasound-guided erector spinae
plane block, followed by 30 ml ropivacaine 0.5% (n = 50) or saline (n =
50). The primary outcome measured was 12-h morphine consumption
postextubation. Secondary outcomes included 24-h morphine use, pain
severity, rescue analgesia need, postoperative complications, and length
of stay. Plasma levels of local anesthetics were also assessed.
<br/>Result(s): The intercostal nerve block group had significantly lower
mean 12-h morphine consumption compared to the erector spinae plane block
group (10.9 mg vs. 17.6 mg; P = 0.0015), as well as lower mean 24-h
consumption (18.7 mg vs. 26.7 mg; P = 0.018). Intercostal blocks also led
to lower pain scores in the first 2 h postoperatively and a reduced need
for rescue analgesia (16% vs. 40%; P = 0.0033). No differences were found
in patient satisfaction, complications, or length of stay. Notably, the
erector spinae plane block group showed higher systemic absorption of
local anesthetics. <br/>Conclusion(s): For uniportal thoracoscopic
surgery, intercostal nerve block significantly reduces morphine
consumption and systemic anesthetic absorption compared to erector spinae
plane block.<br/>Copyright &#xa9; 2025 American Society of
Anesthesiologists. All Rights Reserved.

<43>
[Use Link to view the full text]
Accession Number
2039383459
Title
Comparison of analgesic efficacy and safety of caudal dexmedetomidine
versus intranasal dexmedetomidine in paediatric infraumbilical surgeries:
A randomised controlled trial.
Source
European Journal of Anaesthesiology. 42(10) (pp 899-906), 2025. Date of
Publication: 01 Oct 2025.
Author
Agarwal A.; Shah S.B.; Sinha R.; Prasad G.; Prakash K.; Goel P.
Institution
(Agarwal, Shah, Sinha, Prakash, Goel) Department of Anaesthesiology Pain
Medicine and Critical Care, All India Institute of Medical Sciences, New
Delhi, India
(Prasad) Department of Paediatric Surgery, All India Institute of Medical
Sciences, New Delhi, India
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUNDThe established analgesic efficacy and safety of dexmedetomidine
in children has demonstrated a rise in its use and various administration
routes have been explored. However, clinical comparisons between caudal
and intranasal dexmedetomidine are lacking.OBJECTIVESWe aimed to compare
the analgesic efficacy, postanaesthesia recovery characteristics and side
effects associated with caudal versus intranasal dexmedetomidine as an
adjunct to a single-shot caudal block in paediatric infraumbilical
surgeries.DESIGNA noninferiority randomised controlled trial.SETTINGA
tertiary care hospital from November 2022 to May 2024.PATIENTSSixty-four
children aged 1 to 8years undergoing infraumbilical surgeries under
general anaesthesia supplemented with caudal
analgesia.INTERVENTIONSPatients were randomised to receive either caudal
dexmedetomidine (1mlkg^-1caudal 0.2% ropivacaine +
1mugkg^-1caudal dexmedetomidine) or intranasal dexmedetomidine
(1mlkg^-1caudal 0.2% ropivacaine + 1mugkg^-1intranasal
dexmedetomidine).MAIN OUTCOME MEASURESThe primary outcome was the duration
of postoperative analgesia. Other outcomes assessed included postoperative
pain scores, peri-operative analgesic consumption, peri-operative
haemodynamics, postoperative recovery profile and adverse events for 24h
postoperatively.RESULTSThe duration of postoperative analgesia in caudal
and intranasal group was 527+/-83 and 545+/-90min, respectively (P=0.422).
There was a comparable decrease in the intra-operative heart rate. The
greater number of episodes of intra-operative hypotension in the caudal
group (P=0.016) did not warrant vasopressors. Children in the caudal group
were more sedated until 2h postsurgery following which the sedation scores
in both the groups were equivalent. Postoperative pain scores,
peri-operative analgesic consumption and the incidence of emergence
delirium was comparable. No adverse events were reported in either
group.CONCLUSIONIntranasal dexmedetomidine can be considered a feasible
analgesic adjunct to a single-injection caudal block in children
undergoing infraumbilical surgeries associated with a smooth recovery
profile and no associated adverse effects.CLINICAL TRIAL
REGISTRATIONClinical Trial Registry of India (CTRI/2022/09/045492;
http://www.ctri.nic.in).<br/>Copyright &#xa9; 2025 Lippincott Williams and
Wilkins. All rights reserved.

<44>
Accession Number
2040302727
Title
Postoperative stellate ganglion block reduces high-sensitivity troponin T
release in patients undergoing off-pump coronary artery bypass surgery: a
randomized controlled trial.
Source
Minerva Anestesiologica. 91(7-8) (pp 658-665), 2025. Date of Publication:
01 Jul 2025.
Author
Zhu Y.; Zhu X.; Wang L.; Shen L.; Qi D.
Institution
(Zhu, Zhu, Wang, Shen, Qi) Key Laboratory of Anesthesiology, Xuzhou
Medical University, Xuzhou, China
(Zhu, Zhu, Wang, Shen, Qi) Department of Anesthesiology, Affiliated
Hospital of Xuzhou Medical University, Xuzhou, China
Publisher
Edizioni Minerva Medica
Abstract
BACKGROUND: The non-analgesic applications of stellate ganglion block
(SGB) are increasingly garnering scholarly and clinical interest. This
study aimed to investigate the myocardial protective effects of
postoperative SGB in patients undergoing off-pump coronary artery bypass
grafting (OPCABG). <br/>METHOD(S): In this double-blind, randomized
controlled trial, 62 adults scheduled for OPCABG were randomized to one of
two groups: the right stellate ganglion block group (RSGB group) and the
control group. Postoperation, participants had a right SGB. However,
controls were not blocked. The primary outcome was serum high-sensitivity
troponin T concentration measured within seven days after surgery.
Secondary outcomes included postoperative hemodynamics, postoperative pain
scores, postoperative incidence of atrial fibrillation, postoperative
dosage of vasoactive drugs, postoperative opioid consumption, incidence of
myocardial infarction, 30-day postoperative mortality, and length of
hospital stay. <br/>RESULT(S): At some point after the operation, the RSGB
group patients' serum high-sensitivity troponin levels were noticeably
lower than the control group, with means (standard deviation [SD]) of
146.1 (49.7) vs. 207.8 (50.6) at 12 hours; 132.7 (35.6) vs. 202.6 (43.8)
at 24 hours; 19.7 (9.2) vs. 41.7 (24.7) at seven days; all P<0.001.
Moreover, the RSGB group showed significantly lower pain scores, a
significantly reduced postoperative rate-pressure product (RPP) value, and
a substantially lower incidence of atrial fibrillation.
<br/>CONCLUSION(S): In patients undergoing OPCABG, it was observed that
postoperative right SGB can reduce postoperative high-sensitivity cardiac
troponin T levels.<br/>Copyright &#xa9; 2025 EDIZIONI MINERVA MEDICA.

<45>
[Use Link to view the full text]
Accession Number
2036599436
Title
Feasibility of Alerting Systems and Family Care Partner Support for
Postoperative Delirium Prevention.
Source
Journal of Neurosurgical Anesthesiology. 37(4) (pp 361-370), 2025. Date of
Publication: 01 Oct 2025.
Author
Vlisides P.E.; Runstadler N.; Martinez S.; Ragheb J.W.; Mentz G.; Leis A.;
Schoettinger A.; Hickey K.; McKinney A.; Brooks J.; Zierau M.; Norcott A.;
Mody L.; Inouye S.K.; Avidan M.S.; Min L.
Institution
(Runstadler, Martinez, Mentz, McKinney) Department of Anesthesiology,
Michigan Medicine, Ann Arbor, MI, United States
(Vlisides) Center for Consciousness Science, University of Michigan
Medical School, Ann Arbor, MI, United States
(Ragheb) Department of Anesthesiology, University of Miami Miller School
of Medicine, Miami, FL, United States
(Leis) Department of Epidemiology, School of Public Health, University of
Michigan, Ann Arbor, MI, United States
(Schoettinger) Department of Social Work, University of Michigan, United
States
(Hickey) Department of Nursing, Michigan Medicine, Ann Arbor, MI, United
States
(Brooks) Department of Orthopaedic Surgery, Michigan Medicine, Ann Arbor,
MI, United States
(Zierau) College of Health Professions, University of Detroit Mercy,
Detroit, MI, United States
(Norcott, Mody, Min) Department of Internal Medicine, Division of
Geriatric and Palliative Medicine, Michigan Medicine, Ann Arbor, MI,
United States
(Inouye) Aging Brain Center, Hinda and Arthur Marcus Institute for Aging
Research, Hebrew SeniorLife, Boston, MA, United States
(Inouye) Department of Medicine, Beth Israel Deaconess Medical Center,
Harvard Medical School, Boston, MA, United States
(Avidan) Department of Anesthesiology, Washington University School of
Medicine, St. Louis, MO, United States
(Min) Geriatric Research Education and Clinical Care, Veterans Affairs
Arbor Healthcare System, Ann Arbor, MI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The objective of this study was to determine whether
postoperative pager alerts to the Hospital Elder Life Program (HELP), a
delirium prevention service, would accelerate program enrollment for older
surgical patients. This study also tested feasibility of family care
partner interventions for delirium prevention. <br/>Method(s): This
single-center, pilot clinical trial factorially randomized 57 non-cardiac
surgical patients >= 70 years of age to 4 arms: (1) standard care, (2)
pager alerts to accelerate HELP enrollment, (3) family care partner-based
delirium prevention interventions, or (4) a combined arm with both HELP
and family interventions. The primary clinical outcome was delirium
(assessed through the Confusion Assessment Method). <br/>Result(s): In the
pager alerting arms, 13/24 (54%) participants were enrolled by HELP on
postoperative day 1 compared with 0/26 (0%, P < 0.001) in the non-alerting
arms. Median [interquartile range] time spent in delirium prevention
protocols was significantly longer in pager alerting arms than in
non-alerting arms (39 [5 to 75] min vs. 0 [0 to 0] min; P < 0.001). Family
care partners spent 18 [11 to 25)] hours at the bedside over the first 3
postoperative days. There was no significant difference in delirium
occurrence in participants randomized to pager alert arms compared with
non-alerting arms (odds ratio, 1.02, 95% CI, 0.97-1.07; P = 0.390).
Similarly, there was no significant difference in delirium occurrence in
family intervention arms compared with nonintervention arms (odds ratio,
0.97; 95% CI 0.93-10.02; P = 0.270). <br/>Conclusion(s): Pager alerts
significantly reduced time to HELP enrollment, albeit without reducing
delirium incidence in this pilot study. Family care partners spent
substantial time at the bedside during the study period.<br/>Copyright
&#xa9; 2024 Wolters Kluwer Health, Inc. All rights reserved.

<46>
Accession Number
2039162808
Title
Effects of combining transversus thoracic muscle and serratus anterior
plane blocks on postoperative analgesia and the inflammatory response in
patients undergoing heart valve replacement surgery: A randomized
controlled trial.
Source
Asian Journal of Surgery. 48(9) (pp 5483-5484), 2025. Date of Publication:
01 Sep 2025.
Author
Xing Z.; Zhang S.; Fan Q.; Wang P.; Yuan H.
Institution
(Xing, Fan, Wang, Yuan) Department of Anesthesiology, The First Affiliated
Hospital of Hebei North University, Hebei, Zhangjiakou, China
(Zhang) Department of Anesthesiology, Tianjin Beichen Hospital, Tianjin,
China
Publisher
Elsevier (Singapore) Pte Ltd

<47>
[Use Link to view the full text]
Accession Number
2038614910
Title
Initiating Preventive Care for Hyperlipidemia in the Emergency Department:
The Emergency Medicine Cardiovascular Risk Assessment for Lipid Disorders
Trial.
Source
Critical Pathways in Cardiology. 24(3) (pp e0390), 2025. Date of
Publication: 01 Sep 2025.
Author
Ashburn N.P.; Snavely A.C.; Ehrig M.R.; Shapiro M.D.; Herrington D.M.;
Reboussin D.M.; Gesell S.B.; Mahler S.A.
Institution
(Ashburn, Snavely, Ehrig, Mahler) Department of Emergency Medicine, Wake
Forest University School of Medicine (WFUSM), Winston-Salem, NC, United
States
(Snavely, Ehrig, Reboussin) Department of Biostatistics and Data Science,
WFUSM, Winston-Salem, NC, United States
(Shapiro, Herrington) Section on Cardiovascular Medicine, Department of
Internal Medicine, WFUSM, Winston-Salem, NC, United States
(Herrington, Mahler) Department of Epidemiology and Prevention, WFUSM,
Winston-Salem, NC, United States
(Gesell) Department of Social Sciences and Health Policy, WFUSM,
Winston-Salem, NC, United States
(Gesell, Mahler) Department of Implementation Science, WFUSM, Winston
Salem, NC, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Hyperlipidemia (HLD) is a major contributor to atherosclerotic
cardiovascular disease (ASCVD). Nearly 30% of emergency department (ED)
patients with chest pain have undiagnosed and/or unmanaged HLD, putting
them at an increased risk of ASCVD. Although safe and effective HLD
treatments exist, the ED traditionally focuses on acute care and does not
offer preventive cardiovascular care services. This represents a large,
missed opportunity to improve cardiovascular health for the millions of
Americans evaluated in the ED each year who are not receiving appropriate
preventive care in the outpatient setting. The goals of this study are to
determine the efficacy of novel ED-initiated preventive care on lowering
cholesterol while also informing our understanding of patient adherence
and implementation determinants of ED-initiated preventive cardiovascular
care. <br/>Method(s): We will use a randomized, controlled, parallel-group
trial of 130 ED patients being evaluated for acute coronary syndrome at a
single site. Participants will be 40-75 years old with prior ASCVD, known
diabetes, or 10-year ASCVD risk >=7.5% who are not already receiving
guideline-directed outpatient preventive care. Patients will be randomized
with equal probability to EMERALD (Emergency Medicine Cardiovascular Risk
Assessment for Lipid Disorders) or usual care. Patients in the EMERALD arm
will be started on a statin and referred for a 30-day follow-up with
cardiology or primary care, depending on the 10-year ASCVD risk level.
Usual care arm patients will not be prescribed a statin in the ED and will
be asked to follow up with a primary care provider. The primary outcome
will be a percent change in low-density lipoprotein cholesterol at 30
days. Secondary outcomes include percent change in low-density lipoprotein
cholesterol at 180 days and nonhigh-density lipoprotein cholesterol at
30-and 180 days, the proportion of EMERALD patients who pick up their
statin, and the proportion of patients who attend 30-day outpatient
follow-up. We will also use mixed methods and semistructured interviews to
identify patient adherence facilitators and barriers and implementation
determinants for Emergency Medicine providers. <br/>Discussion(s): This is
the first study to evaluate a novel, protocolized ED-initiated preventive
cardiovascular care approach for HLD. If successful, the EMERALD
intervention may be able to improve the cardiovascular health for at-risk
patients and serve as a use case for other modifiable cardiovascular
disease risk factors, such as diabetes, hypertension, tobacco use, and
obesity. This single-site study will inform a planned multisite
trial.<br/>Copyright c 2025 Wolters Kluwer Health, Inc.

<48>
Accession Number
648098766
Title
Antithrombotic Treatment After Valve-in-Valve, Valve-in-Ring, and
Valve-in-MAC Procedures: A Systematic Review and Meta-Analysis.
Source
Acta medica portuguesa. 38(9) (pp 528-537), 2025. Date of Publication: 01
Sep 2025.
Author
Terleira Batista G.; Costa G.; Delgado Silva J.; Goncalves L.
Institution
(Terleira Batista) Servico de Cardiologia. Centro Hospitalar e
Universitario de Coimbra. Coimbra. Portugal, Portugal
(Costa, Delgado Silva, Goncalves) Servico de Cardiologia. Centro
Hospitalar e Universitario de Coimbra. Coimbra. & Faculdade de Medicina.
Universidade de Coimbra. Coimbra. & Coimbra Institute for Clinical and
Biomedical Research (iCBR). Coimbra. Portugal, Portugal
Abstract
INTRODUCTION: While antithrombotic therapy following transcatheter valve
implantation has been extensively studied in various clinical trials,
there remains a notable gap in evidence regarding the optimal approach
following valve-in-valve (ViV), valve-in-ring (ViR) and valve-in-mitral
annular calcification (ViMAC) procedures, warranting further assessment.
This gap is particularly concerning due to the apparent increased risk of
thrombosis associated with ViV interventions. The aim of this systematic
review was to explore the potential benefits of anticoagulation in ViV,
ViR, and ViMAC procedures. <br/>METHOD(S): We searched PubMed, Embase, and
the Cochrane Central Register of Controlled Trials, as well as the grey
literature, for observational and interventional studies published until
December 2023. Trials were included if a comparative analysis between the
two antithrombotic strategies was feasible and excluded if patients under
18 years old were analysed. The primary efficacy endpoints were incidence
of clinical and total valve thrombosis (VT), major bleeding was the sole
safety primary endpoint. Additional analyses were performed regarding
valves in the mitral position and valve type. The risk of bias was
evaluated using the Newcastle-Ottawa scale. Data was assessed using the
Review Manager 5.4 software. <br/>RESULT(S): A total of five observational
and one case series were included (n = 614 on anticoagulation and n = 468
on antiplatelets), comprising a total of 1082 participants. Clinical VT
rates were 4.2% for all procedures, and patients on anticoagulants were
associated with a a lower risk of clinical VT (1.1% vs 8.3%; OR: 0.18; 95%
CI: 0.07 - 0.42, I2: 0%) and total VT (1.3% vs 8.5%; OR: 0.16; 95% CI:
0.07 - 0.37, I2: 0%). Regarding bleeding events, the existing literature
did not provide adequate information to enable a thorough analysis.
<br/>CONCLUSION(S): Our study suggests a potential benefit of
anticoagulation regimens to decrease the high rates of VT following
valve-in-valve, valve-in-ring and valve-in-mitral annular calcification
procedures. However, the lack of randomized controlled trials and data on
bleeding and mortality emphasises the necessity for further research.

<49>
Accession Number
2039207308
Title
The Protective Effect of Remote Ischemic Preconditioning on Acute Kidney
Injury Following Pediatric Cardiac Surgery: A Systematic Review and
Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(10) (pp 2848-2856),
2025. Date of Publication: 01 Oct 2025.
Author
Cheng P.; Wang G.; An Y.
Institution
(Cheng, Wang, An) Department of Thoracic Surgery, Children's Hospital of
Chongqing Medical University, National Clinical Research Center for Child
Health and Disorders, Ministry of Education, Key Laboratory of Child
Development and Disorders, Chongqing Key Laboratory of Structural Birth
Defect and Reconstruction, Chongqing, China
Publisher
W.B. Saunders
Abstract
Cardiac surgery in children is a major risk factor for acute kidney injury
(AKI) because of the high risk of AKI due to the combination of
hemodynamic instability, ischemia-reperfusion injury, and inflammation.
However, the protective role of remote ischemic preconditioning (RIPC) in
this setting is unclear. This systematic review and meta-analysis was
conducted to assess whether RIPC reduces the incidence of AKI in pediatric
cardiac surgery patients. PubMed, EMBASE, and the Cochrane Library were
systematically searched for randomized controlled trials (RCTs) of RIPC in
pediatric cardiac surgery. The primary outcome indicator was the incidence
of postoperative AKI, and secondary outcome indicators included serum
creatinine (sCr) level, tumor necrosis factor (TNF)-alpha level, and
intensive care unit (ICU) length of stay (LOS). Six RCTs with a total of
1,098 patients were included in the analysis. RIPC significantly reduced
the incidence of AKI (odds ratio, 0.38; 95% confidence interval,
0.25-0.60; p < 0.00001; I2 = 38%). There was no significant effect on
postoperative sCr, TNF-alpha levels and ICU LOS (p > 0.05 for all; I2
>80%). Sensitivity analyses showed a large impact of some studies on the
results. The data indicate that RIPC significantly reduced the incidence
of AKI after pediatric cardiac surgery, showing its potential
renoprotective effect. Although the effect on other postoperative
indicators was not significant, high heterogeneity limits the certainty of
the conclusions. Future studies should focus on multicenter, large-scale
trials with detailed subgroup analyses to explore the mechanism of action
and effects of RIPC in different patient populations.<br/>Copyright &#xa9;
2025 Elsevier Inc.

<50>
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.<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer-Verlag London Ltd., part of Springer Nature 2025.

<51>
Accession Number
2039066258
Title
Right Ventricular Function and Echocardiographic Pressure-Volume Loops:
Overview and Perioperative Clinical Implications.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(10) (pp 2857-2865),
2025. Date of Publication: 01 Oct 2025.
Author
Ahmed U.; Mahmood F.; Nicoara A.; Kiarad V.
Institution
(Ahmed, Mahmood, Kiarad) Department of Anesthesia, Beth Israel Deaconess
Medical Center, Harvard Medical School, Boston, MA, United States
(Nicoara) Department of Anesthesiology, Duke University Hospital, Durham,
NC, United States
Publisher
W.B. Saunders
Abstract
Right ventricular (RV) mechanics have critical roles in cardiovascular
physiology, yet their assessment remains challenging owing to the right
ventricle's complex geometry and unique interaction with the pulmonary
vascular system. This review explores RV structural, functional, and
physiologic considerations, emphasizing their interplay with pulmonary
hypertension (PH), heart failure, and perioperative outcomes. Traditional
pressure- and volume-centric methods of RV evaluation, including
echocardiography and right heart catheterization, often fail to provide
comprehensive, load-independent measures of RV function. The integration
of these measures for pressure-volume (PV) loop analysis has emerged as a
valuable tool, offering insights into RV contractility, compliance, and
ventriculoarterial coupling. This review highlights advances in
intraoperative and noninvasive PV loop methodologies, including
echocardiography-derived techniques and integration with catheter-based
pressure measurements. These approaches enable detailed assessment of RV
function, enhancing prognostic capabilities in such conditions as PH,
heart failure with preserved ejection fraction, and postsurgical
interventions like left ventricular assist device implantation and valve
replacement. Despite the potential of RV PV loop analysis, its clinical
adoption has been limited by technical complexities, cost, and the need
for specialized expertise. This underscores the importance of
standardizing PV loop acquisition techniques and validating surrogate
markers, such as tricuspid annular plane systolic excursion/pulmonary
artery systolic pressure ratio, to improve accessibility and utility. By
providing a comprehensive overview of current and emerging methods for RV
assessment, this review aims to foster a deeper understanding of RV
mechanics, driving innovation in diagnostic, therapeutic, and prognostic
strategies for cardiac surgeries.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<52>
Accession Number
2040338363
Title
Accelerometer-Measured Physical Activity After Mitral Valve Surgery: An
Analysis of the UK Mini Mitral Randomized Controlled Trial.
Source
Circulation. (no pagination), 2025. Date of Publication: 2025.
Author
Wagnild J.M.; Bayliss C.; Maier R.H.; Ogundimu E.; Zacharias J.; Akowuah
E.F.
Institution
(Wagnild) Department of Anthropology, Durham University, United Kingdom
(Ogundimu) Department of Mathematical Sciences, Durham University, United
Kingdom
(Bayliss, Akowuah) Department of Cardiac Surgery, South Tees Hospitals
National Health Service Foundation Trust, Middlesbrough, United Kingdom
(Maier, Akowuah) Academic Cardiovascular Unit James Cook University
Hospital, South Tees Hospitals National Health Service Foundation Trust,
Middlesbrough, United Kingdom
(Maier) Population Health Sciences Institute, Newcastle University, United
Kingdom
(Akowuah) Newcastle University Translational and Clinical Research
Institute, Newcastle University, United Kingdom
(Zacharias) Lancashire Cardiac Centre, Blackpool Teaching Hospitals
National Health Service Foundation Trust, Blackpool, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Wearable accelerometer devices measure free-living physical
activity and sleep without relying on self-reports. Their utility to
measure and compare recovery of physical function after cardiac surgery
procedures has not been previously studied in the setting of a randomized
controlled trial. <br/>METHOD(S): Data were collected during the UK
(United Kingdom) Mini Mitral trial, in which patients were randomized to
undergo either a sternotomy or a minimally invasive thoracoscopically
guided right minithoracotomy procedure (Mini) for mitral valve repair.
This is a secondary analysis of the trial data using a different primary
end point. Patients wore a wrist-worn triaxial accelerometer on their
nondominant wrist for 24 hours over a 7-day period before surgery and at
6, 12, 18, 24, 38, and 52 weeks after surgery. Accelerometer outcomes
included the change from baseline to 52 weeks in total activity counts and
time spent in moderate-to-vigorous physical activity, light physical
activity, and sedentary time. Time spent asleep and sleep efficiency were
also captured. Accelerometry data were processed and analyzed by
researchers blinded to the surgical approach. <br/>RESULT(S): A total of
230 patients (115 in each trial arm) provided valid accelerometry data.
There were significant differences between arms in total activity counts;
the mean difference was 26744 (95% CI, 9085-44403; P=0.003) at 6 weeks and
26060 (95% CI, 6971-45149; P=0.008) at 18 weeks, both favoring Mini. Time
spent in moderate-to-vigorous physical activity also favored the Mini arm
at 6 and 18 weeks, with mean differences of 15 (95% CI, 5.7-24; P=0.001)
and 9.9 (95% CI, 0.31-20; P=0.043) minutes per day, respectively. Those in
the Mini arm also had significantly lower sedentary time (at 12, 18, and
24 weeks) and spent more time in light physical activity (at 18 weeks)
than those in the sternotomy arm. There were no differences in sleep
duration between arms at any time point, although those in the Mini arm
had higher sleep efficiency than those in the sternotomy arm at 12 weeks.
<br/>CONCLUSION(S): This analysis from the UK Mini Mitral trial suggests
that wearable accelerometer devices can be used to compare recovery after
surgical procedures. The data support an overall decline from baseline
activity to 52 weeks in patients undergoing a sternotomy and an earlier
recovery of physical activity after a minimally invasive thoracoscopically
guided right minithoracotomy approach.<br/>Copyright &#xa9; 2025 The
Authors. Circulation is published on behalf of the American Heart
Association, Inc., by Wolters Kluwer Health, Inc.

<53>
Accession Number
2039714281
Title
Robustness of Randomized Controlled Trials Evaluating Acute Normovolemic
Hemodilution as a Blood Conservation Strategy in Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(10) (pp 2649-2659),
2025. Date of Publication: 01 Oct 2025.
Author
Bugo S.; Bottussi A.; D'Andria Ursoleo J.; Mongardini E.; Carravetta M.;
Agosta V.T.; Piazza E.; Erdoes G.; Monaco F.
Institution
(Bugo, Bottussi, D'Andria Ursoleo, Mongardini, Carravetta, Agosta, Piazza,
Monaco) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Erdoes) Department of Anesthesiology and Pain Medicine, Inselspital, Bern
University Hospital, University of Bern, Bern, Switzerland
Publisher
W.B. Saunders
Abstract
Objective: To evaluate the robustness of randomized controlled trials
(RCTs) investigating acute normovolemic hemodilution (ANH), a blood
conservation strategy designed to reduce transfusion requirements, in
cardiac surgery using the Fragility Index (FI). Although recommended in
clinical guidelines, high-quality evidence supporting ANH remains limited.
<br/>Design(s): A systematic review of RCTs. <br/>Setting(s): A search of
PubMed/MEDLINE, the Cochrane Central Register of Controlled Trials, and
EMBASE databases was conducted from their inception. <br/>Participant(s):
Adult patients undergoing cardiac surgery. <br/>Intervention(s): RCTs
comparing ANH with standard care (without ANH) as a blood conservation
strategy in adult patients undergoing cardiac surgery. The statistical
robustness of RCTs was assessed using the FI, reverse FI, and Continuous
FI (CFI), with higher values indicating stronger evidence.
<br/>Measurements and Main Results: Twenty-eight RCTs were identified. The
median sample size was 75.8 patients. On-pump coronary artery bypass
grafting was the most common procedure (39.3%). The median FI for
perioperative transfusion rates was higher in nonsignificant studies (p >=
0.05) than in significant ones (p < 0.05), suggesting weaker evidence for
reducing transfusions in nonsignificant trials. Conversely, the median CFI
for the number of red blood cell units transfused was higher in
significant studies, supporting ANH's effectiveness in reducing
transfusion requirements. <br/>Conclusion(s): RCTs reporting significant
reductions in red blood cell transfusions with ANH exhibited greater
statistical robustness, as indicated by higher FI and CFI values, compared
with nonsignificant studies. The fragility of perioperative transfusion
outcomes highlights the need for larger, methodologically rigorous RCTs to
validate ANH's efficacy in cardiac surgery.<br/>Copyright &#xa9; 2025
Elsevier Inc.

<54>
Accession Number
2036003856
Title
Efficacy of Cerebral Embolic Protection Device in Transcatheter Aortic
Valve Replacement: A Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Shahid S.; Kasbati M.; Adawi S.O.; Ishtiaq S.; Osama M.; Shah S.M.A.;
Saifullah M.; Ali S.; Ahmed R.; Ch I.A.; Khalid S.; Tahirkheli N.K.
Institution
(Shahid) Khawaja Muhammad Safdar Medical College, Sialkot, Pakistan
(Kasbati) Dow University of Health Sciences, Karachi, Pakistan
(Adawi) Al-Quds University, Jerusalem, Palestine
(Ishtiaq) Rawalpindi Medical University, Rawalpindi, Pakistan
(Osama) Hayatabad Medical Complex, Peshawar, Pakistan
(Shah, Saifullah) King Edward Medical University, Lahore, Pakistan
(Ali, Khalid, Tahirkheli) Oklahoma Heart Hospital, Oklahoma City, OK,
United States
(Ahmed) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Ch) South Oklahoma Heart Research, Oklahoma City, OK, United States
Publisher
John Wiley and Sons Inc
Abstract
Transcatheter aortic valve replacement (TAVR) is widely used to treat
severe aortic stenosis; however, periprocedural stroke remains a
significant concern. This systematic review and meta-analysis evaluate
whether the use of cerebral embolic protection devices (CEPDs) during TAVR
reduces the risk of stroke and other complications. To conduct a network
meta-analysis of relevant trials to assess the efficacy of CEPDs currently
used in TAVR. PubMed, Embase, and Scopus were systematically searched
through April 2025 to identify studies comparing TAVR performed with and
without CEPDs. Primary outcomes included stroke, all-cause mortality,
major bleeding, and major vascular complications. Data were analyzed using
RevMan (Version 5.4.1). A random-effects model was used for all analyses,
applying the Mantel-Haenszel method for dichotomous outcomes, reported as
risk ratios with 95% confidence intervals. Funnel plots were used to
assess publication bias. Twenty-four studies (9 randomized controlled
trials and 15 observational studies), including a total of 437,487
patients (59,274 with CEPD and 384,213 without), were included in the
analysis. The mean patient age was 80 years, and 46.4% were female.
Compared to patients undergoing TAVR without protection, those receiving
CEPDs had significantly lower risks of stroke (RR = 0.70; 95% CI:
0.60-0.82; p < 0.0001), all-cause mortality (RR = 0.69; 95% CI: 0.50-0.93;
p = 0.02), disabling stroke (RR = 0.44; 95% CI: 0.26-0.75; p = 0.003),
acute kidney injury (RR = 0.84; 95% CI: 0.79-0.89; p < 0.00001), and
30-day readmission (RR = 0.75; 95% CI: 0.60-0.95; p = 0.02). A reduction
in major bleeding was also observed (RR = 0.83; 95% CI: 0.59-1.17),
although this did not reach statistical significance (p = 0.29). No
significant differences were found between groups in terms of major
vascular complications, transient ischemic attack (TIA), new pacemaker
implantation, or delirium. The use of CEPDs during TAVR is associated with
reduced risks of stroke, disabling stroke, acute kidney injury, and 30-day
readmission. However, discrepancies between randomized and observational
studies warrant cautious interpretation. Further research is needed to
clarify the benefits and evaluate the cost-effectiveness of CEPD
implementation in routine clinical practice.<br/>Copyright &#xa9; 2025 The
Author(s). Catheterization and Cardiovascular Interventions published by
Wiley Periodicals LLC.

<55>
Accession Number
2039276840
Title
Efficacy of Superficial versus Deep Parasternal Intercostal Plane Blocks
in Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(10) (pp 2837-2847),
2025. Date of Publication: 01 Oct 2025.
Author
Dost B.; De Cassai A.; Karapinar Y.E.; Turunc E.; Beldagli M.; Yalin
M.S.O.; Navalesi P.
Institution
(Dost, Turunc) Department of Anesthesiology and Reanimation, Ondokuz Mayis
University Faculty of Medicine, Samsun, Turkey
(De Cassai, Navalesi) Department of Medicine, University of Padua, Padua,
Italy
(De Cassai, Navalesi) Institute of Anesthesia and Intensive Care Unit,
University Hospital of Padua, Padua, Italy
(Karapinar, Yalin) Department of Anesthesiology and Reanimation, Ataturk
University School of Medicine, Erzurum, Turkey
(Beldagli) Department of Anesthesiology and Reanimation, Samsun Training
and Research Hospital, Samsun, Turkey
Publisher
W.B. Saunders
Abstract
Objectives: To compare the analgesic efficacy of superficial parasternal
intercostal plane (S-PIP) block and deep parasternal intercostal plane
(D-PIP) to determine which technique provides superior pain relief in
cardiac surgery. <br/>Design(s): A systematic search of MEDLINE (via
PubMed), Scopus, Embase, Cochrane Library, Web of Science, Google Scholar,
and ClinicalTrials.gov from inception until January 18, 2025. Eligible
studies included randomized controlled trials (RCTs) and observational
studies that compared the S-PIP and D-PIP blocks in patients undergoing
cardiac surgery. The primary outcome of the study was postoperative opioid
consumption of morphine milligram equivalent (MME) at 24 hours. Secondary
outcomes included resting and movement pain scores at 0, 6, 12 and 24
hours, time to first analgesics, incidence of postoperative nausea and
vomiting (PONV), extubation time, length of stay (LOS) in the intensive
care unit (ICU), and the number of patients requiring rescue analgesics.
<br/>Main Result(s): Seven RCTs and 1 observational study, including a
total of 510 patients, were identified. The findings demonstrated no
statistically significant difference in MME at 24 hours between the S-PIP
and D-PIP block groups (mean difference, -1.23; 95% confidence interval,
-2.51 to 0.05; p = 0.061). Additionally, there were no significant
differences in pain scores, PONV incidence, time to rescue analgesics,
extubation time, or ICU LOS of stay between the 2 techniques.
<br/>Conclusion(s): S-PIP and D-PIP blocks provide comparable
postoperative analgesic efficacy in patients undergoing cardiac
surgery.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<56>
Accession Number
2039714369
Title
Acute Normovolemic Hemodilution Versus Norepinephrine Infusion During
Autologous Blood Donation in Coronary Artery Bypass Graft Surgery: A
Prospective Randomized Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(10) (pp 2660-2669),
2025. Date of Publication: 01 Oct 2025.
Author
Ozgodek H.B.; Aydin M.E.; Oksuz D.A.; Karapinar Y.E.; Ahiskalioglu E.O.;
Celik E.C.; Yayik A.M.; Ahiskalioglu A.
Institution
(Ozgodek) Department of Anesthesiology and Reanimation, University of
Health Sciences, Erzurum, Turkey
(Aydin, Karapinar, Ahiskalioglu, Celik, Yayik, Ahiskalioglu) Department of
Anesthesiology and Reanimation, Ataturk University School of Medicine,
Erzurum, Turkey
(Oksuz) Clinic for Anesthesiology, Intensive Care, Emergency Medicine,
Pain Therapy and Palliative Medicine, Marienhaus Klinikum Hetzelstift,
Neustadt an der Weinstrasse, Germany
Publisher
W.B. Saunders
Abstract
Objective: This study was designed to compare the hemodynamic effects of
acute normovolemic hemodilution (ANH) and norepinephrine infusion during
autologous blood donation, with a particular focus on cardiac cycle
efficiency (CCE), an energy-based parameter of cardiovascular performance.
<br/>Design(s): A prospective, randomized clinical trial. <br/>Setting(s):
Single-center, academic hospital. <br/>Participant(s): Forty patients
undergoing coronary artery bypass graft surgery. <br/>Intervention(s): In
the ANH group, a crystalloid solution was administered simultaneously to
the contralateral upper extremity. The volume of replacement fluid was
calculated at a 3:1 ratio relative to the volume of blood withdrawn. In
the norepinephrine infusion (NA) group, no fluid was administered during
the donation process. Instead, norepinephrine infusion was administered at
a rate of 0.05 microg/kg/min. <br/>Measurements and Main Results:
Hemodynamic parameters were monitored at three time points during the
blood donation process. The primary outcome was the comparison of CCE
changes between groups. Secondary outcomes included other advanced
hemodynamic variables, metabolic indicators, and short-term postoperative
clinical results. Changes in CCE during autologous blood donation were
comparable between groups (ANH: 0.20 +/- 0.51, NA: 0.5 +/- 0.57, p =
0.373). Hemodynamic stability was achieved in both groups, with no
relevant differences in cardiac index, stroke volume index, or metabolic
markers (p > 0.05). Dynamic preload parameters showed expected
physiological patterns in the norepinephrine group, consistent with
volume-sparing circulatory support. None of the patients experienced acute
kidney injury. There was no difference between the groups in terms of
intensive care unit or hospital length of stay. <br/>Conclusion(s):
Norepinephrine infusion demonstrated hemodynamic equivalence to ANH in the
setting of autologous blood donation during coronary artery bypass graft
surgery. Its ability to preserve circulatory function without fluid
administration suggests it may serve as a viable alternative to ANH,
particularly in patients requiring careful volume
management.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<57>
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). <br/>Design(s): A prospective,
single-center, single-blind, randomized controlled trial. <br/>Setting(s):
The study was conducted in the Adult Cardiac Surgery Ward 6 of a
large-volume cardiovascular center. <br/>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.
<br/>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.
<br/>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.
<br/>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.<br/>Copyright
&#xa9; 2025 Elsevier Inc.

<58>
Accession Number
2039493671
Title
Prophylactic Intravenous Tranexamic Acid in Thoracic Surgery: A
Matched-pair Analysis From the German Thoracic Registry.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(10) (pp 2642-2648),
2025. Date of Publication: 01 Oct 2025.
Author
Schieren M.; Collaud S.; Bonberg L.; Welters J.; Wappler F.; Defosse J.
Institution
(Schieren, Wappler, Defosse) Department of Anesthesiology and Operative
Intensive Care Medicine, Witten/Herdecke University, Cologne, Germany
(Collaud) Department of Thoracic Surgery, Witten/Herdecke University,
Cologne, Germany
(Bonberg) Faculty of Health, Witten/Herdecke University, Witten, Germany
(Welters) University of Cologne, Department I of Internal Medicine, Center
for Integrated Oncology Aachen Bonn Cologne Dusseldorf (CIO ABCD),
University Hospital Cologne, Cologne, Germany
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate the effect of prophylactic intravenous tranexamic
acid (TXA) on bleeding complications, thromboembolic events, and hospital
stay in patients undergoing thoracic surgery. <br/>Design(s):
Retrospective matched-pair analysis of registry data. <br/>Setting(s):
German Thorax Registry data from multiple thoracic surgery centers across
Germany. <br/>Participant(s): A total of 1,034 adult patients undergoing
thoracic surgical procedures, matched 1:1 (517 received intravenous TXA,
517 did not). <br/>Intervention(s): Administration of prophylactic
intravenous TXA prior to thoracic surgery. <br/>Measurements and Main
Results: Postoperative bleeding complications, including reoperations for
bleeding and transfusion requirements, did not differ significantly
between groups. However, thromboembolic complications were significantly
less frequent in the TXA group (1.0% v 5.1%). Cardiac complications were
also less frequent in the TXA group. No significant differences were
observed in overall complication rates or length of hospital stay.
<br/>Conclusion(s): Prophylactic intravenous TXA did not reduce bleeding
complications in thoracic surgery but was associated with a lower
incidence of thromboembolic and cardiac events. While no definitive
conclusions can be made about the efficacy of TXA in reducing bleeding
complications, the study offers insights into its potential role in
reducing thromboembolic and cardiac complications. A well-powered,
randomized controlled trial is needed to confirm these
results.<br/>Copyright &#xa9; 2025 The Author(s)

<59>
Accession Number
2032854881
Title
Rectus sheath block added to parasternal block may improve postoperative
pain control and respiratory performance after cardiac surgery: a
superiority single-blinded randomized controlled clinical trial.
Source
Regional Anesthesia and Pain Medicine. 50(9) (pp 712-718), 2025. Date of
Publication: 01 Sep 2025.
Author
Strumia A.; Pascarella G.; Sarubbi D.; Pumpo A.D.; Costa F.; Conti M.C.;
Rizzo S.; Stifano M.; Mortini L.; Cassibba A.; Schiavoni L.; Mattei A.;
Ruggiero A.; Agro F.E.; Carassiti M.; Cataldo R.
Institution
(Strumia, Pascarella, Sarubbi, Pumpo, Costa, Conti, Rizzo, Stifano,
Mortini, Schiavoni, Mattei, Agro, Carassiti, Cataldo) Operative Research
Unit of Anesthesia and Intensive Care, Fondazione Policlinico
Universitario Campus Bio-Medico, Roma, Italy
(Cassibba, Ruggiero, Agro, Carassiti, Cataldo) Research Unit of
Anaesthesia and Intensive Care, Department of Medicine, Campus Bio-Medico
University, Roma, Italy
Publisher
BMJ Publishing Group
Abstract
Background The population undergoing cardiac surgery confronts challenges
from uncontrolled post-sternotomy pain, with possible adverse effects on
outcome. While the parasternal block can improve analgesia, its coverage
may be insufficient to cover epigastric area. In this non-blinded
randomized controlled study, we evaluated the analgesic and respiratory
effect of adding a rectus sheath block to a parasternal block. Methods 58
patients undergoing cardiac surgery via median sternotomy were randomly
assigned to receive parasternal block with rectus sheath block
(experimental) or parasternal block with epigastric exit sites of chest
drains receiving surgical infiltration of local anesthetic (control). The
primary outcome of this study was pain at rest at extubation. We also
assessed pain scores at rest and during respiratory exercises, opiate
consumption and respiratory performance during the first 24 hours after
extubation. Results The median (IQR) maximum pain scores (on a 0-10
Numeric Rate Scale (NRS)) at extubation were 4 (4, 4) in the rectus sheath
group and 5 (4, 5) in the control group (difference 1, p value=0.03).
Rectus sheath block reduced opioid utilization by 2 mg over 24 hours (IC
95% 0.0 to 2.0; p<0.01), reduced NRS scores at other time points, and
improved respiratory performance at 6, 12, and 24 hours after extubation.
Conclusion The addition of a rectus sheath block with a parasternal block
improves analgesia for cardiac surgery requiring chest drains emerging in
the epigastric area.<br/>Copyright &#xa9; American Society of Regional
Anesthesia & Pain Medicine 2025. No commercial re-use. See rights and
permissions. Published by BMJ Group.

<60>
Accession Number
2040190350
Title
Development of thoracic spine kyphosis and lumbar spine lordosis in the
growing child from birth to adulthood: protocol for a systematic review.
Source
BMJ Open. 15(8) (no pagination), 2025. Article Number: e095947. Date of
Publication: 25 Aug 2025.
Author
Al-Allaf O.; Mostafa O.E.S.; Henegan N.; Austin-Davies H.; Gardner A.
Institution
(Al-Allaf, Austin-Davies, Gardner) The Royal Orthopaedic Hospital NHS
Foundation Trust, Birmingham, United Kingdom
(Mostafa) Russells Hall Hospital, Dudley, United Kingdom
(Henegan) University of Birmingham, School of Sport and Exercise Sciences,
Birmingham, United Kingdom
(Gardner) University Of Birmingham, Birmingham, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Thoracic kyphosis, a posterior curvature of the thoracic
spine and lumbar lordosis, an anterior curvature of the lumbar spine, are
essential components of spinal alignment that facilitate a biomechanically
efficient upright stance. Understanding the normal growth of the spine and
its constituents, especially during periods of rapid growth, is important
as deviations from normal growth are thought to be initiating factors of
spinal conditions such as scoliosis. While in the coronal plane the spine
is straight, there is variability in the reported normative values of
sagittal spinal shape, reported in the paediatric population. This
variability may well represent the range of normality allowing for
population differences of ethnicity and sex, but could also be attributed
to differing imaging techniques and measurement methods. The aim of this
systematic review is to investigate the normative values for thoracic
kyphosis and lumbar lordosis between birth and adulthood. The review's
findings should enhance the understanding of the development of the spine
and aid in establishing the range that results from differences in
techniques of measurement and imaging modalities used. Methods and
analysis This review protocol is reported in line with the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses Protocols.
Inclusion criteria are participants aged 18 years or less without pain or
spinal pathology, such as scoliosis, any spinal or thoracic surgery and
any other medical conditions that could affect spinal growth and
development. The review will consider studies reporting serial
quantitative measurements of thoracic kyphosis and lumbar lordosis.
Inclusion will be limited to studies published in English. The PubMed,
Embase, Ovid MEDLINE and Cochrane Library databases will be searched.
Following Cochrane guidance, a dual reviewer system will be used where
both reviewers will screen 20% of titles and abstracts to confirm
concordance, and then one reviewer will screen the remaining articles.
During full-text screening, one reviewer will review all the full-text
articles while the second reviewer will review all the articles excluded
by the first reviewer, with a third reviewer being involved to resolve any
discrepancies. A risk of bias assessment will be performed on the
identified studies. The data extracted will be analysed through
meta-analysis if it proves feasible, synthesising continuous data such as
the size of the kyphosis and lordosis, with further subcategorisation by
sex and ethnicity as appropriate. Correlation coefficients will be used to
analyse relationships between variables, and I² values will be
used to assess heterogeneity. Alternatively, if a meta-analysis is not
possible, the data will be presented narratively using the synthesis
without meta-analysis guidelines. An overall statement of confidence in
the cumulative results and findings will be provided using the Grading of
Recommendations, Assessment, Development and Evaluation system. Ethics and
dissemination Ethical approval is not required for this study as no
original data will be collected. The findings will be disseminated to
academic audiences through peer-reviewed journals and conference
presentations.<br/>Copyright &#xa9; Author(s) (or their employer(s) 2025.

<61>
Accession Number
2040210014
Title
Long-term outcomes of surgical repair versus replacement for tricuspid
valve endocarditis - A meta-analysis of reconstructed time-to-event data.
Source
IJC Heart and Vasculature. 60 (no pagination), 2025. Article Number:
101782. Date of Publication: 01 Oct 2025.
Author
Katsuyama E.; Fukunaga C.; Passos F.S.; Lee N.; Ventura de Santana de
Jesus A.C.; Ydy C.M.; Massuda S.J.F.; Kirov H.; Doenst T.; Caldonazo T.
Institution
(Katsuyama, Fukunaga, Massuda) Department of Medicine, Centro
Universitario Faculdade de Medicina do ABC, Santo Andre, Sao Paulo, Brazil
(Passos) Department of Thoracic Surgery, MaterDei Hospital, Bahia,
Salvador, Brazil
(Lee) Department of Medicine, Federal University of Sao Paulo, Sao Paulo,
Brazil
(Ventura de Santana de Jesus) Department of Medicine, Escola Bahiana de
Medicina e Saude Publica, Bahia, Salvador, Brazil
(Ydy) Department of Medicine, Universidade de Ribeirao Preto, Ribeirao
Preto, Sao Paulo, Brazil
(Kirov, Doenst, Caldonazo) Department of Cardiothoracic Surgery, Jena
University Hospital, Friedrich Schiller University of Jena, Jena, Germany
(Caldonazo) Department of Cardiothoracic Surgery, Well Cornell Medicine,
NY, United States
Publisher
Elsevier Ireland Ltd
Abstract
Introduction: Tricuspid valve infective endocarditis (TVIE) is surgically
managed by tricuspid valve repair (TVr) or replacement (TVR). However, the
differences in long-term endpoints and perioperative complications between
the two strategies remain unclear. Therefore, this updated meta-analysis
aimed to evaluate the efficacy and safety of TVr compared with TVR.
<br/>Method(s): MEDLINE, EMBASE, Cochrane Library, LILACS, and
ClinicalTrials.gov were searched. The endpoints of interest were long-term
all-cause mortality (primary), any reoperation, reinfection, postoperative
stroke, and postoperative acute kidney injury (AKI). Data are reported as
hazard ratios (HR) and odds ratios (OR) with their respective 95%
confidence intervals (CI). <br/>Result(s): We included 19 retrospective
cohorts comprising 9,734 patients, of which 59.7 % received TVr and 74.3 %
were intravenous drug users. One study was risk-adjusted. The median age
and follow-up were 35.9 years and 3.9 years, respectively. Compared with
TVR, TVr was associated with lower long-term mortality (HR: 0.77; 95 %CI:
0.60 to 0.98; P = 0.04) and lower odds of any reoperation (OR: 0.73; 95
%CI: 0.60 to 0.89; P < 0.01), reinfection (OR: 0.40; 95 %CI: 0.19 to 0.86;
P = 0.02), and postoperative AKI (OR: 0.79; 95 %CI: 0.68 to 0.92; P <
0.01). No differences were found in postoperative stroke (OR: 1.17; 95
%CI: 0.83 to 1.65; P = 0.41). <br/>Conclusion(s): In this meta-analysis,
TVr improved overall survival and reduced postoperative complications in
patients with TVIE. A possible treatment allocation bias needs to be
considered as a potential concern of series with observational
nature.<br/>Copyright &#xa9; 2025 The Author(s)

<62>
Accession Number
2039818925
Title
Comparison of Two Activated Clotting Time Targets During Cardiac Surgery
With Cardiopulmonary Bypass: A Prospective Multicenter Randomized
Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(10) (pp 2626-2635),
2025. Date of Publication: 01 Oct 2025.
Author
Gorter K.A.M.; Stehouwer M.C.; de Vroege R.; Zuthof D.; Meesters M.I.;
Noordzij P.G.; Niesten E.D.; Suyker W.J.L.
Institution
(Gorter) Department of Perfusion, University Medical Center, Utrecht,
Netherlands
(Stehouwer) Department of Perfusion, Sint Antonius Hospital, Nieuwegein,
Netherlands
(de Vroege) Department of Perfusion, Haga Hospital, Den Haag, Netherlands
(Zuthof) Department of Perfusion, Medisch Spectrum Twente, Enschede,
Netherlands
(Meesters) Department of Anesthesiology, Catharina Hospital, Eindhoven,
Netherlands
(Noordzij) Department of Anesthesiology, Intensive Care and Pain
Management, Sint Antonius Hospital, Nieuwegein, Netherlands
(Noordzij) Department of Intensive Care, University Medical Center,
Utrecht, Netherlands
(Niesten) Department of Anesthesiology, Medisch Spectrum Twente, Enschede,
Netherlands
(Suyker) Department of Cardiothoracic Surgery, University Medical Center,
Utrecht, Netherlands
Publisher
W.B. Saunders
Abstract
Objectives: The present study was designed to investigate the equivalence
of two target activated clotting time (ACT) values with regard to packed
red blood cell (PRBC) transfusion in patients undergoing cardiac surgery
with cardiopulmonary bypass (CPB). Secondary endpoints include
postoperative blood loss, transfusion of other blood products, and
postoperative laboratory parameters, including renal function, intensive
care unit length of stay, postoperative thrombotic events, and other
adverse events. <br/>Design(s): Multicenter, randomized, single-blind,
controlled equivalence trial. Patients were randomized to a lower target
ACT of >=400 seconds or a higher target ACT of >=480 seconds.
<br/>Setting(s): Three tertiary and one university medical center in the
Netherlands. <br/>Participant(s): 1,021 patients >=18 years of age
scheduled for first-time elective cardiac surgery with CPB between
November 2019 and December 2023. <br/>Measurements and Main Results: PRBC
transfusion was equivalent in both ACT groups (19.1% v 17.2% risk
difference -0.029; 0.066). In the low ACT group, blood loss at 6 and 24
hours postoperative was significantly lower (median [interquartile range],
260 [245] v 300 [250] mL, p = 0.003 and 480 [363] v 550 [410] mL, p =
0.007) and the hemoglobin level at 6 hours and 1 day after surgery
significantly higher (mean [95% confidence interval], 11.8 [11.6-11.9] v
11.6 [11.3-11.8] g/dL, p = 0.017 and 11.4 [11.1-11.6] v 11.1 [11.0-11.4]
g/dL, p = 0.045) compared with the high ACT group, but lacking clinical
relevance. The frequency of thromboembolic events was similar in both
groups. <br/>Conclusion(s): This study showed that a target ACT of >=400
seconds is equivalent to a target ACT of >=480 seconds in terms of
intraoperative and postoperative PRBC transfusion rates in the modern
cardiac surgery setting. This target range is considered comparable
regarding the outcomes of patients undergoing cardiac surgery with
CPB.<br/>Copyright &#xa9; 2025 The Author(s)

<63>
Accession Number
2040124339
Title
A Single-blind, Randomized Controlled Trial Comparing Postoperative
Analgesic Effects of Superficial and Deep Parasternal Intercostals Blocks
in Patients Undergoing Coronary Artery Bypass Grafting Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Korkmaz Toker M.; Yazman S.; Altiparmak B.; Uysal A.I.; Harmandar B.
Institution
(Korkmaz Toker, Altiparmak) Department of Anesthesiology and Reanimation,
Mugla Sitki Kocman University, Mugla, Turkey
(Yazman, Harmandar) Department of Cardiovascular Surgery, Mugla Sitki
Kocman University, Mugla, Turkey
(Uysal) Department of Anesthesiology and Reanimation, Mugla Training and
Research Hospital, Mugla, Turkey
(Korkmaz Toker) Anesteziyoloji ve Reanimasyon A.D., Kotekli Mah, Mugla
Sitki Kocman Universitesi Tip Fakultesi, Merkez, Mugla, Turkey
Publisher
W.B. Saunders
Abstract
Objective: To compare the analgesic efficacy of anesthesiologist-performed
ultrasound-guided superficial parasternal intercostal plane block (SPIPB)
and surgeon-performed deep parasternal intercostal plane block (DPIPB) in
patients undergoing coronary artery bypass grafting (CABG) via median
sternotomy. <br/>Design(s): A prospective, randomized, single-blind
clinical trial. <br/>Setting(s): A single, tertiary care university
hospital. <br/>Participant(s): Seventy-five participants (aged 45-80
years, ASA III-IV) scheduled for elective isolated CABG surgery.
<br/>Intervention(s): Participants were randomly assigned to the SPIPB,
DPIPB, or control groups. Regional blocks were performed either under
ultrasound guidance after sternal closure and sterilization of the
surgical site (SPIPB) or intraoperatively under direct vision (DPIPB).
Postoperative pain was managed with multimodal analgesia protocols.
<br/>Measurements and Main Results: Outcomes included pain scores and
tramadol administration at the 1st, 4th, 12th, and 24th postoperative
hours, as well as after extubation. The cumulative 24-hour tramadol
administration (primary outcome) was significantly lower in the DPIPB
group (95 +/- 44 mg) compared with the SPIPB (141 +/- 58 mg) and control
groups (176 +/- 61 mg) (p < 0.001). Compared with the control group, the
DPIPB group had a significantly reduced likelihood of requiring high-dose
tramadol (odds ratio [OR]: 0.18, 95% confidence interval [CI]: 0.06-0.56,
p = 0.003). The SPIPB group showed an intermediate effect compared with
control (OR: 0.52, 95% CI: 0.23-1.18, p = 0.095). When directly compared,
DPIPB was associated with significantly lower tramadol use than SPIPB (OR:
0.34, 95% CI: 0.16-0.72, p < 0.001). Pain scores at all time points were
significantly lower in both block groups compared with control (p < 0.05),
with DPIPB showing the most pronounced effect. No block-related
complications were observed. <br/>Conclusion(s): Both parasternal
intercostal blocks improved postoperative analgesia compared with standard
care. The SPIPB was performed under ultrasound guidance, whereas the DPIPB
was applied under direct vision by the surgeon. The DPIPB demonstrated
superior opioid-sparing effects and improved dynamic pain control. These
findings support the use of parasternal fascial plane blocks, whether
performed under ultrasound guidance or direct vision, as effective
components of multimodal analgesia in cardiac surgery.<br/>Copyright
&#xa9; 2025 Elsevier Inc.

<64>
Accession Number
2040152425
Title
Response to letter to the editor: "Prevalence of postoperative
neurocognitive disorders in older non-cardiac surgical patients: A
systematic review and meta-analysis".
Source
Journal of Clinical Anesthesia. 106 (no pagination), 2025. Article Number:
111973. Date of Publication: 01 Sep 2025.
Author
Huang W.W.Y.; Fan S.; Li W.-Y.; Thangavelu V.; Saripella A.; Englesakis
M.; Yan E.; Chung F.
Institution
(Huang) School of Medicine, University of Limerick, Limerick, Ireland
(Fan) Schulich School of Medicine and Dentistry, Western University,
London, ON, Canada
(Li, Saripella, Yan, Chung) Department of Anesthesia and Pain Management,
Toronto Western Hospital, University Health Network, University of
Toronto, ON, Canada
(Thangavelu, Yan, Chung) Institute of Medical Science, Temerty Faculty of
Medicine, University of Toronto, ON, Canada
(Englesakis) Library & Information Services, University Health Network,
Toronto, ON, Canada
Publisher
Elsevier Inc.

<65>
Accession Number
2035833154
Title
Intravenous methadone for pain management in cardiac surgery: a randomised
controlled trial with plasma concentration analysis*.
Source
Anaesthesia. (no pagination), 2025. Date of Publication: 2025.
Author
Wong H.M.K.; Lai V.K.W.; Chiu S.L.C.; Wong W.T.; Wo S.K.; Zuo J.Z.; Liu
X.; Wong R.H.L.; Ho K.M.
Institution
(Wong, Chiu, Wong, Liu, Ho) Department of Anaesthesia and Intensive Care,
The Chinese University of Hong Kong, Hong Kong
(Lai) Child Health Evaluative Sciences, The Hospital for Sick Children
Research Institute, Toronto, ON, Canada
(Wo, Zuo) School of Pharmacy, Faculty of Medicine, The Chinese University
of Hong Kong, Hong Kong
(Wong) Division of Cardiothoracic Surgery, Department of Surgery, Prince
of Wales Hospital, New Territories, Hong Kong
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Postoperative pain after cardiac surgery remains significant
despite the administration of opioids. Methadone may improve pain control
and decrease the need for postoperative opioids. Randomised controlled
trials, however, are limited and the effects of cardiopulmonary bypass on
methadone pharmacokinetics are unclear. The aims of this study were to
compare methadone and morphine in cardiac surgery, measuring methadone
concentrations and correlating them with pain control. <br/>Method(s):
Patients undergoing cardiac surgery that required cardiopulmonary bypass
were allocated randomly to receive either 0.2 mg.kg^-1 methadone
or 0.2 mg.kg^-1 morphine (based on actual body weight, maximum
20 mg for both drugs). Postoperative pain was assessed at 15 min and 8 h,
12 h, 24 h, 48 h and 72 h after tracheal extubation, by analysis of
morphine consumption and pain scores. Opioid-related adverse events were
evaluated. Postoperative blood samples were collected for 96 h to measure
plasma methadone concentrations. <br/>Result(s): In total, 80 patients
were analysed (40 allocated to the methadone group, 40 allocated to the
morphine group). Patients allocated to the methadone group had
significantly reduced 24-h and total postoperative morphine requirements
compared to those allocated to the morphine group (median (IQR [range]) 9
(5-16 [0-40]) mg vs. 24 (17-43 [4-54]) mg (p < 0.001) at 24 h and 35
(23-52 [5-66]) mg vs. 11 (7-20 [0-44]) mg (p < 0.001) total). Patients
allocated to the methadone group had lower pain scores at rest (beta
-2.24, standard error 0.49, p < 0.001) and on coughing (beta -2.16,
standard error 0.50, p < 0.001). There was no difference in the incidence
of opioid-related adverse effects between the two groups. Plasma methadone
concentration decreased during cardiopulmonary bypass but remained above
the minimum effective analgesic concentration for approximately 24 h after
administration (mean (SD) 51 (24.7) ng.ml^-1 at baseline to 30
(10.7) ng.ml^-1 at 24 h). <br/>Discussion(s): Intra-operative
methadone reduces postoperative analgesia requirements without increasing
the incidence of opioid-related adverse events.<br/>Copyright &#xa9; 2025
The Author(s). Anaesthesia published by John Wiley & Sons Ltd on behalf of
Association of Anaesthetists.

<66>
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. <br/>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. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; The Author(s) 2025.

<67>
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.
<br/>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. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2025 Ren et al.

<68>
Accession Number
2035822122
Title
Effect of SGLT2 inhibitors on cardiac structure and function assessed by
cardiac magnetic resonance: a systematic review and meta-analysis.
Source
Cardiovascular Diabetology. 24(1) (no pagination), 2025. Article Number:
345. Date of Publication: 01 Dec 2025.
Author
Leo I.; Salerno N.; Figliozzi S.; Cersosimo A.; Ielapi J.; Stankowski K.;
Bisaccia G.; Dellegrottaglie S.; Canino G.; De Rosa S.; Sorrentino S.;
Bucciarelli-Ducci C.; Torella D.
Institution
(Leo, Salerno, Cersosimo, Ielapi, Canino, Torella) Department of
Experimental and Clinical Medicine, Magna Graecia University, Catanzaro,
Italy
(Leo, Bucciarelli-Ducci) CMR department, Royal Brompton and Harefield
Hospitals, Guy's and St Thomas' NHS foundation Trust, London, United
Kingdom
(Leo, Salerno, De Rosa, Sorrentino, Torella) Research Center for
Cardiovascular Science, Magna Graecia University, Catanzaro, Italy
(Figliozzi) IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano,
Milan, Italy
(Figliozzi) Department of Biomedical Sciences, Humanitas university, Pieve
Emanuele, Milan, Italy
(Stankowski) Department of Peri-operative Cardiology and Cardiovascular
Imaging, Centro Cardiologico Monzino IRCSS, Milan, Italy
(Bisaccia) Department of Neuroscience, Imaging and Clinical Sciences,
Institute for Advanced Biomedical Technologies "G. d'Annunzio", University
of Chieti- Pescara, Chieti, Italy
(Dellegrottaglie) Advanced Cardiovascular Imaging Unit, Ospedale
Medico-Chirurgico Accreditato Villa dei Fiori, Naples, Italy
(De Rosa, Sorrentino) Department of Medical and Surgical Sciences, Magna
Graecia University, Catanzaro, Italy
(Bucciarelli-Ducci) School of Biomedical Engineering and Imaging Sciences,
Faculty of Life Sciences and Medicine, King's College University, London,
United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background and aim: Sodium-glucose cotransporter-2 inhibitors (SGLT2i)
improve outcomes in patients with heart failure (HF) but underlying
mechanisms remain incompletely understood. Cardiac magnetic resonance
(CMR) is key in evaluating cardiac structure and function, enabling
accurate assessment of reverse remodeling. Aim of this systematic review
and meta-analysis was to assess the effects of SGLT2i on cardiac
remodeling evaluated by CMR changes. <br/>Method(s): We conducted a
systematic review and meta-analysis of studies assessing changes in CMR
parameters in patients treated with SGLT2i (PROSPERO registration:
CRD42024574302). Databases were searched through April 30, 2025.
Random-effects models were used to pool mean changes in left and right
ventricular volumes, mass, function, stroke volume, global longitudinal
strain, left atrial volume, and tissue characterization indices.
Meta-regression and sensitivity analyses were performed to evaluate
potential sources of heterogeneity. <br/>Result(s): Twenty-three studies
and 1008 patients were included. Treatment with SGLT2i was associated with
significant reductions in left ventricular (LV) end-diastolic volume (-
7.10 mL; 95% CI: -13.01 to - 1.19, p = 0.023), left ventricular mass (-
4.24 g; 95% CI: -7.88 to - 0.60, p = 0.027) and epicardial adipose tissue
(-4.94 ml; 95% CI: -9.06, -0.82, p = 0.019). A subgroup analysis in
patients with reduced LV ejection fraction showed improvement in LV stroke
volume. Meta-regression revealed no significant effect of age, male sex or
diabetes prevalence on pooled estimates. <br/>Conclusion(s): SGLT2i are
associated with reductions in LV volumes and mass in line with an overall
favorable reverse remodeling effects as assessed by CMR.<br/>Copyright
&#xa9; The Author(s) 2025.

<69>
Accession Number
2040084428
Title
Impact of short duration smoking cessation on post-operative
complications: A systematic review and meta-analysis.
Source
Journal of Clinical Anesthesia. 106 (no pagination), 2025. Article Number:
111967. Date of Publication: 01 Sep 2025.
Author
Tang E.; Rodriguez R.M.; Srivastava A.; Malhan R.; Laksono I.; Yan E.;
Englesakis M.; Wong J.; Chung F.
Institution
(Tang, Rodriguez, Srivastava, Malhan, Laksono, Yan, Wong, Chung)
Department of Anesthesia and Pain Management, Toronto Western Hospital,
University Health Network, University of Toronto, Toronto, ON, Canada
(Yan, Wong, Chung) Institute of Medical Science, Temerty Faculty of
Medicine, University of Toronto, ON, Canada
(Englesakis, Wong) Library & Information Services, University Health
Network, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Use of tobacco poses significant health risks, particularly in
surgical patients, where smoking is a well-established risk factor for
postoperative complications. Patients are often seen in the pre-assessment
clinic 2-4 weeks prior to surgery, presenting a window of opportunity to
intervene. The objective of our systematic review and meta-analysis is to
explore the impact of short-term smoking cessation on postoperative
outcomes, focusing on the critical 2-4-week period preceding surgery.
<br/>Design(s): Systematic review and meta-analysis. <br/>Setting(s):
MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and
Cochrane Database of Systematic Reviews. <br/>Patient(s): Adults
undergoing surgical procedures with a defined smoking cessation
pre-operative smoking cessation interval. Measurement: Post-operative
complications including pulmonary complications, surgical site infection,
wound complication, bleeding, mortality, and composite complications.
<br/>Result(s): Fifty-five studies were included in the systematic review
and meta-analysis. Pulmonary complications were more prevalent in former
smokers compared to non-smokers, even after cessation. Progressively
longer smoking cessation periods showed improved outcomes. Compared to
active smokers, preoperative cessation reduced pulmonary complications by
27 % at >=2 weeks (RR 0.73, 95 % CI 0.60-0.89), 29 % at >=4 weeks (RR
0.71, 95 % CI 0.61-0.82), and 37 % at >=8 weeks (RR 0.63, 95 % CI
0.41-0.95). With >=4 weeks of cessation, there was a 33 % lower risk of
wound complications (RR 0.67, 95 % CI 0.47-0.94), 31 % lower risk of
composite complications (RR 0.69, 95 %CI 0.63-0.76), and 14 % lower risk
of mortality (RR 0.86, 95 % CI 0.77-0.97). Short term cessation did not
seem to have a significant impact on surgical site infections or bleeding.
<br/>Conclusion(s): Short term cessation of at least 2-4 weeks
demonstrates benefits in reducing post-operative
complications.<br/>Copyright &#xa9; 2025 The Authors

<70>
Accession Number
2040185860
Title
The role of acute normovolemic hemodilution and retrograde autologous
priming in reducing intraoperative packed red blood cell transfusion needs
in coronary artery bypass surgery: A randomized controlled trial.
Source
Perfusion (United Kingdom). (no pagination), 2025. Article Number:
02676591251372497. Date of Publication: 2025.
Author
Boom C.E.; Cintyandy R.; Widodo H.; Putri A.; Givano M.R.; Parmana I.M.A.
Institution
(Boom, Cintyandy, Givano, Parmana) Department of Anesthesiology and
Intensive Care, National Cardiovascular Center Harapan Kita, Jakarta,
Indonesia
(Widodo, Putri) Department of Cardiovascular Surgery, National
Cardiovascular Center Harapan Kita, Jakarta, Indonesia
Publisher
SAGE Publications Ltd
Abstract
Background: Acute normovolemic hemodilution (ANH) and retrograde
autologous priming (RAP) are blood conservation techniques designed to
reduce transfusion requirements. <br/>Purpose(s): This study evaluated the
impact of combining ANH and RAP compared to RAP alone on intraoperative
packed red blood cell (PRBC) transfusion and postoperative outcomes in
coronary artery bypass grafting (CABG) surgery. Research design: A
single-center randomized controlled trial. Study sample: 72 patients
scheduled for CABG surgery from July 2024 to December 2024 at the National
Cardiovascular Center Harapan Kita in Indonesia. Patients were randomly
assigned to ANH + RAP group (n = 36) and RAP group (n = 36). Data
analysis: Multivariate analysis assessed factors influencing final
hemoglobin levels and intraoperative PRBC transfusion needs.
<br/>Result(s): The ANH + RAP group experienced a significant reduction in
the transfusion rate (19.4% vs 47.2%, p = 0.024) and the intraoperative
allogeneic packed red blood cell units (0.2 +/- 0.4 vs 0.5 +/- 0.6, p =
0.012). The optimal ANH volume reduces intraoperative allogeneic PRBC
transfusion was 380 mL (ROC area 0.862, 95% CI 0.703-1.000, p = 0.003).
Single RAP procedure approaches were less effective when compared to the
combination procedure for achieving higher final hemoglobin levels (beta =
-0.824, 95% CI -1.314 to -0.334, p = 0.001) and reducing the likelihood of
intraoperative allogeneic PRBC transfusion (OR = 13.370, 95% CI 2.206 to
81.026, p = 0.005). Postoperative outcomes did not differ between groups.
<br/>Conclusion(s): The combined use of ANH and RAP significantly reduces
intraoperative allogeneic PRBC needs compared to RAP alone without
affecting postoperative outcomes.<br/>Copyright &#xa9; The Author(s) 2025

<71>
Accession Number
2039907865
Title
A New Perspective in Cardiac Surgery: Single- and Two-level Deep
Parasternal Intercostal Plane Blocks for Median Sternotomy Pain.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(10) (pp 2677-2684),
2025. Date of Publication: 01 Oct 2025.
Author
Dolgun I.; Cevirme D.; Bayram E.; Zilifli C.; Erdogan M.B.
Institution
(Dolgun) Haseki Training and Research Hospital, Clinic of Anesthesiology
and Reanimation, Istanbul, Turkey
(Cevirme, Erdogan) Istinye University Faculty of Medicine, Department of
Cardiovascular Surgery, Istanbul, Turkey
(Bayram) Department of Anesthesiology and Reanimation, Faculty of
Medicine, Istinye University Medicalpark Gaziosmanpasa Hospital, Istanbul,
Turkey
(Zilifli) Istinye University Faculty of Medicine, Cardiovascular Surgery
Intensive Care Unit, Istanbul, Turkey
Publisher
W.B. Saunders
Abstract
Objectives: To compare the efficacy of single-level and two-level deep
parasternal intercostal plane (DPIP) blocks in managing postoperative pain
in cardiac surgery patients undergoing median sternotomy. <br/>Design(s):
A prospective, randomized controlled study. <br/>Setting(s): A cardiac
surgery unit in a tertiary hospital, conducted under institutional ethical
approval. <br/>Participant(s): Adult patients (>=18 years) undergoing
elective coronary artery bypass grafting (CABG), valve surgery, or
combined CABG + valve procedures. Exclusion criteria included allergies to
local anesthetics, emergency surgeries, reoperations, chronic pain, and
major comorbidities. <br/>Intervention(s): Single-level DPIP block: 10 mL
of 0.25% bupivacaine bilaterally at the T4/5 intercostal space. Two-level
DPIP block: 5 mL bilaterally at T2/3 and T5/6 intercostal spaces. All
blocks were administered preoperatively under ultrasound guidance.
<br/>Measurements and Main Results: Both techniques provided effective
analgesia. However, single-level blocks yielded significantly lower pain
scores at 4, 6, and 8 hours, particularly during movement and in patients
undergoing CABG. Differences decreased at 12 hours and disappeared by 24
hours. Pain scores were inversely correlated with age. No block-related
complications were observed. <br/>Conclusion(s): Single-level DPIP blocks
demonstrated more consistent early analgesia and were technically simpler
to perform. Given their efficacy, safety, and efficiency, single-level
blocks may serve as a practical alternative for routine use in cardiac
surgery. Further research is warranted to optimize block level, volume,
and concentration based on patient and surgical
characteristics.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<72>
Accession Number
2035808896
Title
Optimizing antithrombotic therapy following mitral valve repair: a
comprehensive network meta-analysis.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
628. Date of Publication: 01 Dec 2025.
Author
Gbreel M.I.; Elkasaby M.H.; Hassan M.; Becher M.U.; Balata M.
Institution
(Gbreel) Faculty of Medicine and Surgery, October 6 University, Giza,
Egypt
(Gbreel) Department of Cardiology, Epyptian Railway Medical Centre (ERMC),
Cairo, Egypt
(Elkasaby) Faculty of Medicine and Surgery, Al-Azhar University, Cairo,
Egypt
(Hassan) Department of Immunology, Theodor Bilharz Research Institute,
Giza, Egypt
(Becher) Department of Cardiology, Stadtisches Klinikum Solingen,
Solingen, Germany
(Balata) Department of cardiology, University hospital Rostock, Rostock,
Germany
Publisher
BioMed Central Ltd
Abstract
Background: Mitral regurgitation (MR) presents either as primary or
secondary, with options for surgical or transcatheter repair.
Thromboembolic risks following surgery are significant despite the use of
antithrombotic medications, and guidelines for postoperative
anticoagulation therapy lack consistency. This systematic review aims to
compare antithrombotic medications after mitral valve repair (MVR). In
this study, we intend to compare antithrombotic medications after MVR.
<br/>Material(s) and Method(s): The study followed the Cochrane handbook
and PRISMA guidelines. We systematically searched databases (PubMed,
Scopus, Ovid, Cochrane, Web of Science) until June 2024 for TMVR studies
using specific criteria. Quality assessment utilized the Newcastle-Ottawa
scale. Data extraction encompassed study characteristics and outcomes.
Primary outcomes included thromboembolic events and bleeding within six
months. Statistical analysis employed R software to assess heterogeneity
and publication bias. <br/>Result(s): From the 121 articles screened, 12
were included in the study. These cohort studies, involving 20,644
participants, spanned from 2008 to 2022. While most studies were of good
to high quality, some exhibited lower quality. Analysis favored oral
anticoagulants (OAC) over single antiplatelet therapy (SAPT) for reducing
bleeding risk (RR = 0.31, 95% CI: [0.11-0.87], P < 0.05), with moderate
heterogeneity. Thromboembolic events did not significantly differ among
interventions. Transient ischemic attacks and stroke outcomes were similar
between SAPT and vitamin K antagonists (VKA). Six-month mortality rates
were comparable between SAPT and VKA, with notable heterogeneity and
higher mortality with SAPT in one study. Qualitative synthesis highlighted
procedural success rates and bleeding complications across different
interventions in transcatheter mitral valve repair studies.
<br/>Conclusion(s): OACs showed a lower risk of bleeding compared to
antiplatelet therapies, while VKAs and OAC + SAPT may reduce
thromboembolic events. No significant differences were found in stroke,
TIA, or short-term mortality. These findings support individualized
therapy and highlight the need for further randomized
trials.<br/>Copyright &#xa9; The Author(s) 2025.

<73>
Accession Number
2040164828
Title
Radiation exposure risk for various personnel in the catheterization
laboratory: A systematic review and meta-analysis.
Source
Physica Medica. 137 (no pagination), 2025. Article Number: 105096. Date of
Publication: 01 Sep 2025.
Author
Balazs B.B.; Laczko D.; Gergo D.; Szabo B.; Duray G.; Molnar Z.; Horvathy
D.B.; Papp J.; Hegyi P.; Merkely B.; Edes I.F.
Institution
(Balazs, Laczko, Duray, Merkely, Edes) Heart and Vascular Center,
Semmelweis University, Budapest, Hungary
(Balazs, Laczko, Gergo, Szabo, Duray, Molnar, Horvathy, Papp, Hegyi, Edes)
Center for Translational Medicine, Semmelweis University, Budapest,
Hungary
(Gergo) Faculty of Pharmacy, Department of Pharmacognosy, Semmelweis
University, Budapest, Hungary
(Szabo, Hegyi) Institute for Translational Medicine, Medical School,
University of Pecs, Pecs, Hungary
(Duray, Papp) Department of Cardiology, Central Hospital of Northern Pest
- Military Hospital Budapest, Hungary
(Molnar) Department of Anesthesiology and Intensive Therapy, Semmelweis
University, Budapest, Hungary
(Molnar) Department of Anesthesiology and Intensive Therapy, Poznan
University of Medical Sciences, Poznan, Poland
(Horvathy) Department of Interventional Radiology, Heart and Vascular
Center, Semmelweis University, Budapest, Hungary
(Hegyi) Institute of Pancreatic Diseases, Semmelweis University, Budapest,
Hungary
Publisher
Associazione Italiana di Fisica Medica
Abstract
Purpose: Radiation exposure is a well-recognized occupational hazard for
catheterization lab personnel. However, the extent of exposure disparities
among different staff roles remains unclear. Existing research primarily
focuses on primary operators, leaving a gap in understanding radiation
risks for ancillary staff. This study aims to evaluate how staff
positioning and shielding affect radiation exposure, focusing on
disparities between primary operators and ancillary staff during
fluoroscopy-guided cardiovascular procedures. <br/>Method(s): After a
systematic search across five databases on November 20, 2023, we included
studies reporting radiation data for coronary angiographies, structural
heart interventions, electrophysiological procedures, or endovascular
aorta interventions, with at least one ancillary staff member in
prespecified positions. Radiation exposures were compared relative to the
primary operator using the Ratio of Means (ROM) during meta-analysis. Risk
of Bias was assessed using RoB-2 or ROBINS-E. The review protocol was
registered as CRD42023484491. <br/>Result(s): Our meta-analysis, based on
8116 measurements from 3091 procedures across 23 studies, suggests that
personnel at the patient's head without shielding may experience higher
radiation exposure than primary operators (ROM 1.77, 95% CI: 0.75-4.18),
although this difference didn't reach statistical significance. Shielded
workers at the head or in secondary/assistant positions received
significantly lower radiation than primary operators (ROM 0.26, 95% CI:
0.12-0.57; ROM 0.33, 95% CI: 0.25-0.43). <br/>Conclusion(s): Our results
suggest a potential disparity in radiation exposure among catheterization
laboratory personnel, with unshielded workers at the patient's head
tending to receive the highest levels of exposure. Dedicated shielding
solutions and attention to all personnel are imperative.<br/>Copyright
&#xa9; 2025 Associazione Italiana di Fisica Medica e Sanitaria

<74>
Accession Number
2040123398
Title
Ipsilateral High Thoracic Ultrasound-Guided Erector Spinae Plane Block for
Post-Thoracotomy Shoulder Pain in Thoracic Cancer Surgeries: A Randomized
Controlled Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Kotb T.A.; Tantawy A.M.; Mahran E.; Elbosraty O.M.M.; Saad F.S.; Megahed
M.M.; Elshiha R.; Samy S.F.
Institution
(Kotb, Tantawy, Mahran, Elbosraty, Saad, Megahed, Samy) Anesthesia,
Surgical Intensive Care, and Pain Relief Department, National Cancer
Institute, Cairo University, Cairo, Egypt
(Elshiha) Clinical and Chemical Pathology Department, National Nutrition
Institute, Cairo, Egypt
Publisher
W.B. Saunders
Abstract
Objectives: To assess the safety and efficacy of ultrasound-guided high
thoracic erector spinae plane block (HT-ESPB) in the management of
post-thoracotomy ipsilateral shoulder pain (PTISP). <br/>Design(s):
Randomized, double-blind, parallel-group, controlled, clinical trial.
<br/>Setting(s): The National Cancer Institute. <br/>Participant(s):
Seventy-six adult patients undergoing thoracic cancer surgery.
<br/>Intervention(s): Patients were randomized into two equal groups: A
control group received thoracic epidural analgesia (TEA) alone (TEA
group), and a study group received ultrasound-guided HT-ESPB plus TEA
(ESPB group). <br/>Measurements and Main Results: Outcomes included the
incidence of PTISP, time to first rescue analgesia and total rescue
analgesic doses for ISP, intraoperative fentanyl consumption, heart rate,
mean arterial pressure, oxygen saturation, and complications. The ESPB
group had a significantly lower incidence of ISP in the first
postoperative hour compared to the TEA group (60.5% v 97.4%, p < 0.001).
The ESPB group also exhibited lower postoperative visual analog scale
scores, longer time to first rescue analgesia, and a reduced number of
rescue analgesic doses for ISP, as well as lower heart rate and mean
arterial pressure. No significant complications were reported.
<br/>Conclusion(s): Ultrasound-guided HT-ESPB is a safe and efficacious
strategy for the management of PTISP. It demonstrated a significant
reduction in the incidence and severity of ISP and postoperative analgesic
requirements when compared to TEA alone. This approach enhanced
hemodynamic stability without significant complications.<br/>Copyright
&#xa9; 2025 Elsevier Inc.

<75>
Accession Number
2040160080
Title
Optimizing the handling of missing data in the UNOS database.
Source
Journal of Heart and Lung Transplantation. 44(9) (pp 1525), 2025. Date of
Publication: 01 Sep 2025.
Author
Yang H.; Fu Y.; Ji Z.
Institution
(Yang, Fu, Ji) Department of Surgery, Beijing Organ Transplant Center,
Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
Publisher
Elsevier Inc.

<76>
Accession Number
2035822154
Title
Cusp-overlap view versus three cusp coplanar view during transcatheter
aortic valve replacement using self-expandable valves: a systematic
review, meta-analysis and meta-regression.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
619. Date of Publication: 01 Dec 2025.
Author
Khalefa B.B.; Awad A.K.; Gonnah A.R.; Yassin M.N.A.; Hamam N.G.; Eldeeb
H.; Ramadan M.; Dway A.; Alsalhi K.; Osman M.T.; Alqeeq B.F.; Al-Tawil M.;
Sicouri S.; Baudo M.; Yamashita Y.; Ramlawi B.
Institution
(Khalefa, Awad, Osman) Faculty of Medicine, Ain Shams University, Cairo,
Egypt
(Awad) Department of Cardiothoracic Surgery, Ain-shams University
Hospitals, Cairo, Egypt
(Gonnah) Imperial College Healthcare NHS Trust, London, United Kingdom
(Yassin, Hamam) Faculty of Medicine, Cairo University, Cairo, Egypt
(Eldeeb) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Ramadan) Faculty of Medicine, Suez University, Suez, Egypt
(Dway) Faculty of Medicine, Al-Andalus University for Medical Sciences,
Tartus, Syrian Arab Republic
(Alsalhi) Faculty of Medicine, Batterjee Medical College, Jeddah, Saudi
Arabia
(Alqeeq) Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
(Al-Tawil) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
(Sicouri, Baudo, Yamashita, Ramlawi) Department of Cardiothoracic Surgery
Research, Lankenau Institute for Medical Research, Wynnewood, PA, United
States
(Baudo, Yamashita, Ramlawi) Department of Cardiothoracic Surgery, Lankenau
Heart Institute, Wynnewood, PA, United States
Publisher
BioMed Central Ltd
Abstract
Transcatheter aortic valve replacement (TAVR) is currently the treatment
of choice for most patients with severe aortic stenosis. We conducted this
meta-analysis to compare the outcomes of the cusp overlap technique (COT)
versus the standard three-cusp technique during self-expandable valves
implantation. We systematically searched PubMed, Scopus, Embase, Cochrane,
and Web of Science (WOS) from inception to March 5, 2024. To estimate the
effect size, dichotomous outcomes were pooled as RR, and continuous
outcome was pooled as MD with their respective 95% CI. We included
seventeen studies with a total of 3,129 patients in cusp-overlap technique
(COT) arm and 2,818 patients in standard technique (ST) arm. The rate of
30-day mortality was borderline reduced in COT compared with ST, however,
with no significant difference (RR = 0.61; 95% CI: [0.37-1.00], P = 0.05).
Regarding conduction abnormalities, COT was related to lower risk of
complete atrioventricular (AV) block (RR = 0.51; 95% CI: [0.37-0.69], P <
0.01), and permanent pacemaker implantation (PPM) (RR = 0.56; 95% CI:
[0.46-0.70], P < 0.01). Mild to severe paravalvular leak (PVL) (RR = 1.00;
95% CI: [0.66-1.51], P = 1.00, I2 = 62%; P = 0.02) were comparable between
COT and ST. Our study findings suggest that COT offers several advantages
over ST, including reduced 30-day mortality, bleeding complications, and
shorter procedural duration. The COT most importantly lowers the risk of
conduction abnormalities, and hence the incidence PPM.<br/>Copyright
&#xa9; The Author(s) 2025.

<77>
Accession Number
2035842431
Title
Incidence and risk factors of intraoperative acquired pressure injury in
open heart surgical patients: a meta-analysis of prospective studies.
Source
European Journal of Medical Research. 30(1) (no pagination), 2025. Article
Number: 814. Date of Publication: 01 Dec 2025.
Author
Fang Z.; Chen T.; Zheng W.; Chen Q.; Chen P.; Zhuo Q.
Institution
(Fang, Chen, Zhuo) Department of Operating Room, Fujian Children's
Hospital (Fujian Branch of Shanghai Children's Medical Center), Fujian,
Fuzhou, China
(Chen) Department of Anesthesiology, Fujian Children's Hospital (Fujian
Branch of Shanghai Children's Medical Center), Fujian, Fuzhou, China
(Zheng, Chen) Department of Operating Room, Fujian Maternity and Child
Health Hospital, Fujian, Fuzhou, China
(Fang, Chen, Zheng, Chen, Chen, Zhuo) College of Clinical Medicine for
Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian,
Fuzhou, China
Publisher
BioMed Central Ltd
Abstract
Purpose: This meta-analysis aimed to evaluate the incidence and risk
factors of intraoperative acquired pressure injuries (IAPIs) in open heart
surgical patients, focusing exclusively on prospective studies to address
gaps in the existing literature. <br/>Method(s): A systematic search was
conducted across PubMed, Embase, and Web of Science up to January 2025.
Data on incidence and risk factors were extracted, and statistical
analyses were performed using random-effects models. Heterogeneity was
assessed using I² statistics; publication bias was assessed by
funnel plot and Egger's test. <br/>Result(s): Ten prospective studies
involving 1311 patients were included. The pooled incidence of IAPIs was
25% (95% CI 16%-35%), with high heterogeneity (I² = 94%).
Sensitivity analysis confirmed stable results. Significant risk factors
included prolonged surgical duration (SMD: 1.76, 95% CI 0.10-3.42,
I² = 98%), advanced age (SMD: 0.30, 95% CI 0.14-0.46,
I² = 0%), female sex (RR: 1.36, 95% CI 1.03-1.80, I²
= 53%), and perioperative corticosteroid use (RR: 3.63, 95% CI 1.64-8.06,
I² = 0%). <br/>Conclusion(s): This study assessed the incidence
of IAPIs in open heart surgical patients and identifies key risk factors,
including prolonged surgical duration, advanced age, female sex, and
perioperative corticosteroid use. However, the results should be
interpreted with caution due to the high heterogeneity observed across
studies. Future research should focus on larger, multicenter prospective
studies to provide more robust evidence.<br/>Copyright &#xa9; The
Author(s) 2025.

<78>
Accession Number
2035956570
Title
Efficacy, safety and cost-effectiveness of 40 mg versus 80 mg atorvastatin
in a Sri Lankan cohort with acute coronary syndrome: a protocol for a
single-centre randomised controlled clinical trial.
Source
Trials. 26(1) (no pagination), 2025. Article Number: 326. Date of
Publication: 01 Dec 2025.
Author
Fernando K.; Fernando N.; Welhenge C.; Liyanage S.; Dayanath B.K.T.P.; De
Silva S.; Mettananda C.
Institution
(Fernando, Liyanage) Department of Biochemistry and Clinical Chemistry,
Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
(Fernando, Dayanath) Department of Chemical Pathology, Colombo North
Teaching Hospital, Ragama, Sri Lanka
(Fernando, Welhenge, De Silva) University Medical Unit, Colombo North
Teaching Hospital, Ragama, Sri Lanka
(De Silva) Department of Medicine, Faculty of Medicine, University of
Kelaniya, Kelaniya, Sri Lanka
(Mettananda) Department of Pharmacology, Faculty of Medicine, University
of Kelaniya, Kelaniya, Sri Lanka
Publisher
BioMed Central Ltd
Abstract
Background: Most guidelines recommend high-intensity statins for the
secondary prevention of acute coronary syndrome (ACS). However, several
studies from other Asian populations suggest enhanced sensitivity to
statins, with effective low-density lipoprotein cholesterol (LDL-C)
reduction seen at lower doses and possible higher incidence of adverse
effects at higher statin doses. However, there is no published data from
Sri Lanka. Therefore, we aimed to explore this hypothesis by comparing the
efficacy, safety and cost-effectiveness of atorvastatin at doses of 40 mg
and 80 mg in a cohort of South Asian individuals presenting with ACS from
Sri Lanka. <br/>Method(s): This single-centre, prospective, randomised,
controlled, open-label clinical trial is being conducted among patients
naive for statins admitted with incident ACS to a tertiary care setting in
Sri Lanka. All patients will have LDL-C measured at baseline and are
randomised to receive atorvastatin 40 mg or 80 mg in addition to standard
of care. Data are collected using an interviewer-administered proforma.
Patients are evaluated at 6, 12 and 24 weeks for adverse drug reactions
and LDL-C level. The primary endpoint is the percentage of patients
achieving LDL-C <= 70 mg/dL at 12 weeks. This outcome will be analysed by
the intention-to-treat analysis. Secondary outcomes include safety
assessments and a cost-effectiveness evaluation. For the latter, data on
medication costs, including the number of tablets consumed, will be
collected to calculate the average cost-effectiveness ratio and
incremental cost-effectiveness ratio between the two dosing regimens.
<br/>Discussion(s): This will be the first head-to-head comparison of
atorvastatin 40 mg and 80 mg in a South Asian cohort. The findings will
provide evidence on efficacy and safety of prescribing atorvastatin 40 mg
dose in South Asians with ACS. Trial registration: Sri Lanka Clinical
Trial Registry, SLCTR/2023/003. Registered on 03 March 2023,
https://slctr.lk/trials/slctr-2023-003.<br/>Copyright &#xa9; The Author(s)
2025.

<79>
Accession Number
2037539830
Title
Transcatheter versus surgical aortic valve replacement in patients younger
than 65 years in the United States.
Source
Journal of Thoracic and Cardiovascular Surgery. 170(3) (pp 698-706.e19),
2025. Date of Publication: 01 Sep 2025.
Author
Alabbadi S.; Bowdish M.E.; Sallam A.; Tam D.Y.; Hasan I.; Kumaresan A.;
Alzahrani A.H.; Iribarne A.; Egorova N.; Chikwe J.
Institution
(Alabbadi, Alzahrani, Egorova) Department of Population Health Science and
Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Bowdish, Sallam, Tam, Hasan, Kumaresan, Chikwe) Department of Cardiac
Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
Calif, United States
(Sallam) National Clinician Scholars Program, University of California,
Los Angeles, Los Angeles, Calif, United States
(Iribarne) Department of Cardiothoracic Surgery, Staten Island University
Hospital, Northwell Health, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Objective: The study objective was to characterize the trends and outcomes
of aortic valve replacement in patients aged less than 65 years with
aortic stenosis between 2013 and 2021. <br/>Method(s): This retrospective
analysis included 9557 patients who underwent biological aortic valve
replacement in California, New York, and New Jersey from 2013 to 2021.
Patients were stratified by approach: transcatheter aortic valve
replacement versus surgical aortic valve replacement. Our primary outcomes
were 30-day and 6-year mortality and morbidity (stroke, heart failure
rehospitalization, reintervention, and new pacemaker implantation). After
propensity score matching, Cox proportional hazard and Fine-Gray models
were used to compare outcomes after transcatheter aortic valve replacement
and surgical aortic valve replacement. <br/>Result(s): The proportion of
patients aged less than 65 years with aortic stenosis undergoing
transcatheter aortic valve replacement versus surgical aortic valve
replacement increased from 7.1% in 2013 to 54.7% in 2021. After propensity
score matching, 30-day mortality was similar between both groups (1.0% vs
1.5%, P = .33). Transcatheter aortic valve replacement had a higher 6-year
mortality (23.3% vs 10.5%, hazard ratio, 2.27; 95% CI, 1.82-2.83; P <
.001). The 30-day rate of new pacemaker implantation was higher after
transcatheter aortic valve replacement (10.7% vs 6.2%, P < .001). There
was no difference in the 6-year cumulative incidence of stroke, heart
failure hospitalizations, or reoperations. Multiple sensitivity analyses
confirmed these findings. <br/>Conclusion(s): Despite clinical guidelines,
the use of transcatheter aortic valve replacement has increased in
patients aged less than 65 years. Transcatheter aortic valve replacement
in this population is associated with a higher 6-year mortality and a
higher rate of new permanent pacemaker implantation when compared with a
matched cohort treated with biologic surgical aortic valve replacement.
These findings support the need for a randomized controlled trial
comparing long-term outcomes of transcatheter aortic valve replacement
versus surgical aortic valve replacement in patients aged less than 65
years.<br/>Copyright &#xa9; 2025

<80>
Accession Number
2039302189
Title
Modified Measurement of Tricuspid Annular Plane Systolic Excursion for
Assessing Right Ventricular Function During Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(10) (pp 2827-2836),
2025. Date of Publication: 01 Oct 2025.
Author
Ye K.; Zhao Y.; Hu X.; Zhou X.
Institution
(Ye, Zhao, Hu, Zhou) Department of Anesthesiology, Second Affiliated
Hospital, Zhejiang University School of Medicine, Hangzhou, China
Publisher
W.B. Saunders
Abstract
Precise and prompt identification of right ventricular (RV) dysfunction is
critical in cardiac surgery. Tricuspid annular plane systolic excursion
(TAPSE) has been widely used as a simple, rapid, and repeatable index for
assessing RV function. However, the current measurement of TAPSE is based
mainly on M-mode ultrasound and is used predominantly in transthoracic
echocardiography (TTE). Owing to differences in imaging views and the
angle dependence of M-mode ultrasound, directly applying TAPSE measurement
from TTE to transesophageal echocardiography (TEE) is not advisable.
Therefore, exploring a modified TAPSE measurement method suitable for TEE
is of great value for obtaining more accurate TAPSE values and informing
subsequent clinical decision making. This review summarizes and discusses
in detail the research progress on modified TAPSE in TEE as reported in
the literature. By systematically reviewing relevant studies, it aims to
provide new methods and insights for cardiac subspecialist
anesthesiologists. Modified measurement methods will enable them to more
accurately use TAPSE to assess RV function during perioperative TEE. This
not only will help optimize clinical decision making, but also will
provide an important basis for predicting patients' clinical
outcomes.<br/>Copyright &#xa9; 2025 The Authors

<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.<br/>Copyright &#xa9; 2025 The Author(s).

<82>
Accession Number
2040124687
Title
Psychological well-being and the effects of supportive coaching during
SPECT myocardial perfusion imaging in patients with suspected ischemic
heart disease.
Source
Journal of Psychosomatic Research. 197 (no pagination), 2025. Article
Number: 112355. Date of Publication: 01 Oct 2025.
Author
Roovers T.; Vermeltfoort I.A.C.; Widdershoven J.W.; Kop W.J.
Institution
(Roovers, Widdershoven, Kop) Department of Medical and Clinical
Psychology, Center of Research on Psychological Disorders and Somatic
Diseases (CoRPS), Tilburg University, Tilburg, Netherlands
(Vermeltfoort) Department of Nuclear Medicine, Institute Verbeeten,
Tilburg, Netherlands
(Widdershoven) Department of Cardiology, Elisabeth-TweeSteden Hospital,
Tilburg, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Diagnostic procedures for ischemic heart disease are common,
but the consequences for the patient's psychological well-being are not
well understood. The current study investigates changes in negative affect
as a measure of psychological well-being during myocardial perfusion
imaging (MPI-SPECT) and whether supportive coaching during diagnostic
testing improves well-being, reduces symptom burden, and increases patient
satisfaction. <br/>Method(s): Patients undergoing MPI-SPECT were randomly
assigned to a supportive coaching intervention group or a care-as-usual
control group. Negative affect was assessed at nine time-points throughout
the 2-day diagnostic MPI visits. Anginal and adenosine-related symptoms
were evaluated during cardiac stress testing (CST) and patient
satisfaction at completion of MPI-SPECT. Data were analyzed using
regression analysis, t-tests, and linear mixed models. <br/>Result(s): A
total of 149 patients were randomized (mean age = 68.5 [SD = 9.6] years,
41.6 % women; 74 intervention and 75 control condition). Negative affect
changed significantly throughout the MPI procedure (F(8, 244.098) = 8.689,
p < .001), with the highest level occurring during the peak phase of CST.
Negative affect was associated with higher concurrent anginal (beta =
0.285, p = .001) and adenosine-related symptoms (beta = 0.252, p = .004)
during CST. No significant benefits of supportive coaching were found for
well-being or symptoms, inducibility of ischemia, or patient satisfaction
(all p-values > .200). <br/>Conclusion(s): Negative affect during
MPI-SPECT is associated with cardiac symptoms during CST. No benefits were
found of the short-term supportive coaching intervention during the
MPI-SPECT procedure. Patient well-being might be improved by providing
support during the entire diagnostic phase for ischemic heart disease
rather than just during the MPI-SPECT procedure. Trial registration
#NCT05896982. Open science statement/Preregistration: Medical Ethics
Committee METC-Brabant NL81600.028.22 / P2234.<br/>Copyright &#xa9; 2025
The Authors

<83>
Accession Number
2040174307
Title
From pioneering to innovation: A comprehensive review of acupuncture
anesthesia in cardiothoracic surgeries.
Source
Journal of Integrative Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Wu X.-D.; Wei X.-Q.; Chen T.-Y.; Zhou W.-X.; Wang K.; Zhou J.
Institution
(Wu, Wei, Wang, Zhou) Department of Clinical Research Institute of
Acupuncture and Anesthetic, Yueyang Hospital of Integrated Traditional
Chinese and Western Medicine, Shanghai University of Traditional Chinese
Medicine, Shanghai, China
(Wu, Zhou) Department of Intensive Care Unit, Yueyang Hospital of
Integrated Traditional Chinese and Western Medicine, Shanghai University
of Traditional Chinese Medicine, Shanghai, China
(Chen, Zhou) Department of Cardiothoracic Surgery, Yueyang Hospital of
Integrated Traditional Chinese and Western Medicine, Shanghai University
of Traditional Chinese Medicine, Shanghai, China
(Wang) Office of National Clinical Research Base of Traditional Chinese
Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western
Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai,
China
Publisher
Elsevier (Singapore) Pte Ltd
Abstract
The evolution of acupuncture anesthesia (AA) has spanned six decades.
Cardiothoracic surgery serves as a representative case study to illustrate
this evolution. Reflecting on its historical development, the use of AA in
cardiothoracic surgery has advanced from basic AA procedures in the 1960s
to combined acupuncture and drug anesthesia techniques in the early 1980s.
Since 2005, the innovative use of non-intubation AA combined anesthesia
has been implemented extensively in cardiothoracic surgery. As the medical
industry continues to evolve, the techniques applied in AA have expanded
to encompass the entire perioperative period in cardiothoracic surgery,
leading to the introduction of the concept of modern AA. The use of AA in
cardiothoracic surgery exemplifies the ongoing advances and integration of
traditional Chinese and Western medicine. Moving forward, it is imperative
to enhance the theoretical framework of AA through the execution of
rigorous multicenter clinical trials, to further strengthen the body of
evidence supporting evidence-based medicine, and to finally explore the
underlying mechanisms of AA. Please cite this article as: Wu XD, Wei XQ,
Chen TY, Zhou WX, Wang K, Zhou J. From pioneering to innovation: A
comprehensive review of acupuncture anesthesia in cardiothoracic
surgeries. J Integr Med. 2025; Epub ahead of print.<br/>Copyright &#xa9;
2025 Shanghai Yueyang Hospital Affiliated to Shanghai University of
Traditional Chinese Medicine

<84>
Accession Number
2035801517
Title
Unveiling the Future of Infective Endocarditis Diagnosis: The
Transformative Role of Metagenomic Next-Generation Sequencing in
Culture-Negative Cases.
Source
Journal of Epidemiology and Global Health. 15(1) (no pagination), 2025.
Article Number: 108. Date of Publication: 01 Dec 2025.
Author
Shinge S.A.U.; Zhang B.; Zheng B.; Qiang Y.; Ali H.M.; Melchiade Y.T.V.;
Zhang L.; Gao M.; Feng G.; Zeng K.; Yang Y.
Institution
(Shinge, Zhang, Zheng, Qiang, Zhang, Gao, Feng, Zeng, Yang) Department of
Cardiovascular Surgery, The Eighth Affiliated Hospital of Sun Yat-sen
University, Futian, Shenzhen, China
(Yang) Department of Cardiothoracic and Vascular Surgery, University
Hospital, Linkoping University, Linkoping, Sweden
(Melchiade) Department of Cardiovascular Surgery, Sun Yat-sen Memorial
Hospital, Sun Yat-sen University, Guangzhou, China
(Ali) Department of Pediatric, The First Affiliated Hospital of Sun
Yat-sen University, Guangzhou, China
Publisher
Springer Science and Business Media B.V.
Abstract
Culture-negative infective endocarditis (CNE) remains a significant
diagnostic challenge in cardiology and infectious disease, often leading
to delayed or empirical treatment. Metagenomic next-generation sequencing
(mNGS) has emerged as a complementary diagnostic tool capable of
identifying fastidious, unexpected, or novel pathogens without prior
assumptions. This narrative review synthesizes evidence from 152 studies
(2015-2024), evaluating mNGS within existing diagnostic frameworks for
culture-negative IE. Compared to conventional diagnostics (blood cultures,
PCR, 16 S rRNA sequencing), mNGS demonstrates enhanced detection
capabilities for polymicrobial infections and rare pathogens, though
methodological heterogeneity across studies precludes definitive
performance comparisons. Performance varies substantially based on sample
type, sequencing platform, and bioinformatic pipelines. Real-world
applications reveal persistent challenges, including cost barriers,
interpretive complexities in low-biomass samples, and contamination risks.
Integration with host-response biomarkers and AI-driven interpretation
platforms shows promise for advancing clinical utility. For mNGS to be
effectively integrated into routine CNE care, standardization, regulatory
clarity, and equitable implementation will be essential.<br/>Copyright
&#xa9; The Author(s) 2025.

<85>
[Use Link to view the full text]
Accession Number
2040182888
Title
Pressure-controlled ventilation versus volume-controlled ventilation for
adult patients with acute respiratory failure: A systematic review and
meta-analysis.
Source
Medicine (United States). 104(34) (pp e43774), 2025. Date of Publication:
22 Aug 2025.
Author
Suntrawanichakul S.; Ngamjarus C.; Sawanyawisuth K.; Khamsai S.
Institution
(Suntrawanichakul) Faculty of Medicine, Khon Kaen University, Khon Kaen,
Thailand
(Ngamjarus) Department of Epidemiology and Biostatistics, Faculty of
Public Health, Khon Kaen University, Khon Kaen, Thailand
(Sawanyawisuth, Khamsai) Department of Medicine, Faculty of Medicine, Khon
Kaen University, Khon Kaen, Thailand
Publisher
Lippincott Williams and Wilkins
Abstract
Background: There is limited data on the effectiveness of
pressure-controlled ventilation (PCV) and volume-controlled ventilation
(VCV) in adult patients with acute respiratory failure. This study aimed
to compare the effectiveness of these 2 ventilations. <br/>Method(s): We
performed a comprehensive search of 4 electronic databases, including
PubMed, Central, Scopus, and CINAHL, from inception to July 14, 2023. This
systematic review included randomized controlled trials that compared VCV
and PCV ventilator modes in intubated adult patients with acute
respiratory failure from any condition. Eligible studies were evaluated
for study characteristics and outcomes. Details of study characteristics
included authors, publication year, country, study aims, study design,
study population, and characteristics of eligible patients: age, sex,
disease severity, and comorbidities. The outcomes of interest were the
incidence of barotrauma or pneumothorax and the in-hospital mortality
rate. Meta-analysis with a fixed-effect model was used to pool the results
of included studies. <br/>Result(s): There were 27 articles that were
eligible; 4 articles met the study criteria. These studies included acute
respiratory distress syndrome patients (3 studies) and chronic obstructive
pulmonary disease patients with open heart surgery. The total patients in
the VCV and PCV groups were 581 and 548, respectively. There was no
significant difference in the incidence of barotrauma between the VCV and
PCV groups (risk ratio = 0.79, 95% confidence interval: 0.56-1.12). The
VCV group had a slightly higher mortality rate than the PCV group (risk
ratio = 1.15, 95% confidence interval: 1.00-1.33). <br/>Conclusion(s): PCV
and VCV had no significant difference in both barotrauma incidence and
mortality rate. PCV mode may have slightly lower mortality and may be a
preferable ventilator mode in patients with acute respiratory distress
syndrome. Further included studies may be required to confirm the results
of this study.<br/>Copyright &#xa9; 2025 the Author(s).

<86>
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). <br/>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. <br/>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.
<br/>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.<br/>Copyright
&#xa9; The Author(s) 2025.

<87>
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). <br/>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. <br/>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. <br/>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).<br/>Copyright &#xa9; 2025 Informa UK Limited,
trading as Taylor & Francis Group.

<88>
Accession Number
2035827902
Title
Surgical Management of Substernal Goiters: A Systematic Review and
Meta-Analysis.
Source
Laryngoscope. (no pagination), 2025. Date of Publication: 2025.
Author
Cheung M.H.; Walker A.M.; Nguyen S.A.; Butehorn H.; Albergotti W.G.
Institution
(Cheung, Walker, Nguyen, Butehorn, Albergotti) Medical University of South
Carolina, Department of Otolaryngology-Head and Neck Surgery, Charleston,
SC, United States
(Cheung) SUNY Upstate Medical University, School of Medicine, Syracuse,
NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: Defining indication for intervention in substernal goiter, and
secondarily define when thoracic intervention may be required. <br/>Data
Sources: PubMed, Scopus, CINAHL. <br/>Method(s): A systematic review and
meta-analysis were performed on studies employing thyroidectomy for
substernal goiters. Meta-analysis of continuous measures, proportions, and
comparison of weighted proportions was performed for patient
characteristics, symptoms, and outcomes. <br/>Result(s): Data from 102
studies were included, with a total study population of 15,719 patients
undergoing substernal thyroidectomies. Criteria for classifying substernal
goiter were heterogeneous across studies, with a plurality (21/102)
defining diagnosis by > 50% of the goiter mass located below the thoracic
inlet. There was a female predominance at 67% (CI 64.2-69.9) with a mean
age of 58 years old (10-94). Most common preoperative symptoms were a
described "neck mass" (71.1%, CI 57.6-82.9) and overall compressive
symptoms (64.8%, CI 52.4-76.2). 27.6% (CI 22.4-33.1) of the population
remained asymptomatic. On radiologic imaging, tracheal deviation and
compression were identified in 60.6% (CI 52.5-68.5) and 48.6% (CI
37.6-59.6) of the population, respectively. Cervical approach alone was
performed in 88.7% (CI 86.0-91.1) of the population, while 10.4% (CI
8.2-12.8) required additional thoracic intervention. Malignancy was
moderate and seen in 12.4% (CI 10.4-14.6) of cases. <br/>Conclusion(s):
Results highlight the indication for substernal surgery is largely due to
the presence of clinical symptoms or compressive findings on imaging;
however, over a quarter of the population is asymptomatic and over 50% are
without compressive findings on imaging. When surgery is undertaken, a
cervical approach is often adequate, suggesting that only a minority of
the population may require thoracic intervention.<br/>Copyright &#xa9;
2025 The Author(s). The Laryngoscope published by Wiley Periodicals LLC on
behalf of The American Laryngological, Rhinological and Otological
Society, Inc.

<89>
Accession Number
2035032961
Title
SciScribe: Automating and contextualizing literature reviews in cardiac
surgery.
Source
Journal of Thoracic and Cardiovascular Surgery. 170(3) (pp 793-801), 2025.
Date of Publication: 01 Sep 2025.
Author
Mahboubi R.; Dinkla K.; Weiss A.; Acierto A.; Staar P.; Robinson J.;
Hammoud M.S.; Karamlou T.
Institution
(Mahboubi, Weiss, Robinson, Hammoud, Karamlou) Department of Thoracic and
Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic,
Cleveland, Ohio, United States
(Dinkla, Staar) IBM Research, Zurich, Switzerland
(Acierto) Syracuse University, Syracuse, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: The task of writing structured content reviews and guidelines
has grown stronger and more complex. We propose to go beyond search tools
and toward curation tools by automating time-consuming and repetitive
steps of extracting and organizing information. <br/>Method(s): SciScribe
is built as an extension of IBM's Deep Search platform, which provides
document processing and search capabilities. This platform was used to
ingest and search full-content publications from PubMed Central (PMC) and
official, structured records from the ClinicalTrials and OpenPayments
databases. Author names and NCT numbers, mentioned within the
publications, were used to link publications to these official records as
context. Search strategies involve traditional keyword-based search as
well as natural language question and answering via large language models
(LLMs). <br/>Result(s): SciScribe is a web-based tool that helps
accelerate literature reviews through key features: (1) accumulating a
personal collection from publication sources, such as PMC or other
sources; (2) incorporating contextual information from external databases
into the presented papers, promoting a more informed assessment by
readers; (3) semantic questioning and answering of documents to quickly
assess relevance and hierarchical organization; and (4) semantic question
answering for each document within a collection, collated into tables.
<br/>Conclusion(s): Emergent language processing techniques are opening
new avenues to accelerate and enhance the literature review process, for
which we have demonstrated a use case implementation in cardiac surgery.
SciScribe automates and accelerates this process, mitigates errors
associated with repetition and fatigue, and contextualizes results by
linking relevant external data sources instantaneously.<br/>Copyright
&#xa9; 2024 The American Association for Thoracic Surgery

<90>
Accession Number
2040112653
Title
Clinical Presentation, Biomarker Trajectories, and Outcomes in Women and
Men Hospitalized for Acute Heart Failure.
Source
JACC: Heart Failure. 13(10) (no pagination), 2025. Article Number: 102524.
Date of Publication: 01 Oct 2025.
Author
Ravera A.; Qin H.; ter Maaten J.M.; Santema B.T.; Adamo M.; Ponikowski P.;
Cotter G.; Davison B.A.; Felker G.M.; Filippatos G.S.; Pang P.S.;
Greenberg B.H.; Gimpelewicz C.; Severin T.; Teerkink J.R.; Voors A.A.;
Metra M.
Institution
(Ravera, Adamo, Metra) Institute of Cardiology, ASST Spedali Civili di
Brescia and Department of Medical and Surgical Specialties, Radiologic
Sciences and Public Health, University of Brescia, Brescia, Italy
(Ravera, Qin, ter Maaten, Santema, Voors) Department of Cardiology,
University of Groningen, Groningen, Netherlands
(Ponikowski) Department of Heart Diseases, Medical University, Wroclaw,
Poland
(Ponikowski) Department of Cardiology, Center for Heart Diseases, Clinical
Military Hospital, Wroclaw, Poland
(Cotter, Davison) Momentum Research, Durham, NC, United States
(Felker) Division of Cardiology and Duke Clinical Research Institute, Duke
University School of Medicine, Durham, NC, United States
(Filippatos) Department of Cardiology, Athens University Hospital Attikon,
School of Medicine, National and Kapodistrian University of Athens,
Athens, Greece
(Pang) Department of Emergency Medicine, Indiana University School of
Medicine, Indianapolis, IN, United States
(Greenberg) University of California San Diego Health, Cardiovascular
Institute, La Jolla, CA, United States
(Gimpelewicz, Severin) Novartis Pharma, Basel, Switzerland
(Teerkink) Section of Cardiology, San Francisco Veterans Affairs Medical
Center and School of Medicine, University of California, San Francisco,
CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Previous studies have shown important but sometimes
heterogeneous differences between women and men with heart failure (HF).
<br/>Objective(s): This study aims to investigate sex differences in the
phenotype and journey of men and women in a large contemporary acute heart
failure (AHF) cohort. <br/>Method(s): The authors analyzed 6,545 AHF
patients (40% women) enrolled in RELAX-AHF-2 (Efficacy, Safety and
Tolerability of Serelaxin When Added to Standard Therapy in AHF).
<br/>Result(s): Women were older (78 vs 72 years; P < 0.001) and had
higher ejection fraction (45% vs 35%; P < 0.001). During hospitalization,
women received lower diuretic doses (furosemide equivalent through day 5:
200 vs 240 mg intravenous; P < 0.001) and achieved lower weight loss
(relative; P = 0.026), with slightly lower diuretic response (-0.33 vs
-0.36 kg/40 mg furosemide at day 5; P = 0.011) and similar sign and
symptom improvement by day 5 compared with men (all adjusted P > 0.05).
More women experienced worsening renal function by day 5 (WRF; adjusted
HR: 1.24 [95% CI: 1.06-1.46]; P = 0.009). Women experiencing WRF had
increased risk of 180-day cardiovascular death and rehospitalizations for
HF or renal failure (RF) and of rehospitalizations for HF/RF compared with
men and women without WRF (adjusted P for interaction: P < 0.001).
Incidence of other outcomes was similar in women and men (all P > 0.2).
<br/>Conclusion(s): During an AHF hospitalization, women received lower
doses of loop diuretic agents and achieved less weight loss with slightly
lower diuretic response compared with men, despite similar symptom relief
and postdischarge outcomes. Early incident WRF was more frequent in women
and was associated with worse 180-day outcomes. (Efficacy, Safety and
Tolerability of Serelaxin When Added to Standard Therapy in AHF
[RELAX-AHF-2]; NCT01870778)<br/>Copyright &#xa9; 2025

<91>
Accession Number
2035811200
Title
Randomized, controlled trial comparing the efficacy of intercostal nerve
block in thoracoscopic surgery by timing: study protocol for a randomized
clinical trial.
Source
Trials. 26(1) (no pagination), 2025. Article Number: 301. Date of
Publication: 01 Dec 2025.
Author
Sekine Y.; Ichimura H.; Ueda S.; Kitazawa S.; Kobayashi N.; Murata Y.;
Yamada K.; Inomata S.; Maruo K.; Sato Y.
Institution
(Sekine, Ichimura, Ueda, Kitazawa, Kobayashi, Sato) Department of Thoracic
Surgery, University of Tsukuba Hospital, Tsukuba, Japan
(Murata, Yamada, Inomata) Department of Anesthesiology, University of
Tsukuba Hospital, Tsukuba, Japan
(Maruo) Department of Biostatistics, Institute of Medicine, University of
Tsukuba, Tsukuba, Japan
(Ichimura) Department of Thoracic Surgery, Institute of Medicine,
University of Tsukuba, 1-1-1 Tennodai, Ibaraki, Tsukuba, Japan
Publisher
BioMed Central Ltd
Abstract
Background: Even minimally invasive thoracic surgeries carry a
postoperative cost in pain. While regional anesthesia may alleviate this
anticipated pain, especially intercostal nerve blocks (ICNB), the timing
of block administration for optimal effect (at the beginning of surgery
vs. before wound closure) remains controversial. Here, we plan (1) to test
the hypothesis that performing ICNB at the beginning of surgery provides
superior postoperative analgesic effects compared to before wound closure
and (2) to observe perioperative outcomes to determine whether the timing
affects acute and chronic postoperative pain, or intraoperative patient
management. <br/>Method(s): This single-blinded, single-center,
randomized, controlled trial will be conducted at the Department of
Thoracic Surgery, University of Tsukuba Hospital from Sep 29, 2024, to
June 30, 2026. Patients 16-79 years old within the regular population of
patients undergoing lung wedge resection via video-assisted thoracoscopic
surgery (VATS) without a utility window approach and who are ASA-PS
classes 1-3 will be enrolled to receive ICNB either pre-operatively or
before wound closure. Groups will be single-blinded (patient only) at
random, and the primary outcome will be assessment by Numerical Rating
Scale (NRS) pain scores during movement, measured 4 h after returning to
the ward. Secondary outcomes will be (1) any additional analgesic use
within the 4-h return window, (2) intraoperative measurements (including
amounts of remifentanil used, time from surgery completion to extubation,
occurrence of shivering or nausea after extubation, use of antiemetics,
and maximum blood pressure/heart rate), (3) acute pain during
hospitalization (using routinely administered NRS), (4) postoperative
analgesic use, and (5) quality of life (QOL) scores on EQ-5D and SF-36
questionnaires at preoperative and 3-month postoperative timepoints.
Chronic pain at 3 months post-surgery will also be determined by NRS.
<br/>Discussion(s): A complete evaluation of ICNB efficacy as a preemptive
analgesic approach will contribute to the development of improved
perioperative pain management techniques. A reduction in the duration of
surgery-related symptoms and an improvement in postoperative QOL will be
the result. Trial registration: Japan Registry of Clinical Trials:
identifier jRCT1031240358. Registered on 29 Sep 2024.
https://jrct.niph.go.jp/latest-detail/jRCT1031240358.<br/>Copyright &#xa9;
The Author(s) 2025.

<92>
Accession Number
2039727152
Title
Nefopam for Analgesia Following Cardiac Surgery: A Randomized
Placebo-Controlled Double-Blind Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(10) (pp 2700-2707),
2025. Date of Publication: 01 Oct 2025.
Author
Vacharaksa K.; Kongkanond T.; Taechawattananan N.; Weinberg L.; Lertkovit
S.; Subtaweesin T.; Saraphang S.; Kitisin N.; Raykateeraroj N.
Institution
(Vacharaksa, Kongkanond, Taechawattananan, Lertkovit, Kitisin,
Raykateeraroj) Department of Anesthesiology, Faculty of Medicine, Siriraj
Hospital, Mahidol University, Bangkok, Thailand
(Kongkanond) Department of Anesthesiology, Charoenkrung Pracharak
Hospital, Bangkok, Thailand
(Weinberg) Department of Anaesthesia, Austin Health, Heidelberg, Australia
(Weinberg) Department of Critical Care, The University of Melbourne,
Parkville, VIC, Australia
(Subtaweesin) Department of Cardiothoracic Surgery, Faculty of Medicine,
Siriraj Hospital, Mahidol University, Bangkok, Thailand
(Saraphang) Division of Nursing, Faculty of Medicine, Siriraj Hospital,
Mahidol University, Bangkok, Thailand
Publisher
W.B. Saunders
Abstract
Objective: To evaluate the analgesic efficacy, opioid-sparing effects, and
safety profile of nefopam compared with placebo following elective cardiac
surgery. <br/>Design(s): Randomized, double-blind, placebo-controlled
trial at a tertiary care center. <br/>Setting(s): Perioperative care.
<br/>Participant(s): A total of 103 adults (mean age, 57.9 +/- 11.3 years)
undergoing elective cardiac surgery via median sternotomy were randomized
to receive nefopam (n = 50) or placebo (n = 53). <br/>Intervention(s):
Patients were randomized to receive nefopam (20 mg intravenous [IV] bolus,
followed by an 80 mg continuous infusion over 24 hours) or placebo, with
both groups receiving standardized IV fentanyl via patient-controlled
analgesia. <br/>Measurements and Main Results: The primary outcome was
cumulative fentanyl consumption over 48 hours. Secondary outcomes included
pain scores (NRS 0-10), intubation duration, intensive care unit
(ICU)/hospital length of stay, and adverse events. Both fentanyl
consumption and pain scores were assessed at 3, 6, 12, 24, and 48 hours
postoperatively. The nefopam group consumed 25% less fentanyl over 48
hours (mean, 16.3 +/- 1.6 microg/kg vs 21.9 +/- 1.6 microg/kg; p = 0.014),
with significant reductions from 6 hours to 48 hours. Pain scores were
lower in the nefopam group at rest at 48 hours (p = 0.03) and during
movement at 24 and 48 hours (p = 0.04 and 0.01), although overall pain
remained mild. Adverse events (eg, sinus tachycardia, agitation/delirium)
were comparable in the 2 groups. Duration of intubation and ICU/hospital
length of stay did not differ between the 2 groups. <br/>Conclusion(s):
Nefopam was well tolerated and associated with statistically significant
but clinically modest reductions in fentanyl use and pain scores after
cardiac surgery, supporting its role as a safe adjunct in multimodal
analgesia.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<93>
Accession Number
2040185858
Title
Commentary on manuscript entitled "Association of vasoactive
active-inotropic score and poor outcomes in patients who underwent
coronary artery bypass grafting: Systematic review and meta-analysis" in
press Perfusion.
Source
Perfusion (United Kingdom). (no pagination), 2025. Article Number:
02676591251372494. Date of Publication: 2025.
Author
Flores J.; Nugent K.
Institution
(Flores, Nugent) Department of Internal Medicine, Texas Tech University
Health Sciences Center, Lubbock, TX, United States
Publisher
SAGE Publications Ltd

<94>
Accession Number
2032120568
Title
Early left ventricular unloading during extracorporeal membrane
oxygenation in cardiogenic shock: A systematic review and meta-analysis.
Source
Artificial Organs. 49(4) (pp 556-570), 2025. Date of Publication: 01 Apr
2025.
Author
Abuelazm M.; Nawlo A.; Ibrahim A.A.; Amin A.M.; Mahmoud A.; Elshenawy S.;
Alabdallat Y.J.; Turkmani M.; Abdelazeem B.; Caccamo M.
Institution
(Abuelazm) Faculty of Medicine, Tanta University, Tanta, Egypt
(Nawlo) Division of Infectious Diseases, Department of Medicine, Brigham
and Women's Hospital, Harvard Medical School, Boston, MA, United States
(Ibrahim) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Amin) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Mahmoud) Faculty of Medicine, Minia University, Minia, Egypt
(Elshenawy) Faculty of Medicine, Alexandria University, Alexandria, Egypt
(Alabdallat) Faculty of Medicine, Hashemite University, Amman, Jordan
(Turkmani) Faculty of Medicine, Michigan State University, East Lansing,
MI, United States
(Turkmani) Department of Internal Medicine, McLaren Health Care, Oakland,
MI, United States
(Abdelazeem, Caccamo) Department of Cardiology, West Virginia University,
Morgantown, WV, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Left ventricular (LV) unloading is a crucial intervention to
decrease the harmful consequences of extracorporeal membrane oxygenation
(ECMO) on hemodynamic status in cardiogenic shock (CS) patients. However,
a lingering question preoccupies experts: Should we intervene early or
wait until clinical deterioration caused by increasing afterload is
detected?. <br/>Method(s): A systematic review and meta-analysis
synthesizing studies, which were retrieved by systematically searching
PubMed, Web of Science, SCOPUS, and Cochrane through December 2023. We
used R V. 4.3 to pool dichotomous data using risk ratio (RR) and
continuous data using mean difference (MD) with a 95% confidence interval
(CI). PROSPERO ID: CRD42024501643. <br/>Result(s): Eight studies with
2.117 patients were included. Early/prophylactic LV unloading was
associated with a lower incidence of all-cause mortality [RR: 0.87 with
95% CI (0.79, 0.95), p < 0.01]. However, there was no significant
difference between the two groups regarding cardiac mortality [RR: 1.01
with 95% CI (0.68, 1.48), p = 0.98], non-cardiac mortality [RR: 0.86 with
95% CI (0.46, 1.62), p = 0.64], and in-hospital mortality [RR: 0.95 with
95% CI (0.86, 1.05), p = 0.30]. There was no significant difference
between the two groups regarding ECMO weaning, myocardial recovery, ECMO
duration, and length of hospitalization. <br/>Conclusion(s):
Early/prophylactic LV unloading during ECMO for CS patients was associated
with a decreased incidence of all-cause mortality and sepsis or infection,
with no effect on ECMO weaning, myocardial recovery, ECMO duration, and
hospital length of stay.<br/>Copyright &#xa9; 2024 The Author(s).
Artificial Organs published by International Center for Artificial Organ
and Transplantation (ICAOT) and Wiley Periodicals LLC.

<95>
Accession Number
2040190557
Title
Superficial parasternal intercostal plane blocks with liposomal
bupivacaine did not significantly reduce opioid use after cardiac surgery:
A randomized clinical trial.
Source
Regional Anesthesia and Pain Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Simon E.R.; Mallery A.; Silva J.; De Biasi A.; Osaki S.; Krause B.M.;
Meyer P.
Institution
(Simon, Mallery, Silva, Krause, Meyer) Department of Anesthesiology,
University of Wisconsin, Madison School of Medicine and Public Health,
Madison, WI, United States
(De Biasi, Osaki) Department of Surgery, University of Wisconsin, Madison
School of Medicine and Public Health, Madison, WI, United States
Publisher
BMJ Publishing Group
Abstract
Background: Acute pain after cardiac surgery via median sternotomy is
commonly managed with multimodal analgesia, but optimal regional
techniques remain uncertain. Superficial parasternal intercostal plane
(SPIP) blocks have shown promise for postoperative pain control, with the
use of catheters extending these benefits up to three days. This study
evaluated the efficacy of single-injection SPIP blocks with liposomal
bupivacaine in reducing opioid consumption following cardiac surgery.
<br/>Method(s): In this prospective, randomized, double-blind controlled
trial, 100 patients undergoing elective coronary artery bypass grafting or
valve surgery via median sternotomy were randomized to receive bilateral
SPIP blocks with either a mixture of bupivacaine and liposomal bupivacaine
or saline placebo prior to incision. The primary outcome was total opioid
consumption in oral morphine milligram equivalents (MME) over the first 72
postoperative hours. Secondary outcomes included pain scores, time to
extubation, intensive care unit (ICU) and hospital length of stay and
opioid use at 90 days. <br/>Result(s): Total opioid consumption in the
first 72 hours was not significantly different between groups (SPIP
intervention: 165 (IQR 103-284) MME vs saline placebo: 205 (IQR 145-282)
MME, p=0.30). Pain scores, extubation time, ICU and hospital length of
stay, and opioid use at 90 days were also similar between groups. No
serious adverse events were reported. <br/>Conclusion(s): Preincision
bilateral SPIP blocks with a mixture of bupivacaine and liposomal
bupivacaine did not significantly reduce opioid consumption or improve
postoperative analgesic outcomes compared with saline placebo in cardiac
surgical patients. These findings suggest that single-injection SPIP
blocks with liposomal bupivacaine may not be as effective as repeated
injections or catheters in cardiac surgical patients. Further studies
should explore modifications to block techniques such as multilevel
injections, the timing of the block relative to surgery, alternative local
anesthetics, and strategies specifically targeting chest tube-related
pain. Trial registration number: NCT04928339.<br/>Copyright &#xa9;
American Society of Regional Anesthesia & Pain Medicine 2025. No
commercial re-use. See rights and permissions. Published by BMJ Group.

<96>
Accession Number
2035832909
Title
Phenotype characterization of heart failure with preserved ejection
fraction in medical device and surgical trials.
Source
ESC Heart Failure. (no pagination), 2025. Date of Publication: 2025.
Author
Araz K.; Fioretti F.; Ladak S.; Obaidan M.; Butler J.; Hameed A.
Institution
(Araz, Ladak) School of Medicine, RCSI University of Medicine and Health
Sciences, Dublin, Ireland
(Fioretti, Butler) Baylor Scott & White Research Institute, Dallas, TX,
United States
(Obaidan) UCD School of Medicine, UCD Health Sciences Centre, University
College Dublin, Dublin, Ireland
(Butler) University of Mississippi, Jackson, MS, United States
(Hameed) Tissue Engineering Research Group (TERG), Department of Anatomy
and Regenerative Medicine, RCSI University of Medicine and Health
Sciences, Dublin, Ireland
(Hameed) Trinity Centre for Biomedical Engineering (TCBE), Trinity College
Dublin (TCD), Dublin, Ireland
Publisher
John Wiley and Sons Inc
Abstract
Aims: Heart failure with preserved ejection fraction (HFpEF) prevalence is
nearing 50% of all heart failure cases and is often associated with
advanced age, obesity, atrial fibrillation and hypertension, and medical
approaches are limited. This review aims to determine the potential of
medical devices or surgical interventions in treating HFpEF and to propose
specific phenotypes of HFpEF. <br/>Methods and Results: A systematic
review was conducted using various clinical trial databases and the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) guidelines followed by descriptive analysis and methodology
quality assessment. Inclusion criteria included a medical device or
surgical intervention involving HFpEF patients defined by a left
ventricular ejection fraction (LVEF) >=50% and signs of diastolic
dysfunction. Twenty-four novel trials were identified involving n = 1752
participants: 17 medical device trials [3 interatrial shunt device trials
(n = 1069), 1 atrial flow regulator trial (n = 41), 3 vagal nerve
stimulation trials (n = 112), 1 baroreflex activation therapy trial (n =
21), 1 cardiac contractility modulator trial (n = 47), 6 cardiac
resynchronization therapy trials (n = 178) and 2 functional electrical
stimulation therapy trials (n = 89)] and 7 surgical intervention trials [1
renal denervation trial (n = 25), 3 greater splanchnic nerve ablation
trials (n = 111), 2 catheter ablation trials (n = 55) and 1 pericardiotomy
procedure trial (n = 4)]. One trial completed phase 3 trials, 20 trials
completed phase 1 trials with further trials, and 5 trials completed phase
1 trials without further trials. <br/>Conclusion(s): Overall, 16 out of 24
trials have at least demonstrated safety and feasibility. However, despite
many trials of a medical device or surgical procedure showing proof of
concept to treat HFpEF phenotypes, they do not provide sufficient evidence
of long-term benefit. More robust and phenotype-based clinical trials are
needed to ensure evidence-based solutions are developed in
HFpEF.<br/>Copyright &#xa9; 2025 The Author(s). ESC Heart Failure
published by John Wiley & Sons Ltd on behalf of European Society of
Cardiology.

<97>
Accession Number
2040209687
Title
Reduced-dose vs full-dose direct oral anticoagulants for extended
treatment of venous thromboembolism: a meta-analysis of randomized
controlled trials.
Source
Research and Practice in Thrombosis and Haemostasis. 9(5) (no pagination),
2025. Article Number: 102996. Date of Publication: 01 Jul 2025.
Author
Ahmed M.; Zulfiqar E.; Ashraf H.; Hashmi T.M.; Ahmed R.; Rana J.S.; Greene
S.J.; Mentz R.J.; Fudim M.; Fonarow G.C.
Institution
(Ahmed, Ashraf, Hashmi) Rawalpindi Medical University, Rawalpindi,
Pakistan
(Zulfiqar) Dow University of Health Sciences, Karachi, Pakistan
(Ahmed) Department of Cardiology, Royal Brompton Hospital, London, United
Kingdom
(Ahmed) Division of Cardiology, National Heart and Lung Institute,
Imperial College London, London, United Kingdom
(Rana) Division of Cardiology, Kaiser Permanente Northern California,
Oakland, CA, United States
(Rana) Division of Research, Kaiser Permanente Northern California,
Oakland, CA, United States
(Greene, Mentz, Fudim) Division of Cardiology, Duke University Medical
Center, Durham, NC, United States
(Greene, Mentz, Fudim) Division of Cardiology, Duke Clinical Research
Institute, Durham, NC, United States
(Fonarow) Division of Cardiology, Ahmanson-UCLA Cardiomyopathy Center,
University of California Los Angeles, Los Angeles, CA, United States
Publisher
Elsevier B.V.
Abstract
Background: Venous thromboembolism (VTE) is a major cause of
cardiovascular morbidity and mortality globally. Although direct oral
anticoagulants (DOACs) have improved extended VTE treatment, the optimal
dose for balancing efficacy and safety remains unclear. <br/>Objective(s):
This systematic review and meta-analysis aimed to evaluate the efficacy
and safety of reduced-dose DOACs vs full-dose regimens during extended
anticoagulation for VTE. <br/>Method(s): A literature search of PubMed,
Embase, and Cochrane Library was performed up to April 2025 to identify
randomized controlled trials (RCTs) comparing reduced-dose vs full-dose
DOACs for extended VTE treatment in patients with or without cancer. Risk
ratios (RR) and 95% CIs were estimated using a random-effects model.
Primary outcomes were recurrent VTE and major or clinically relevant
nonmajor bleeding. The secondary outcomes included major bleeding,
clinically relevant nonmajor bleeding, all-cause mortality, and
VTE-related mortality. <br/>Result(s): Five RCTs involving 8781 patients
were included in the meta-analysis. The mean +/- SD age of patients was
61.3 +/- 13.4 years, and median follow-up duration was 12 months.
Reduced-dose DOACs were comparable with full-dose regimens in preventing
recurrent VTE (RR, 0.94; 95% CI, 0.68-1.29) and all-cause death (RR, 0.86;
95% CI, 0.63-1.17). However, reduced-dose DOACs significantly lowered the
risk of major or clinically relevant nonmajor bleeding (RR, 0.71; 95% CI,
0.61-0.82), major bleeding (RR, 0.62; 95% CI, 0.42-0.92), and clinically
relevant nonmajor bleeding (RR, 0.75; 95% CI, 0.63-0.88) compared with
full-dose regimens. No significant subgroup differences were observed
between cancer-associated and general VTE populations. <br/>Conclusion(s):
Reduced-dose DOACs are as effective as full-dose regimens in preventing
recurrent VTE and are associated with significantly lower bleeding risks.
However, more RCTs with extended follow-up and focused inclusion of cancer
patients are warranted to validate these findings.<br/>Copyright &#xa9;
2025 The Authors

<98>
Accession Number
2037038794
Title
A comparative cost analysis study of pulmonary robotic and video-assisted
lobectomy: results of a randomized controlled trial (BRAVO Study).
Source
Revista do Colegio Brasileiro de Cirurgioes. 52 (no pagination), 2025.
Article Number: e20253553. Date of Publication: 2025.
Author
Terra R.M.; Trindade J.R.M.; de Araujo P.H.X.N.; Lauricella L.L.; Zaidan
E.P.; Fernandesa P.M.P.
Institution
(Terra, Trindade, de Araujo, Lauricella, Zaidan) Universidade de Sao
Paulo, Instituto do Cancer do Estado de Sao Paulo, Departamento de
Cirurgia Toracica, SP, Sao Paulo, Brazil
(Fernandesa) Universidade de Sao Paulo Instituto do Coracao, Departamento
de Cirurgia Toracica, SP, Sao Paulo, Brazil
Publisher
Colegio Brasileiro de Cirurgioes
Abstract
Introduction: Robotic thoracic surgery has potential benefits, but the
cost is still considered a limiting factor for its wide dissemination in
most countries. <br/>Method(s): We compared the costs of robotic-assisted
(RATS) and video-assisted thoracic surgery (VATS) in the treatment of lung
cancer or pulmonary metastasis. Cost analysis was based on micro-costing
and individual cost analysis during surgical admission and frequency of
services (emergency service, clinic visits, imaging exams, chemotherapy
and radiotherapy, reoperation or additional procedures, rehospitalization,
and ICU stay) during postoperative 90-day follow-up. <br/>Result(s): A
total of 76 patients were included in this cost analysis (RATS=37,
VATS=39). Groups were equivalent in terms of age, gender, comorbidities,
and pre-operative status. Total costs of pulmonary lobectomy did not
differ between the RATS and VATS groups when considering cost of surgical
hospitalization and follow-up of up to 90 days. Mean individual cost per
patient in the RATS group was R$35,590.41 (+/-12,514.97) and R$41,066.98
(+/-25,891.04) in the VATS group, p=0.564. <br/>Conclusion(s): Robotic and
video-assisted thoracic surgery had similar costs, but longer follow-up
studies could be important to demonstrate RATS and VATS costs
differences.<br/>Copyright &#xa9; 2025, Colegio Brasileiro de Cirurgioes.
All rights reserved.

<99>
Accession Number
2035776603
Title
Depression and health outcomes: An umbrella review of systematic reviews
and meta-analyses of observational studies.
Source
Translational Psychiatry. 15(1) (no pagination), 2025. Article Number:
298. Date of Publication: 01 Dec 2025.
Author
Chen X.; Liu X.; Li F.; He H.; Li X.; Qin T.; Jiang B.; Chen Y.; Wang Y.;
Su Y.; Wang X.; Liang L.; Hua H.; Wu J.; Ma J.; Hu F.; Qin P.
Institution
(Chen, Li, Li, Wang, Su) School of Public Health, Shantou University,
Guangdong, Shantou, China
(Liu, Hua) Department of Respiratory and Critical Care Medicine, the
Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
(He) Department of Urology, Shenzhen Qianhai Shekou Free Trade Zone
Hospital, Shenzhen, China
(Qin) Institute of Software Chinese Academy of Sciences, Guangdong,
Beijing, China
(Jiang, Wang, Wu, Ma) Department of Neurology, Shenzhen Qianhai Shekou
Free Trade Zone Hospital, Guangdong, Shenzhen, China
(Chen, Liang) Department of Gynecology and Obstetrics, Shenzhen Qianhai
Shekou Free Trade Zone Hospital, Guangdong, Shenzhen, China
(Hu) Department of Biostatistics and Epidemiology, School of Public
Health, Shenzhen University Medical School, Shenzhen, China
(Qin) Department of Behavioural Science and Health, University College
London, London, United Kingdom
Publisher
Springer Nature
Abstract
Background: Currently, most studies of depression are limited to a single
disease endpoint. <br/>Aim(s): This study aimed to conduct an umbrella
review to comprehensively assess the association between depression and
health outcomes. <br/>Method(s): Until December 17, 2024, we conducted a
systematic search of systematic reviews and meta-analyses in PubMed,
Embase, and Web of Science. We reanalyzed the summary effects and 95%
confidence intervals for each study using random models. We assessed the
methodological quality and evidence quality of the research with A
Measurement Tool to Assess Systematic Reviews 2 and Grade of
Recommendations, Assessment, Development and Evaluation, classifying
studies into four categories based on evidence classification criteria.
<br/>Result(s): We selected a total of 72 articles from 27,150 resulting
in 114 meta-analyses and 109 health outcomes. Depression exposure was
associated with 23 mortality, 21 cardiovascular outcomes, 15 offspring
outcomes, 9cancer outcomes, 9 neurological outcomes, 5 endocrine outcomes,
5 dental outcomes, 3 digestive outcomes, and 19 other health outcomes.
Moderate-quality evidence linked depression to specific mortality in
bladder cancer (Class IV), all-cause mortality in myocardial infarction
(Class III), mortality within 2 years of initial assessment in coronary
artery disease (Class IV), major adverse cardiovascular events after
percutaneous coronary intervention (Class III), irritable bowel syndrome
(insignificant), fear of falling (Class III), and frailty (Class III).
<br/>Conclusion(s): Depression has a significant impact on health
outcomes, primarily mortality and cardiovascular outcomes. However, more
definitive conclusions still require randomized controlled trials or
prospective studies for validation.<br/>Copyright &#xa9; The Author(s)
2025.

<100>
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.<br/>Copyright &#xa9; 2025 The
Author(s).

<101>
Accession Number
2035724074
Title
The Effects of Low-Dose Esketamine Combined with Paravertebral Block on
Postoperative Hyperalgesia and Enhanced Recovery in Non-Intubated
Video-Assisted Thoracic Surgery: A Randomized Controlled Trial.
Source
Drug Design, Development and Therapy. 19 (pp 7033-7043), 2025. Date of
Publication: 2025.
Author
Zhang R.; Luo Z.; Zhang H.; Wang Q.; Luo C.; He J.; Wang T.
Institution
(Zhang, Wang) Department of Thoracic Surgery, The Third Affiliated
Hospital of Chongqing Medical University, Yubei District, Chongqing City,
China
(Luo, Zhang, Luo, Wang) Department of Thoracic Surgery, The Third
Affiliated Hospital of Chongqing Medical University, Chongqing City, China
(He) Department of Ultrasound, Renji Hospital Affiliated to Chongqing
University (Chongqing Fifth People's Hospital), Chongqing City, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: Non-intubated video-assisted thoracic surgery (NIVATS) reduces
airway trauma but may lead to postoperative hyperalgesia and opioid
dependence, contradicting enhanced recovery after surgery (ERAS)
principles. We hypothesized that combining low-dose esketamine with a
paravertebral block (PVB) may mitigate hyperalgesia, decrease opioid
requirements, and improve recovery quality in NIVATS. <br/>Patients and
Methods: This prospective single-center, double-blind randomized
controlled trial (RCT) enrolled 82 patients undergoing uniportal NIVATS.
Patients were randomized into two groups: esketamine (0.25 mg/kg
pre-induction + 0.15 mg/kg/h intraoperatively) and control. Both groups
received ultrasound-guided T4 and T6 PVB (with 0.375% ropivacaine). The
primary outcome was mechanical pain threshold (MPT; central/peripheral),
quantified preoperatively and at 0.5-48 h postoperatively using pressure
algometry after laryngeal mask airway (LMA) removal. Secondary outcomes
included quality of recovery-40 (QoR-40) scores, intraoperative
sufentanil/norepinephrine use, postoperative rescue analgesia use, and
other related complications. <br/>Result(s): Compared to controls, the
esketamine group exhibited significantly higher MPT at 6 h postoperatively
(central: 2.77 +/- 0.80 vs 2.17 +/- 0.59 kgf/cm2, P < 0.001; and
peripheral: 2.95 +/- 0.89 vs 2.17 +/- 0.62 kgf/cm2, P < 0.001). It also
showed markedly improved QoR-40 scores (POD1: 182.3 +/- 6.0 vs 175.8 +/-
7.2, P < 0.001; and POD3: 190.3 +/- 2.9 vs 186.8 +/- 3.6, P < 0.001).
Compared to controls, the esketamine group also showed significantly lower
intraoperative sufentanil consumption (median 5.0 vs 17.5 mug) and
norepinephrine requirement (219.1 +/- 124.7 vs 393.7 +/- 182.3 mug), as
well as postoperative rescue analgesia use (P < 0.05). Except for
postoperative nausea and vomiting (PONV) incidence (P < 0.05), both groups
had similar profiles in other adverse events. <br/>Conclusion(s): Low-dose
esketamine combined with PVB attenuates postoperative hyperalgesia,
reduces intraoperative opioid use by 71.4%, and enhances recovery in
NIVATS, offering a clinically effective opioid-sparing strategy for ERAS
protocols.<br/>Copyright &#xa9; 2025 Zhang et al.

<102>
Accession Number
2039977964
Title
Long-Term Outcomes After Fractional Flow Reserve vs Intravascular
Ultrasound to Guide PCI: The FLAVOUR Trial Extended Follow-Up.
Source
Journal of the American College of Cardiology. 86(8) (pp 593-606), 2025.
Date of Publication: 26 Aug 2025.
Author
Koo B.-K.; Wang J.; Hu X.; Nam C.-W.; Koh J.-S.; Lee K.; Jung S.D.; Jiang
J.; Sun Y.; Li C.; Zhu L.; Gao F.; Dong L.; Zhang J.; Li S.; Park K.W.;
Kang J.; Hwang D.; Yang S.; Hahn J.-Y.; Lee J.M.; Choi K.H.; Cho Y.-K.;
Doh J.-H.; Lee B.-K.; Huang J.; Tong G.; Jiang F.; Xu W.; Kim W.; Woo
J.S.; Zhou H.; Chen C.; Chen P.; Ye S.; Tang L.; Du C.; Jiang W.; Chen H.;
Chen X.; Cui H.; He W.; Xie Y.; Ahn S.G.; Tahk S.-J.; Yoon M.-H.; Kim U.;
Shin E.-S.; Ki Y.-J.; Jang E.-C.; Lee S.H.; Jo J.-W.; Zheng G.
Institution
(Yang, Hwang, Kang, Koo) Seoul National University Hospital, Seoul, South
Korea
(Hu, Zhang, Jiang, Wang) The Second Affiliated Hospital of Zhejiang
University School of Medicine, State Key Laboratory of Transvascular
Implantation Devices, Heart Regeneration and Repair Key Laboratory of
Zhejiang Province, Transvascular Implantation Devices Research Institute,
Hangzhou, Hangzhou, China
(Hahn) Samsung Medical Center, Seoul, South Korea
(Doh) Inje University Ilsan Paik Hospital, Goyang, South Korea
(Lee) Kangwon National University Hospital, Gangwon-Do, Chuncheon, South
Korea
(Kim) Kyung Hee University Hospital, Seoul, South Korea
(Huang) Hangzhou First People's Hospital, Hangzhou, China
(Jiang) The Affiliated Hospital of Hangzhou Normal University, Hangzhou,
China
(Zhou) The First Affiliated Hospital of Wenzhou Medical University,
Wenzhou, China
(Chen) The Second Affiliated Hospital and Yuying Children's Hospital of
Wenzhou Medical University, Wenzhou, China
(Tang) Zhejiang Hospital, Hangzhou, China
(Jiang, Chen) The Third Clinical Institute Affiliated to Wenzhou Medical
University, Wenzhou, China
(Chen, He) The First Affiliated Hospital of Ningbo University, Ningbo,
China
(Ahn) Wonju Severance Christian Hospital, Gangwon-Do, Wonju, South Korea
(Tahk) Ajou University Hospital, Suwon, South Korea
(Kim) Yeungnam University Medical Center, Daegu, South Korea
(Ki) Uijeongbu Eulji Medical Center, Gyeonggi-Do, Uijeongbu, South Korea
(Shin) Ulsan University Hospital, University of Ulsan College of Medicine,
Ulsan, South Korea
(Nam) Keimyung University Dongsan Hospital, Daegu, South Korea
Publisher
Elsevier Inc.
Abstract
Background: The optimal treatment strategy for patients with intermediate
coronary stenosis remains uncertain. <br/>Objective(s): The aim of this
study was to investigate the long-term outcomes of a randomized,
open-label, multinational trial comparing fractional flow reserve
(FFR)-guided vs intravascular ultrasound (IVUS)-guided treatment
strategies. <br/>Method(s): Patients aged >=19 years with de novo
intermediate coronary stenosis (40%-70%) and target vessel diameters >=2.5
mm were randomized 1:1 to FFR- or IVUS-guided treatment across 18 sites in
Korea and China. The primary endpoint was a composite of all-cause death,
myocardial infarction, and any revascularization occurring after the index
procedure. Secondary endpoints included individual components of the
primary outcome and per vessel outcomes according to treatment type.
Extended follow-up continued through September 2024. <br/>Result(s):
Between July 2016 and August 2019, 1,682 patients were assigned to the
FFR-guided (n = 838) and IVUS-guided (n = 844) groups. Over a median
follow-up period of 6.3 years (Q1-Q3: 5.6-6.9 years), the primary outcome
occurred in 339 patients (22.0%), with no statistically significant
difference between groups (179 [23.1%] for FFR vs 160 [20.9%] for IVUS;
HR: 1.15; 95% CI: 0.93-1.42; P = 0.208). The revascularization rate after
the index procedure was higher in the FFR group (113 [14.9%] vs 87
[11.8%]; HR: 1.32; 95% CI: 1.00-1.75; P = 0.049), particularly for target
vessel revascularization (72 [9.6%] vs 44 [6.2%]; HR: 1.67; 95% CI:
1.15-2.43; P = 0.007). Landmark analysis at 2 years and per vessel
analyses indicated that the higher revascularization rate after the index
procedure was driven primarily by late (2-7 years) revascularizations in
vessels in which percutaneous coronary intervention (PCI) was initially
deferred. Nevertheless, the overall rate of target vessel PCI, including
procedures at index and during follow-up, was significantly lower in the
FFR group (38.8% vs 60.5%; P < 0.001), with no statistically significant
differences in the annual cumulative incidence of death or myocardial
infarction between groups. <br/>Conclusion(s): FFR-guided and IVUS-guided
treatment strategies resulted in comparable long-term outcomes, with no
significant difference in patient-oriented composite outcomes. Although
FFR-guided treatment was associated with a higher incidence of late target
vessel revascularization, the overall target vessel PCI rate, accounting
for both the index procedure and revascularization during follow-up,
remained significantly lower in the FFR-guided treatment group, with
comparable rates of hard outcomes between the 2 groups.<br/>Copyright
&#xa9; 2025 American College of Cardiology Foundation

<103>
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.
<br/>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. <br/>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).
<br/>Conclusion(s): DEX has pulmonary protective and anti-inflammatory
effects in patients undergoing cardiac surgery with CPB.<br/>Copyright
&#xa9; The Author(s) 2025.

<104>
Accession Number
2040356249
Title
The effect of exogenous melatonin and melatonin receptor agonists on
intensive care unit and hospital length of stay: A systematic review and
meta-analysis.
Source
PLOS ONE. 20(9 September) (no pagination), 2025. Article Number: e0332031.
Date of Publication: 01 Sep 2025.
Author
Kelleher A.B.; O'Donovan M.; O'Doherty D.; Lavery R.; Lehane E.; Saab M.M.
Institution
(Kelleher, O'Doherty, Lavery, Lehane, Saab) Catherine McAuley School of
Nursing and Midwifery, University College Cork, Cork, Ireland
(O'Donovan) College of Medicine and Health, University College Cork, Cork,
Ireland
(O'Doherty) Oncology Department, Beaumont Hospital, Dublin, Ireland
(Lavery) Mater Private Hospital, City Gate, Mahon, Cork, Ireland
Publisher
Public Library of Science
Abstract
Introduction Melatonin supplements and melatonin receptor agonists are
linked to reduced delirium in the Intensive Care Unit (ICU) which we
hypothesised may affect the length of stay (LOS) in ICU or in hospital. In
this review, we identified and critically appraised the literature on the
effect of exogenous melatonin and melatonin receptor agonists on the ICU
and/or hospital LOS among adults admitted to the ICU. Methods Six
electronic databases and three trial registries were searched for
randomised controlled trials (RCTs). Screening, risk of bias assessment,
quality appraisal, and level of evidence assessment were conducted and
cross-checked by two reviewers independently. Meta-analyses with
disease-specific subgroups were conducted to assess the mean difference in
LOS for exogenous melatonin and melatonin receptor agonists compared with
a placebo. Results Twenty RCTs were reviewed with 14 having a low risk of
bias. For ICU LOS (18 studies) there was significant statistical
heterogeneity (I²=73%); compared with placebo the 95%
prediction interval for the mean difference was -3.18 and 1.39 days. For
hospital stay (12 studies, I²=79%) the 95% prediction interval
ranged from -6.68 to 3.52. Removing two statistical outliers, and
correcting for publication bias, there was no overall statistically
significant difference in mean ICU LOS (p-value=0.298) or mean hospital
LOS (p-value=0.456). The subgroup analysis found statistically significant
improvements for those who underwent coronary artery bypass graft surgery
(ICU LOS -0.47 days, 95% CI: -0.78 to -0.16, p-value=0.003); and patients
with COVID-19 (hospital LOS -3.90 days, 95% CI: -6.28 to -1.51,
p-value=0.001). Conclusion There was a very low certainty of evidence that
melatonin and melatonin receptor agonists were associated with reductions
in ICU and hospital LOS in ICU patients overall. However, further research
is needed for surgical patients and those with pneumonia.<br/>Copyright
&#xa9; 2025 Kelleher et al. This is an open access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided
the original author and source are credited.

<105>
Accession Number
648520386
Title
Effects of Progressive Muscle Relaxation on Pain and Sleep: Randomized
Controlled Study.
Source
Pain management nursing : official journal of the American Society of Pain
Management Nurses. (no pagination), 2025. Date of Publication: 06 Sep
2025.
Author
Bolatturk G.; Kol E.
Institution
(Bolatturk) Fundamentals of Nursing Department, Suleyman Demirel
University Nursing Departmant, Isparta, Turkey
(Kol) Fundamentals of Nursing Department, Akdeniz University Nursing
Faculty, Antalya, Turkey
Abstract
PURPOSE: This study aimed to evaluate the effectiveness of Progressive
Muscle Relaxation (PMR) on postoperative pain level and sleep quality in
patients undergoing open heart surgery. DESIGN: A single center,
two-group, single-blind randomized controlled trial. <br/>METHOD(S): This
study comprised 60 patients who were admitted to the cardiovascular
surgery department and undergoing open heart surgery between January 2023
and April 2024. Patients were randomized into 30 in the experimental group
and 30 in the control group. Data were collected using Patient
Identification Form, Short-form of McGill's Pain Questionnaire (SF-MPQ)
and Richard-Campbell Sleep Questionnaire (RCSQ). PMR were applied twice a
day, morning and evening, on the post-operative days 1st, 2nd, and 3rd
days to experimental group. Before and after PMR, the patients' pain level
and sleep quality were evaluated. The control group received usual care
and treatment. <br/>RESULT(S): In the experimental group, pain level
decreased significantly from 9.36 points on the 1st day to 1.50 points on
the 3rd day in the post-operative service (p0.001). In the control group,
pain level decreased only to 6.13 points on the 3rd day. It was determined
that sleep quality gradually increased in the experimental group and
reached 545.83 points on the 3rd day in the post-operative service. In the
control group, it increased only to 330.16 points. A significant
difference was found pain level and sleep quality in all measurements
between the experimental and control groups. <br/>CONCLUSION(S): In this
study, it was suggested that progressive muscle relaxation reduces pain
and improves sleep quality in patients undergoing open heart surgery. It
is recommended that nurses include progressive muscle relaxation in
postoperative pain control and sleep management in usual
care.<br/>Copyright &#xa9; 2025. Published by Elsevier Inc.

<106>
Accession Number
2040400219
Title
The Role of Angiotensin Receptor/Neprilysin Inhibitor in Moderate Ischemic
Mitral Regurgitation After Isolated Coronary Artery Bypass Grafting
(ARNI-MIMIC): Study Protocol for a Randomized Controlled Trial.
Source
American Journal of Cardiology. 256 (pp 102-106), 2025. Date of
Publication: 01 Dec 2025.
Author
Tiemuerniyazi X.; Chen L.; He L.; Yang Z.; Huang S.; Nan Y.; Song Y.; Yuan
X.; Hu Z.; Zhao D.; Zhao W.; Feng W.
Institution
(Tiemuerniyazi, Chen, He, Yang, Huang, Nan, Song, Yuan, Hu, Zhao, Zhao,
Feng) Department of Cardiovascular Surgery, Fuwai Hospital, National
Center for Cardiovascular Diseases, National Clinical Research Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking
Union Medical College, Beijing, China
Publisher
Elsevier Inc.
Abstract
Debates have been existed regarding the treatment of moderate ischemic
mitral regurgitation (IMR) in patients undergoing coronary artery bypass
grafting (CABG). While it might have priority on reducing the risk of
recurrent IMR, studies showed that concomitant mitral valve repair
increases the risk of adverse outcomes, such as neurological events, as
well as the in-hospital costs. In recent studies, angiotensin
receptor/neprilysin inhibitor (ARNI) was discovered to have potential
benefit in reducing the severity of IMR. The ARNI-MIMIC is a randomized
controlled clinical trial aiming to reduce the risk of recurrent IMR in
isolated CABG patients. A total of 220 eligible patients with moderate IMR
will be allocated into control (non-ARNI) and intervention (ARNI) groups
in a 1:1 pattern after isolated CABG. Patients in the intervention group
will be administered with continuous sacubitril/valsartan for 6 months
postoperatively, while patients in the control group will receive
guideline recommended therapy only. All of the patients will be invited to
complete 6-month follow-up. The primary endpoint is the change in the
effective regurgitant orifice area (EROA) of the mitral valve, which is
obtained by echocardiography and calculated by subtracting the follow-up
EROA from the preoperative EROA. This trial aims to investigate the
potential role of ARNI as compared to the control in moderate IMR patients
undergoing isolated CABG. If ARNI is proven to reduce the risk of moderate
IMR recurrence, patients will benefit from both improved life quality and
decreased medical costs. The This study was approved by the Institutional
Review Board of Fuwai Hospital on October 18th 2024, with an approval
number of 2024-2446. The results of this trail will be disseminated
through international academic conferences and publication in medical
journals regardless of the study outcomes. ClinicalTrials.gov ID
NCT06917664<br/>Copyright &#xa9; 2025 The Author(s)

<107>
Accession Number
648518608
Title
Impact of preoperative beta-hydroxy-beta-methylbutyrate, arginine, and
glutamine supplementation on inflammation in patients with cardiac
surgery: A secondary analysis of a randomized controlled trial.
Source
Journal of cardiology. (no pagination), 2025. Date of Publication: 04 Sep
2025.
Author
Ogawa M.; Satomi-Kobayashi S.; Yoshida N.; Komaki K.; Hirabayashi T.;
Wakida K.; Saitoh S.; Inoue T.; Yamashita T.; Sakai Y.; Takahashi M.;
Hirata K.-I.
Institution
(Ogawa) Division of Rehabilitation Medicine, Kobe University Graduate
School of Medicine, Hyogo, Japan; Department of Public Health, Kobe
University Graduate School of Health Sciences, Hyogo, Japan
(Satomi-Kobayashi, Hirata) Division of Cardiovascular Medicine, Department
of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo,
Japan
(Yoshida) Division of Cardiovascular Medicine, Department of Internal
Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan;
Department of Cardiovascular Aging, National Cerebral and Cardiovascular
Center, Osaka, Japan
(Komaki, Hirabayashi) Division of Rehabilitation Medicine, Kobe University
Hospital, Hyogo, Japan
(Wakida, Saitoh, Takahashi) Department of Nutrition, Kobe University
Hospital, Hyogo, Japan
(Inoue) Department of Cardiac Surgery, Hyogo Prefectural Awaji Medical
Center, Hyogo, Japan
(Yamashita) Department of Advanced Medical Science, Kobe University
Graduate School of Science, Technology and Innovation, Hyogo, Japan
(Sakai) Division of Rehabilitation Medicine, Kobe University Graduate
School of Medicine, Hyogo, Japan
Abstract
BACKGROUND: Preoperative physical frailty is a significant predictor of
adverse postoperative outcomes in older patients undergoing cardiac
surgery. Inflammation plays a crucial role in the development of frailty
and contributes to postoperative complications. This study investigated
the effects of preoperative beta-hydroxy-beta-methylbutyrate (HMB),
arginine, and glutamine supplementation on inflammatory markers,
nutritional status, and renal function in older patients undergoing
cardiac surgery. <br/>METHOD(S): This was a secondary analysis of a
single-center, open-label, randomized controlled trial. Patients aged >=65
years scheduled for elective cardiac surgery were randomized to receive
either HMB supplementation (1200 mg HMB, 7000 mg l-glutamine, and 7000 mg
L-arginine, twice daily) or routine care for at least two weeks before
surgery. Serum levels of tumor necrosis factor-alpha (TNF-alpha), and
other biochemical markers were measured at baseline, pre-surgery, and two
weeks post-surgery. <br/>RESULT(S): Forty-four patients (mean age 72.5
years, 36 % women) were analyzed. Preoperative HMB supplementation
significantly reduced pre-surgery serum TNF-alpha levels compared to the
control group (0.85 +/- 0.28 pg/mL vs. 1.10 +/- 0.44 pg/mL, p = 0.039).
However, this difference was not observed two weeks post-surgery. No
significant differences were observed in C-reactive protein levels or
other nutritional markers between the two groups at any time point.
<br/>CONCLUSION(S): Preoperative supplementation with a combination of
HMB, glutamine, and arginine was effective in reducing preoperative
TNF-alpha levels in older patients undergoing cardiac surgery, suggesting
a potential anti-inflammatory effect. This anti-inflammatory effect
suggests a potential mechanism for improving postoperative outcomes and
warrants further investigation.<br/>Copyright &#xa9; 2025. Published by
Elsevier Ltd.

<108>
Accession Number
2040433986
Title
Interleukin-1 blockade in patients with ST-segment elevation myocardial
infarction with and without history of coronary artery disease.
Source
International Journal of Cardiology. 442 (no pagination), 2026. Article
Number: 133888. Date of Publication: 01 Jan 2026.
Author
Lopez R.I.; Morello M.; Golino M.; Hogwood A.C.; Marchetta M.; Del Buono
M.G.; Moroni F.; Mbualungu J.; Agatiello C.R.; Van Tassell B.W.; Abbate A.
Institution
(Lopez, Morello, Golino, Hogwood, Marchetta, Moroni, Mbualungu, Abbate)
Robert M. Berne Cardiovascular Research Center and Department of Medicine,
University of Virginia, Charlottesville, VA, United States
(Lopez, Agatiello) Interventional Cardiology Department, Hospital Italiano
de Buenos Aires, Buenos Aires, Argentina
(Morello) Department of Molecular and Translational Medicine, University
of Brescia, Brescia, Italy
(Golino) Pauley Heart Center, Virginia Commonwealth University, Richmond,
VA, United States
(Del Buono) Department of Cardiovascular Medicine, Fondazione Policlinico
Universitario A. Gemelli IRCCS, Rome, Italy
(Van Tassell) Department of Pharmacotherapy & Outcomes Sciences, Virginia
Commonwealth University, Richmond, VA, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Patients with a history of coronary artery disease (CAD)
presenting with ST-elevation myocardial infarction (STEMI) have high risk.
We aimed to determine whether patients with CAD history presenting with
STEMI had greater systemic inflammation and/or whether they benefitted
similarly from IL-1 blockade. <br/>Method(s): We pooled data from three
randomized clinical trials, including 139 patients with STEMI treated with
anakinra or placebo. Patients were stratified by history of CAD defined as
prior documented CAD, MI or coronary revascularization. The area under the
curve (AUC) for C-reactive protein (CRP) was used to assess systemic
inflammation. Event-free survival defined as the time from enrollment to
the occurrence of a predefined adverse outcome, including new-onset heart
failure, hospitalization for heart failure, or death, was compared using
Cox regression analysis. <br/>Result(s): Of the 139 patients, 113 (81 %)
had no history of CAD, while 26 (19 %) had a history of CAD. The CRP-AUC
was significantly lower in the anakinra group compared placebo,
independent of history of CAD: 85 [47-137] vs. 349 [154-580] mg.day/L for
anakinra and placebo, respectively, in patients with history of CAD, and
86 [43-179] vs. 213 [115-341] mg.day/L in patients without CAD history; p
for interaction = (0.27). No significant interactions were found between
history of CAD and treatment allocation for the composite outcome for
patients with and without history of CAD, respectively, p for interaction
= (0.48). <br/>Conclusion(s): IL-1 blockade with anakinra in STEMI leads
to similar reductions in systemic inflammation and improvement in
HF-related outcomes inpatients both with and without history of
CAD.<br/>Copyright &#xa9; 2025

<109>
Accession Number
2040398933
Title
Effectiveness of aromatherapy in pain relief postcardiac surgery: a
systematic review and meta-analysis protocol.
Source
BMJ Open. 15(9) (no pagination), 2025. Article Number: e099639. Date of
Publication: 11 Sep 2025.
Author
Camara R.P.d.P.O.A.; Silva M.C.B.; Teixeira F.d.C.; Pereira V.d.S.L.;
Pontes B.C.R.; Alves Sarmento A.C.; Medeiros K.S.; Dantas R.A.N.; Dantas
D.V.
Institution
(Camara, Silva, Teixeira, Pereira, Pontes) Federal University of Rio
Grande do Norte, Natal, Brazil
(Alves Sarmento) Liga Contra o Cancer, Natal, Brazil
(Medeiros) Institute of Education, Research and Innovation, Liga Contra o
Cancer, Natal, Brazil
(Medeiros) Postgraduate Program in Health Sciences, Federal University of
Rio Grande do Norte, Natal, Brazil
(Dantas, Dantas) Department of Nursing, Federal University of Rio Grande
do Norte, Natal, Brazil
Publisher
BMJ Publishing Group
Abstract
Introduction Acute pain in the postoperative period of cardiac surgery is
mostly treated with opioid analgesics. However, with the risk of adverse
reactions and complications, strategies which do not involve opioid
analgesics can be considered, such as aromatherapy. This systematic review
aims to analyse the effectiveness of aromatherapy in relieving pain in
post-cardiac surgery patients. Methods and analysis Two researchers will
independently and simultaneously conduct searches and select studies from
the following databases: PubMed, Embase, Cumulative Index to Nursing and
Allied Health Literature, Latin American and Caribbean Literature on
Health Sciences, Scopus, Web of Science, Cochrane (Library) and clinical
trial registries (clinicaltrials.com), with no language or publication
date restrictions. Randomised and quasi-randomised clinical trials on the
use of aromatherapy for pain relief in postcardiac surgery patients will
be included. Then, two researchers will independently examine the studies
based on inclusion criteria, extract data from the included studies and
assess the risk of bias using the Risk of Bias 2 tool and the Risk of Bias
in Non-randomized Studies of Interventions tool from Cochrane. Data will
be synthesised using Review Manager software. The strength of the evidence
will be evaluated using the Grading of Recommendation Assessment,
Development and Evaluation approach. The literature search, study
selection, review and meta-analysis stages will be conducted from early
October 2025 to April 2026. Ethics and dissemination This study is based
on secondary data, and therefore ethical approval from a research ethics
committee was not required. The results will be disseminated through
publication in a peer-reviewed scientific journal. PROSPERO registration
number CRD42024568532.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ Group.

<110>
Accession Number
2040370509
Title
Evolving biomarkers in evaluating the reversibility of pulmonary arterial
hypertension associated with congenital heart disease: a literature
review.
Source
Pediatric Medicine. 8 (no pagination), 2025. Article Number: 15. Date of
Publication: 30 Aug 2025.
Author
Ali A.M.; Hanna W.J.
Institution
(Ali) Division of Pediatric Cardiac Critical Care, West Viginia University
Children's, Morgantown, WV, United States
(Hanna) Pediatric Critical Care Department, Pediatric Institute, Cleveland
Clinic Foundation, Cleveland, OH, United States
Publisher
AME Publishing Company
Abstract
Background and Objective: Pulmonary arterial hypertension (PAH) is a
devastating complication of pediatric congenital heart disease (CHD).
Surgical correction, while sometimes effective, has not been a guarantee
for cure in this patient cohort. Furthermore, assessment of reversibility
to stratify surgical candidacy remains a grey zone, as no consensus has
yet been reached on a reliable and safe tool. This review aims to
synthesize current evidence on biomarkers predicting the reversibility of
PAH in pediatric CHD. <br/>Method(s): A comprehensive English-language
literature search [2000-2024] was conducted via PubMed, Google Scholar,
and Scopus, supplemented by manual screening. Key Content and Findings:
This literature review focuses on available research investigating the use
of biomarkers for assessing the reversibility of PAH in the context of
pediatric CHD. Several studies have emphasized the importance of apoptosis
resistance in the reversibility of PAH. Advances in molecular profiling
such as cellular senescence markers (p16^ink4A and
p21^cip1) and apoptosis regulators including Bcl-2 protein show
potential for evaluating the reversibility process. Other studies looking
into blood-based endothelial markers such as circulating endothelial cells
(CECs) and apoptosis markers including survivin offer promising tools for
non-invasive and effective methods of detecting reversibility in PAH.
Histopathological changes which have been the historical focus of prior
research studies and popular method for classification of PAH have
recently been re-explored from a new perspective. Associated protein
markers for vascular remodeling have been investigated such as
endothelin-1 (ET-1), transgelin, nestin and thrombospondin-4 (THBS4), have
been found to show a positive correlation with irreversibility. Other
potential markers for future research such as miR-19 and genetic markers
have been explored for assessing the severity of PAH, but not in relation
to reversibility. <br/>Conclusion(s): A panel of tissue and blood
biomarkers have recently surfaced with the potential for predicting
reversibility and aiding management decisions on operability, markers that
would avoid the need for invasive diagnostic procedures such as lung
biopsies and potentially outperform available biomarkers. Ongoing research
should focus on validating the performance of such biomarkers via larger
clinical trials.<br/>Copyright &#xa9; AME Publishing Company.

<111>
Accession Number
2040337660
Title
Nurse-led cardiac rehabilitation programme on physical capacity and mental
health for heart valve patients: study protocol of a quasi-experimental
study.
Source
BMJ Open. 15(9) (no pagination), 2025. Article Number: e096823. Date of
Publication: 02 Sep 2025.
Author
Zhou J.; Zhou Y.; Huang Y.; Wang P.
Institution
(Zhou, Zhou, Huang, Wang) Southeast University Zhongda Hospital,
Department of cardiac surgery, Jiangsu, Nanjing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Evidence-based early rehabilitation intervention after heart
valve surgery has been proven to have many benefits, but the experience of
implementing nurse-led early rehabilitation combining exercise and
psychology is still lacking. It is urgent to find a more acceptable and
cost-effective method to provide exercise intervention and psychological
support. The aim of this study is to design a nurse-led cardiac
rehabilitation programme to increase the physical capacity and mental
health for heart valve patient based on broaden-and-build theory. Methods
and analysis A non-blinded randomised controlled trial will be conducted.
A total of 86 adults diagnosed with heart valve disease will be recruited
and randomly assigned to the control group and intervention group. The
recovery for valvular heart disease intervention, based on the
broaden-and-build theory, will be guided one-on-one by a multidisciplinary
team and will consist of two main components: physical intervention and
psychological intervention. The baseline assessment will be conducted 1 to
2 days after admission, and sequent evaluations will be implemented at
post-intervention, 3 months after intervention and 6 months after
intervention. The primary outcome is the finding of six-min walk test and
mental state. Other outcomes include quality of life, 36-item short-form
health survey, Short Physical Performance Battery, stress, coping modes
and social support. Ethics and dissemination This study was conducted
following the Helsinki Declaration and was approved by the ethics
committee of the Zhong Da Hospital, Southeast University
(2024ZDSYLL098-P01). The results of this study are scheduled to be
published in relevant peer-reviewed journals.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ Group.

<112>
Accession Number
648535339
Title
Minimally invasive surgical approaches for pneumothorax: evolution and
current perspectives.
Source
Expert review of respiratory medicine. (no pagination), 2025. Date of
Publication: 10 Sep 2025.
Author
Mizobuchi T.; Ito Y.; Sobue A.; Tada Y.; Nagato K.; Yamamoto T.
Institution
(Mizobuchi, Ito, Sobue, Tada, Nagato, Yamamoto) Department of General
Thoracic Surgery, Social Welfare Organization Saiseikai Imperial Gift
Foundation, Chibaken Saiseikai Narashino Hospital, Chiba, Japan
Abstract
INTRODUCTION: PubMed was used for a literature search (1990-2025) on the
minimally invasive surgical approaches for pneumothorax, which have
evolved markedly, with video-assisted thoracic surgery (VATS) emerging as
a preferred procedure. Systematic reviews of randomized control trials
indicate that VATS is less invasive than traditional thoracotomy.
Furthermore, uniportal VATS provides less postoperative pain and better
cosmetic outcomes than thoracotomy. Currently, uniportal VATS seems
preferred as the minimally invasive surgical approach for pneumothorax.
New devices such as small-diameter thoracoscopes and forceps, which are
used in uniportal subxiphoid VATS and uniportal subcostal robot-assisted
thoracic surgery, may contribute to reducing the postoperative incidence
of intercostal neuralgia and enhancing satisfaction with the cosmetic
results. AREAS COVERED: The ideal surgical approaches for pneumothorax,
referencing guidelines, and studies from various countries. EXPERT
OPINION: This review explores various aspects of minimally invasive
surgical approaches for pneumothorax. Uniportal VATS for pneumothorax via
the intercostal approach is commonly performed worldwide and ensures high
surgical quality. This review discusses what should be performed within
the thoracic cavity to reduce the postoperative recurrence rate of
pneumothorax, problems associated with thoracic adhesions that may be
disadvantageous for pneumothorax patients in the future, and the latest
surgical approaches that may become mainstream.

<113>
Accession Number
2040433430
Title
Reappraisal of Evidentiary Support for Transcatheter Aortic Valve
Implantation for Low-Risk Aortic Stenosis: Insights From Midterm Results
of the PARTNER 3 and Evolut LR Trials.
Source
Journal of the American College of Cardiology. 86(13) (pp 1002-1005),
2025. Date of Publication: 30 Sep 2025.
Author
Kaul S.
Institution
(Kaul) Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
Publisher
Elsevier Inc.

<114>
Accession Number
648537203
Title
Outcomes of no-touch vs conventionally harvested saphenous veins for
coronary artery bypass surgery: A meta-analysis of randomized trials.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2025.
Date of Publication: 10 Sep 2025.
Author
Sandner S.; Hirofuji A.; Mantaj P.; Di Franco A.; Rahouma M.; Gregg A.;
Krieger K.; Demetres M.; Gaudino M.
Institution
(Sandner, Hirofuji, Mantaj, Di Franco, Rahouma, Gregg, Krieger, Demetres,
Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New
York, NY, USA
(Sandner, Mantaj) Department of Cardiac Surgery, Medical University of
Vienna, Vienna, Austria
Abstract
OBJECTIVES: The no-touch (NT) technique for saphenous vein (SV) harvesting
in coronary artery bypass surgery preserves perivascular tissue and has
been proposed to improve vein graft patency compared to conventional (CON)
harvesting. However, recent large randomized clinical trials (RCTs) have
reported conflicting results. We performed a meta-analysis of all
available RCTs comparing graft patency and clinical outcomes between NT-SV
and CON-SV harvesting techniques. <br/>METHOD(S): A systematic review was
conducted through May 9, 2025 to identify RCTs with systematic imaging
follow-up comparing the NT-SV and CON-SV. The primary outcome was graft
failure. Secondary outcomes included mortality, major adverse cardiac
events (MACE; composite of mortality, myocardial infarction, or repeat
revascularization), and leg wound complications. Outcomes were pooled
using inverse variance random and fixed effects models. <br/>RESULT(S):
Eight RCTs involving 4286 patients (NT-SV: 2155; CON-SV: 2131) were
analyzed. NT-SV was associated with a significantly lower incidence of
graft failure than CON-SV (IRR, 0.70; 95% CI 0.60-0.82; P < 0.001) at a
weighted mean follow-up of 3.7 years; this result was solid in multiple
sensitivity analyses. Mortality (IRR, 1.03; 95% CI, 0.72-1.47, P = 0.87)
and MACE (IRR, 0.89; 95% CI, 0.67-1.18; P = 0.42) were similar between
groups. NT-SV was associated with a higher incidence of leg wound
complications (IRR, 1.73; 95% CI, 1.32-2.27; P < 0.001).
<br/>CONCLUSION(S): The NT-SV harvesting technique was associated with a
significant reduction in graft failure and an increased risk of wound
complications compared to the CON-SV. Further research is warranted to
evaluate clinical NT-SV outcomes, and strategies are needed to mitigate
NT-SV harvest-site complications.<br/>Copyright &#xa9; The Author(s) 2025.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. 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 informat

<115>
Accession Number
2040377856
Title
Outcomes of Transcatheter Edge-to-Edge Mitral Valve Repair in Hypertrophic
Cardiomyopathy: A Patient-Level Meta-Analysis.
Source
Structural Heart. (no pagination), 2025. Article Number: 100664. Date of
Publication: 2025.
Author
Mascarenhas L.; Yang G.; Sharma A.; Bertog S.; Hubers S.; Adabag S.
Institution
(Mascarenhas) Cardiology Division, Baylor College of Medicine, Houston,
TX, United States
(Yang, Sharma, Bertog, Hubers, Adabag) Cardiology Division, Minneapolis
Veterans Affairs Medical Center, Minneapolis, MN, United States
Publisher
Cardiovascular Research Foundation
Abstract
Background: Hypertrophic cardiomyopathy (HCM) is commonly associated with
left ventricular outflow tract (LVOT) obstruction and mitral regurgitation
(MR). Transcatheter edge-to-edge repair (TEER) of the mitral valve has
been introduced as a therapeutic alternative for individuals with LVOT
obstruction and concurrent MR, but there are insufficient outcome data. We
aim to perform a systematic review and patient-level meta-analysis of the
studies reporting the outcomes of TEER of the mitral valve in HCM.
<br/>Method(s): Original studies published in PubMed and Google Scholar
were included if >=1 of the following pre- and post-TEER measures were
reported: peak resting or provoked LVOT gradients, MR grade, mitral valve
gradient, or New York Heart Association (NYHA) functional class. One
unpublished case from the Minneapolis Veterans Affairs Medical Center was
also included. <br/>Result(s): Nineteen publications and 37 patients (mean
age 70.1 [+/-15.2] years, 50% male, mean follow-up time of 9.2 [+/-6.4]
months) were analyzed. Compared to baseline measurements, there was a
significant reduction in the mean peak resting and provoked LVOT gradients
(69.2 [+/-40.3] mmHg vs. 11.7 [+/-8.6] mmHg and 98.2 [+/-53.4] mmHg vs.
14.1 [+/-13.9] mmHg, respectively), median MR grade (4.0 [3.0-4.0] vs. 1.0
[1.0-1.0]), and proportion of patients with an NYHA functional class >=3
(100 vs. 7%) post-TEER (all p < 0.001). There was a significant increase
in mean mitral valve gradients post-TEER (2.2 [+/-1.0] mmHg vs. 4.3
[+/-1.3] mmHg, p < 0.001). <br/>Conclusion(s): TEER can be an effective
therapeutic option for improving LVOT obstruction, MR severity, and NYHA
functional class in patients with HCM.<br/>Copyright &#xa9; 2025

<116>
Accession Number
648521937
Title
Safety and Feasibility of Lumbar CSF Drainage with Intrathecal Pressure
Monitoring in Acute Severe Spinal Cord Injury: A Randomized Pilot Trial.
Source
World neurosurgery. (pp 124441), 2025. Date of Publication: 05 Sep 2025.
Author
Dembour V.; Beloauer A.; Diaz S.; Maeder B.; Germann M.; Rothenfluh D.;
Barges-Coll J.
Institution
(Dembour) Department of Neurosurgery, Hopitaux Universitaires de
Strasbourg, Strasbourg, France
(Beloauer, Diaz, Maeder, Germann, Rothenfluh, Barges-Coll) Department of
Spinal Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne,
Switzerland
Abstract
BACKGROUND: Spinal cord perfusion impairment is a critical secondary
mechanism in acute spinal cord injury (SCI). Although lumbar cerebrospinal
fluid (CSF) drainage is widely used in cardiothoracic surgery, its use in
SCI remains limited. This study presents an evaluation of the safety and
feasibility of lumbar CSF drainage with intrathecal pressure (ITP) and
spinal cord perfusion pressure (SCPP) monitoring in acute SCI patients.
<br/>METHOD(S): We conducted a prospective randomized pilot trial
involving 21 patients with acute traumatic SCI (ASIA A-C). Twelve patients
received continuous lumbar CSF drainage and SCPP monitoring over 72 hours,
whereas nine received standard care. The primary outcome measured was the
change in ASIA scores at 12 months. The secondary outcomes included ITP
measurements, MAP requirements, and feasibility and safety data.
<br/>RESULT(S): The initial ITP in the drainage group averaged 15 mmHg and
was reduced to 6 mmHg via controlled drainage. This group maintained lower
MAPs (74 vs. 82 mmHg, p = 0.004) compared to the control group and
required less vasopressor support. Neurologically, 4 patients in the
drainage group improved to ASIA C or D, compared to 1 patient in the
control group. The mean motor score improvement was greater in the
drainage group (DELTA11 vs. DELTA7), although the difference was not
statistically significant. No drainage-related complications occurred.
<br/>CONCLUSION(S): Lumbar CSF drainage is a safe and feasible
intervention for the treatment of acute SCI, enabling tailored perfusion
management. Although preliminary findings are promising, larger
multicenter trials are needed to validate their clinical efficacy and
define optimal SCPP targets.<br/>Copyright &#xa9; 2025 The Author(s).
Published by Elsevier Inc. All rights reserved.

<117>
Accession Number
648521760
Title
Effects of virtual reality-guided imagery relaxation intervention in
improving anxiety among lung cancer patients:A Randomized Controlled
Trial.
Source
Asian nursing research. (no pagination), 2025. Date of Publication: 05
Sep 2025.
Author
Li H.; Liu F.; Li S.; Li C.; Tian Z.
Institution
(Li) The Fourth Affiliated Hospital of Hebei Medical University; Address:
The Fourth Affiliated Hospital of Hebei Medical University, No. 12
Jiankang Road, Chang'an District, Shijiazhuang City, Hebei Province,
050000, People's Republic of China. Electronic address:
48600924@hebmu.edu.cn
(Liu) The Fourth Affiliated Hospital of Hebei Medical University; Address:
The Fourth Affiliated Hospital of Hebei Medical University, No. 12
Jiankang Road, Chang'an District, Shijiazhuang City, Hebei Province,
050000, People's Republic of China. Electronic address:
13932192058@hebmu.edu.cn
(Li, Tian) The Fourth Affiliated Hospital of Hebei Medical University;
Address: The Fourth Affiliated Hospital of Hebei Medical University, No.
12 Jiankang Road, Chang'an District, Shijiazhuang City, Hebei Province,
050000, People's Republic of China
(Li) The Fourth Affiliated Hospital of Hebei Medical University; Address:
The Fourth Affiliated Hospital of Hebei Medical University, No. 12
Jiankang Road, Chang'an District, Shijiazhuang City, Hebei Province,
050000, People's Republic of China. Electronic address: 584400494@qq.com
Abstract
PURPOSE: To examine the effectiveness of virtual reality (VR)-guided
imagery relaxation (VRGI) intervention in reducing anxiety among lung
cancer surgery patients. <br/>METHOD(S): A randomized clinical trial was
conducted at the Fourth Affiliated Hospital of Hebei Medical University
(Shijiazhuang, Hebei, China) to recruit patients scheduled for their first
elective endoscopic lung cancer surgery under general anesthesia between
December 2023 and March 2024. Patients were randomly assigned in a 1:1
ratio to either the control group, receiving routine treatment and staged
care in thoracic surgery, or the experimental group, receiving VRGI
intervention in addition to the control group's protocol. The primary
outcome was the State-Trait Anxiety Inventory (STAI) score for anxiety
assessment. Secondary outcomes included physiological stress markers
changes (systolic blood pressure[SBP], diastolic blood pressure [DBP], and
heart rate [HR]). Outcome were assessed at 3 time points: on the day of
admission (T1), immediately before surgery (T2), and at discharge (T3). A
repeated-measures analysis of variance (ANOVA) was applied to compare
changes in outcomes over time. <br/>RESULT(S): A total of 98 participants
(M [QIR] age, 60.00[54.25, 68.00]years; 39 men [39.8%] and 59 women
[60.2%]) were recruited and randomized to the control group (53
participants) and experimental group (45 participants). The age (beta,
6.29; 95%CI, 2.09 to 10.69; P=.005), education level (beta, -5.57; 95%CI,
-9.76 to -1.37; P=.011), awareness of the disease (beta, 6.11; 95%CI, 1.80
to 10.62; P=.007), and gender (beta, 5.75; 95%CI, 1.09 to 10.40; P=.018)
was the major influencing factor of preoperative anxiety. Compared with
the control group, the VRGI experimental group showed an even smaller
increase in SAI (t=2.20; P=.003), SBP (t=2.75; P=.007), DBP (t=2.53;
P=.013) and HR (t=2.17; P=.033) at T2, whereas showed significant
decreases in SAI (t= 4.79; P < .001), SBP (t=3.25; P=.0027), DBP (t=2.96;
P=.004) and HR (t=4.26; P<.001) at T3. The results of the repeated
measures ANOVA demonstrated statistically significant differences in SAI
score, SBP, DBP and HR across time effect, group effect and timexgroup
interaction effect (P<.05), the intervention group exhibited superior
outcomes compared to the control group. However, no statistically
significant difference was observed in the TAI score (P>.05).
<br/>CONCLUSION(S): The findings of this study suggest that VRGI is a
feasible and effective approach to reducing the anxiety in lung cancer
patients undergoing elective endoscopic surgery. Furthermore, it
demonstrates potential to alleviate physiological stress responses and
enhance patient self-confidence. The positive outcomes observed in this
investigation suggest that large-scale, multicenter randomized controlled
trials are needed to confirm the intervention's efficacy across diverse
clinical populations. TRIAL REGISTRATION: This study is retrospectively
registered with the ITMCTR (identifier: ITMCTR2025001481, registered 26
July 2025).
http://itmctr.ccebtcm.org.cn/zh-CN/UserPlatform/ProjectView?Pid=48c26a67-4
e2b-4aea-a504-f379602513b0.<br/>Copyright &#xa9; 2025. Published by
Elsevier B.V.

<118>
Accession Number
2036019022
Title
Outcomes of coronary revascularization in patients with metabolic
dysfunction-associated steatotic liver disease: a systematic review.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1609071. Date of Publication: 2025.
Author
Gries J.J.; Hassan Virk H.U.; Wang Z.; Alam M.; Sharma S.; Strauss M.;
Krittanawong C.
Institution
(Gries) Department of Gastroenterology, Allegheny Health Network,
Pittsburgh, PA, United States
(Hassan Virk) Harrington Heart & Vascular Institute, Case Western Reserve
University, University Hospitals Cleveland Medical Center, Cleveland, OH,
United States
(Wang) Robert D. and Patricia E. Kern Center for the Science of Health
Care Delivery, Mayo Clinic, Rochester, MN, United States
(Wang) Division of Health Care Policy and Research, Department of Health
Sciences Research, Mayo Clinic, Rochester, MN, United States
(Alam) The Texas Heart Institute, Baylor College of Medicine, Houston, TX,
United States
(Sharma) Cardiac Catheterization Laboratory of the Cardiovascular
Institute, Mount Sinai Hospital, New York, NY, United States
(Strauss) Department of Cardiology, Sector Preventive Medicine, Health
Promotion, Faculty of Health, School of Medicine, University
Witten/Herdecke, Hagen, Germany
(Strauss) Department of Cardiology I-Coronary and Periphal Vascular
Disease, Heart Failure Medicine, University Hospital Muenster, Muenster,
Germany
(Krittanawong) HumanX, Delaware, DE, United States
Publisher
Frontiers Media SA
Abstract
Introduction: A growing amount of evidence suggests that metabolic
dysfunction-associated steatotic liver disease (MASLD) may independently
increase the risk of coronary artery disease and acute coronary syndrome,
thus necessitating revascularization interventions such as percutaneous
coronary intervention (PCI) and coronary artery bypass grafting (CABG)
[2,3]. However, a limited number of studies have evaluated the impact of
MASLD on the outcomes of these interventions. <br/>Method(s): A
comprehensive search of the PubMed/MEDLINE and Embase databases was
conducted to identify relevant studies from August 2015 to August 2025
using a combination of Medical Subject Headings (MeSH) terms and text
words related to MASLD and cardiovascular revascularization.
<br/>Result(s): Two hundred nineteen papers from the PubMed/MEDLINE and
Embase databases were reviewed. Six met the inclusion criteria (Figure 1).
Five studies covered PCI, and one covered CABG. Supplemental information
was added using targeted PubMed/MEDLINE searches. <br/>Conclusion(s):
MASLD may pose an increased risk of in-hospital and long-term mortality
following PCI. Risks for cardiogenic shock, cardiac arrest, in-stent
thrombosis, gastrointestinal bleeding, or invasive mechanical ventilation
following PCI may also be increased. Further studies are needed to
determine the optimal coronary revascularization method and
post-revascularization medical therapy for patients with
MASLD.<br/>Copyright 2025 Gries, Hassan Virk, Wang, Alam, Sharma, Strauss
and Krittanawong.

<119>
Accession Number
2040416488
Title
The role of 3D printing and finite element-based computational simulations
in transcatheter pulmonary valve replacement.
Source
Progress in Biomedical Engineering. 7(4) (no pagination), 2025. Article
Number: 042007. Date of Publication: 01 Oct 2025.
Author
Perez-Cualtan C.E.; Castro-Paez C.; Guerrero-Chalela C.E.; Iaizzo P.A.;
Navarro-Rueda J.; Briceno J.C.
Institution
(Perez-Cualtan, Castro-Paez, Briceno) Department of Biomedical
Engineering, Universidad de los Andes, Bogota, Colombia
(Perez-Cualtan, Castro-Paez, Guerrero-Chalela, Navarro-Rueda, Briceno)
Center for 3D Modeling and Printing, Fundacion Cardioinfantil, Instituto
de Cardiologia, Bogota, Colombia
(Guerrero-Chalela) Adult Congenital Heart Disease Service, Fundacion
Cardioinfantil, Instituto de Cardiologia, Bogota, Colombia
(Iaizzo, Navarro-Rueda) Visible Heart Laboratories, Institute for
Engineering in Medicine, Department of Surgery, University of Minnesota,
Minneapolis, MN, United States
(Navarro-Rueda) Department of Industrial Engineering, Pontificia
Universidad Javeriana, Bogota, Colombia
Publisher
Institute of Physics
Abstract
Background. Transcatheter pulmonary valve replacement (TPVR) has emerged
as a less invasive alternative to surgical pulmonary valve replacement for
patients with right ventricular outflow tract dysfunction, such is
especially important for those individuals whom had previous cardiac
surgical procedures. Recently, three-dimensional (3D) printing and finite
element (FE) computational simulation technologies have been employed to
enhance preoperative planning processes; however, their effectiveness and
clinical significance remain to be fully validated. This systematic review
aims to describe the applications and potential impacts of 3D printing and
FE simulation technologies for TPVR in clinical practice. Methods. A
systematic search of PubMed, Science Direct, Web of Science, and Google
Scholar was conducted to identify studies using patient-specific
3D-printed models and FE simulations for preoperative planning and device
performance testing. Results. From 289 identified articles, 28 met the
inclusion criteria for this review. The quality assessment of the articles
showed that the article selection process was adequate. The eligible
studies demonstrated that both 3D printing and FE-based simulations have
been primarily used to select the appropriate pulmonary valve size as well
as predict the optimal placement; i.e. to avoid potential complications
such as paravalvular leakage or pulmonary regurgitation. These
technologies are generally used in complex congenital and adult-congenital
cases. Additionally, these studies provide valuable insights into the
mechanical performances of the transcatheter valves using patient-specific
anatomies. Conclusion. 3D-printed models and FE simulations have both
demonstrated utilities in TPVR planning; by accurately reproducing a given
patient's anatomy and allowing evaluations of potential device-tissue
interactions. These tools thus allow for personalized treatments and also
contribute to device innovations and development. Yet, further research in
this field is required due to the noted limitations of current studies,
including small sample sizes, insufficient standardization, and/or
challenges in replicating the biomechanics of cardiac
tissue.<br/>Copyright &#xa9; 2025 The Author(s). Published by IOP
Publishing Ltd.

<120>
Accession Number
648523940
Title
Outcomes of Left Atrial Appendage Patency After Device Closure Detected by
Cardiac CT: A Meta-Analysis.
Source
JACC. Cardiovascular imaging. (no pagination), 2025. Date of Publication:
08 Sep 2025.
Author
Jacquemyn X.; Sa M.P.; Korsholm K.; Nielsen-Kudsk J.E.; Iriart X.; Saw J.;
Alkhouli M.; Jain S.; Bittencourt M.S.; Sultan I.
Institution
(Jacquemyn, Sultan) Department of Cardiothoracic Surgery, University of
Pittsburgh, Pittsburgh, Pennsylvania, USA; UPMC Heart and Vascular
Institute, University of Pittsburgh Medical Center, Pittsburgh,
Pennsylvania, USA
(Sa) Cleveland Clinic Florida, Weston, FL, United States
(Korsholm, Nielsen-Kudsk) Department of Cardiology, Aarhus University
Hospital, Skejby, Denmark
(Iriart) Department of Pediatric and Adult Congenital Cardiology, Hopital
Cardiologique du Haut-Leveque, Bordeaux-Pessac, CHU de Bordeaux, France
(Saw) Division of Interventional Cardiology, Vancouver General Hospital
and the University of British Columbia, Vancouver, BC, Canada
(Alkhouli) Department of Cardiology, Mayo Clinic School of Medicine
Rochester, MN, United States
(Jain) UPMC Heart and Vascular Institute, University of Pittsburgh Medical
Center, Pittsburgh, PA, United States
(Bittencourt) Department of Medicine and Radiology University of
Pittsburgh, Pittsburgh, United States
Abstract
BACKGROUND: Residual leaks are common after left atrial appendage
occlusion (LAAO). <br/>OBJECTIVE(S): The authors aimed to systematically
evaluate the prognostic implications of residual left atrial appendage
(LAA) patency and peridevice leaks (PDLs) detected by cardiac computed
tomography (CT) following LAAO. <br/>METHOD(S): The authors used
traditional meta-analytical methods and a Bayesian framework to assess the
probability of increased risks associated with these residual leaks.
<br/>RESULT(S): Seventeen studies encompassing 2,036 patients met the
inclusion criteria. During follow-up, the presence of any LAA patency was
significantly associated with an almost 2-fold increased OR of
thromboembolism (pooled OR: 1.87, 95% CI: 1.08-3.24), corresponding to 28
(95% CI: 3-68) additional events per 1,000 patients. Although PDL showed a
similar trend, it was not significantly associated with increased
thromboembolism risk (pooled OR: 1.50, 95% CI: 0.85-2.65). For
thromboembolism with LAA patency, under a noninformative prior, the mean
logOR was 0.59 (95% credible interval [Crl]: 0.06-1.15), and translated
median OR of 1.87 (95% CrI: 1.06-3.14) and a mean absolute risk difference
(ARD) of 2.8% (95% CrI: 0.2%-6.8%). The posterior probability of ARD >0%
was 98.5%. For any PDL, the mean logOR was 0.38 (95% CrI: -0.22 to 0.95),
with a median OR of 1.53 (95% CrI: 0.80-2.59) and mean ARD of 1.9% (95%
CrI: -0.7% to 5.4%). The posterior probability of ARD >0% was 89.8%.
<br/>CONCLUSION(S): LAA patency and PDL identified by CT may be associated
with an increased risk of thromboembolism. These findings indicate that
residual leaks detected by CT may be clinically significant and should not
be regarded as benign.<br/>Copyright &#xa9; 2025 The Authors. Published by
Elsevier Inc. All rights reserved.

<121>
Accession Number
2040429424
Title
Prognostic impact of prior percutaneous coronary intervention on patients
undergoing coronary artery bypass grafting - A meta-analysis of
reconstructed time-to-event data.
Source
American Heart Journal Plus: Cardiology Research and Practice. 59 (no
pagination), 2025. Article Number: 100606. Date of Publication: 01 Nov
2025.
Author
Kirov H.; Caldonazo T.; Woehlecke H.; Fazini L.; Fischer J.; Costa V.;
Amorim P.; Runkel A.; Rodrigues E.; Mukharyamov M.; de Sa M.P.L.; Doenst
T.
Institution
(Kirov, Caldonazo, Woehlecke, Fischer, Runkel, Mukharyamov, Doenst)
Department of Cardiothoracic Surgery, Friedrich-Schiller-University Jena,
Germany
(Fazini) Department of Medical Sciences and Public Health, Clinical
Cardiology Unit, University of Cagliari, Cagliari, Italy
(Fazini) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
United States
(Costa, Amorim, Rodrigues, de Sa) Federal University of Rio de Janeiro,
Rio de Janeiro, Brazil
Publisher
Elsevier Inc.
Abstract
Background: There is controversy on the effect of percutaneous coronary
intervention (PCI) on outcomes of patients undergoing coronary artery
bypass grafting (CABG). We meta-analytically assessed the prognostic
impact of prior PCI in patients with coronary artery disease (CAD) who
underwent CABG. <br/>Method(s): We performed a systematic review and
meta-analysis of studies comparing patients who underwent CABG and had
prior PCI in the past with patients who underwent CABG as primary
treatment of CAD. Three databases were assessed. The primary endpoint was
perioperative mortality. The secondary outcomes were long-term survival,
perioperative myocardial infarction, neurological events, bleeding, acute
renal failure, and hospital length of stay. Reconstruction of
time-to-event data and pairwise meta-analysis were performed.
<br/>Result(s): Nineteen studies met the criteria for inclusion in the
final analysis. Risk of perioperative mortality in patients undergoing
CABG after a prior PCI was higher than in those undergoing primary CABG
(OR: 1.16, 95 % CI, 1.03-1.31, p = 0.02). However, the prior PCI group
presented higher survival rates when compared to the primary CABG group
over the entire follow-up (HR: 0.90, 95 % CI, 0.86-0.94, p < 0.01). There
was no significant difference between the groups regarding the other
secondary outcomes. <br/>Conclusion(s): When compared with patients who
underwent CABG as primary treatment of CAD, prior PCI is associated with
higher perioperative mortality for patients undergoing CABG. However, this
increase in perioperative risk does not correlate with a decrease in
long-term survival.<br/>Copyright &#xa9; 2025 The Authors

<122>
Accession Number
2040433425
Title
Low-Risk Patients, High-Impact Trials: Rapidly Evolving Evidence for
Transcatheter Aortic Valve Replacement.
Source
Journal of the American College of Cardiology. 86(13) (pp 1006-1008),
2025. Date of Publication: 30 Sep 2025.
Author
Reddy R.K.; Windecker S.; Ahmad Y.
Institution
(Reddy) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Reddy) Nuffield Department of Population Health, University of Oxford,
Oxford, United Kingdom
(Windecker) Department of Cardiology, Bern University Hospital, University
of Bern, Bern, Switzerland
(Ahmad) Division of Cardiology, University of California, San Francisco,
San Francisco, CA, United States
Publisher
Elsevier Inc.

<123>
Accession Number
2036083030
Title
The Use of Advanced Glycation End-Product Measurements to Predict
Post-Operative Complications After Cardiac Surgery.
Source
Journal of Clinical Medicine. 14(17) (no pagination), 2025. Article
Number: 6176. Date of Publication: 01 Sep 2025.
Author
Agrawal D.S.; Motta J.C.; Ali J.M.
Institution
(Agrawal) School of Clinical Medicine, University of Cambridge, Cambridge,
United Kingdom
(Motta, Ali) Department of Cardiothoracic Surgery, Royal Papworth Hospital
NHS Foundation Trust, Papworth Road, Trumpington, Cambridge, United
Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Frailty is increasingly recognised as an important
contributor to outcomes following cardiac surgery. There are various
measures of frailty described, but many include subjective assessments
impacting reliability and reproducibility of measurement. A potential
biomarker: advanced glycation end products (AGEs) have been suggested to
closely correlate with frailty. This may offer the opportunity to
objectively measure frailty and have potential use in preoperative risk
assessment. The objective and aim of this narrative review is to assess
the association between AGEs and outcomes following surgery, in order to
evaluate the use of AGEs for preoperative risk assessment. <br/>Method(s):
This review involved searching five databases including the following:
MEDLINE (through Ovid), Embase, Cochrane, ClinicalTrials.gov, and a
specified Google Scholar search for studies published between database
inception and 20 February 2025. The 1142 identified articles were then
subjected to various inclusion and exclusion criteria. This exclusion
criteria included all articles that were not in the English language,
studies involving patients under 18 years of age, and studies that were
incomplete or for whom the data was not yet available. This left 11
articles for which a 'related articles' search was performed on Google
Scholar on 6 March 2025, as per the PRISMA-S extension guidelines, to
obtain all relevant articles available. In the end, data analysis was
conducted on 13 articles with a total of 2402 participants. These were
categorised by type of surgery before analysis was performed for each
surgical category. The quality of evidence was assessed using ROBINS-I
tool and a risk of bias table has been provided. This study was provided
no external sources of funding. <br/>Result(s): Four out of the five
studies in cardiac surgery showed a statistically significant association
between AGE levels and post-operative complications and outcomes. This
association was also seen across thoracic and general surgery. Association
was demonstrated with various post-operative complications as well as
mortality. These relationships are supported by various pathophysiological
mechanisms, including the ability of AGEs to induce oxidative stress,
activate inflammatory mediators, and cause endothelial dysfunction.
<br/>Conclusion(s): There is a body of evidence supporting the association
between AGEs level and cardiac surgical outcomes. This objective measure
of frailty could have significant utility in preoperative risk assessment
and offer the opportunity to identify patients who will benefit from
undergoing prehabilitation.<br/>Copyright &#xa9; 2025 by the authors.

<124>
Accession Number
648523963
Title
Management of asymptomatic severe aortic stenosis: a systematic review and
meta-analysis of randomized controlled trials.
Source
Minerva cardiology and angiology. (no pagination), 2025. Date of
Publication: 09 Sep 2025.
Author
Johnson N.; Anil S.; Craig N.J.; Shah B.N.; Ring L.; Tsampasian V.;
Vassiliou V.S.
Institution
(Johnson, Anil, Tsampasian) Norwich Medical School, Bob Champion Research
and Education, Rosalind Franklin Road, Norwich, United Kingdom
(Craig) British Heart Foundation Centre of Research Excellence, University
of Edinburgh, Scotland and Edinburgh Heart Centre, Royal Infirmary of
Edinburgh, Edinburgh, United Kingdom
(Shah) Department of Cardiology, Wessex Cardiac Centre, Southampton,
United Kingdom
(Ring) West Suffolk Hospital, Bury St. Edmunds, United Kingdom
(Tsampasian, Vassiliou) Norfolk and Norwich University Hospital, Norwich,
United Kingdom
(Vassiliou) Norwich Medical School, Bob Champion Research and Education,
Rosalind Franklin Road, Norwich, United Kingdom
Abstract
INTRODUCTION: Whilst aortic stenosis remains the most prevalent valvular
abnormality, the management of asymptomatic severe aortic stenosis remains
a clinical challenge. Recently, two randomised-controlled trials (RCTs) -
EVOLVED (Early Intervention in Patients With Asymptomatic Severe Aortic
Stenosis and Myocardial Fibrosis) and Early TAVR (Transcatheter
Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis) - have
been published, alongside an extended follow-up from the AVATAR (Aortic
Valve Replacement Versus Conservative Treatment in Asymptomatic Severe
Aortic Stenosis) study. EVIDENCE ACQUISITION: In response, we conducted a
systematic review of PubMed, Ovid, and Cochrane databases, identifying
RCTs up to October 29, 2024, that compared early intervention with
conventional management. EVIDENCE SYNTHESIS: Four studies met the
inclusion criteria, with a combined total of 1427 patients across the
trials. Meta-analysis of the primary endpoints across these studies
demonstrated a benefit with early intervention (HR=0.50, 95% CI:
0.35-0.73). However, we did not find mortality and cardiac mortality to
show significant reductions (HR=0.68, 95% CI: 0.40-1.18 and HR=0.66, 95%
CI: 0.33-1.29, respectively). Crucially, stroke outcomes were improved
with early intervention (HR=0.60, 95% CI: 0.38-0.95), as were unplanned
hospitalizations (HR=0.40, 95% CI: 0.30-0.53). <br/>CONCLUSION(S): These
findings confirm the safety of early intervention and suggest a reduction
in stroke incidence, although no significant benefits were observed in
overall or cardiac mortality; results which can help to guide shared
decision-making with patients and prevent adverse health outcomes.

<125>
Accession Number
648478720
Title
Reappraisal of Evidentiary Support for Transcatheter Aortic Valve
Implantation for Low-Risk Aortic Stenosis: Insights From Midterm Results
of the PARTNER 3 and Evolut LR Trials.
Source
Journal of the American College of Cardiology. (no pagination), 2025.
Date of Publication: 25 Jul 2025.
Author
Kaul S.
Institution
(Kaul) Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles,
CA, United States

<126>
Accession Number
2035927436
Title
Effect of Ciprofol on Postoperative Cognitive Function in Patients
Undergoing Cardiac Surgery with Cardiopulmonary Bypass: A Prospective,
Randomized, Controlled Trial.
Source
Drug Design, Development and Therapy. 19 (pp 7541-7552), 2025. Date of
Publication: 2025.
Author
Lu J.; Shi Y.; Lan X.; Tang G.; Shao Y.; Chen C.; Xiong X.; Chen D.; Shi
J.
Institution
(Lu, Shi, Lan, Tang, Shao, Chen, Xiong, Shi) Department of Anesthesiology,
the Affiliated Hospital of Guizhou Medical University, Guiyang, China
(Chen) Department of Anesthesiology, West China second Hospital, Sichuan
University, Chengdu, China
(Chen) Key Laboratory of Birth Defects and Related Diseases of Women and
Children, Sichuan University, Chengdu, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: To investigate the effects of ciprofol on postoperative cognitive
function in patients undergoing cardiac surgery with cardiopulmonary
bypass (CPB). <br/>Patients and Methods: A total of 138 patients who
underwent cardiac surgery with cardiopulmonary bypass were included in
this prospective, randomized, controlled study. Patients were randomized
into two groups: the Ciprofol group (Group C) and the Propofol group
(Group P). During anesthesia induction and maintenance, the patients in
Group C received ciprofol, whereas those in Group P received propofol. The
primary outcome measure was the incidence of postoperative delirium (POD),
which was assessed twice daily for 7 days after surgery via either the
Confusion Assessment Method (CAM) or the Confusion Assessment Method for
the Intensive Care Unit (CAM-ICU). Statistical analyses included
chi-square tests for categorical outcomes and relative risk calculations
for POD. Additionally, delirium subtypes were recorded. The incidence of
postoperative cognitive dysfunction (POCD) was evaluated at 1 and 3 months
after surgery using the Telephone Montreal Cognitive Assessment (T-MoCA).
Furthermore, the occurrence of postinduction adverse events, including
hypotension, bradycardia, and tachycardia, as well as the incidence of
postoperative complications, were also documented. <br/>Result(s): POD
occurred in 19/64 (29.69%) patients in the Ciprofol group and 34/65
(52.31%) patients in the Propofol group (RR = 0.57; 95% confidence
interval = 0.37 to 0.88; p = 0.009). There was no significant difference
in the incidence of POCD at 1 month (22.03% vs 26.62%, p = 0.547) or 3
months (16.25% vs 16.00%; p = 0.771) after surgery between the two groups.
<br/>Conclusion(s): Ciprofol was found to decrease the incidence of POD in
patients who underwent cardiac surgery with cardiopulmonary bypass.
Nevertheless, no significant effect of this intervention on the incidence
of POCD was demonstrated at either 1 or 3 months after surgery. A
reduction in the incidence of delirium may be associated with improved
postoperative recovery, shortened hospital stays, and a decrease in
long-term cognitive impairments. Registration: The study had been
registered in the Chinese Clinical Trials Registry (www.chictr.org.cn;
Trial Identifier: ChiCTR2200061712).<br/>Copyright &#xa9; 2025 Lu et al.

<127>
Accession Number
2036108360
Title
Epidural Analgesia Versus Systemic Opioids for Postoperative Pain
Management After VATS: A Systematic Review and Meta-Analysis.
Source
Acta Anaesthesiologica Scandinavica. 69(9) (no pagination), 2025. Article
Number: e70122. Date of Publication: 01 Oct 2025.
Author
Holm J.H.; Bak M.; Brochner A.C.
Institution
(Holm, Bak) Department of Anaesthesia and Intensive Care, Odense
University Hospital, Odense, Denmark
(Brochner) Department of Regional Health Research, University of Southern
Denmark, Odense, Denmark
(Brochner) Department of Anesthesiology and Intensive Care Medicine,
Kolding Hospital, Kolding, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: Firm consensus on the best perioperative pain management after
Video-Assisted Thoracic Surgery (VATS) is lacking. Recommendations often
assess different loco-regional techniques as part of a multimodal
approach, but few discuss omitting regional analgesia altogether,
eliminating any risk of procedural complications. A reasonable
prerequisite for this approach would be that the alternative provides
comparable pain relief. To compare the efficacy of systemic opioids and
epidural analgesia for postoperative pain management, we conducted a
systematic review and meta-analysis of current studies. <br/>Method(s): We
did a systematic review and meta-analysis of randomized controlled trials
(RCTs) and observational studies on VATS with the primary objective of
examining postoperative pain at rest and during activity at POD1, POD2,
and POD3. The secondary objectives were to evaluate the efficacy of the
treatments, examining the need for postoperative "rescue" opioid, the
hospital length of stay, and side effects. We did literature searches of
Medline, Embase, and the Cochrane Library from inception to 07 April 2025.
Additionally, we searched ClinicalTrials.gov, the EU Clinical Trials
Register, the WHO International Clinical Trials Registry Platform, Scopus,
and Google Scholar. We included adult patients undergoing VATS receiving
either epidural analgesia or systemic opioids for postoperative pain
management. <br/>Result(s): We included four randomized controlled trials
(RCTs) and four observational studies encompassing 946 patients. The
primary meta-analysis of the RCTs found that epidural analgesia reduced
pain compared with systemic opioids by a pooled mean difference of 0.8
NRS/VAS points (95% CI 0.2-1.3) at rest and 1.1 points (0.7-1.5) during
activity over POD 1 to 3. Heterogeneity was substantial (I² 99%
and 98%, respectively) and was largely explained by the presence of
baseline multimodal analgesia on POD 2. Rescue-opioid use was lower with
epidurals in three of four trials, with no consistent differences in
length of stay or adverse effects. Evidence certainty was moderate. The
observed difference is below or at the lower bound of the minimal
clinically important difference of 1-2 NRS/VAS points. <br/>Conclusion(s):
Epidural analgesia offers a small but possibly subclinical reduction in
acute postoperative pain after VATS compared with systemic opioids,
particularly when combined with baseline multimodal analgesia. High
heterogeneity and moderate certainty underscore the need for adequately
powered trials. PROSPERO Registration: CRD42024598757.<br/>Copyright
&#xa9; 2025 The Author(s). Acta Anaesthesiologica Scandinavica published
by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica
Foundation.

<128>
Accession Number
2039905289
Title
Non-culprit lesion revascularization in patients with acute myocardial
infarction: A systematic review and meta-analysis.
Source
Revista Habanera de Ciencias Medicas. 24 (no pagination), 2025. Article
Number: e5779. Date of Publication: 23 Jan 2025.
Author
de la Torre Fonseca L.M.; Medrano Pincay J.M.; Pacheco Naranjo A.M.;
Guaman Castro R.A.; Cedeno Farias D.; Alarcon Cedeno R.
Institution
(de la Torre Fonseca) Hospital Docente Clinico Quirurgico "Comandante
Manuel Fajardo", La Habana, Cuba
(de la Torre Fonseca) Universidad de Ciencias Medicas de La Habana, La
Habana, Cuba
(Medrano Pincay) Hospital "Teodoro Maldonado Carbo", Guayaquil, Ecuador
(Pacheco Naranjo) Hospital "Clinica San Francisco", Guayaquil, Ecuador
(Guaman Castro) Clinica "Sur Hospital", Guayaquil, Ecuador
(Cedeno Farias) Hospital General del Norte de Guayaquil IESS Los Ceibos,
Guayaquil, Ecuador
(Alarcon Cedeno) Hospital "Alvaro Cunqueiro", Area Sanitaria de Vigo,
Sergas, Spain
Publisher
Universidad de Ciencias Medicas de La Hab
Abstract
Introduction: Multivessel disease is present in approximately 50% of
patients experiencing acute myocardial infarction. Initially,
revascularization of the culprit lesion during primary PCI was exclusively
recommended for patients in cardiogenic shock. <br/>Objective(s): The aim
of this study was to assess whether complete revascularization is
associated with reduced cardiovascular mortality and adverse
cardiovascular events. <br/>Material(s) and Method(s): A search was
conducted in the following bibliographic databases: MEDLINE, Cochrane,
Embase, ISI Web of Science, and CENTRAL (Cochrane Central Register of
Controlled Trials), SciELO. The search was performed in February 2024,
without a time limit, and was updated monthly until June 2024. Randomized
controlled trials or meta-analyses of randomized controlled trials were
selected, with no restrictions on publication year or language that
included the following terms: myocardial revascularization, ST-segment
elevation myocardial infarction, coronary artery disease, and coronary
stenosis. <br/>Result(s): The systematic review and meta-analysis included
seven randomized controlled trials involving 6597 patients, comparing
complete revascularization with culprit-only percutaneous coronary
intervention. The complete revascularization strategy was associated with
a significantly lower risk of major adverse cardiovascular events (RR=
0.50, 95% CI: 0.56-0.74; p<0.001, I2= 0%) and repeated revascularizations
(RR=0.32, 95% CI: 0.24-0.42; p<0.001, I2= 42%). <br/>Conclusion(s): Our
findings demonstrate that revascularization of non-culprit lesions in
patients with STEMI is associated with a significant reduction in major
adverse cardiovascular events, repeated revascularizations, and the
composite outcome of cardiac death and nonfatal myocardial
infarction.<br/>Copyright &#xa9; Este es un articulo de Acceso Abierto
distribuido segun los terminos de la Licencia Creative Commons
Atribucion-NoComercial 4.0 que permite el uso, distribucion y reproduccion
no comerciales y sin restricciones en cualquier medio, siempre que sea
deidamente citada la fuente primaria de publicacion.

<129>
Accession Number
2040332307
Title
Half-Dose versus Full Dose of Aprotinin in Cardiac Surgery: A Post-hoc
Analysis of the Aprotinin European Registry.
Source
European Journal of Cardio-thoracic Surgery. 67(9) (no pagination), 2025.
Article Number: ezaf260. Date of Publication: 01 Sep 2025.
Author
Colson P.H.; Gaudriot B.; Provenchere S.; Rozec B.; Cholley B.; Mauriat
P.; Senard M.; Fellahi J.-L.
Institution
(Colson) Departement d'anesthesie-reanimation, CHU Montpellier, Avenue
Doyen Giraud, Montpellier, France
(Gaudriot) CHU Rennes, 2 rue Henri-Le-Guilloux, Rennes, France
(Provenchere) AP-HP, Bichat-Claude Bernard Hospital, 46 Rue Henri Huchard,
Paris, France
(Rozec) CHU Nantes, Boulevard Jacques Monod, Nantes, France
(Cholley) Service d'Anesthesie-Reanimation, Hopital Europeen Georges
Pompidou, AP-HP, 20 rue Leblanc, Paris, France
(Mauriat) CHU Bordeaux, 1 Avenue de Magellsn, Bordeaux, France
(Senard) CHU Liege, Avenue de l'Hopital, Liege, Belgium
(Fellahi) HCL, Louis Pradel Hospital, 59 Boulevard Pinel, Bron, France
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives To compare the effectiveness and safety of the full and half
doses of aprotinin, using the extended version of the Nordic Aprotinin
Patient Registry, which was imposed by the European Medicines Agency
following the reintroduction of aprotinin in cardiac surgery in the
European market. Methods A post-hoc analysis was performed on data
prospectively collected from adult patients exposed to aprotinin during
cardiac surgery, in 83 cardiovascular surgical centres in 9 European
countries, from February 26, 2016 to October 5, 2022. Full-dose (FD) and
half-dose (HD) regimens were used at the surgical team's discretion. The
FD loading, priming, and infusion doses were 2 MKIU, 2 MKIU, and 0.5
MKIU/h, respectively. Incidence of re-exploration for bleeding/tamponade 2
days after surgery (2 D-re-exploration), 7 D-mortality, 3 D-MACCE (major
adverse cardiac and cerebral events), and 1 D-AKI (acute kidney injury)
were compared between FD and HD patients using propensity score methods to
reduce confounders. Results A total of 2961 (44.4%) patients received the
FD regimen and 3703 (55.6%) the HD regimen. After adjustment, the
incidence of 2 D-re-exploration was estimated at 3.2% in the FD group and
4.4% in the HD group: OR [95% CI] = 0.70 [0.53-0.94] (P =. 015). No
difference in 7 D-mortality or 3 D-MACCE was observed between the 2
regimens. The incidence of 1 D-AKI was higher in patients with
pre-operative renal dysfunction who received the FD regimen. Conclusions
Patients receiving the FD aprotinin regimen had less surgical
re-exploration than those receiving the HD regimen. An increased risk of
early postoperative AKI was observed in the FD group, mainly for patients
with pre-operative chronic kidney disease.<br/>Copyright &#xa9; 2025 The
Author(s). Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery.

<130>
Accession Number
2040328030
Title
Study design and rationale of the TXL-CAP trial: a randomized,
double-blind, placebo-controlled, multicenter clinical trial assessing the
effect of Tongxinluo capsules on the stability of coronary atherosclerotic
plaques.
Source
Journal of Geriatric Cardiology. 22(7) (pp 615-624), 2025. Date of
Publication: 2025.
Author
Ni M.; Ti Y.; Qi Y.; Zhang M.; Duan D.; Yao C.; Jia Z.-H.; Zhang Y.; Bu
P.-L.
Institution
(Ni, Ti, Qi, Zhang, Zhang, Bu) State Key Laboratory for Innovation and
Transformation of Luobing Theory, Chinese Ministry of Education, Chinese
National Health Commission, Qilu Hospital of Shandong University, Jinan,
China
(Ni, Ti, Qi, Zhang, Zhang, Bu) Key Laboratory of Cardiovascular Remodeling
and Function Research, Chinese Ministry of Education, Chinese National
Health Commission, Chinese Academy of Medical Sciences, Qilu Hospital of
Shandong University, Jinan, China
(Ni, Ti, Qi, Zhang, Zhang, Bu) Department of Cardiology, Qilu Hospital of
Shandong University, Jinan, China
(Duan) Center for Phenomics of Traditional Chinese Medicine, Affiliated
TCM Hospital Southwest Medical University, Luzhou, China
(Yao) Peking University Clinical Research Institute, Peking University,
Beijing, China
(Jia) National Key Laboratory of Luobing Research and Innovative Chinese
Medicine, Shijiazhuang, China
(Jia) Hebei Yiling Hospital, Key Disciplines of State Administration of
Tcm for Collateral Disease, Shijiazhuang, China
Publisher
Science Press
Abstract
Recent clinical trials have demonstrated a protective effect in using
traditional Chinese medicine Tongxinluo (TXL) capsule to treat
atherosclerosis. However, clinical evidence of the effects of TXL
treatment on coronary plaque vulnerability is unavailable. In response, we
developed this study to investigate the hypothesis that on the basis of
statin therapy, treatment with TXL capsule may stabilize coronary lesions
in patients with acute coronary syndrome (ACS). The TXL-CAP study was an
investigator-initiated, randomized, double-blind clinical trial conducted
across 18 medical centers in China. Patients with ACS aging from 18 to 80
years old who had a non-intervened coronary target lesion with a fibrous
cap thickness (FCT) < 100 mum and lipid arc > 90degree as defined by
optical coherence tomography (OCT) were recruited. A total of 220 patients
who met the selection criteria but did not meet the exclusion criteria
will be finally recruited and randomized to receive treatment with TXL (n
= 110) or placebo (n = 110) for a duration of 12 months. The primary
endpoint was the difference in the minimum FCT of the coronary target
lesion between TXL and placebo groups at the end of the 12-month
follow-up. Secondary endpoints included: (1) changes of the maximum lipid
arc and length of the target plaque, and the percentage of lipid, fibrous,
and calcified plaques at the end of the 12-month period; (2) the incidence
of composite cardiovascular events and coronary revascularization within
the 12 months; (3) changes in the grade and scores of the angina pectoris
as assessed using the Canadian Cardiovascular Society (CCS) grading system
and Seattle angina questionnaire (SAQ) score, respectively; and (4)
changes in hs-CRP serum levels. The results of the TXL-CAP trial will
provide additional clinical data for revealing whether TXL capsules
stabilizes coronary vulnerable plaques in Chinese ACS
patients.<br/>Copyright &#xa9; 2025 JGC All rights reserved.

<131>
Accession Number
648501791
Title
Effect of evolocumab on saphenous vein graft patency after coronary artery
bypass surgery (NEWTON-CABG CardioLink-5): an international, randomised,
double-blind, placebo-controlled trial.
Source
Lancet (London, England). (no pagination), 2025. Date of Publication: 28
Aug 2025.
Author
Verma S.; Leiter L.A.; Teoh H.; Mancini G.B.J.; Quan A.; Elituv R.; Verma
M.; Misner E.; Szarek M.; Thorpe K.E.; Saha T.; Whitlock R.P.; Yanagawa
B.; Merkely B.; Juni P.; Koren M.J.; Nicholls S.J.; Bhatt D.L.; Mazer C.D.
Institution
(Verma) Division of Cardiac Surgery, St Michael's Hospital-Unity Health
Toronto, Toronto, ON, Canada; Department of Surgery, University of
Toronto, Toronto, ON, Canada; Department of Pharmacology and Toxicology,
University of Toronto, Toronto, ON, Canada; North York Diagnostic and
Cardiac Centre, Toronto, ON, Canada
(Leiter) Division of Endocrinology and Metabolism, St Michael's
Hospital-Unity Health Toronto, Toronto, ON, Canada; Department of
Medicine, University of Toronto, Toronto, ON, Canada; Department of
Nutritional Sciences, University of Toronto, Toronto, ON, Canada
(Teoh) Division of Cardiac Surgery, St Michael's Hospital-Unity Health
Toronto, Toronto, ON, Canada; Division of Endocrinology and Metabolism, St
Michael's Hospital-Unity Health Toronto, Toronto, ON, Canada
(Mancini) Division of Cardiology, Centre for Cardiovascular Innovation,
Dilawri Cardiovascular Institute, University of British Columbia,
Vancouver, BC, Canada
(Quan, Misner) Division of Cardiac Surgery, St Michael's Hospital-Unity
Health Toronto, Toronto, ON, Canada
(Elituv) Division of Cardiac Surgery, St Michael's Hospital-Unity Health
Toronto, Toronto, ON, Canada; North York Diagnostic and Cardiac Centre,
Toronto, ON, Canada
(Verma) Royal College of Surgeons in Ireland, Dublin, Ireland
(Szarek) Division of Cardiology, University of Colorado School of
Medicine, Aurora, CO, USA; CPC Clinical Research, University of Colorado
School of Medicine, Aurora, CO, USA; Mount Sinai Fuster Heart Hospital,
Icahn School of Medicine at Mount Sinai, New York, NY, USA
(Thorpe) Dalla Lana School of Public Health, University of Toronto,
Toronto, ON, Canada
(Saha) Department of Anesthesiology and Perioperative Medicine, Kingston
Health Sciences Centre, Kingston, ON, Canada; Department of Anesthesiology
and Perioperative Medicine, Queen's University, Kingston, ON, Canada
(Whitlock) Department of Surgery, McMaster University, Hamilton, ON,
Canada; Department of Health Research Methodology, Evidence and Impact,
McMaster University, Hamilton, ON, Canada; Perioperative and Surgery
Research Program, Population Health Research Institute, Hamilton, ON,
Canada
(Yanagawa) Division of Cardiac Surgery, St Michael's Hospital-Unity Health
Toronto, Toronto, ON, Canada; Department of Surgery, University of
Toronto, Toronto, ON, Canada; Department of Pharmacology and Toxicology,
University of Toronto, Toronto, ON, Canada
(Merkely) Heart and Vascular Center, Semmelweis University, Budapest,
Hungary
(Juni) Clinical Trial Service Unit and Epidemiological Studies Unit,
Nuffield Department of Population Health, University of Oxford, Oxford,
United Kingdom
(Koren) Jacksonville Center for Clinical Research, Flourish Research
Group, Jacksonville, FL, United States
(Nicholls) Victorian Heart Institute, Monash University, Melbourne, VIC,
Australia
(Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at
Mount Sinai, New York, NY, USA
(Mazer) Department of Anesthesia, St Michael's Hospital-Unity Health
Toronto, Toronto, ON, Canada; Department of Pharmacology and Toxicology,
University of Toronto, Toronto, ON, Canada; Department of Anesthesiology
and Pain Medicine, University of Toronto, Toronto, ON, Canada; Department
of Physiology, University of Toronto, Toronto, ON, Canada
Abstract
BACKGROUND: Saphenous vein graft (SVG) failure remains a substantial
challenge after coronary artery bypass graft (CABG). LDL cholesterol
(LDL-C) is a causal risk factor for atherosclerosis, but its role in SVG
failure is not well established. We evaluated whether early initiation of
intensive LDL-C lowering with evolocumab could reduce SVG failure.
<br/>METHOD(S): NEWTON-CABG CardioLink-5 was a multicentre, double-blind,
randomised, placebo-controlled trial conducted at 23 sites in Canada, the
USA, Australia, and Hungary. Eligible participants were adults (age >=18
years) who underwent CABG with at least two SVGs and were being treated
with statin therapy of moderate or high intensity. Participants were
randomly allocated (1:1; variable block size) within 21 days of CABG to
subcutaneous evolocumab 140 mg or placebo every 2 weeks. The primary
endpoint was the 24-month vein graft disease rate (VGDR; the proportion of
SVGs with >=50% occlusion on coronary CT angiography or clinically
indicated invasive angiography) in the modified intention-to-treat
population. This trial is registered with ClinicalTrials.gov, NCT03900026,
and is completed. FINDINGS: Between June 17, 2019, and Nov 10, 2022, 782
individuals were randomly assigned (389 to evolocumab and 393 to placebo).
At baseline, among the 554 participants with primary outcome data
available, the median age was 66 years (IQR 60-72), 471 (85%) of 554
participants were male and 83 (15%) were female, and the median LDL-C was
1.85 mmol/L (IQR 1.25-2.84) in the evolocumab group and 1.86 mmol/L
(1.20-2.76) in the placebo group. Evolocumab resulted in a mean 48.4%
placebo-adjusted reduction in LDL-C at 24 months (-52.4% vs -4.0%). The
24-month VGDR was 21.7% (149 of 686 grafts) in the evolocumab group and
19.7% (127 of 644 grafts) in the placebo group (difference 2.0% [95% CI
-3.1 to 7.1]; p=0.44). Treatment was well tolerated, with similar adverse
event profiles between the groups. INTERPRETATION: Among patients who
underwent CABG, evolocumab did not reduce SVG disease at 24 months
following the index surgery despite substantial LDL-C lowering. Further
LDL-C lowering does not appear to meaningfully affect the
pathophysiological mechanisms responsible for early SVG failure. FUNDING:
Amgen Canada.<br/>Copyright &#xa9; 2025 Elsevier Ltd. All rights reserved,
including those for text and data mining, AI training, and similar
technologies.

<132>
Accession Number
648482233
Title
Machine perfusion across different donor pathways in heart
transplantation: A systematic review and network meta-analysis.
Source
The Journal of heart and lung transplantation : the official publication
of the International Society for Heart Transplantation. (no pagination),
2025. Date of Publication: 22 Aug 2025.
Author
Kim D.-Y.; Kang M.; Kim J.; Choi D.; Lee S.-J.
Institution
(Kim, Kang, Kim) Department of Surgery, Hanyang University College of
Medicine, Seoul, South Korea
(Choi) Department of Surgery, Hanyang University College of Medicine,
Seoul 04763, Republic of Korea; Research Institute of Regenerative
Medicine and Stem Cells, Hanyang University, Seoul 04763, Republic of
Korea; Hanyang Institute of Bioscience and Biotechnology, Hanyang
University, Seoul 04763, Republic of Korea; Department of HY-KIST
Bio-convergence, Hanyang University, Seoul 04763, Republic of Korea.
Electronic address: skjnlee@gmail.com
(Lee) Division of Cardiology, Department of Internal Medicine, Dongtan
Sacred Heart Hospital, Hallym University, South Korea
Abstract
BACKGROUND: The shortage of donor hearts significantly limits heart
transplantation. Innovative machine perfusion strategies have emerged to
address the shortcomings of traditional static cold storage after brain
death (SCS-DBD), potentially enhancing outcomes and broadening donor
eligibility. We performed a systematic review and network meta-analysis to
compare the effectiveness of heart transplantation using machine perfusion
techniques with conventional SCS-DBD. <br/>METHOD(S): The MEDLINE, Embase,
and PubMed databases were systematically searched for articles published
between January 2024 and March 2025. Additional relevant studies from 2014
to 2023 were identified through previous systematic reviews and reference
lists. Included were randomized clinical trials and non-randomized studies
evaluating outcomes of heart transplantation methods utilizing hearts from
donors after brain death (DBD) and donors after circulatory death (DCD).
Meta-analysis was performed examining 30-day and 1-year survival, acute
rejection, and primary graft dysfunction. <br/>RESULT(S): From 1,758
screened records, 19 studies involving 22,029 patients met inclusion
criteria. No significant differences in 30-day mortality were observed
between preservation methods. At 1-year, direct procurement with perfusion
of DCD (risk ratio [RR] 0.63 [95% credible interval [CrI] 0.45-0.89]; high
certainty) and normothermic regional perfusion of DCD (RR 0.68 [CrI
0.47-0.96]; low certainty) significantly reduced mortality compared with
SCS-DBD. Among DBD groups, no mortality differences emerged. Hypothermic
oxygenated machine perfusion of DBD significantly reduced severe primary
graft dysfunction compared with SCS-DBD (0.27 [0.10-0.63]; high
certainty), but acute rejection rates were similar across all methods.
<br/>CONCLUSION(S): Outcomes of machine perfusion strategies appear
non-inferior to those of the conventional SCS, proving its potential to
broaden the donor pool.<br/>Copyright &#xa9; 2025. Published by Elsevier
Inc.

<133>
Accession Number
2040394652
Title
Effects of nurse-led transitional care program on patient outcomes
following transcatheter aortic valve implantation: a randomized controlled
trial.
Source
Geriatric Nursing. 66 (no pagination), 2025. Article Number: 103620. Date
of Publication: 01 Nov 2025.
Author
Akbaba A.; Mert H.
Institution
(Akbaba, Mert) Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
Publisher
Elsevier Inc.
Abstract
Objectives: This study evaluated the impact of a nurse-led transitional
care program on self-care behaviors, quality of life, medication
adherence, and rehospitalization rates in TAVI patients. <br/>Method(s): A
randomized controlled trial with two parallel groups involved 60
consenting patients. Outcomes were assessed at baseline (T0), 4 weeks
(T1), and 12 weeks (T2). The Generalized Estimation Equation Model (GEE)
analyzed the effects of group, time, and their interaction.
<br/>Result(s): Compared to the usual care group, patients in the
intervention group showed significant improvements in self-care and
quality of life. The intervention group also had fewer rehospitalizations
at T1 and T2 post-intervention. However, there was no statistically
significant difference in medication adherence, except for adherence with
antihypertensive treatment. <br/>Conclusion(s): The transitional care
program improved self-care behaviors, enhanced quality of life, and
decreased rehospitalization rates. Integrating transitional care programs
into usual patient care in clinics holds promise for further improving
patient outcomes.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<134>
Accession Number
648514517
Title
Efficacy and safety of prothrombin complex concentrate versus frozen
plasma in cardiac surgery: a systematic review and meta-analysis with
trial sequential analysis.
Source
British journal of anaesthesia. (no pagination), 2025. Date of
Publication: 05 Sep 2025.
Author
Shalabi L.; Ibrahim A.; Zreigh S.; Tawfik A.M.; Shalabi S.; Rifai M.;
Legrand M.
Institution
(Shalabi) Faculty of Medicine, Gharyan University, Gharyan, Libyan Arab
Jamahiriya
(Ibrahim, Tawfik) Faculty of Medicine, Alexandria University, Alexandria,
Egypt
(Zreigh) Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara,
Turkey
(Shalabi) College of Pharmacy, Gharyan University, Gharyan, Libyan Arab
Jamahiriya
(Rifai) Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt
(Legrand) Department of Anesthesia and Perioperative Care, University of
California, San Francisco, CA, United States

<135>
Accession Number
2040378528
Title
Pleural drain placement following lung resection in children: A
prospective observational study of the Western Pediatric Surgery Research
Consortium.
Source
Journal of Pediatric Surgery. (no pagination), 2025. Article Number:
162541. Date of Publication: 2025.
Author
Kahan A.M.; Kelley-Quon L.I.; Acker S.N.; Vincent S.; Chao S.D.;
Nepomuceno H.; Lee J.H.; Padilla B.E.; Ignacio R.C.; Fialkowski E.A.;
Fowler K.L.; Cairo S.B.; Munar D.; Pandya S.R.; Russell K.W.; Fenton S.J.;
Lee S.L.; Rothstein D.H.
Institution
(Kahan, Russell, Fenton) Department of Surgery, Division of Pediatric
Surgery, University of Utah, Salt Lake City, UT, United States
(Kelley-Quon) Division of Pediatric Surgery, Children's Hospital Los
Angeles, Department of Surgery, Keck School of Medicine of University of
Southern California, Los Angeles, CA, United States
(Acker, Vincent) Department of Pediatric Surgery, University of Colorado
School of Medicine, Children's Hospital Colorado, Aurora, CO, United
States
(Chao, Nepomuceno) Division of Pediatric Surgery, Stanford Children's
Hospital, Palo Alto, CA, United States
(Lee, Padilla) Division of Pediatric Surgery, Phoenix Children's Hospital,
University of Arizona College of Medicine, Phoenix, AZ, United States
(Ignacio) Division of Pediatric Surgery, Department of Surgery, University
of California San Diego, Rady Children's Hospital, San Diego, CA, United
States
(Fialkowski, Fowler) Division of Pediatric Surgery, Doernbecher Children's
Hospital, Oregon Health and Science University, Portland, OR, United
States
(Cairo, Munar) Department of Surgery, University of California San
Francisco School of Medicine, CA, United States
(Pandya) Department of Pediatric General and Thoracic Surgery, University
of Texas Southwestern, Dallas, TX, United States
(Lee, Rothstein) Department of Pediatric General and Thoracic Surgery,
Seattle Children's Hospital, Seattle, WA, United States
(Cairo, Munar) Division of Pediatric Surgery, University of California San
Francisco Benioff Children's Hospitals, San Francisco, CA, United States
Publisher
W.B. Saunders
Abstract
Purpose: Pleural drains are used routinely after thoracic surgery in
children despite evidence that drainage is not always necessary. The
purpose of this study was to assess the necessity of intraoperative drain
placement after resectional lung surgery in children, provide a
contemporary characterization of the use of pleural drains, and evaluate
the utility of intraoperative air leak testing. <br/>Method(s): A
multi-institutional prospective cohort study was performed at 10
free-standing children's hospitals in the United States from 2023 to 2024.
Patients <=18 years old who underwent open or thoracoscopic wedge
resection or lobectomy were included. Patients undergoing operation for
spontaneous pneumothorax or trauma, those on extra-corporeal life support,
those undergoing bi-lobectomy or pneumonectomy, and those undergoing
reoperation in the affected hemithorax were excluded. Operative
parameters, intra-operative air leak, length of post-operative drain
placement, and number of post-operative chest x-rays were evaluated using
bivariate comparisons. <br/>Result(s): Among 229 patients (58% male,
median age 12.3 years [IQR 5-16]), 113 (49%) underwent wedge resection and
the remaining 116 (51%) underwent lobectomy. 201 patients (87.8%) had a
pleural drain vs 28 (12.2%) without. Air leak testing was performed for
198 children: among those with a negative leak test (168, 73.4%), 144
(85.7%) had a pleural drain placed. Of the 90 children undergoing wedge
resection with air leak test results available, 78 (87%) had a negative
leak test and 57 (73%) of those patients still received pleural drainage.
None of the 28 cases initially without pleural drainage required
post-operative insertion of a pleural drain. Children with pleural
drainage had significantly more post-operative chest x-rays compared to
those without (median 5 vs 2, p < 0.001), and a significantly longer
post-operative length of stay (median 3 vs 1 days, p < 0.001).
<br/>Conclusion(s): Pleural drain placement after lung resection in
pediatric patients is routine but may not be necessary. Patients with
pleural drain incur significantly higher postoperative radiation exposure
compared to those without. Randomized control trials of pleural drainage
after resectional lung surgery are needed to examine further if the
routine use of pleural drainage is necessary. <br/>Level of Evidence:
III.<br/>Copyright &#xa9; 2025 The Author(s)

<136>
Accession Number
2040338519
Title
Open-lung ventilation and mechanical power in thoracic surgery: Post hoc
analysis of a multicentre randomised trial.
Source
European Journal of Anaesthesiology. (no pagination), 2025. Article
Number: 42. Date of Publication: 2025.
Author
Zorrilla-Vaca A.; Barbeta E.; Librero J.; Ferrando C.
Institution
(Zorrilla-Vaca) Department of Anesthesiology Perioperative and Pain
Medicine, Brigham and Women's Hospital, Boston, MA, United States
(Zorrilla-Vaca) Department of Anesthesiology, Hospital Universitario
Evaristo Garcia Universidad del Valle, Cali, Colombia
(Barbeta, Ferrando) Department of Anesthesiology and Critical Care,
Hospital Clinic de Barcelona, Barcelona, Spain
(Librero) Red de Investigacion en Servicios de Salud Navarrabiomed
Complejo Hospitalario de Navarra, Pamplona, Spain
(Ferrando) Institut D'investigacio August Pi I Sunyer, Barcelona, Spain
(Ferrando) CIBER de Enfermedades Respiratorias CIBERES Instituto de Salud
Carlos III, Madrid, Spain
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND Individualisation of positive-end expiratory pressure (PEEP) is
an open-lung ventilation strategy associated with better respiratory
mechanics. Mechanical power has been associated with lung injury in
critical care settings, but the interaction between optimisation of PEEP
and mechanical power during one-lung ventilation (OLV) remains poorly
understood. OBJECTIVE This study aimed to determine the effect of
individualisation of PEEP on mechanical power during OLV as well as to
establish the association between mechanical power and postoperative
pulmonary complications after thoracic surgery. DESIGN This is a post hoc
analysis of a multicentre randomised trial. SETTING Operating rooms.
PATIENTS Thoracic surgery cases requiring OLV. INTERVENTION Open-lung
ventilation strategy (i.e. individualised PEEP titration based on
respiratory compliance) versus standard PEEP. Mechanical power and its
components were compared between both groups at five different
time-points: two-lung ventilation (T0), baseline OLV (T1), 20 min after
OLV (T2), end of OLV (T3) and before extubation (T4). MAIN OUTCOME
MEASURES Our primary outcome included a composite of postoperative
pulmonary complications within 30 days after surgery. Multivariable
mixed-effects logistic regressions were performed to assess associations
between various thresholds of mechanical power and postoperative pulmonary
complications. RESULTS A total 1253 patients were included in this
analysis, of which 635 received open-lung ventilation, and 618 received
conventional ventilation. The median difference in mechanical power was
higher in the open-lung ventilation group during OLV than in the control
group at T2, T3 and T4: 1.39 [95% confidence interval (CI), 0.91 to 1.86]
J min^-1, 1.27 (95% CI, 0.79 to 1.75) J min^-1 and
2.12 (95% CI, 1.60 to 2.63) J min^-1, respectively. While the
resistive component of mechanical power was associated with postoperative
pulmonary complications [odds ratio (OR), 1.07 (95% CI, 1.01 to 1.13) per
J min^-1], the static component was protective [OR, 0.91 (95%
CI, 0.85 to 0.98) per J min^-1]. CONCLUSION Individualisation of
PEEP during OLV leads to nonclinically significant higher levels of
mechanical power compared with standard PEEP. Each component of mechanical
power seems to have different interactions with the occurrence of
postoperative pulmonary complications.<br/>Copyright &#xa9; 2025 European
Society of Anaesthesiology and Intensive Care. Unauthorized reproduction
of this article is prohibited.

<137>
Accession Number
648483258
Title
Application Effects of Single-Lumen Endotracheal Tube Intubation for
General Anesthesia in Totally Thoracoscopic Cardiac Surgery.
Source
Brazilian journal of cardiovascular surgery. (no pagination), 2025. Date
of Publication: 25 Aug 2025.
Author
Yi X.; Wang L.
Institution
(Yi) First Hospital of Jilin University Second Operating Room Changchun
Jilin People's Republic of China Second Operating Room, First Hospital of
Jilin University, Changchun, Jilin, China
(Wang) First Hospital of Jilin University Department of Cardiac Surgery
Changchun Jilin People's Republic of China Department of Cardiac Surgery,
First Hospital of Jilin University, Changchun, Jilin, China
Abstract
INTRODUCTION: The rapid advancement of medical technology has enabled the
application of single-lumen endotracheal tube (SLET) incubation anesthesia
in thoracoscopic surgeries for thoracic diseases, demonstrating promising
results. This study aims to explore the application of extracorporeal
circulation (ECC) and combined intravenous-inhalation anesthesia (CIIA)
with SLET intubation in totally thoracoscopic cardiac surgery (TTCS).
<br/>METHOD(S): In this single-center, double-blind, randomized controlled
trial, we assessed primary outcomes, including intraoperative metrics and
postoperative conditions. Secondary outcomes included the number of
patients achieving spontaneous resuscitation and those requiring
extracorporeal defibrillation after opening the ascending aorta,
alertness/sedation scores five minutes post-extubation, and incidence of
postoperative complications. <br/>RESULT(S): The observation group showed
shorter durations in the anesthesia recovery room, intensive care unit
retention, extubation, eye-opening time, and postoperative hospital stay
compared to the control group (t = 5.913, 8.820, 7.792, 6.904, 11.140; all
P < 0.001) and had higher proportion of patients with an
alertness/sedation score of five (43/109, 39.45%) and rate of spontaneous
resuscitation after opening the ascending aorta (97/109, 88.99%) compared
to the control group ([8/109, 34%], [84/109, 77.06%]). In contrast, the
rate of external electrical defibrillation (12/109, 11.01%) and the
incidence of postoperative complications (2/109, 1.83%) were lower than in
the control group ([25/109, 22.94%], [10/109, 9.17%]) (chi = 31.350,
5.501, 5.644; all P < 0.05). <br/>CONCLUSION(S): Maintaining oxygen
saturation in thoracoscopic surgery requires effective cooperation of
anesthesia and ECC. The combined use of ECC and CIIA with SLET intubation
in TTCS is a safe, effective approach that warrants broader clinical
application.

<138>
Accession Number
648477430
Title
A Commentary on "preemptive left stellate ganglion block reduces the
incidence and severity of cardiac surgery-associated acute kidney injury:
a randomized clinical trial".
Source
International journal of surgery (London, England). (no pagination),
2025. Date of Publication: 25 Aug 2025.
Author
Ye X.; Haifeng W.; Shi F.
Institution
(Ye) Department of Urology, Second Affiliated Hospital of Kunming Medical
University, Yunnan, China

<139>
Accession Number
648476800
Title
Impact of Right Atrial Appendage Ligation vs. Repair on Serum Atrial
Natriuretic Peptide, Brain Natriuretic Peptide, and Atrial Fibrillation
following Coronary Artery Bypass Grafting.
Source
Brazilian journal of cardiovascular surgery. (no pagination), 2025. Date
of Publication: 25 Aug 2025.
Author
Can M.F.; Sicim H.; Selcuk I.; Selcuk UN.; Temizkan V.
Institution
(Can) Adana Cukurova State Hospital Department of Cardiovascular Surgery
Adana Turkiye Department of Cardiovascular Surgery, Adana Cukurova State
Hospital, Adana, Turkey
(Sicim) Kirklareli Training and Research Hospital Department of
Cardiovascular Surgery Kirklareli Turkiye Department of Cardiovascular
Surgery, Kirklareli Training and Research Hospital
(Selcuk, Temizkan) Sultan Abdulhamid Han Training and Research Hospital
Department of Cardiovascular Surgery Istanbul Turkiye Department of
Cardiovascular Surgery, Sultan Abdulhamid Han Training and Research
Hospital, Istanbul, Turkey
(Selcuk) Dr. Siyami Ersek Thoracic and Cardiovascular Training and
Research Hospital Department of Cardiovascular Surgery Istanbul Turkiye
Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and
Cardiovascular Training and Research Hospital, Istanbul, Turkey
Abstract
OBJECTIVE: In this study, we aimed to compare the levels of serum atrial
natriuretic peptide (ANP) and brain natriuretic peptide (BNP) with
ligation and primary repair of right atrial appendage after venous
decannulation procedure in isolated coronary artery bypass grafting (CABG)
and their relationship with postoperative atrial fibrillation (POAF).
<br/>METHOD(S): In this prospective randomized study, 38 patients who
underwent isolated CABG in Haydarpasa Training Hospital between March 2015
and November 2015 were included. Patients were divided into two groups
whose atrial appendage were ligated (group A) or primary repaired (group
B) after right atrial appendage decannulation. Both groups were evaluated
in terms of perioperative serum ANP/BNP levels and POAF incidence. ANP/BNP
levels were measured by taking blood samples through the central venous
catheter on the preoperative day and postoperative days 1 and 3.
<br/>RESULT(S): While six POAF incidents were observed in group A, there
were none in group B. There was no statistical difference between the
groups (P > 0.05) in the evaluation of ANP/BNP levels. POAF rate in group
A was statistically significantly higher than in group B (P < 0.05).
<br/>CONCLUSION(S): No significant difference in perioperative ANP/BNP
levels was observed between the two groups. Also, no correlation between
ANP/BNP levels and POAF were detected. Development of POAF significantly
increased in group A. Therefore, we advocate that the prevalence of atrial
fibrillation might be reduced in patients who had undergone right atrial
repair with primary repair method.

<140>
Accession Number
648468861
Title
DAPAgliflozin for Renal protection in Heart Transplant recipients.
Rationale and design of the randomized controlled DAPARHT trial.
Source
American heart journal. (no pagination), 2025. Date of Publication: 19
Aug 2025.
Author
Holmen S.; Manintveld O.; Damman K.; Braun O.; Lofman I.H.; Szymanski M.;
Ravnestad H.; Gude E.; Bjorkelund E.; Andreassen A.K.; Gullestad L.; Broch
K.
Institution
(Holmen) Department of Cardiology, Oslo University Hospital,
Rikshospitalet, Oslo, Norway; Innlandet Hospital Trust, Hamar, Norway;
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo,
Norway. Electronic address: b19808@ous-hf.no
(Manintveld) Department of Cardiology, Cardiovascular Institute, Erasmus
Medical Center, 3015 GD, Rotterdam, The Netherlands; Erasmus MC Transplant
Institute, Erasmus University Medical Center Rotterdam, Rotterdam, The
Netherlands
(Damman) Department of Cardiology, University of Groningen, University
Medical Center Groningen, Groningen, Netherlands
(Braun) Skane University Hospital and Department of Clinical Sciences
Lund, Cardiology, Lund University, Lund, Sweden
(Lofman) Department of Medicine Solna, Karolinska Institutet, Department
of Cardiology, Karolinska University Hospital, Stockholm, Sweden
(Szymanski) University Medical Center Utrecht, Department of Cardiology,
Utrecht, Netherlands
(Ravnestad, Gullestad, Broch) Department of Cardiology, Oslo University
Hospital, Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine,
Faculty of Medicine, University of Oslo, Norway
(Gude, Bjorkelund, Andreassen) Department of Cardiology, Oslo University
Hospital, Rikshospitalet, Oslo, Norway
Abstract
BACKGROUND AND AIMS: Heart transplantation is the preferred treatment for
selected patients with end stage heart failure. Kidney function often
declines after heart transplantation. Sodium-glucose cotransporter 2
inhibitors (SGLT2i) slow the decline in eGFR in different populations.
However, the effect of SGLT2i on kidney function in heart transplant
recipients is unknown. <br/>METHOD(S): The DAPAgliflozin for Renal
protection in Heart Transplant recipients (DAPARHT) trial is an
investigator initiated, double blind, randomized, placebo-controlled trial
designed to assess dapagliflozin`s effect on kidney function in heart
transplant recipients. Adults heart transplanted at least one year prior
to randomization are eligible. Exclusion criteria include an estimated
glomerular filtration rate (eGFR) < 25 mL/min/1.73m2, diabetes type I, and
contraindication to study medication. Four hundred and thirty patients
will be randomized 1:1 to receive 12 months blinded treatment with
dapagliflozin 10 mg o.d. or placebo, followed by 24-months open-label
treatment. The primary endpoint is the chronic slope of the eGFR from two
weeks to 12 months after starting randomized treatment. The open-label
phase evaluates dapagliflozin's long-term effects on kidney function,
clinical outcomes, safety, and tolerability. Enrolment began in June 2022.
As of December 18th 2024, 300 patients were enrolled. The mean baseline
creatinine was 104 +/- 28 mumol/L with corresponding eGFR of 66 +/- 22
mL/min/1.73m2. Estimated last patient visit is in September, 2028.
<br/>CONCLUSION(S): The DAPARHT trial will test whether dapagliflozin
improves eGFR slope compared to placebo during one year of follow-up,
providing the first randomized evidence of the efficacy of SGLT2i in heart
transplant recipients.<br/>Copyright &#xa9; 2025. Published by Elsevier
Inc.

<141>
Accession Number
648472766
Title
The role of angiotensin receptor/neprilysin inhibitor in moderate ischemic
mitral regurgitation after isolated coronary artery bypass grafting
(ARNI-MIMIC): study protocol for a randomized controlled trial.
Source
The American journal of cardiology. (no pagination), 2025. Date of
Publication: 21 Aug 2025.
Author
Tiemuerniyazi X.; Chen L.; He L.; Yang Z.; Huang S.; Nan Y.; Song Y.; Yuan
X.; Hu Z.; Zhao D.; Zhao W.; Feng W.
Institution
(Tiemuerniyazi, Chen, He, Yang, Huang, Nan, Song, Yuan, Hu, Zhao, Feng)
Department of Cardiovascular Surgery, Fuwai Hospital, National Center for
Cardiovascular Diseases, National Clinical Research Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking
Union Medical College, Beijing, China
(Zhao) Department of Cardiovascular Surgery, Fuwai Hospital, National
Center for Cardiovascular Diseases, National Clinical Research Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking
Union Medical College, Beijing, China
Abstract
Debates have been existed regarding the treatment of moderate ischemic
mitral regurgitation (IMR) in patients undergoing coronary artery bypass
grafting (CABG). While it might have priority on reducing the risk of
recurrent IMR, studies showed that concomitant mitral valve repair
increases the risk of adverse outcomes, such as neurological events, as
well as the in-hospital costs. In recent studies, angiotensin
receptor-neprilysin inhibitor (ARNI) was discovered to have potential
benefit in reducing the severity of IMR. The ARNI-MIMIC is a randomized
controlled clinical trial aiming to reduce the risk of recurrent IMR in
isolated CABG patients. A total of 220 eligible patients with moderate IMR
will be allocated into control (non-ARNI) and intervention (ARNI) groups
in a 1:1 pattern after isolated CABG. Patients in the intervention group
will be administered with continuous sacubitril/valsartan for 6 months
postoperatively, while patients in the control group will receive
guideline recommended therapy only. All of the patients will be invited to
complete 6-month follow-up. The primary endpoint is the change in the
effective regurgitant orifice area (EROA) of the mitral valve, which is
obtained by echocardiography and calculated by subtracting the follow-up
EROA from the preoperative EROA. This trial aims to investigate the
potential role of ARNI as compared to the control in moderate IMR patients
undergoing isolated CABG. If ARNI is proven to reduce the risk of moderate
IMR recurrence, patients will benefit from both improved life quality and
decreased medical costs. ETHICS APPROVAL AND DISSEMINATION: The This study
was approved by the Institutional Review Board of Fuwai Hospital on
October 18th 2024, with an approval number of 2024-2446. The results of
this trail will be disseminated through international academic conferences
and publication in medical journals regardless of the study outcomes.
TRIAL REGISTRATION: ClinicalTrials.gov ID NCT06917664.<br/>Copyright
&#xa9; 2025 The Author(s). Published by Elsevier Inc. All rights reserved.

<142>
Accession Number
648462663
Title
Understanding the Rhythm Within: How Anti-Obesity Treatments Alter Heart
Rate Variability.
Source
Obesity Facts. Conference: 32nd European Congress on Obesity, ECO 2025.
Malaga Spain. 18(Supplement 1) (pp 603), 2025. Date of Publication: 01 Jul
2025.
Author
Rodrigues Facanha J.; Carvalho Junior J.; De Oliveira J.M.P.; Beatriz Vera
Rodrigues C.; Giorelli G.; Bedin-Pochini A.
Institution
(Rodrigues Facanha, Carvalho Junior, De Oliveira, Beatriz Vera Rodrigues)
Nutrology Academy, Brazil
(Giorelli, Bedin-Pochini) Hospital Israelita Albert Einstein, Brazil
Publisher
S. Karger AG
Abstract
Introduction: Heart rate variability (HRV) reflects fluctuations in the
timing between heartbeats, offering insights into the autonomic nervous
system's (ANS) activity and balance. Research suggests HRV is a valuable
health indicator, with lower variability linked to an increased risk of
mortality and the early onset of various health conditions. Studies
further reveal an inverse relationship between HRV and weight gain or
obesity. <br/>Method(s): A PubMed database search was conducted using the
strategy: (('Anti-Obesity Agents' OR 'Bariatric Surgery') AND 'Heart
Rate'), yielding 319 articles. A filter was applied to include studies
published in the last 20 years, reducing the count to 185 articles. After
screening titles and abstracts for eligibility, 22 articles were
considered relevant, with one excluded due to inaccessible full text.
<br/>Result(s): Three RCTs assessed the effects of GLP-1 agonists on HRV
using 5-minute ECG recordings. Exenatide (acute, 1 week) increased the
LF/HF ratio (median: 0.6, [-0.3 to -3.2]; p < 0.05), while liraglutide (12
weeks) showed no significant impact on HRV (p > 0.05). Fifteen studies
examined the impact of bariatric surgery (6 to 12 months post-operation)
and consistently identified positive effects on HRV (p < 0.05). Two
studies found additional HRV improvements in patients who engaged in
aerobic exercise following surgery. Findings for sibutramine were mixed.
One observational study reported increased HRV with weight loss, while
another found no change despite weight loss. A separate case-control study
using 24-hour Holter monitoring showed no HRV improvement.
<br/>Conclusion(s): Most studies evaluate HRV over short periods, limiting
the understanding of long-term effects, as treatments may yield
fluctuating impacts. Further research is needed, and wearable devices
could offer a promising approach for continuous HRV monitoring, providing
deeper insights into the relationship between anti-obesity treatments and
autonomic function.

<143>
Accession Number
648471042
Title
A Commentary on "preemptive Left Stellate Ganglion Block Reduces the
Incidence and Severity of Cardiac Surgery-associated Acute Kidney Injury:
a Randomized Clinical Trial".
Source
International journal of surgery (London, England). (no pagination),
2025. Date of Publication: 21 Aug 2025.
Author
Xue F.-S.; Wang D.-F.; Zheng X.-C.
Institution
(Xue, Wang, Zheng) Department of Anesthesiology, Shengli Clinical Medical
College of Fujian Medical University, Fuzhou University Affiliated
Provincial Hospital, Fujian Provincial Hospital, Fuzhou, China
(Xue) Department of Anesthesiology, Beijing Anzhen Hospital, Capital
Medical University, Beijing, China

<144>
Accession Number
648435674
Title
Fractional Flow Reserve-Guided Complete vs Culprit-Only Revascularization
in Non-ST-Elevation Myocardial Infarction and Multivessel Disease: The
SLIM Randomized Clinical Trial.
Source
JAMA. (no pagination), 2025. Date of Publication: 31 Aug 2025.
Author
Pustjens T.F.S.; Veenstra L.; Camaro C.; Ruiters A.W.; Lux A.; Ruzsa Z.;
Piroth Z.; Ilhan M.; Vainer J.; Gho B.; Winkler P.J.C.; Stein M.;
Theunissen R.A.L.J.; Kala P.; Polad J.; Berta B.; Gabrio A.; van Royen N.;
van 't Hof A.W.J.; Rasoul S.
Institution
(Pustjens, Veenstra, Ruiters, Ilhan, Gho, Winkler, Stein, van 't Hof,
Rasoul) Department of Cardiology, Zuyderland Medical Centre, Heerlen,
Netherlands
(Pustjens, Lux, van 't Hof, Rasoul) Department of Cardiovascular Research
Institute Maastricht (CARIM), Maastricht University, Maastricht,
Netherlands
(Pustjens, Veenstra, Lux, Ilhan, Vainer, Theunissen, van 't Hof, Rasoul)
Department of Cardiology, Maastricht University Medical Centre,
Maastricht, Netherlands
(Camaro, van Royen) Department of Cardiology, Radboud University Medical
Centre, Nijmegen, Netherlands
(Ruzsa) Invasive Cardiology Division, Internal Medicine Department,
University of Szeged, Szeged, Hungary
(Piroth) Hungarian Institute of Cardiology, Budapest, Hungary
(Kala) Clinic of Cardiology, Masaryk University and University Hospital
Brno, Brno, Czechia
(Polad) Department of Cardiology, Jeroen Bosch Hospital, 's-Hertogenbosch,
Netherlands
(Berta) Invasive Cardiology Department, Bacs-Kiskun County Hospital,
Kecskemet, Hungary
(Gabrio) Department of Methodology and Statistics, Faculty of Health
Medicine and Life Science, Maastricht University, Maastricht, Netherlands
Abstract
Importance: The benefits of fractional flow reserve (FFR)-guided complete
coronary revascularization in patients with non-ST-segment elevation
myocardial infarction (NSTEMI) and multivessel disease remain unclear.
<br/>Objective(s): To compare FFR-guided complete revascularization of
nonculprit lesions vs culprit-only revascularization in patients with
NSTEMI and multivessel disease. <br/>Design, Setting, and Participant(s):
This prospective, investigator-initiated, multicenter, international
randomized clinical trial was conducted at 9 hospitals in Europe. Patients
with NSTEMI and multivessel disease who had successful revascularization
of the culprit lesion were enrolled between June 2018 and July 2024, and
final follow-up was completed on July 21, 2025. The analysis was conducted
on July 28, 2025. Eligibility criteria included the presence of at least 1
stenosis of at least 50% in a nonculprit lesion amendable for
revascularization. <br/>Intervention(s): Patients were randomized to
receive either FFR-guided complete or culprit-only revascularization
during the index procedure. Staged revascularization within 6 weeks after
the index procedure was allowed in the culprit-only group. <br/>Main
Outcomes and Measures: The primary outcome was a composite of all-cause
death, nonfatal myocardial infarction, any revascularization, and stroke
at 1 year. Key secondary outcomes included individual components of the
primary outcome, net adverse clinical events, all-cause death or nonfatal
myocardial infarction, cardiac rehospitalization, and bleeding events.
<br/>Result(s): Among 478 randomized patients (mean [SD] age, 65.9 [10.6]
years; 347 [72.9%] males), 240 were randomized to receive FFR-guided
complete revascularization and 238 were randomized to receive culprit-only
revascularization, with crossover occurring in 7 patients in the
culprit-only group. The primary outcome occurred in 13 patients (5.5%) in
the FFR-guided complete revascularization group vs 32 patients (13.6%) in
the culprit-only group (hazard ratio [HR], 0.38 [95% CI, 0.20-0.72]; P =
.003). Rates of any revascularization (3.0% vs 11.5%; HR, 0.24 [95% CI,
0.11-0.56]; P < .001) and net adverse clinical events (6.3% vs 15.3%; HR,
0.39 [95% CI, 0.21-0.70]; P = .002) were also significantly lower in the
complete revascularization group, while there were no significant
differences in the remaining secondary outcomes. Conclusion and Relevance:
FFR-guided complete revascularization during the index procedure resulted
in a significant reduction in the composite of all-cause death, nonfatal
myocardial infarction, any revascularization, and stroke at 1 year. This
was mainly driven by reduced repeat revascularization. Trial Registration:
ClinicalTrials.gov Identifier: NCT03562572.

<145>
Accession Number
648430684
Title
Discontinuation of renin-angiotensin system inhibitors before non-cardiac
surgery: a meta-analysis.
Source
European heart journal. (no pagination), 2025. Date of Publication: 29
Aug 2025.
Author
Bena Nnang J.Y.; Tembi T.B.T.; Fodop S.G.J.; Mekontso J.G.K.; Esene I.N.
Institution
(Bena Nnang, Fodop, Esene) Research Division, Winners Foundation, Yaounde,
Cameroon
(Bena Nnang) Faculty of Medicine and Biomedical Sciences, University of
Yaounde I, Yaounde, Cameroon
(Tembi) Hubert Department of Global Health, Rollins School of Public
Health, Emory University, Atlanta, United States
(Fodop) School of Health and Medical Sciences, Catholic University, Kumbo,
Cameroon
(Mekontso) New York City Health + Hospitals, South Brooklyn Health, NY,
United States
(Esene) Faculty of Health Sciences, University of Bamenda, Cameroon
Abstract
BACKGROUND AND AIMS: The best management approach for renin-angiotensin
system (RAS) inhibitor use before surgery is controversial. Some studies
have suggested that continuation could increase the risk of clinically
significant peri-operative hypotension and, thus, organ injury. By
contrast, others believe that withholding them significantly increases the
risk of severe hypertension and heart failure. To determine the most
effective strategy, this systematic review and meta-analysis of randomized
controlled trials compared discontinuation vs continuation of RAS
inhibitors in patients undergoing non-cardiac and non-vascular surgeries.
<br/>METHOD(S): PubMed, Embase, and the Cochrane Central Register of
Controlled Trials (CENTRAL) databases were searched for randomized
controlled trials that compared discontinuation vs continuation of RAS
inhibitors in patients undergoing non-cardiac and non-vascular surgery.
<br/>RESULT(S): Five randomized controlled trials (n = 10 773 patients;
5388 randomized to discontinuation) were included. Discontinuation of an
RAS inhibitor probaby reduced peri-operative hypotension (27.66% vs
34.06%; risk ratio [RR] 0.81, 95% confidence interval [CI] 0.73-0.89;
moderate certainty). The evidence is very uncertain about effects on
peri-operative hypertension (9.46% vs 8.05%; RR 1.38, 95% CI 0.66-2.89;
very low certainty). For major clinical outcomes, discontinuation
suggested little to no difference in acute kidney injury (10.45% vs
10.69%; RR 0.98, 95% CI 0.66-1.45; low certainty), acute heart failure
(5.38% vs 5.32%; RR 1.00, 95% CI 0.76-1.31; low certainty), myocardial
infarction (1.22% vs 1.00%; RR 1.19, 95% CI 0.60-2.39; low certainty),
stroke (0.42% vs 0.40%; RR 1.04, 95% CI 0.56-1.93; low certainty), and
arrhythmias (1.80% vs 1.40%; RR 1.28, 95% CI 0.69-2.38; low certainty).
<br/>CONCLUSION(S): These findings suggest that discontinuation of RAS
inhibitors is likely to reduce peri-operative hypotension in patients
undergoing non-cardiac, non-vascular surgery, but the evidence is very
uncertain about effects on peri-operative hypertension and major clinical
outcomes.<br/>Copyright &#xa9; 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

<146>
Accession Number
648445466
Title
Aspirin dosing after acute coronary syndrome with suspected aspirin
resistance: the ANDAMAN trial.
Source
European heart journal. (no pagination), 2025. Date of Publication: 30
Aug 2025.
Author
Dillinger J.-G.; Pezel T.; Batias L.; Angoulvant D.; Goralski M.; Ferrari
E.; Cayla G.; Silvain J.; Gilard M.; Lemesle G.; Souteyrand G.; Lim P.;
Roubille F.; Georges J.-L.; Bal Dit Sollier C.; Petroni T.; Morel O.;
Delarche N.; Elbaz M.; Puymirat E.; Toupin S.; Montalescot G.; Drouet L.;
Vicaut E.; Henry P.
Institution
(Dillinger, Pezel, Toupin, Henry) Department of Cardiology, Hopital
Lariboisiere, Assistance Publique-Hopitaux de Paris ,2 Rue Ambroise Pare,
Paris, France
(Dillinger, Pezel, Toupin) MIRACL.ai Laboratory, Multimodality Imaging for
Research and Artificial Intelligence Core Laboratory, University Hospital
of Lariboisiere (AP-HP), Paris, France
(Dillinger, Bal Dit Sollier, Drouet) Centre de Reference et d'Education
des Antithrombotiques d'Ile de France, Hopital Lariboisiere, Assistance
Publique-Hopitaux de Paris, Paris, France
(Batias) Centre Hospitalier Metropole Savoie, Service de Cardiologie,
Place Lucien Biset, Chambery 73000, France
(Angoulvant) Cardiology Department, CHU Tours, Universite de Tours, Tours,
France
(Goralski) Cardiology Department, Orleans, France
(Ferrari) Cardiology Department, Pasteur University Hospital, Nice, France
(Cayla) Cardiology Department, Nimes University Hospital, Montpellier
University, ACTION Study Group, Nimes, France
(Silvain, Montalescot) ACTION Study Group, Sorbonne Universite, INSERM
UMRS1166, Hopital Pitie-Salpetriere (AP-HP), Paris, France
(Gilard) Chest Diseases, CHU Brest, Univ Brest, Brest, France
(Lemesle) Heart and Lung Institute, University Hospital of Lille, CHU
Lille, Lille F, France
(Lemesle) Medical School, University of Lille, France
(Lemesle) Institut Pasteur of Lille, Lille F, France
(Lemesle) FACT (French Alliance for Cardiovascular Trials), Paris F,
France
(Souteyrand) Institut Pascal, CNRS SIGMA UCA UMR 6602 University Hospital
Gabriel Montpied, Clermont-Ferrand, France
(Lim) Service de Cardiologie, Univ Paris Est Creteil, INSERM, IMRB, AP-HP,
Hopital Universitaire Henri-Mondor, Creteil F-94010, France
(Roubille) PhyMedExp, Cardiology Department, Universite de Montpellier,
INSERM, CNRS, CHU de Montpellier, Montpellier, France
(Georges) Service de Cardiologie, Cardiologie Interventionnelle, Centre
Hospitalier de Versailles, Hopital Andre Mignot, France
(Petroni) Cardiology Department, Clinique Pont de Chaume, Montauban,
France
(Morel) Division of Cardiovascular Medicine, Nouvel Hopital Civil,
Strasbourg University Hospital, UR 3074 Translational CardioVascular
Medicine CRBS, Strasbourg, France
(Delarche) Cardiology Department, Hopital Francois Mitterrand, Pau, France
(Elbaz) Center for Clinical Investigation (CIC1436)/CARDIOMET, Rangueil
University Hospital, Toulouse, France
(Puymirat) Department of Cardiology, Assistance Publique-Hopitaux de Paris
(AP-HP), Hopital Europeen Georges Pompidou, Paris, France
(Puymirat) Faculte de Sante, Paris, France
(Vicaut) Unite de Recherche Clinique, ACTION Group, Paris, France
Abstract
BACKGROUND AND AIMS: Despite current antithrombotic treatments, the
recurrence of ischaemic events remains high in patients with diabetes
mellitus (DM) or aspirin resistance after acute coronary syndrome (ACS).
Whether twice-daily aspirin dosing reduces major adverse cardiovascular
events (MACE) in this population remains unknown. <br/>METHOD(S): In this
prospective multicentre, randomized trial, patients with ACS and DM or
high-risk of aspirin resistance (HRAR) defined as: (i) an index event
occurring while on aspirin; (ii) body mass index >=27 kg/m2; or (iii)
increased waist circumference were assigned to receive enteric-coated
aspirin once daily (100 mg/day) or twice daily (100 mg morning and
evening). The primary outcome was MACE, a composite of any death,
myocardial infarction, stroke, urgent coronary revascularization, stent
thrombosis, or acute arterial thrombotic event assessed using a
time-to-first-event analysis. The main secondary outcome was major
bleeding (Bleeding Academic Research Consortium type 3-5). <br/>RESULT(S):
In total, 2484 participants were enrolled (77.2% with DM, 55.5% with
ST-elevation segment myocardial infarction). The median follow-up duration
was 18 (interquartile range: 17.6-18.3) months. The primary outcome
occurred in 95 of 1228 participants (7.7%) in the twice-daily aspirin
group, and 110 of 1256 (8.8%) in the once-daily group (hazard ratio [HR]
0.90; 95% confidence interval [CI] 0.69-1.19; P = .42). Major bleeding
rates were similar between the groups (1.9% vs 2.1%; HR 0.88; 95% CI
0.50-1.55). <br/>CONCLUSION(S): In patients with ACS and DM or HRAR,
twice-daily aspirin did not significantly reduce the risk of MACE compared
to once-daily dosing. No significant difference was observed in major
bleeding between groups. TRIAL REGISTRATION: NCT02520921/EUDRACT No:
2015-000947-18.<br/>Copyright &#xa9; 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

<147>
Accession Number
648435790
Title
Beta-Blockers after Myocardial Infarction in Patients without Heart
Failure.
Source
The New England journal of medicine. (no pagination), 2025. Date of
Publication: 30 Aug 2025.
Author
Munkhaugen J.; Kristensen A.M.D.; Halvorsen S.; Holmager T.; Olsen M.H.;
Bakken A.; Sehested T.S.G.; Ruddox V.; Maeng M.; Vikenes K.; Jensen S.E.;
Steigen T.; Lambrechtsen J.; Jortveit J.; Bovin A.; Schirmer H.;
Christiansen M.K.; Wiseth R.; Mikkelsen D.; Larsen A.I.; Kjaergaard C.L.;
Andresen K.; Gustafsson I.; Tuseth V.; Larsen M.L.; Deeg P.S.; Veien K.;
Bohmer E.; Botker H.E.; Brattrud A.O.; Bronnum-Schou J.; Pettersen A.R.;
Bang L.E.; Oie E.; Engstrom T.; Borg E.B.; Kristensen K.; Nymo S.H.;
Gislason G.; Vethe N.T.; Abdulla J.A.M.; Dammen T.; Mouridsen M.R.; Bendz
B.; Bertelsen M.L.N.; Hove J.D.; Schierbeck L.; Snoer M.; Davidsen C.;
Egholm G.; Thomsen K.K.; Jadou G.; Poenaru M.; Krarup N.T.; Bottcher M.;
Staehr P.B.; Zwisler A.-D.; Edvardsen T.; Torp-Pedersen C.; Otterstad
J.E.; Lange T.; Fagerland M.W.; Atar D.; Prescott E.
Institution
(Munkhaugen) Department of Medicine, Drammen Hospital, Vestre Viken Trust,
Drammen, Norway
(Munkhaugen) Department of Behavioural Medicine, Faculty of Medicine,
University of Oslo, Oslo, Norway
(Kristensen, Holmager, Kjaergaard, Gustafsson, Prescott) Department of
Cardiology, Bispebjerg-Frederiksberg Hospital, University of Copenhagen,
Copenhagen, Denmark
(Halvorsen, Bakken, Atar) Department of Cardiology, Oslo University
Hospital Ullevaal, Oslo, Norway
(Halvorsen, Schirmer, Andresen, Oie, Dammen, Bendz, Edvardsen, Atar)
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo,
Oslo, Norway
(Olsen) Department of Clinical Medicine, University of Copenhagen,
Copenhagen, Denmark
(Olsen) Department of Internal Medicine, Holbaek Hospital, Denmark
(Sehested, Bang, Engstrom) Department of Cardiology, Copenhagen University
Hospital-Rigshospitalet, Copenhagen, Denmark
(Ruddox, Otterstad) Department for Cardiology, Vestfold Hospital Trust,
Vestfold, Norway
(Maeng) Department of Cardiology, Aarhus University Hospital, Aarhus,
Denmark
(Vikenes, Tuseth) Department of Heart Disease, Haukeland University
Hospital
(Vikenes, Tuseth, Davidsen) University of Bergen, Bergen, Norway
(Jensen, Larsen) Department of Cardiology, Aalborg University Hospital,
Aalborg, Denmark
(Steigen) Department of Cardiology, Tromso, University Hospital of North
Norway and the Arctic University of Tromso, Norway
(Lambrechtsen) Odense University Hospital Svendborg and Cardiovascular
Research Unit, Odense, Denmark
(Jortveit) Department of Cardiology, Sorlandet Hospital Arendal, Arendal,
Norway
(Bovin) Department of Cardiology, Sygehus Lillebaelt, Vejle, Denmark
(Schirmer) Department of Cardiology, Akershus University Hospital, Norway
(Christiansen) Department of Internal Medicine, Horsens Regional Hospital,
Viborg, Denmark
(Christiansen, Krarup) Department of Cardiology, Viborg Regional Hospital,
Viborg, Denmark
(Wiseth) Clinic of Cardiology, St. Olavs University Hospital, Trondheim,
Norway
(Wiseth) Norwegian University of Science and Technology, Trondheim, Norway
(Mikkelsen) Department of Cardiology, Copenhagen University Hospital -
Naestved, Slagelse, and Ringsted, Slagelse, Denmark
(Mikkelsen) Slagelse Hospital, Slagelse, Denmark
(Larsen) Department of Cardiology, Stavanger University Hospital and
University of Bergen, Stavanger, Norway
(Andresen, Bendz, Edvardsen) Department of Cardiology, Oslo University
Hospital Rikshospitalet, Oslo, Norway
(Deeg) Department of Cardiology, Ostfold Hospital Trust Kalnes, Norway
(Veien, Egholm) Department of Cardiology, Odense University Hospital,
Odense, Denmark
(Bohmer) Innlandet Hospital Trust, Lillehammer, Norway
(Botker) Department of Clinical Medicine, Section of Clinical Epidemiology
and Cardiology, Health, Aarhus University, Aarhus, Denmark
(Brattrud) Innlandet Hospital Trust, Hamar, Norway
(Bronnum-Schou) Department of Cardiology, Copenhagen University Hospital -
Amager and Hvidovre, Denmark
(Pettersen) Department of Medicine, Vestre Viken Hospital Trust, Ringerike
Hospital, Buskerud, Norway
(Oie) Department of Internal Medicine, Diakonhjemmet Hospital, Oslo,
Norway
(Borg) Innlandet Hospital Trust, Norway
(Kristensen) Department of Internal Medicine, Copenhagen University
Hospital, Denmark
(Nymo) Department of Cardiology, Nordland Hospital Trust, Bodo, Norway
(Gislason) Department of Cardiology, Copenhagen University Hospital -
Herlev and Gentofte, Gentofte, Denmark
(Vethe) Department of Pharmacology, Oslo University Hospital and
Department of Pharmacy, University of Oslo, Oslo, Norway
(Abdulla) Department of Medicine, Section of Cardiology, Glostrup
Hospital, Copenhagen, Denmark
(Dammen) Division of Mental Health and Addiction, Department of Research
and Innovation, Oslo University Hospital, Oslo, Norway
(Mouridsen) Department of Cardiology, Copenhagen University Hospital,
Herlev, Denmark
(Bertelsen, Schierbeck, Torp-Pedersen) Department of Cardiology,
Copenhagen University Hospital-North Zealand Hospital, Denmark
(Hove) Department of Cardiology, Copenhagen University Hospital - Amager
and Hvidovre, Hvidovre, Denmark
(Snoer) Department of Cardiology, Zealand University Hospital Roskilde,
Roskilde, Denmark
(Thomsen) Department of Cardiology, Sydvestjysk Sygehus, Esbjerg, Denmark
(Jadou) Department of Cardiology, Sygehus Sonderjylland, Aabenraa, Denmark
(Poenaru) Department of Cardiology, Sygehus Lillebaelt, Kolding, Denmark
(Bottcher) Department of Cardiology, Godstrup Hospital, Herning, Denmark
(Staehr) Department of Cardiology, North Denmark Regional Hospital,
Denmark
(Zwisler) Clinic for Palliative Medicine, Rehabilitation and
Patient-centered Care, Department of Oncology, Rigshospitalet, Copenhagen,
Denmark
(Zwisler) Department of Clinical Medicine, Faculty of Health and Medical
Sciences, University of Copenhagen, Copenhagen, Denmark
(Lange) Section of Biostatistics, Department of Public Health, University
of Copenhagen, Copenhagen, Denmark
(Fagerland) Oslo Centre for Biostatistics and Epidemiology, Research
Support Services, Oslo University Hospital, Oslo, Norway
Abstract
BACKGROUND: The evidence supporting beta-blocker therapy after myocardial
infarction was established before the introduction of modern coronary
reperfusion therapy and secondary prevention strategies. <br/>METHOD(S):
In an open-label, randomized trial with blinded end-point evaluation,
conducted in Denmark and Norway, we assigned patients who had had a
myocardial infarction and who had a left ventricular ejection fraction of
at least 40%, in a 1:1 ratio, to receive long-term beta-blocker therapy
within 14 days after the event or no beta-blocker therapy. The primary end
point was a composite of death from any cause or major adverse
cardiovascular events (new myocardial infarction, unplanned coronary
revascularization, ischemic stroke, heart failure, or malignant
ventricular arrhythmias). <br/>RESULT(S): A total of 5574 patients
underwent randomization and were included in the main analyses - 2783 in
the beta-blocker group and 2791 in the no-beta-blocker group. After a
median follow-up of 3.5 years (interquartile range, 2.2 to 4.6), a primary
end-point event had occurred in 394 patients (14.2%) in the beta-blocker
group and in 454 patients (16.3%) in the no-beta-blocker group (hazard
ratio, 0.85; 95% confidence interval [CI], 0.75 to 0.98; P = 0.03). Death
from any cause occurred in 4.2% of the patients in the beta-blocker group
and in 4.4% of those in the no-beta-blocker group; myocardial infarction
occurred in 5.0% and 6.7%, respectively (hazard ratio, 0.73; 95% CI, 0.59
to 0.92), unplanned coronary revascularization in 3.9% and 3.9%, ischemic
stroke in 1.6% and 1.3%, heart failure in 1.5% and 1.9%, and malignant
ventricular arrhythmias in 0.5% and 0.6%. No apparent differences in
safety outcomes were observed between the groups. <br/>CONCLUSION(S):
Among patients with a myocardial infarction and a left ventricular
ejection fraction of at least 40%, beta-blocker therapy led to a lower
risk of death or major adverse cardiovascular events than no beta-blocker
therapy. (Funded by the Health South-East research program in Norway and
others; BETAMI-DANBLOCK ClinicalTrials.gov numbers, NCT03646357 and
NCT03778554.).<br/>Copyright &#xa9; 2025 Massachusetts Medical Society.

<148>
Accession Number
2040345495
Title
Recto-intercostal fascial plane block: A scoping review.
Source
Trends in Anaesthesia and Critical Care. 64 (no pagination), 2025. Article
Number: 101590. Date of Publication: 01 Oct 2025.
Author
Sirohiya P.; Singh R.; Ratre B.K.; Kumar B.
Institution
(Sirohiya, Kumar) Department of Onco-Anaesthesia and Palliative Medicine,
National Cancer Institute (Jhajjar), AIIMS, New Delhi, India
(Singh) Department of Anaesthesiology, Pain Medicine and Critical Care,
AIIMS, New Delhi, India
(Ratre) Department of Onco-Anaesthesia and Palliative Medicine, Dr. BRA
IRCH, AIIMS, New Delhi, India
Publisher
Churchill Livingstone
Abstract
Background: The recto-intercostal fascial plane block (RIFPB) is a novel
ultrasound-guided regional anesthesia technique intended to provide
analgesia for the anterior thoracoabdominal wall, particularly the
subxiphoid and epigastric regions. Unlike established modalities such as
thoracic epidural, transversus abdominis plane (TAP) block, or parasternal
intercostal plane block (PIPB)-which are limited by side-effect profiles
or incomplete cranial/epigastric spread-RIFPB seeks to target intercostal
nerves in a safe and relatively avascular plane. Early case reports
suggest potential benefits in patients undergoing sternotomy or upper
abdominal surgery, but the evidence base remains preliminary.
<br/>Objective(s): This scoping review aimed to systematically map and
synthesize the current evidence on RIFPB, focusing on its anatomical
basis, technical feasibility, clinical applications, dermatomal coverage,
and safety considerations. Eligibility criteria: Eligible sources included
cadaveric studies, letters, case reports, case series, abstracts, and
conceptual reports describing the anatomical spread, technique, or
clinical utility of RIFPB. Only studies published in English were
considered. Randomized controlled trials were not identified. Sources of
evidence: A comprehensive search was conducted across PubMed, Embase,
Scopus, Cochrane Library, and Google Scholar from database inception to
June 2025. Grey literature, including professional society proceedings
(ASRA, ESRA) and preprint servers (medRxiv, Research Square), was also
screened. Charting methods: Records were imported into EndNote, then
transferred to Rayyan.ai for screening. Duplicates were removed manually.
Title/abstract and full-text screening were independently performed by two
reviewers, with discrepancies resolved by consensus or a third reviewer. A
standardized data extraction form (Microsoft Excel) was used to capture
study characteristics, technique details, dermatomal coverage, and
outcomes. <br/>Result(s): Ten publications were included: six case
reports/letters, one cadaveric study, one conceptual description, one case
series, and one conference abstract. Most clinical reports described use
in cardiac surgery, typically in combination with a PIPB for sternotomy
analgesia. Two reports involved upper abdominal surgery. The cadaveric
study demonstrated consistent dye spread between T6-T9, supporting the
anatomical rationale for epigastric analgesia. Clinical studies variably
reported sensory involvement from T5-T11, although testing methods were
inconsistent. No randomized controlled trials were identified. Across
available evidence, RIFPB was consistently described as technically
feasible, safe, and free from major complications, including in pediatric
patients. <br/>Conclusion(s): RIFPB appears to be a feasible, anatomically
rational, and potentially valuable adjunct to the existing repertoire of
anterior thoracoabdominal wall blocks. Its ability to provide epigastric
analgesia positions it as complementary to PIPB and TAP blocks,
particularly in cardiac and upper abdominal surgery. However, the current
evidence is limited to preliminary, case-based reports without
standardized outcome measures or comparative data. Future research should
focus on prospective, randomized trials with validated pain scores, opioid
consumption metrics, and safety endpoints to establish efficacy and
generalizability. Until then, RIFPB should be regarded as an experimental
but promising technique rather than a replacement for established
modalities.<br/>Copyright &#xa9; 2025 Elsevier Ltd

<149>
Accession Number
648431510
Title
Tricuspid valve replacement outcomes by baseline tricuspid regurgitation
severity: the TRISCEND II trial.
Source
European heart journal. (no pagination), 2025. Date of Publication: 29
Aug 2025.
Author
Lurz P.; Hahn R.T.; Kodali S.; Makkar R.; Sharma R.P.; Davidson C.J.;
O'Neill B.P.; Yadav P.; Zahr F.; Chadderdon S.; Eleid M.F.; Szerlip M.;
Smith R.; Whisenant B.; Garcia S.; Kister T.; Kipperman R.M.; Lim S.;
Saxon J.; Kapadia S.; Hermiller J.; Mishell J.M.; Rassi A.; Herrmann H.C.;
Szeto W.; Hausleiter J.; Babaliaros V.; Barker C.M.; Lindman B.R.; Latib
A.; Muhammad K.; von Bardeleben R.S.; Summers M.; Chetcuti S.; Ailawadi
G.; Russo M.; Rinaldi M.; Chehab B.M.; Nickenig G.; Stinis C.;
Inglessis-Azuaje I.; Dhoble A.; Chhatriwalla A.K.; Petrossian G.; Shah P.;
Staniloae C.; Williams M.; Nores M.; McCabe J.M.; Singh G.; Baldus S.;
Rudolph V.; Barb I.; Klodell C.; Gray W.; Strote J.; Sannino A.; Grayburn
P.; Mack M.J.; Leon M.B.; Thourani V.H.
Institution
(Lurz, von Bardeleben) University Medical Centre Mainz, Mainz, Germany
(Hahn, Kodali, Leon) Columbia University Irving Medical Center, NY, United
States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Sharma) Stanford University, Stanford, CA, United States
(Davidson) Northwestern University, Chicago, IL, United States
(O'Neill) Henry Ford Hospital, Detroit, MI, United States
(Yadav, Thourani) Piedmont Heart Institute, Atlanta, GA, United States
(Zahr, Chadderdon) Oregon Health & Science University, Portland, Oregon,
USA
(Eleid) Mayo Clinic, Rochester, MN, United States
(Szerlip, Smith, Grayburn, Mack) Baylor Scott & White: The Heart Hospital
Plano, Plano, TX, United States
(Whisenant) Intermountain Medical Center, Murray, UT, United States
(Garcia) Christ Hospital, Cincinnati, OH, United States
(Kister) Heart Center Leipzig at Leipzig University, Leipzig, Germany
(Kipperman) Atlantic Health System Morristown Medical Center, Morristown,
NJ, United States
(Lim, Saxon) University of Virginia, Charlottesville, VA, United States
(Kapadia) Cleveland Clinic Foundation, Cleveland, OH, United States
(Hermiller) Ascension St. Vincent Heart Center of Indiana, Indianapolis,
IN, United States
(Mishell, Rassi) Kaiser San Francisco Medical Center, San Francisco, CA,
United States
(Herrmann, Szeto) University of Pennsylvania, Philadelphia, PA, United
States
(Hausleiter) Klinikum der Universitat Munchen, Munich, Germany
(Babaliaros) Emory University Atlanta, Atlanta, GA, United States
(Barker, Lindman) Vanderbilt University Medical Center, Nashville, TN,
United States
(Latib) Montefiore Medical Center, The Bronx, NY, United States
(Muhammad) Oklahoma Heart Institute, Tulsa, OK, United States
(Summers) Sentara Norfolk General Hospital, Norfolk, VA, United States
(Chetcuti, Ailawadi) University of Michigan Hospital and Health Systems,
Ann Arbor, MI, United States
(Russo) Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ,
United States
(Rinaldi) Sanger Heart and Vascular Institute, Advocate Health, Charlotte,
North Carolina, USA
(Chehab) University of Kansas, Ascension Via Christi Hospital, Wichita,
KS, United States
(Nickenig) University Hospital Bonn, Bonn, Germany
(Stinis) Scripps Memorial Hospital La Jolla, La Jolla, CA, United States
(Inglessis-Azuaje) Massachusetts General Hospital, Boston, MA, United
States
(Dhoble) University of Texas Health Science Center at Houston, Houston,
TX, United States
(Chhatriwalla) Saint Luke's Hospital of Kansas City, Kansas City, MO,
United States
(Petrossian) St. Francis Hospital, Roslyn, NY, United States
(Shah) Brigham and Women's Hospital, Boston, MA, United States
(Staniloae, Williams) New York University Langone Medical Center, NY,
United States
(Nores) Florida Heart & Vascular Care - JFK, Atlantis, FL, United States
(McCabe) University of Washington, Seattle, WA, United States
(Singh) UC Davis Medical Center Sacramento, Sacramento, CA, United States
(Baldus) University Hospital of Cologne, Cologne, Germany
(Rudolph) University of Bad Oyenhausen, Germany
(Barb, Klodell) North Florida Hospital, Gainesville, FL, United States
(Gray) Lankenau Medical Center, Wynnewood, PA, United States
(Strote) UC Health Northern Colorado (Medical Center of the Rockies),
Loveland, CO, United States
(Sannino, Grayburn) Baylor Scott & White Research Institute Cardiac
Imaging Core Laboratory, Plano, TX, United States
Abstract
BACKGROUND AND AIMS: The TRISCEND II trial demonstrated superior clinical
benefits for patients with >=severe tricuspid regurgitation (TR) treated
with the EVOQUE transcatheter tricuspid valve replacement (TTVR) system
plus medical therapy versus medical therapy alone. This work reports
1-year and 18-month outcomes in patients stratified by baseline TR
severity. <br/>METHOD(S): The multicentre, prospective TRISCEND II trial
enrolled 400 patients with symptomatic, >=severe TR and randomised 2:1 to
TTVR (n=267) or control (n=133). In a post-hoc analysis, patients were
stratified into severe TR (n=172) and massive/torrential TR (n=220)
cohorts. Clinical and quality-of-life outcomes were reported at 1 year,
with Kaplan-Meier estimates for all-cause mortality and heart failure (HF)
hospitalisation assessed at 18 months. Study oversight included an
independent echocardiographic core laboratory, clinical events committee,
and data safety monitoring board. <br/>RESULT(S): One year after TTVR, TR
was <=mild in 95.2% of severe TR and 95.3% of massive/torrential TR
patients. The primary safety and effectiveness endpoint (win ratio)
favoured TTVR over control regardless of baseline TR severity: severe
(1.64 [95% CI: 1.11, 2.43]) and massive/torrential (2.20 [1.55, 3.14]). At
18 months, TTVR patients had similar mortality to controls (rate
difference: severe 0.2% [-11.6, 11.9], massive/torrential -5.8% [-17.6,
6.0], whereas HF hospitalisation rates favoured TTVR in the
massive/torrential cohort (vs. control, severe 9.8% [-3.0, 22.7],
massive/torrential -15.2% [-28.9, -1.5]). <br/>CONCLUSION(S): Patients
with >=severe TR benefit from TTVR, experiencing improvements in TR
severity, functional capacity, and quality of life regardless of baseline
TR severity, with a signal for greater benefit in patients with more
advanced disease.<br/>Copyright &#xa9; 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

<150>
Accession Number
648445951
Title
Practice Changing Updates in Perioperative Medicine Literature 2024. A
Systematic Review.
Source
The American journal of medicine. (no pagination), 2025. Date of
Publication: 29 Aug 2025.
Author
Khambaty M.; Silbert R.E.; Stephenson C.R.; Bartlett M.A.; Regan D.W.;
Sanchez J.J.; Sundsted K.K.; Mauck K.F.
Institution
(Khambaty, Regan, Sanchez, Sundsted) Division of Hospital Internal
Medicine, Department of Medicine, Mayo Clinic and Mayo Clinic College of
Medicine, Rochester, MN, United States
(Silbert, Stephenson, Bartlett, Mauck) Division of General Internal
Medicine, Department of Medicine, Mayo Clinic and Mayo Clinic College of
Medicine, Rochester, MN, United States
Abstract
Every year, new publications advance our understanding of perioperative
medicine. These publications are spread over a variety of journals that
require dedicated effort to identify. To aid this task, we have undertaken
a multi-database literature search from January to December of 2024. We
included original research articles, systematic reviews, meta-analyses,
and guidelines. We excluded abstracts, case reports, letters, or
literature pertaining to cardiovascular surgery, pediatrics, and
obstetrics. Two authors reviewed each reference using the Distiller SR
systematic review software (Evidence Partners Inc., Ottawa, Ontario,
Canada). A modified Delphi technique was used to narrow down to seven of
the most impactful publications and another seven tabular summaries. The
purpose of this review is to understand the strength and limitations of
the new literature in order to improve perioperative outcomes for
patients.<br/>Copyright &#xa9; 2025. Published by Elsevier Inc.

<151>
Accession Number
648446200
Title
Surgical left atrial appendage occlusion in valvular heart disease without
atrial fibrillation: the OPINION trial.
Source
European heart journal. (no pagination), 2025. Date of Publication: 01
Sep 2025.
Author
Yuan X.; Ju F.; Wu H.; Zhao Y.; Liu S.; Wang X.; Zhu J.; Su P.; Xu F.;
Feng W.; Yang Y.; Wang Y.; Sun H.
Institution
(Yuan, Ju, Wu, Wang, Liu, Wang, Xu, Feng, Yang, Sun) Department of
Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical
Sciences and Peking Union Medical College, National Centre for
Cardiovascular Diseases, No. 167 North Lishi Road, Xicheng District,
Beijing, China
(Zhao, Wang) Medical Research and Biometrics Centre, Fuwai Hospital,
Chinese Academy of Medical Sciences and Peking Union Medical College,
National Centre for Cardiovascular Diseases, No. 167 North Lishi Road,
Xicheng District, Beijing, China
(Zhu) Department of Cardiovascular Surgery, Beijing Anzhen Hospital,
Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing,
China
(Su) Department of Cardiac Surgery, Beijing Chaoyang Hospital, Capital
Medical University, No. 8 Gongti South Road, Chaoyang District, Beijing,
China
Abstract
BACKGROUND AND AIMS: While surgical left atrial appendage occlusion
(SLAAO) reduces stroke in atrial fibrillation (AF) patients, its efficacy
in patients without pre-operative AF but with CHA2DS2-VASc >=2 remains
uncertain despite their high post-operative AF risk (15-54%). The aim of
this study was to evaluate whether prophylactic SLAAO reduces
post-operative thrombo-embolic events in valvular surgery patients.
<br/>METHOD(S): The OPINION was a multicentre, open-label, randomized,
superiority trial conducted at three cardiac surgery centres in China.
Eligible non-AF patients with CHA2DS2-VASc >=2 and an indication for valve
repair or replacement due to mitral or aortic valve lesions were randomly
assigned (1:1) to undergo SLAAO (intervention arm) or not undergo SLAAO
(control arm) during surgery. The primary outcome was a composite of
ischaemic stroke, transient ischaemic attack (TIA), or cardiovascular
mortality assessed at 1 year. The primary analysis was done in the
intention-to-treat population. <br/>RESULT(S): Between April 2021 and June
2024, a total of 2157 patients were enrolled and randomized. After
exclusion of 39 patients who withdrew informed consent, 2118 participants
were included in the intention-to-treat population (1062 in the SLAAO
group and 1056 in the control group). Baseline characteristics were
well-balanced between the SLAAO group and control group (mean age 55.5
[11.4] vs 55.6 [11.5] years, P = .65; female 32.9% vs 32.3%, P = .78;
CHA2DS2-VASc score 2.88 [0.98] vs 2.87 [0.96], P = .83; median EuroSCORE
II 1.58% [1.42%] vs 1.56% [1.28%], P = .74). The 1-year primary endpoint
occurred in 73 (6.9%) patients in the SLAAO group and in 87 (8.2%)
patients in the control group (hazard ratio 0.83; 95% confidence interval
0.61-1.14; P = .25). <br/>CONCLUSION(S): For valvular surgery patients
with CHA2DS2-VASc scores >=2 but no pre-operative AF, routine prophylactic
left atrial appendage closure did not significantly reduce the incidence
of the primary composite endpoint (ischaemic stroke, TIA, and
cardiovascular mortality) at 1-year follow-up. TRIAL REGISTRATION:
ChiCTR.org registry ChiCTR2100042238.<br/>Copyright &#xa9; The Author(s)
2025. Published by Oxford University Press on behalf of the European
Society of Cardiology.

<152>
Accession Number
648432505
Title
Systematic Review on Radiation-Induced DNA Damage and Cancer Risk in
Endovascular Operators.
Source
Journal of vascular surgery. (no pagination), 2025. Date of Publication:
26 Aug 2025.
Author
Maris E.-L.; Klaassen J.; Hazenberg C.E.V.B.; Petri B.-J.; Trimarchi S.;
van Herwaarden J.A.
Institution
(Maris, Klaassen, Hazenberg, Petri, van Herwaarden) Department of Vascular
Surgery, Utrecht Medical Centre Utrecht, Utrecht, Netherlands
(Trimarchi) Section of Vascular Surgery, Cardiac Thoracic Vascular Dept,
Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Milan, Italy;
Dept of Clinical and Community Sciences, University of Milan, Milan, Italy
Abstract
OBJECTIVE: Endovascular interventions have increasingly replaced open
surgery due to their minimally invasive nature and benefits such as faster
recovery and fewer wound complications. This shift has led to greater
reliance on fluoroscopy, raising concerns about occupational radiation
exposure. Ionizing radiation, while essential for guiding procedures, can
damage living tissue and potentially induce long-term health effects.
Recent guidelines from the European Society for Vascular Surgery and the
Cardiovascular and Interventional Radiological Society of Europe emphasize
growing radiation risks and advocate for dose optimization and protective
strategies. Endovascular specialists-vascular surgeons, interventional
cardiologists, and radiologists-are among the most exposed hospital staff.
Yet, limited studies have specifically examined the effects of
fluoroscopy-induced DNA damage and carcinogenesis in these professionals.
The aim of this systematic review is to evaluate the extent to which
occupational radiation exposure contributes to DNA damage and cancer risk
in endovascular operators. <br/>METHOD(S): A systematic search of the
literature from 2000 to April 2025 of PubMed and EMBASE was conducted
following PRISMA-guidelines. All experimental studies, observational
studies and case reports that examine DNA damage or cancer occurrence in
operators performing endovascular procedures due to occupational radiation
exposure were included in this review. Studies were categorized into two
primary outcomes: cancer and DNA damage. A risk of bias assessment was
performed according to Cochrane guidelines. <br/>RESULT(S): Twenty-five
studies were identified. The findings from these studies suggest that
occupational radiation exposure in endovascular operators may lead to
early-stage DNA damage shortly after exposure. Additionally, the studies
observed chronic DNA damage, including double-strand DNA breaks and
chromosomal aberrations, which are hypothesized to be a contributing
factor to genomic instability and carcinogenesis. Furthermore, the studies
researching carcinogenesis suggests an elevated risk of cancer development
in endovascular operators, with particular emphasis on cancer
localizations that are more susceptible to radiation, such as leukaemia
and thyroid cancer, and in unprotected body areas, such as the skin and
the brain. <br/>CONCLUSION(S): This systematic review suggests that
endovascular operators involved in fluoroscopy-guided interventional
procedures may face an increased risk of stochastic health effects, with a
particular emphasis on chronic DNA damage and carcinogenesis in
localizations more vulnerable to radiation. This review highlights the
critical need for enhanced radiation safety measures, awareness, and
preventative strategies.<br/>Copyright &#xa9; 2025 THE AUTHOR(S).
Published by Elsevier Inc. All rights reserved.

<153>
Accession Number
2040325712
Title
Shaping the future of cardiac interventions and cardiac surgeries: The
impact of virtual reality and artificial intelligence.
Source
Global Cardiology Science and Practice. 4 (no pagination), 2025. Article
Number: 37. Date of Publication: 2025.
Author
AbdelMassih A.F.; Nasser A.F.; AbdelRahman G.; Mkarem L.E.; AbuShashieh
M.M.; AbuGhosh R.; Nasr E.G.
Institution
(AbdelMassih) Pediatric Cardiology Unit, Pediatrics' Department, Faculty
of Medicine, Cairo University, Cairo, Egypt
(AbdelMassih) Pediatric Cardiology Division, Cardiac Sciences Department,
SKMC, Abu Dhabi, United Arab Emirates
(Nasser, AbdelRahman, Mkarem, AbuGhosh) Pediatric Residency Program,
Pediatrics' department, SKMC, Abu Dhabi, United Arab Emirates
(AbuShashieh) Bachelor of Jordan University of Science and Technology,
Amman, Jordan
(Nasr) Aswan Heart Center, Aswan, Egypt
Publisher
HBKU Press
Abstract
Background: Virtual reality (VR) and artificial intelligence (AI) have had
a profound impact on transforming cardiac interventions by enhancing
procedure planning, execution, and medical education. Virtual reality
enables healthcare professionals to refine their skills by practicing
procedures in a simulated environment while also improving patient
understanding of their conditions. Artificial intelligence enhances
diagnosis and treatment planning by analyzing patient data, detecting
patterns, and improving both accuracy and personalized care. The aim of
this review was to analyze the anatomical scopes of both technologies in
the context of cardiac interventions as well as the radiologic modalities
involved in image reconstruction in virtual reality. Methodology: A
literature search using the keywords "reviews," "artificial intelligence,"
"virtual reality," and "cardiac interventions" was conducted across
PubMed, Scopus, and Google Scholar. The search was limited to
English-language systematic reviews; narrative reviews, individual
research articles, editorials, and opinion papers were excluded.
<br/>Result(s): An analysis of three reviews encompassing 71 studies
revealed the applications of virtual reality (VR) and artificial
intelligence (AI) in cardiac surgery. VR training was most frequently
applied to mitral valve repair, while VR planning was most common for
conotruncal anomalies. AI-driven decision support was most prevalent in
heart transplantation. <br/>Conclusion(s): This article highlights the
established roles of virtual reality and artificial intelligence in
cardiac care, encompassing surgical training, procedural planning, risk
assessment, and outcome prediction. However, current VR training methods
often rely on time-consuming and expensive imaging techniques like CMR and
CT angiography. Within cardiology, AI-driven decision-making is most
prominent in heart transplantation.<br/>Copyright 2025 The Author(s)

<154>
Accession Number
648446837
Title
Preoperative continuation of RAAS inhibitors in hypertensive patients
undergoing non-cardiac surgery.
Source
American journal of hypertension. (no pagination), 2025. Date of
Publication: 01 Sep 2025.
Author
Siwamogsatham S.; Zaw M.T.; Nerapusee O.; Chongmelaxme B.; Thin S.M.;
Kittisopee T.
Institution
(Siwamogsatham) Chula clinical research center (Chula CRC), Faculty of
Medicine, Chulalongkorn University, 1873 Rama IV Road ,Pathumwan, Bangkok,
Thailand
(Siwamogsatham) Division of Perioperative and Ambulatory Medicine,
Department of Medicine, Faculty of Medicine, Chulalongkorn University,
1873 Rama IV Road ,Pathumwan, Bangkok, Thailand
(Zaw) Integrated Specialty Medicine, St. James's HospitalWest Yorkshire,
Leeds, United Kingdom
(Nerapusee) School of Pharmacy, Eastern Asia University, 200
Rangsit-nakornnayok Road, Thailand
(Chongmelaxme, Thin) Faculty of Pharmaceutical Sciences, Chulalongkorn
University, 254 Phayathai Road ,Pathumwan, Bangkok, Thailand
(Kittisopee) Faculty of Pharmacy, Siam University, 38 Phet Kasem Road,
Bangkok, Thailand
Abstract
BACKGROUND: There has been incongruent evidence on the outcomes relating
to whether continuing or withholding renin-angiotensin-aldosterone system
inhibitors (RAASi) preoperatively. This study aimed to systematically
analyse the effect of preoperative RAASi on perioperative and
postoperative outcomes in patients undergoing non-cardiac surgeries.
<br/>METHOD(S): PubMed, Scopus, ScienceDirect, and Cochrane databases were
used with no limitation of the starting date, till 30th September 2024.
The revised Cochrane risk-of-bias tool (RoB-2) and the Newcastle-Ottawa
Scale (NOS) were used for quality assessment. The primary study outcomes
were hemodynamic outcomes while the secondary outcomes included
postoperative 30-day mortality, myocardial infarction, stroke and
postoperative atrial fibrillation (POAF). <br/>RESULT(S): Among 1,897
articles, 6 eligible randomized control trials and 6 observational studies
were enrolled. The patients preoperatively continuing RAASi had a higher
risk of intraoperative hypotension [OR (Odds Ratio) = 1.54; 95% CI
(Confidence interval) = 1.31,1.82], along with lower systolic and
diastolic blood pressures compared to those withholding RAASi.
Postoperative complications including 30-day mortality, myocardial
infarction, stroke, atrial fibrillation, acute kidney injury, septicemia,
myocardial injury, postoperative hypertension and unplanned ICU admission,
showed no significant differences. However, there was a marginal
significance in lower POAF in the RAASi continuing group (OR = 0.73, 95%
CI = 0.52, 1.02). <br/>CONCLUSION(S): Withholding RAASi prior to
non-cardiac operation significantly reduced the risk of intraoperative
hypotension but may increase a chance to develop POAF without significant
impact on 30-day mortality and other postoperative complications.
Discontinuation of RAASi before non-cardiac surgery is recommended unless
obligate indication.<br/>Copyright &#xa9; The Author(s) 2025. Published by
Oxford University Press on behalf of American Journal of Hypertension,
Ltd. 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 sitea"for further information
please co

<155>
Accession Number
648455491
Title
Acute heart failure in non-cardiac surgery.
Source
European heart journal. (no pagination), 2025. Date of Publication: 21
Aug 2025.
Author
Gualandro D.M.; Masip J.; Halvorsen S.; Price S.; Rossello X.; Chioncel
O.; Peacock W.F.; Miro O.; Oliveira Junior M.T.; Mebazaa A.; Platz E.;
Amir O.; Schaubroeck H.; Grand J.; Sionis A.; Tavazzi G.; Poss J.;
Verbrugge F.H.; Gambaro A.; Tica O.; Arrigo M.; Mueller C.
Institution
(Gualandro, Mueller) Department of Cardiology and Cardiovascular Research
Institute Basel (CRIB), University Hospital Basel, University of Basel,
Spitalstrasse 2, Basel CH, Switzerland
(Masip) Consorci Sanitari Integral, University of Barcelona, Barcelona,
Spain
(Halvorsen) Department of Cardiology, Oslo University Hospital Ulleval,
Oslo, Norway
(Halvorsen) Department of Cardiology, University of Oslo, Oslo, Norway
(Price) Royal Brompton Hospital, London, United Kingdom
(Rossello) Cardiology Department, Hospital Universitari Son
Espases-IDISBA, Universitat de les Illes Baleares (UIB), Palma de
Mallorca, Spain
(Chioncel) University of Medicine Carol Davila, Emergency Institute for
Cardiovascular Diseases 'Prof. C.C. Iliescu', Bucharest, Romania
(Peacock) Department of Emergency Medicine, Baylor College of Medicine,
Houston, TX, United States
(Miro) Emergency Department, Hospital Clinic, IDIBAPS, University of
Barcelona, Barcelona, Catalonia, Spain
(Oliveira Junior) Heart Institute (InCor), University of Sao Paulo Medical
School, Sao Paulo, Brazil
(Mebazaa) Department of Anesthesiology and Critical Care Unit, Paris,
France
(Platz) Cardiovascular Division, Brigham and Woman's Hospital and Harvard
Medical School, Boston, MA, United States
(Amir) Heart Institute, Hadassah-Hebrew University Medical Center,
Jerusalem, Israel
(Schaubroeck) Department of Intensive Care Medicine, Internal Medicine and
Pediatrics, Ghent University Hospital, Ghent, Belgium
(Grand) Department of Cardiology, Copenhagen University Hospital
Amager-Hvidovre, Hvidovre, Denmark
(Sionis) Department of Cardiology, Hospital de la Santa Creu I Sant Pau,
Barcelona, Spain
(Tavazzi) Department of Clinical-surgical, Diagnostics and Pediatric
Science, University of Pavia, Pavia, Italy
(Poss) Department of Cardiology, Herzzentrum Leipzig, Leipzig, Germany
(Verbrugge) Centre for Cardiovascular Diseases, University Hospital
Brussels, Laarbeeklaan 101, Jette, Belgium
(Verbrugge) Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel,
Laarbeeklaan 101, Jette, Belgium
(Gambaro) Cardiology Division, Department of Medicine, Azienda Ospedaliera
Universitaria Integrata Verona, Verona, Italy
(Tica) Institute of Cardiovascular Sciences, University of Birmingham,
Birmingham, United Kingdom
(Tica) Cardiology Department, Emergency County Clinical Hospital of Bihor,
Oradea, Romania
(Arrigo) Department of Internal Medicine, Ente Ospedaliero Cantonale,
Lugano, Switzerland
(Arrigo) Faculty of Biomedical Sciences, Universita della Svizzera
Italiana, Lugano, Switzerland
Abstract
More than 64 million people worldwide have heart failure (HF), and these
numbers are expected to rise. Acute HF (AHF) is the leading cause of
hospitalization in patients over 65 years old and is linked to high
mortality and readmission rates. AHF may also be a frequent complication
in patients hospitalized for other medical reasons as well as after
cardiac or non-cardiac surgery. These three entities are summarized as
secondary AHF. As secondary AHF has been largely overlooked by medical
research and education, little is known about its pathophysiology,
phenotypes, diagnosis, management, and prognosis. Secondary AHF occurring
after non-cardiac surgery warrants particular attention due to its very
high mortality rates of up to 44% within 1 year and is therefore the focus
of this review. The scope of this document is to summarize the available
evidence regarding the pathophysiology, prevention, diagnosis, treatment,
and prognosis of AHF after non-cardiac surgery. Key to prevention is
understanding and addressing the pathophysiology of AHF after non-cardiac
surgery, which involves close monitoring of fluid status to avoid volume
overload and/or hypovolemia, avoiding hypo- and/or hypertension, treating
pain and anaemia to prevent tachycardia, and avoiding electrolyte
disturbances to prevent arrhythmias. Cardiac biomarkers, such as cardiac
troponins and natriuretic peptides, serve as important diagnostic tools
and enhance risk stratification in the perioperative setting. A low
threshold to perform echocardiography in this population is suggested.
Vigilant post-operative care is essential for the early recognition and
treatment of AHF after non-cardiac surgery, which could help improve
outcomes for patients.<br/>Copyright &#xa9; The Author(s) 2025. Published
by Oxford University Press on behalf of the European Society of
Cardiology.

<156>
Accession Number
648444854
Title
Transcatheter or Surgical Treatment of Patients With Aortic Stenosis at
Low to Intermediate Risk: An Individual Participant Data Meta-Analysis.
Source
JAMA cardiology. (no pagination), 2025. Date of Publication: 30 Aug 2025.
Author
Ludwig S.; Klimek M.; Bay B.; Blankenberg S.; Granada J.F.; Hildick-Smith
D.; Hudson J.; Jorgensen T.H.; Leon M.B.; Magnussen C.; Thiele H.; Horsted
Thyregod H.G.; Wendler O.; de Backer O.; Toff W.D.; Ziegler A.; Seiffert
M.
Institution
(Ludwig, Bay, Blankenberg, Magnussen, Ziegler) Department of Cardiology,
University Heart and Vascular Center Hamburg, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany
(Ludwig, Bay, Blankenberg, Magnussen, Ziegler) Centre for Population
Health Innovation, University Heart and Vascular Center Hamburg,
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Ludwig, Bay, Blankenberg, Magnussen, Thiele, Seiffert) German Centre for
Cardiovascular Research Partner Site North, Germany
(Ludwig, Granada, Leon) Cardiovascular Research Foundation, NY, United
States
(Klimek, Blankenberg, Ziegler) Medizincampus Davos, Davos, Switzerland
(Hildick-Smith) Sussex Cardiac Centre, Brighton and Sussex University
Hospitals National Health Service Trust, Brighton, United Kingdom
(Hudson) Aberdeen Centre for Evaluation, University of Aberdeen, Aberdeen,
United Kingdom
(Jorgensen, Horsted Thyregod, de Backer) Rigshospitalet, Copenhagen,
Denmark
(Leon) NewYork-Presbyterian Hospital/Columbia University Irving Medical
Center, NY, United States
(Thiele) Department of Cardiology, Heart Center Leipzig at Leipzig
University and Leipzig Heart Science, Leipzig, Germany
(Wendler) Cleveland Clinic, London, United Kingdom
(Toff) Department of Cardiovascular Sciences, University of Leicester,
Leicester, United Kingdom
(Toff) National Institute for Health Research Biomedical Research Centre,
Glenfield Hospital, Leicester, United Kingdom
(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, Bochum, Germany
Abstract
Importance: Mounting evidence suggests transcatheter aortic valve
implantation (TAVI) as preferred treatment for patients at low to
intermediate surgical risk. However, limitations in study design and
statistical power raise concerns about the generalizability of individual
randomized clinical trials (RCTs) comparing TAVI and surgical aortic valve
replacement (SAVR) to routine clinical practice. <br/>Objective(s): To
compare 1-year outcomes of TAVI vs SAVR in patients with severe
symptomatic aortic stenosis at low to intermediate surgical risk applying
a 2-stage individual participant data (IPD) and aggregate meta-analyses.
<br/>Data Sources: MEDLINE databases were searched for RCTs comparing TAVI
and SAVR in patients with aortic stenosis until June 15, 2025. Study
Selection: RCTs were selected comparing TAVI vs SAVR in patients with
severe symptomatic aortic stenosis at low or intermediate surgical risk
with 1-year follow-up. Data Extraction and Synthesis: IPD were obtained
from all investigator-initiated RCTs (DEDICATE, NOTION, NOTION-2, and UK
TAVI) and analyzed in 1- and 2-stage IPD meta-analyses. An overall
meta-analysis was performed by adding aggregate data from
industry-sponsored RCTs. <br/>Main Outcomes and Measures: The primary end
point was all-cause death or any stroke 1 year after randomization.
Secondary end points included all-cause death, any stroke, disabling
stroke, cardiovascular death, rehospitalization for cardiovascular cause,
myocardial infarction, new-onset atrial fibrillation, new permanent
pacemaker implantation, and aortic valve reintervention. <br/>Result(s):
The IPD meta-analysis included 4 RCTs comprising 2873 patients (mean [SD]
age, 76.7 [5.5] years; 805 [56.1%] male) at low to intermediate surgical
risk randomly assigned to TAVI (n = 1439) or SAVR (n = 1434). At 1 year,
the hazard ratio (HR) for the primary end point for TAVI compared to SAVR
was 0.73 (95% CI, 0.56-0.95) in the 1-stage and 0.79 (95% CI, 0.49-1.27)
in the 2-stage IPD meta-analysis. In the 2-stage overall meta-analysis the
HR for the primary end point was 0.76 (95% CI, 0.60-0.97).
<br/>Conclusions and Relevance: In this IPD meta-analysis of 4 RCTs, and
an overall meta-analysis of 8 RCTs of patients with severe symptomatic AS
at low to intermediate risk, TAVI was associated with a reduction in the
1-year incidence of all-cause death or any stroke. These findings
emphasize TAVI as alternative option in patients at low to intermediate
risk. Long-term follow-up is warranted to evaluate sustainability of these
findings.

<157>
Accession Number
648438456
Title
Peri-interventional Anesthesia Strategies for Transcatheter Aortic Valve
Implantation: A Multicenter, Randomized, Controlled, Non-inferiority
Trial.
Source
Circulation. (no pagination), 2025. Date of Publication: 29 Aug 2025.
Author
Feistritzer H.-J.; Ender J.; Lauten P.; Rudolph T.K.; Rudolph V.; Geisler
T.; Massberg S.; Adam M.; Baldus S.; Sossalla S.; Joner M.; Mollmann H.;
Wolf A.; Kim W.-K.; Borger M.A.; Noack T.; Magunia H.; von Dossow V.;
Sander M.; Vigelius-Rauch U.; Feuerecker M.; Zakhary W.; Boening A.;
Bleiziffer S.; Hohenstein S.; Hoesler N.; Buske M.; Desch S.; Abdel-Wahab
M.; Thiele H.
Institution
(Feistritzer, Ender, Borger, Noack, Zakhary, Buske, Desch, Abdel-Wahab)
Heart Center Leipzig at Leipzig University, Leipzig, Germany
(Lauten) Zentralklinik Bad Berka, Bad Berka, Germany
(Rudolph, Rudolph, von Dossow) Heart and Diabetes Center NRW, Bad
Oeynhausen, Germany
(Geisler, Magunia) University Hospital Tubingen, Tubingen, Germany
(Massberg, Feuerecker) Department of Medicine I, Ludwig Maximilian
University Munich, Munich, Germany
(Adam, Baldus) Heart Center, University of Cologne, Cologne, Germany
(Sossalla, Kim, Sander, Vigelius-Rauch, Boening) University Hospital
Giessen, Giessen, Germany
(Joner) Department of Cardiology, German Heart Center Munich, Technical
University of Munich, Munich, Germany
(Mollmann) Department of Cardiology, St.-Johannes Hospital Dortmund,
Dortmund, Germany
(Wolf) Heart Center Wuppertal, Witten-Herdecke University, Wuppertal,
Germany
(Bleiziffer) Zentralklinik Bad Berka, Bad Berka, Germany; Heart and
Diabetes Center NRW, Bad Oeynhausen, Germany
(Hohenstein) Helios Health Institute, Leipzig, Germany
(Hoesler) Leipzig Heart Science, Leipzig, Germany
(Thiele) Heart Center Leipzig at Leipzig University, Leipzig, Germany;
Leipzig Heart Science, Leipzig, Germany
Abstract
BACKGROUND: Minimalist treatment strategies for transcatheter aortic valve
implantation (TAVI) have been widely adopted due to continued procedural
evolution, but large randomized trials are lacking. The DOUBLE-CHOICE
trial evaluated safety and efficacy of a minimalist approach (MA) compared
with standard of care (SoC) for transfemoral TAVI. <br/>METHOD(S): In this
investigator-initiated, 2x2 factorial, open-label, randomized,
multicenter, non-inferiority trial, patients with symptomatic aortic
stenosis were included at 10 German sites. Patients were randomly assigned
to MA, including isolated local anesthesia, versus SoC using conscious
sedation. The primary endpoint was a composite of all-cause mortality,
vascular and bleeding complications, infections requiring antibiotic
therapy, and neurologic events at 30 days. Non-inferiority of MA compared
with SoC was tested in the intention-to-treat population with an absolute
non-inferiority margin of -6% at alpha-level of 0.05. <br/>RESULT(S):
Between July 11, 2022, and January 14, 2025, 752 patients were randomly
assigned to MA (n=377) and SoC (n=375). The median age was 83
(interquartile range [IQR] 79-86) years, 439 (58.5%) patients were female,
and the median Society of Thoracic Surgeons (STS) risk score was 4.6% (IQR
2.9-8.0). The primary endpoint occurred in 80 (22.9%) of 350 patients in
the MA group and in 91 (25.8%) of 353 patients in the SoC group (rate
difference 2.9%, lower boundary of the 1-sided 95% confidence interval
[CI] -2.4%, p for non-inferiority 0.003, 2-sided 95% CI -3.4 to 9.3, p for
difference 0.37). Patient-reported anxiety and stress levels during the
procedure were higher in the MA group. <br/>CONCLUSION(S): MA including
isolated local anesthesia was non-inferior to SoC with conscious sedation,
highlighting the safety and efficacy of MA for TAVI. The burden of
intraprocedural pain and discomfort is potentially higher in the MA group.

<158>
Accession Number
648435783
Title
Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral
Anticoagulation.
Source
The New England journal of medicine. (no pagination), 2025. Date of
Publication: 31 Aug 2025.
Author
Lemesle G.; Didier R.; Steg P.G.; Simon T.; Montalescot G.; Danchin N.;
Bauters C.; Blanchard D.; Bouleti C.; Angoulvant D.; Andrieu S.; Vanzetto
G.; Kerneis M.; Decalf V.; Puymirat E.; Mottier D.; Diallo A.; Vicaut E.;
Gilard M.; Cayla G.
Institution
(Lemesle, Bauters) Heart and Lung Institute, University Hospital of Lille,
Centre Hospitalier Universitaire (CHU) Lille, Lille, France
(Lemesle) Institut Pasteur de Lille, INSERM Unite 1011, Lille, France
(Lemesle, Bauters) Universite de Lille, Lille, France
(Lemesle, Steg, Simon, Danchin) French Alliance for Cardiovascular Trials,
Paris, United States
(Didier, Gilard) Cardiology Department, CHU Brest, Brest, France
(Didier, Mottier, Gilard) INSERM Unite Mixte de Recherche (UMR)
1304-Groupe d'Etudes Tumeurs et Biotherapies Oncologiques (GETBO) Brest,
France
(Didier, Mottier, Gilard) University of Brest, Brest, France
(Steg, Puymirat) ParisUnited States
(Steg, Simon) INSERM Unite 1148, Paris, United States
(Steg) Assistance Publique-Hopitaux de Paris (AP-HP), Hopital Bichat,
Paris, United States
(Simon, Montalescot) Sorbonne Universite, Paris, United States
(Simon, Diallo, Vicaut) Unite de Recherche Clinique de l'Est Parisien
(URCEST), Paris, United States
(Simon) Department of Clinical Pharmacology, AP-HP, Hopital Saint Antoine,
Paris, United States
(Montalescot, Kerneis) AP-HP, Hopital Pitie-Salpetriere, Paris, United
States
(Montalescot) ParisUnited States
(Montalescot, Diallo, Vicaut, Cayla) ACTION Group, Paris, United States
(Danchin) Department of Cardiology, Saint Joseph Hospital, Paris, United
States
(Bauters) INSERM Unite 1167, Lille, France
(Blanchard, Puymirat) Department of Cardiology, AP-HP, Hopital Europeen
Georges Pompidou, Paris, United States
(Bouleti) University of Poitiers, Clinical Investigation Center, Poitiers,
France
(Bouleti) Department of Cardiology, University Hospital of Poitiers,
Poitiers, France
(Angoulvant) Cardiology Department, Hopital Trousseau, Centre Hospitalier
Regional Universitaire de Tours, Tours, France
(Angoulvant) INSERM Unite 1327 ISCHEMIA "Membrane Signalling and
Inflammation in Reperfusion Injuries, Tours, France
(Angoulvant) Universite de Tours, Tours, France
(Andrieu) Department of Cardiology, Hopital Henri-Duffaut, Avignon, France
(Vanzetto) Department of Cardiology, Grenoble University Hospital, La
Tronche, France
(Decalf) Department of Cardiology and Cardiovascular Diseases, Pontoise,
France
(Puymirat) Paris Cardiovascular Research Center (PARCC), Paris, United
States
(Mottier) Departement de Medecine Interne et Pneumologie, CHU Brest,
Brest, France
(Mottier) French Clinical Research Infrastructure Network INNOVTE
(Investigation Network on Venous Thromboembolism), Saint Etienne, France
(Diallo, Vicaut) AP-HP, Hopital Fernand Widal, Paris, United States
(Diallo, Vicaut) Statistique, Analyse, et Modelisation Multidisciplinaire,
EA4543, Paris
(Diallo, Vicaut) Universite Paris 1 Pantheon Sorbonne, Paris, United
States
(Cayla) Service de Cardiologie, CHU de Nimes, Nimes, France
(Cayla) Universite de Montpellier, Montpellier, France
Abstract
BACKGROUND: The appropriate antithrombotic regimen for patients with
chronic coronary syndrome who are at high atherothrombotic risk and
receiving long-term oral anticoagulation remains unknown. <br/>METHOD(S):
We conducted a multicenter, double-blind, randomized, placebo-controlled
trial in France involving patients with chronic coronary syndrome who had
undergone a previous stent implantation (>6 months before enrollment) and
were at high atherothrombotic risk and currently receiving long-term oral
anticoagulation. The patients were randomly assigned in a 1:1 ratio to
receive aspirin (100 mg once daily) or placebo; all the patients continued
to receive their current oral anticoagulation therapy. The primary
efficacy outcome was a composite of cardiovascular death, myocardial
infarction, stroke, systemic embolism, coronary revascularization, or
acute limb ischemia. The key safety outcome was major bleeding.
<br/>RESULT(S): A total of 872 patients underwent randomization; 433 were
assigned to the aspirin group, and 439 to the placebo group. The trial was
stopped early at the advice of the independent data and safety monitoring
board after a median follow-up of 2.2 years because of an excess of deaths
from any cause in the aspirin group. A primary efficacy outcome event
occurred in 73 patients (16.9%) in the aspirin group and in 53 patients
(12.1%) in the placebo group (adjusted hazard ratio, 1.53; 95% confidence
interval [CI], 1.07 to 2.18; P = 0.02). Death from any cause occurred in
58 patients (13.4%) in the aspirin group and in 37 (8.4%) in the placebo
group (adjusted hazard ratio, 1.72; 95% CI, 1.14 to 2.58; P = 0.01). Major
bleeding occurred in 44 patients (10.2%) in the aspirin group and in 15
patients (3.4%) in the placebo group (adjusted hazard ratio, 3.35; 95% CI,
1.87 to 6.00; P<0.001). A total of 467 and 395 serious adverse events were
reported in the aspirin group and placebo group, respectively.
<br/>CONCLUSION(S): Among patients with chronic coronary syndrome at high
atherothrombotic risk who were receiving an oral anticoagulant, the
addition of aspirin led to a higher risk of cardiovascular death,
myocardial infarction, stroke, systemic embolism, coronary
revascularization, or acute limb ischemia than placebo, as well as higher
risks of death from any cause and major bleeding. (Funded by the French
Ministry of Health and Bayer Healthcare; ClinicalTrials.gov number,
NCT04217447.).<br/>Copyright &#xa9; 2025 Massachusetts Medical Society.

<159>
Accession Number
648446003
Title
Ticagrelor and Aspirin or Aspirin Alone after Coronary Surgery for Acute
Coronary Syndrome.
Source
The New England journal of medicine. (no pagination), 2025. Date of
Publication: 01 Sep 2025.
Author
Jeppsson A.; James S.; Moller C.H.; Malm C.J.; Dalen M.; Vanky F.; Modrau
I.S.; Andersen K.; Anttila V.; Atroshchenko G.V.; Barbu M.; Dreifaldt M.;
El-Akkawi A.I.; Friberg O.; Gudbjartsson T.; Gunn J.; Haaverstad R.;
Halonen J.; Hansson E.C.; Holm J.; Husso A.; Juvonen T.; Jakobsen O.;
Jideus L.; Johannesson E.; Jonsson Holmdahl A.; Jonsson K.; Kolseth S.M.;
Krasniqi L.; Makela T.; Mennander A.; Mohagen Krogstad L.-E.; Rafiq S.;
Raivio P.; Riber L.; Tahir A.; Thorsen C.; Tonnessen T.; Wahba A.;
Zindovic I.; Pivodic A.; Nielsen S.J.; Erlinge D.; Alfredsson J.; Sartipy
U.
Institution
(Jeppsson, Malm, Hansson, Jonsson, Nielsen) Department of Cardiothoracic
Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
(Jeppsson, Malm, Hansson, Jonsson, Nielsen) Department of Molecular and
Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University
of Gothenburg, Gothenburg, Sweden
(James) Department of Medical Sciences, Cardiology, Uppsala University,
Uppsala, Sweden
(Moller, Rafiq) Department of Cardiothoracic Surgery, University Hospital,
Copenhagen, Denmark
(Dalen, Sartipy) Department of Cardiothoracic Surgery, Karolinska
University Hospital, Stockholm, Sweden
(Dalen, Sartipy) Department of Molecular Medicine and Surgery, Karolinska
Institutet, Stockholm, Sweden
(Vanky, Holm) Department of Cardiothoracic and Vascular Surgery, Linkoping
University Hospital, Linkoping, Sweden
(Vanky, Holm) Department of Health, Medicine, Caring Sciences, Unit of
Cardiovascular Medicine, Linkoping University, Linkoping Sweden, Sweden
(Modrau, El-Akkawi) Department of Cardiothoracic and Vascular Surgery,
Aarhus University Hospital, Aarhus, Denmark
(Modrau, El-Akkawi) Department of Clinical Medicine, Aarhus University,
Aarhus, Denmark
(Andersen) Department of Cardiology, Landspitali University Hospital,
Reykjavik, Iceland
(Andersen, Gudbjartsson) Faculty of Medicine, University of Iceland,
Reykjavik, Iceland
(Anttila) Heart Center, Turku University Hospital and University of Turku,
Turku, Finland
(Atroshchenko) Department of Cardiothoracic Surgery, Aalborg University
Hospital, Aalborg, Denmark
(Barbu, Thorsen) Department of Cardiology and Cardiothoracic Surgery,
Blekinge Hospital, Karlskrona, Sweden
(Dreifaldt, Friberg) Department of Cardiothoracic and Vascular Surgery,
Orebro University Hospital, Sweden
(Dreifaldt, Friberg) Faculty of Medicine and Health, Orebro University,
Sweden
(Gudbjartsson) Department of Cardiothoracic Surgery, Landspitali
University Hospital, Reykjavik, Iceland
(Gunn) Department of Emergency Services, Turku University Hospital and
University of Turku, Turku, Finland
(Haaverstad, Kolseth) Department of Heart Disease, Haukeland University
Hospital, Bergen, Norway
(Halonen, Husso) Department of Cardiac Surgery, Heart Center, Kuopio
University Hospital, Kuopio, Finland
(Halonen) University of Eastern Finland, Kuopio, Finland
(Juvonen, Raivio) Department of Cardiac Surgery, Heart and Lung Center,
Helsinki University Hospital and University of Helsinki, Helsinki, Finland
(Jakobsen) Department of Clinical Medicine, Arctic University of Norway,
Tromso, Norway
(Jakobsen) Department of Cardiothoracic and Vascular Surgery, University
Hospital of North Norway, Tromso, Norway
(Jideus) Department of Cardiothoracic Surgery, Uppsala University
Hospital, Uppsala, Sweden
(Johannesson, Zindovic) Department of Cardiothoracic Surgery, Skane
University Hospital, Lund, Sweden
(Johannesson, Zindovic) Department of Clinical Sciences, Lund University,
Lund, Sweden
(Jonsson Holmdahl) Department of Cardiothoracic Surgery, Umea University
Hospital, Umea, Sweden
(Jonsson Holmdahl) Department of Public Health and Clinical Medicine,
Medical Faculty, Umea University, Umea, Sweden
(Krasniqi, Riber) Department of Cardiac, Vascular, Thoracic Surgery,
Odense University Hospital, Odense, Denmark
(Krasniqi, Riber) Department of Clinical Research, University of Southern
Denmark, Odense, Denmark
(Makela) Research Unit of Translational Medicine, Medical Research Center
Oulu, Oulu University Hospital, Oulu, Finland
(Makela) Department of Cardiothoracic Surgery, Oulu University Hospital,
Oulu, Finland
(Mennander) Tampere University Heart Hospital, Tampere, Finland
(Mennander) Tampere University, Tampere, Finland
(Mohagen Krogstad, Wahba) Department of Cardio-Thoracic Surgery, St.
Olav's University Hospital, Trondheim, Norway
(Tahir, Tonnessen) Department of Cardiothoracic Surgery, Oslo University
Hospital, Oslo, Norway
(Tahir, Tonnessen) University of Oslo, Oslo, Norway
(Wahba) Department of Circulation and Medical Imaging, Norwegian
University of Science and Technology, Trondheim, Norway
(Pivodic) Molndal, Sweden
(Pivodic) Center for Person-Centered Care, Sahlgrenska Academy, University
of Gothenburg, Gothenburg, Sweden
(Erlinge) Department of Cardiology, Clinical Sciences, Lund University,
Lund, Sweden
(Alfredsson) Department of Health, Medicine, Caring Sciences, Linkoping
University, Linkoping, Sweden
(Alfredsson) Department of Cardiology, Linkoping University, Linkoping,
Sweden
Abstract
BACKGROUND: Patients benefit from antiplatelet therapy after
coronary-artery bypass grafting (CABG) for an acute coronary syndrome.
Whether the addition of ticagrelor to aspirin, as compared with aspirin
alone, further reduces the risk of adverse cardiovascular outcomes is
unclear. <br/>METHOD(S): In this open-label, registry-based, clinical
trial conducted at 22 Nordic cardiothoracic surgery centers, we randomly
assigned patients in a 1:1 ratio to receive either ticagrelor plus aspirin
or aspirin alone for 1 year after CABG for an acute coronary syndrome. The
primary outcome was a composite of death, myocardial infarction, stroke,
or repeat revascularization, evaluated at 1 year. A key secondary outcome
was net adverse clinical events, defined as a primary-outcome event or
major bleeding. <br/>RESULT(S): A total of 2201 patients were randomly
assigned to receive ticagrelor plus aspirin (1104 patients) or aspirin
alone (1097 patients). The mean age of the patients was 66 years, and
14.4% were women. A primary-outcome event occurred in 53 patients (4.8%)
in the ticagrelor-plus-aspirin group and 50 (4.6%) in the aspirin-alone
group (hazard ratio, 1.06; 95% confidence interval [CI], 0.72 to 1.56; P =
0.77). Net adverse clinical events occurred in 9.1% of patients in the
ticagrelor-plus-aspirin group and 6.4% in the aspirin-alone group (hazard
ratio, 1.45; 95% CI, 1.07 to 1.97). Major bleeding occurred in 4.9% of
patients in the ticagrelor-plus-aspirin group and 2.0% in the
aspirin-alone group (hazard ratio, 2.50; 95% CI, 1.52 to 4.11).
<br/>CONCLUSION(S): Among patients who underwent CABG for an acute
coronary syndrome, ticagrelor plus aspirin did not result in a lower
incidence of death, myocardial infarction, stroke, or repeat coronary
revascularization than aspirin alone at 1 year. (Funded by the Swedish
Research Council and others; TACSI ClinicalTrials.gov number, NCT03560310;
EudraCT number, 2017-001499-43; EU Clinical Trials number,
2023-508551-40-00.).<br/>Copyright &#xa9; 2025 Massachusetts Medical
Society.

<160>
Accession Number
648444755
Title
Impact of Cerebral Embolic Protection On Cognitive Function Following
Transcatheter Aortic Valve Implantation: Data From the BHF PROTECT-TAVI
Randomized Trial.
Source
Circulation. (no pagination), 2025. Date of Publication: 30 Aug 2025.
Author
Kennedy J.; Blackman D.J.; Dodd M.; Poggesi A.; Read L.; Jamal Z.; Evans
R.; Clayton T.; Kharbanda R.K.; Hildick-Smith D.
Institution
(Kennedy) Acute Multidisciplinary Imaging & Interventional Centre,
Radcliffe Department of Medicine, University of Oxford, Oxford, UK; NIHR
Oxford Biomedical Research Centre, Oxford, UK
(Blackman) Leeds Teaching Hospitals NHS Trust, University of Leeds, Leeds,
United Kingdom
(Dodd, Read, Jamal, Evans, Clayton) Clinical Trials Unit, London School of
Hygiene & Tropical Medicine, United Kingdom
(Poggesi) NEUROFARBA Department, Neuroscience Section, University of
Florence, Italy
(Kharbanda) Acute Multidisciplinary Imaging & Interventional Centre,
Radcliffe Department of Medicine, University of Oxford, Oxford, UK; NIHR
Oxford Biomedical Research Centre, Oxford, UK; Department of
Cardiovascular Medicine, John Radcliffe Hospital, Oxford, UK
(Hildick-Smith) Sussex Cardiac Centre, University Hospitals Sussex, United
Kingdom
Abstract
BACKGROUND: In addition to the risk of stroke, patients undergoing
transcatheter aortic valve implantation (TAVI) are susceptible to a
decline in neurocognitive function. This may occur due to embolization of
material (e.g., valve, calcium) to the brain. Cerebral embolic protection
(CEP) devices are engineered to capture this debris, potentially
mitigating its incidence. <br/>METHOD(S): This is a secondary analysis of
the BHF PROTECT-TAVI trial where participants with aortic stenosis from
across 33 centers in the United Kingdom were randomly assigned in a 1:1
ratio to undergo TAVI with a CEP device (SENTINEL, Boston Scientific;
Sentinel CEP group) or TAVI without a CEP device (control group). This
analysis is restricted to those who underwent cognitive assessment. The
primary outcome was the mean change in the telephone version of the
Montreal Cognitive Assessment (t-MoCA) between baseline and 6-8 weeks
post-TAVI. The secondary outcome was a >=3-point drop in total t-MoCA
score between baseline and 6-8 weeks post-TAVI. <br/>RESULT(S): A total of
3535 participants,1763 in the Sentinel CEP group and 1772 in the Control
group (mean age 81.0 years, 37.7% female) randomized in BHF PROTECT-TAVI
were included in the modified ITT population for this analysis. The median
t-MoCA at presentation was 18 (IQR: 16 to 20). The median t-MoCA at 6-8
weeks was 20 (IQR: 17 to 21). The mean change in total t-MoCA score
between baseline and 6-8 weeks adjusted for the baseline score was 0.83
(95% CI 0.70 to 0.96) in the Sentinel CEP group, and 0.91 (95% CI 0.79 to
1.04) in the Control group. There was no difference in means between the
treatment groups (-0.07; 95% CI -0.22 to 0.09; p=0.42). The incidence of a
>=3-point drop in the total t-MoCA score was 154/1763 (8.7%) in the
Sentinel CEP group and 142/1772 (8.0%) in the Control group. The
corresponding RD was 0.72% (95% CI -1.10 to 2.55; p=0.44). These findings
were robust to sensitivity analyses. There was no evidence for an
interaction between treatment assignment and any of subgroups assessed.
<br/>CONCLUSION(S): In the BHF PROTECT-TAVI trial, the use of CEP did not
impact cognition following TAVI.

<161>
Accession Number
648446027
Title
Defining the Learning Curve in Minimally Invasive Cardiac Surgery: A
Systematic Review and Meta-Analysis.
Source
The Annals of thoracic surgery. (no pagination), 2025. Date of
Publication: 29 Aug 2025.
Author
Elsebaie A.; Boutros C.S.; Awad A.K.; Sanad M.; Pelletier M.; Abu-Omar Y.;
El-Diasty M.
Institution
(Elsebaie) Faculty of Health Sciences, Queen's University, Kingston, ON,
Canada
(Boutros, Pelletier, Abu-Omar) Cardiac Surgery Department, Harrington
Heart and Vascular Institute, University Hospitals Cleveland Medical
Center, Cleveland, OH, United States
(Awad) Cardiac Surgery Department, Harrington Heart and Vascular
Institute, University Hospitals Cleveland Medical Center, Cleveland, OH,
USA; Faculty of Medicine, Ain-Shams University, Cairo, Egypt
(Sanad) Cardiothoracic Surgery Department, Mansoura University, Mansoura,
Egypt
(El-Diasty) Cardiac Surgery Department, Harrington Heart and Vascular
Institute, University Hospitals Cleveland Medical Center, Cleveland, OH,
USA; Department of Biomedical and Molecular Sciences, Queen's University,
Kingston, ON, Canada. Electronic address: med7@queensu.ca
Abstract
BACKGROUND: Minimally invasive cardiac surgery (MICS) has become a popular
approach due to its potential benefits such as improved cosmesis, faster
recovery, shorter hospital stays, and cost effectiveness compared to
traditional median sternotomy. However, there have been some concerns
regarding procedural efficiency and surgical outcomes especially in the
early phase of the learning curve of these procedures. <br/>METHOD(S): In
March 2025, a systematic review was conducted using MEDLINE, Embase, the
Cochrane Library and Google Scholar databases to identify potential
studies that quantitively assessed the learning curve in MICS using
pre-defined metrics based on surgical times and/or clinical outcomes.
<br/>RESULT(S): Twenty-eight studies involving 13,257 patients met the
inclusion criteria, most of which were retrospective, focusing on three
types of MICS: mitral valve surgery (MIMVS), aortic valve replacement
(MIAVR), and coronary artery bypass grafting (MICABG). The learning curve
was assessed using arbitrary (split-group) and non-arbitrary (cumulative
sum) methods. Common perioperative metrics included operative,
cardiopulmonary bypass, aortic cross-clamp times, and postoperative
complications. The reported number of cases needed to overcome the
learning curve varied widely, ranging from 23 to 125 (mean: 39 [for
repair] and 78 [for replacement]) for MIMVS, 40 to 138 (mean: 93) for
MIAVR, and 16 to 100 (mean: 40) for MICABG. <br/>CONCLUSION(S):
Differences in surgical process and postoperative outcomes suggest a
learning curve in MICS, though stable morbidity and mortality rates
indicate the safe adoption of these procedures with appropriate training.
Nonetheless, significant heterogeneity across studies prevents precise
learning curve characterization, highlighting the need for standardized,
multi-variable assessment frameworks.<br/>Copyright &#xa9; 2025. Published
by Elsevier Inc.