EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
2038418195
Title
Clinical impact of surgical left atrial appendage occlusion during cardiac
surgery in patients in sinus rhythm: A meta-analysis.
Source
Heart Rhythm. 22(10) (pp 2595-2602), 2025. Date of Publication: 01 Oct
2025.
Author
Burton S.; Ahmed R.; King N.; Reynolds A.; Modi A.; Asopa S.
Institution
(Burton, Reynolds) Bristol Heart Institute, Bristol Royal Infirmary,
Bristol, United Kingdom
(Burton) Bristol Medical School, University of Bristol, Bristol, United
Kingdom
(Ahmed) Keele University School of Medicine, Keele, United Kingdom
(King) Faculty of Health, University of Plymouth, Plymouth, United Kingdom
(Modi, Asopa) Department of Cardiothoracic Surgery, Southampton General
Hospital, Southampton, United Kingdom
Publisher
Elsevier B.V.
Abstract
Background: The clinical efficacy of surgical occlusion of the left atrial
appendage in patients with sinus rhythm undergoing cardiac surgery remains
controversial. <br/>Objective(s): This meta-analysis aims to evaluate the
impact of left atrial appendage occlusion (LAAO) on early and late
outcomes in sinus rhythm patients undergoing cardiac surgery.
<br/>Method(s): Screened and selected studies were sourced from PubMed,
Embase, and Web of Science databases, following the Preferred Reporting
Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Early
clinical outcomes were pooled using odds ratio, and long-term outcomes
were extracted from Kaplan-Meier curves to reconstruct individual
time-to-event patient data and allow for proportional hazards regression.
Bias-treated data were selected when available. <br/>Result(s): Six
studies, comprising 2742 patients, were included from the initial 1431
reports. Pooling of data demonstrated no significant association between
LAAO and the development of postoperative atrial fibrillation (odds ratio
1.157; 95% confidence interval [CI] 0.904-1.481; I² = 46%; P =
.246). Reconstruction of Kaplan-Meier data revealed greater freedom from
cerebrovascular events in the LAAO group than in the no-LAAO group (hazard
ratio 0.482; 95% CI 0.361-0.643; P < .001). The LAAO group also
demonstrated improved midterm survival (hazard ratio 0.701; 95% CI
0.554-0.886; P = .003). <br/>Conclusion(s): This meta-analysis has
demonstrated an improved freedom from cerebrovascular events and a midterm
survival benefit in sinus rhythm patients undergoing cardiac surgery and
surgical LAAO. This meta-analysis does not demonstrate an increased
occurrence of postoperative atrial fibrillation in the LAAO group. Larger
randomized controlled trials, stratified by cardiac pathology, are
required to validate these findings.<br/>Copyright &#xa9; 2025 Heart
Rhythm Society

<2>
Accession Number
2040433695
Title
Comparison of clopidogrel monotherapy versus prolonged DAPT based on the
GRACE risk score in patients with acute coronary syndromes at high
ischemic and bleeding risk: a subgroup analysis of the OPT-BIRISK
randomized clinical trial.
Source
European Journal of Pharmacology. 1006 (no pagination), 2025. Article
Number: 178151. Date of Publication: 05 Nov 2025.
Author
Zhang S.; Li J.; Qiu M.; Li Y.; Wang X.; Wang Z.; Su S.; Zhang Y.; Liu A.;
Han Y.
Institution
(Zhang, Li, Qiu, Li, Wang, Han) State Key Laboratory of Frigid Zone
Cardiovascular Disease, Department of Cardiology, The General Hospital of
Northern Theater Command, Shenyang, China
(Zhang) Postgraduate Training Base of the General Hospital of Northern
Theater of Operations, China Medical University, Shenyang, China
(Wang, Su) Xinxiang Central Hospital, Xinxiang, China
(Zhang) Xuzhou Cancer Hospital, Xuzhou, China
(Liu) Benxi Central Hospital, Benxi, China
Publisher
Elsevier B.V.
Abstract
Objective: This study assessed the effect of clopidogrel monotherapy
versus extended Dual antiplatelet therapy (DAPT) on outcomes in patients
with acute coronary syndromes (ACS) who have completed 9-12 months of DAPT
after Percutaneous Coronary Intervention (PCI) and meet both high bleeding
and high ischemia risk (birisk), stratified by Global Registry of Acute
Coronary Events (GRACE) risk score. <br/>Method(s): In the OPT-BIRISK
study, 7758 ACS Patients who completed 9-12 months of DAPT after PCI were
randomized either to clopidogrel monotherapy or extended DAPT. This
prespecified subgroup analysis categorized patients by GRACE score into
intermediate-high-risk (>88) and low-risk (<=88) groups. The primary
endpoint of the study was BARC 2, 3, or 5 bleeding. The key secondary
endpoint was the rate of major adverse cardio-cerebral events (MACCE; the
composite of all-cause death, myocardial infarction, stroke or clinically
driven revascularization). <br/>Finding(s): In low-risk patients, BARC 2,
3, or 5 bleeding occurred in 49 (2.7 %) with clopidogrel monotherapy
versus 69 (3.6 %) with extended DAPT (HR 0.73, 95 % CI 0.50-1.05; p =
0.088).In intermediate-high-risk patients, clopidogrel monotherapy versus
extended DAPT showed comparable BARC 2, 3, or 5 bleeding (2.3 % vs. 3.0 %;
HR 0.77, 95 % CI 0.52-1.14; p = 0.8377), but significantly reduced MACCE
(2.9 % vs. 4.1 %; HR 0.69, 95 % CI 0.49-0.97; p = 0.0332). In the overall
trial population, there was no significant interaction between the GRACE
score and treatment group for the primary or key secondary endpoints (P >
0.05 for all outcomes). <br/>Conclusion(s): Among birisk patients with
ACS, clopidogrel monotherapy was associated with lower incidence of all
bleeding events (BARC 1-5) versus extended DAPT regardless of GRACE score,
but showed no significant difference in BARC 2, 3, or 5 bleeding.
Moreover, it was associated with lower MACCE incidence versus extended
DAPT in intermediate-high-risk groups.<br/>Copyright &#xa9; 2025

<3>
Accession Number
2040463125
Title
Impact of perioperative selenium supplementation on perioperative
hemodynamics in patients undergoing cardiac surgery: a post hoc analysis
of the Sustain CSX trial.
Source
Journal of Clinical Anesthesia. 107 (no pagination), 2025. Article Number:
112011. Date of Publication: 01 Nov 2025.
Author
Mohsen G.; Catena D.; Lee Z.-Y.; Notz Q.; Jiang X.; Velten M.; O'Brien B.;
Kleine-Brueggeney M.; Ott S.; Heyland D.K.; Duerr G.D.; Meybohm P.; Stoppe
C.
Institution
(Mohsen, Catena, Lee, O'Brien, Kleine-Brueggeney, Ott, Stoppe) Department
of Cardiac Anaesthesiology and Intensive Care Medicine, Deutsches
Herzzentrum der Charite, Augustenburgerplatz 1, Berlin, Germany
(Mohsen, Catena, Lee, O'Brien, Kleine-Brueggeney, Ott, Stoppe)
Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat
Berlin, Humboldt-Universitat zu Berlin, Berlin, Germany
(Lee) Department of Anaesthesiology, Faculty of Medicine, University of
Malaysia, Jln Profesor Diraja Ungku Aziz, Seksyen 13, Kuala Lumpur,
Petaling Jaya, Malaysia
(Notz, Meybohm, Stoppe) Department of Anaesthesiology, Intensive Care,
Emergency and Pain Medicine, University Hospital, Wurzburg,
Josef-Schneider-Strasse 2, Wurzburg, Germany
(Jiang, Heyland) Clinical Evaluation Research Unit, Department of Critical
Care Medicine, Queen's University, 99 University Ave, Kingston, ON, Canada
(Velten) Department of Anesthesiology and Pain management, Division of
Cardiovascular thoracic Anesthesiology, University of Texas Southwestern
Medical Center, 5323 Harry Hines Blvd, Dallas, TX, United States
(O'Brien) St Bartholomew's Hospital and Barts Heart Centre, Department of
Perioperative Medicine, London, United Kingdom
(Ott) DZHK (German Centre for Cardiovascular Research), Partner Site
Berlin, Berlin, Germany
(Ott) Outcomes Research Consortium, Department of Anesthesiology,
Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, United States
(Duerr) Department of Cardiovascular Surgery, University Medical Center
Mainz (Johannes Gutenberg-University Mainz), Langenbeckstrasse 1, Mainz,
Germany
(Ott) Department of Cardiothoracic and Vascular Surgery, Deutsches
Herzzentrum der Charite, Berlin, Germany
Publisher
Elsevier Inc.

<4>
Accession Number
648152476
Title
The effect of the ShotBlocker and breastfeeding on pain and comfort level
during heel lance procedure in newborns: randomized controlled trial.
Source
Intensive & critical care nursing. 91 (pp 104164), 2025. Date of
Publication: 01 Dec 2025.
Author
Dinc C.; Gerceker G.O.; Kalkanli O.
Institution
(Dinc) Department of Neonatology, Ministry of Health, Dr. Behcet Uz
Pediatric Diseases and Surgery Training and Research Hospital, Izmir,
Turkey; Dokuz Eylul University, Institute of Health Sciences, Department
of Nursing, Izmir, Turkey
(Gerceker) Pediatric Nursing Department, Dokuz Eylul University Faculty of
Nursing, Izmir, Turkey
(Kalkanli) Department of Neonatology, Ministry of Health, Dr. Behcet Uz
Pediatric Diseases and Surgery Training and Research Hospital, Izmir,
Turkey
Abstract
BACKGROUND: Newborns are subjected to painful attempts in the early days
of their lives due to medical requirements. Breastfeeding and innovative
devices such as ShotBlocker are used to alleviate pain. <br/>OBJECTIVE(S):
This study was planned to evaluate the effect of non-pharmacological
methods on newborns' pain and comfort level during the heel lance
procedure in newborns. DESIGN: The study was a single-center, randomized
controlled trial. SETTING: This study was conducted in the first-level
neonatal intensive care unit between August 2021 and September 2022.
<br/>METHOD(S): Ninety-six newborns were included in this study based on
inclusion criteria. The newborns were randomly assigned to four groups:
(a) breastfeeding, (b) ShotBlocker, (c) breastfeeding + ShotBlocker, and
(d) standard care. Pain and comfort levels of newborns were evaluated
according to the Neonatal Infant Pain Scale and the Newborn Comfort
Behavior Scale before, during, and after the heel lance procedure. Crying
time, heart rate, and oxygen saturation were recorded. <br/>RESULT(S): The
difference between the groups in terms of average crying time (p = 0.001)
and comfort levels after the procedure (p = 0.001) was statistically
significant. There was no difference in pain during and after the
procedure. As a result of multiple analyses of variance in repeated
measurements, a difference was found in comfort scores in terms of group,
time, and group-time interaction (p < 0.05). <br/>CONCLUSION(S): The
breastfeeding + ShotBlocker group had the lowest mean crying time. There
was no difference in procedure-related pain scores between the groups. The
most comfortable groups after heel lance were the breastfeeding and
breastfeeding + ShotBlocker groups. IMPLICATION FOR CLINICAL PRACTICE:
Breastfeeding, currently the gold non-pharmacological standard, increased
comfort levels during the heel lance procedure. The breastfeeding +
ShotBlocker had a significant reduction in crying time and a significantly
greater post-procedural comfort level (Clinical Trials number:
NCT05246787).<br/>Copyright &#xa9; 2025 Elsevier Ltd. All rights reserved.

<5>
Accession Number
2040434779
Title
The impact of the getting into light exercise for heart failure
(GENTLE-HF) randomized controlled trial on physical-psychological outcomes
and exercise adherence.
Source
Heart and Lung. 75 (pp 47-57), 2026. Date of Publication: 01 Jan 2026.
Author
Kim J.; Byon H.D.; Platz K.; Toledo G.; Howie-Esquivel J.
Institution
(Kim, Byon) School of Nursing, University of Virginia, 225 Jeanette
Lancaster Way, Charlottesville, VA, United States
(Platz) UVA Health System, 1215 Lee St, Charlottesville, VA, United States
(Toledo) UVA Health System, PO Box 800386, Charlottesville, VA, United
States
(Howie-Esquivel) School of Nursing, University of California, 490 Illinois
St., San Francisco, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Few investigators have tested the effect of alternative,
gentle exercise interventions among patients with stable heart failure
(HF). <br/>Objective(s): In a 6-month online gentle exercise vs education
only intervention program, we evaluated: 1) Change in physical and
psychological function; 2) whether age or sex moderates the efficacy of
the intervention on physical function; 3) the relationship between quality
of life (QOL) and exercise adherence. <br/>Method(s): Data from the
GEtting iNTo Light Exercise for HF (GENTLE-HF) randomized controlled trial
(n = 61) was analyzed. Measures included physical function, psychological
function, QOL, and exercise adherence. ANCOVA-approach general linear
models were used to examine physical and psychological function, adjusting
for age, years of education, baseline scores, and grouping (control or
intervention). The moderating effects of age and sex were tested by
incorporating interaction terms into the ANCOVA-based models. Pearson
correlation analysis was used to examine the relationship between QOL and
adherence. <br/>Result(s): Compared to control, the intervention group had
improved upper body strength (p = .004), lower body strength (p = .002),
and endurance (p = .003). Age moderated the effect of the intervention on
upper body strength (p = .012) and endurance (p = .028). Exercise
adherence was high at 84.4 %. Greater QOL was associated with higher
adherence (p = .039). <br/>Conclusion(s): The online yoga intervention led
to improved physical function, had an additional positive effect for
participants over 65 years, and had high adherence rates. These findings
can inform future large-scale yoga studies that may influence future study
designs and supplement physical activity guidelines, ultimately improving
patient outcomes.<br/>Copyright &#xa9; 2025

<6>
Accession Number
2034706771
Title
Randomised Comparison of Culotte- versus Double Kissing Crush Stenting in
de novo non-left Main Coronary Bifurcation Lesions: Rationale and Design
of the Bifurcation Bad Krozingen trial-3 (BBK-3).
Source
Journal of Cardiovascular Translational Research. 18(4) (pp 1005-1012),
2025. Date of Publication: 01 Aug 2025.
Author
Rahimi F.; Loffelhardt N.; Minners J.; Breitbart P.; Franke K.;
Hartikainen T.S.; Valina C.; Muhlen C.V.Z.; Nuhrenberg T.; Kastrati A.;
Woitek F.; Elsaesser A.; Abdel-Wahab M.; Sossalla S.; Hochholzer W.;
Westermann D.; Neumann F.-J.; Olivier C.; Ferenc M.
Institution
(Rahimi, Loffelhardt, Minners, Breitbart, Franke, Hartikainen, Valina,
Muhlen, Nuhrenberg, Westermann, Neumann, Olivier, Ferenc) Department of
Cardiology and Angiology, Medical Center, Faculty of Medicine, University
of Freiburg, University of Freiburg, Suedring 15, Bad Krozingen, Germany
(Kastrati) Department of Cardiology, Technische Universitaet Muenchen,
Deutsches Herzzentrum Muenchen, Munich, Germany
(Woitek) Department of Internal Medicine and Cardiology, Heart Center
Dresden, University Hospital, Technische Universitat Dresden, Dresden,
Germany
(Elsaesser) Heart-Circulation Centre, Clinic Oldenburg, Oldenburg, Germany
(Abdel-Wahab) Heart Center Leipzig, University of Leipzig, Leipzig,
Germany
(Sossalla) Department of Cardiology, University Hospital Giessen Kerckhoff
Clinic, Giessen, Germany
(Hochholzer) Department of Cardiology and Intensive Care Medicine,
Klinikum Wuerzburg Mitte, Wurzburg, Germany
Publisher
Springer
Abstract
Whether culotte or double kissing (DK)-crush stenting is the superior
systematic 2-stent technique in non-left main bifurcation lesions is
unclear. The BBK-3 (unique identifier NCT 04192760) is a multicenter,
prospective, randomized controlled trial to test the hypothesis that
culotte stenting reduces maximal percent diameter restenosis at 9-month
follow-up compared to DK-crush stenting in de-novo non-left main coronary
bifurcation lesions using approved, third-generation drug-eluting stents
(DES). A total of 400 patients will be randomized in a 1:1 ratio to
receive a two-stent strategy. The primary study endpoint is the maximal
percent diameter in-stent restenosis within the bifurcation at 9 months,
assessed by quantitative coronary angiography. Secondary endpoints include
target lesion revascularization (TLR), the composite of death and
myocardial infarction, emergent cardiac bypass surgery and TLR (MACE) at
12 months. BBK-3 will assist in the identification of the preferable,
contemporary 2-stent strategy in the treatment of de-novo non-left main
coronary bifurcation lesions.<br/>Copyright &#xa9; The Author(s) 2025.

<7>
Accession Number
2040352288
Title
Transendocardial Injection of Expanded Autologous CD34+ Cells After
Myocardial Infarction: Results of the EXCELLENT Trial.
Source
JACC: Heart Failure. 13(11) (no pagination), 2025. Article Number: 102626.
Date of Publication: 01 Nov 2025.
Author
Roncalli J.; Roubille F.; Cottin Y.; Leroux L.; Mathur A.; Irving J.; Khan
S.Q.; Meneveau N.; Bresson D.; Hovasse T.; Pompilio G.; Matta A.; Henon
P.; Trebuchet G.; de Kalbermatten M.; Garitaonandia I.; Saloux E.;
Manrique A.; Meyer N.; Marie P.-Y.; Bhatt D.L.; Solomon S.D.; Montalescot
G.; Newby D.E.; Zannad F.; Baumbach A.; Chopard R.; Townend J.; George S.;
Seguy B.; Gerbaud E.; Cruden N.; Mills N.; Rochette G.B.; Vanzetto G.;
Greenwood J.; Wheatcroft S.; Lefevre T.; Benamer H.; Delseny D.; Bouisset
F.
Institution
(Roncalli, Matta) Department of Cardiology, Institute Cardiomet, Centre
d'Investigations Cliniques Biotherapies 1436, INSERM I2MC 1297, Toulouse
University Hospital, Toulouse, France
(Roubille) Cardiology Department, Montpellier University Hospital,
Montpellier, France
(Cottin) Cardiology Unit, Dijon University Hospital, Dijon, France
(Leroux) Department of Interventional Cardiology and Intensive Care,
Haut-Leveque Hospital, Pessac, France
(Mathur) Department of Cardiology, Barts Heart Centre Barts Health NHS
Trust, London, United Kingdom
(Irving) Ninewells Hospital and Medical School Cardiology department,
Dundee, United Kingdom
(Khan) Department of Interventional Cardiology, Queen Elizabeth Hospital,
University Hospitals Birmingham NHS Foundation Trust, Birmingham, United
Kingdom
(Meneveau) Department of Cardiology, University Hospital Jean Minjoz,
Besancon, France
(Bresson) Cardiology Division, University Hospital of Mulhouse, Hopital
Emile Muller, Mulhouse, France
(Hovasse) Cardiovascular Institute Paris-Sud (ICPS), Cardiology, Massy,
France
(Pompilio) Unit of Vascular Biology and Regenerative Medicine, Centro
Cardiologico Monzino IRCCS, Milano, Italy
(Pompilio) Dipartimento di Scienze Biomediche, Chirurgiche ed
Odontoiatriche, University of Milano, Milano, Italy
(Henon, Trebuchet, de Kalbermatten, Garitaonandia) CellProthera, Mulhouse,
France
(Saloux) Department of Cardiology, Caen University Hospital, Caen, France
(Manrique) Department of Nuclear Medicine, Normandie Univ, UNICAEN, CHU de
Caen Normandie, Caen, France
(Meyer) GMRC, Pole de Sante Publique, University Hospital, Strasbourg,
France
(Marie) Nuclear Medicine and Nancyclotep Experimental Platform,
CHRU-Nancy, Universite de Lorraine, Nancy, France
(Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Solomon) Cardiovascular Division, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Montalescot) ACTION Group, Sorbonne University, Institute of Cardiology,
Pitie-Salpetriere Hospital (AP-HP), Paris, France
(Newby) British Heart Foundation Centre of Research Excellence, University
of Edinburgh, Edinburgh, United Kingdom
(Zannad) Universite de Lorraine, Inserm, Centre d'Investigations Cliniques
Plurithematique 1433, Centre Hospitalier Regional Universitaire de Nancy,
Nancy, France
Publisher
Elsevier Inc.

<8>
Accession Number
2039904438
Title
SCAI/HRS technical review on transcatheter left atrial appendage
occlusion.
Source
Heart Rhythm. 22(10) (pp e1064-e1074), 2025. Date of Publication: 01 Oct
2025.
Author
Cronin E.M.; Filby S.; Field M.E.; Huded C.; Indik J.H.; Sharma A.; Armah
C.; Firestone S.; Fix A.M.; Senerth E.; Morgan R.L.; Falck-Ytter Y.
Institution
(Cronin) Lewis Katz School of Medicine at Temple University, Philadelphia,
Pennsylvania, United States
(Filby) University Hospitals Cleveland Medical Center, Cleveland, Ohio,
United States
(Field) Roper St. Francis Healthcare, Charleston, South Carolina, United
States
(Huded) Saint Luke's Mid America Heart Institute, Kansas City, Missouri,
United States
(Indik) Sarver Heart Center, University of Arizona, Tucson, AZ, United
States
(Sharma) Rutgers New Jersey Medical School, Newark, New Jersey, United
States
(Armah, Firestone) Society for Cardiovascular Angiography & Interventions,
Washington, DC, United States
(Fix) Heart Rhythm Society, Washington, DC, United States
(Senerth, Morgan, Falck-Ytter) Evidence Foundation, Cleveland Heights, OH,
United States
(Morgan) School of Medicine, Case Western Reserve University, Cleveland,
Ohio, United States
(Morgan) Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
(Falck-Ytter) Case Western Reserve University, Cleveland, Ohio, United
States
(Falck-Ytter) Division of Gastroenterology and Hepatology, Veterans
Affairs Northeast Ohio Healthcare System, Cleveland, Ohio, United States
Publisher
Elsevier B.V.
Abstract
Background: Nonvalvular atrial fibrillation (NVAF) is associated with an
increased risk of stroke due to thrombus formation in the left atrial
appendage, where over 90% of thrombi originate. While oral anticoagulation
(OAC) is the standard therapy for stroke prevention, many patients cannot
tolerate long-term OAC due to bleeding risks. Percutaneous left atrial
appendage occlusion (LAAO) has emerged as an alternative strategy. Despite
its rapid adoption, substantial variability exists in clinical practice
regarding patient selection, imaging techniques, procedural guidance, and
postprocedural management. This systematic review aims to collect and
synthesize evidence to inform the development of new Society for
Cardiovascular Angiography & Interventions and the Heart Rhythm Society
guidelines on LAAO. <br/>Method(s): We searched PubMed, Embase, and
Cochrane Library from inception through January 5, 2024, for studies of
the percutaneous LAAO procedure. Eligible studies were conducted in adults
with NVAF undergoing LAAO, or with peridevice leak or device-related
thrombus after an occlusion procedure. Studies of surgical LAAO, double
device or combined procedures, and devices that are not currently marketed
in the United States were excluded. Data were extracted from studies in
duplicate and summarized using meta-analysis and narrative synthesis. Risk
of bias (RoB) was assessed using the RoB in nonrandomized studies of
interventions tool, and version 2 of the Cochrane RoB tool for randomized
trials (RoB 2.0). Overall certainty of evidence was assessed using the
Grading of Recommendations Assessment, Development, and Evaluation
approach. <br/>Result(s): Our search identified 3769 titles and abstracts,
of which 27 studies met eligibility criteria and contributed data to the
analysis. Data were abstracted to address outcomes of LAAO for stroke
prevention in patients with NVAF, in comparison to OAC, no therapy, and
across various approaches including preprocedure imaging, intraprocedure
guidance, and postprocedure antithrombotic regimens. <br/>Conclusion(s):
Left atrial appendage occlusion is an effective alternative to OAC for
stroke prevention in NVAF patients with bleeding risks, but uncertainties
remain regarding imaging strategies and postprocedural
management.<br/>Copyright &#xa9; 2025 Society for Cardiovascular
Angiography & Interventions Foundation and Heart Rhythm Society.

<9>
[Use Link to view the full text]
Accession Number
2034750607
Title
2024 AHA/ACC/ACS/ASNC/HRS/SCA/ SCCT/SCMR/SVM Guideline for Perioperative
Cardiovascular Management for Noncardiac Surgery: A Report of the American
College of Cardiology/American Heart Association Joint Committee on
Clinical Practice Guidelines.
Source
Circulation. 150(19) (pp e351-e442), 2024. Date of Publication: 05 Nov
2024.
Author
Thompson A.; Fleischmann K.E.; Smilowitz N.R.; de las Fuentes L.;
Mukherjee D.; Aggarwal N.R.; Ahmad F.S.; Allen R.B.; Altin S.E.; Auerbach
A.; Berger J.S.; Chow B.; Dakik H.A.; Eisenstein E.L.; Gerhard-Herman M.;
Ghadimi K.; Kachulis B.; Leclerc J.; Lee C.S.; Macaulay T.E.; Mates G.;
Merli G.J.; Parwani P.; Poole J.E.; Rich M.W.; Ruetzler K.; Stain S.C.;
Sweitzer B.; Talbot A.W.; Vallabhajosyula S.; Whittle J.; Williams K.A.
Publisher
Lippincott Williams and Wilkins
Abstract
AIM: The "2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for
Perioperative Cardiovascular Management for Noncardiac Surgery" provides
recommendations to guide clinicians in the perioperative cardiovascular
evaluation and management of adult patients undergoing noncardiac surgery.
<br/>METHOD(S): A comprehensive literature search was conducted from
August 2022 to March 2023 to identify clinical studies, reviews, and other
evidence conducted on human subjects that were published in English from
MEDLINE (through PubMed), EMBASE, the Cochrane Library, the Agency for
Healthcare Research and Quality, and other selected databases relevant to
this guideline. STRUCTURE: Recommendations from the "2014 ACC/AHA
Guideline on Perioperative Cardiovascular Evaluation and Management of
Patients Undergoing Noncardiac Surgery" have been updated with new
evidence consolidated to guide clinicians; clinicians should be advised
this guideline supersedes the previously published 2014 guideline. In
addition, evidence-based management strategies, including pharmacological
therapies, perioperative monitoring, and devices, for cardiovascular
disease and associated medical conditions, have been
developed.<br/>Copyright &#xa9; 2024 by the American Heart Association,
Inc., and the American College of Cardiology Foundation.

<10>
Accession Number
2040495332
Title
Prevention of readmission by intensified follow-up after transcatheter
aortic valve implantation: Feasibility results of the PREMISS randomised
controlled trial.
Source
International Journal of Cardiology. 442 (no pagination), 2026. Article
Number: 133894. Date of Publication: 01 Jan 2026.
Author
Kirk B.H.; Palm P.; Norgaard M.W.; Borregaard B.; Norekval T.M.; De Backer
O.
Institution
(Kirk, Palm, De Backer) Department of Cardiology, The Heart Centre,
Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
(Kirk, Palm, De Backer) Department of Clinical Medicine, University of
Copenhagen, Copenhagen, Denmark
(Norgaard) Centre for Clinical Guidelines, Faculty of Medicine, Aalborg
University, Aalborg, Denmark
(Borregaard) Department of Cardiology, Odense University Hospital, Odense,
Denmark
(Borregaard) Department of Clinical Research, University of Southern
Denmark, Odense, Denmark
(Norekval) Department of Heart Disease, Haukeland University Hospital,
Bergen, Norway
(Norekval) Department of Clinical Science, University of Bergen, Bergen,
Norway
Publisher
Elsevier Ireland Ltd
Abstract
Background: Hospital readmissions after transcatheter aortic valve
implantation (TAVI) are common. This study aimed to investigate the
feasibility and impact of an intensified follow-up intervention on cardiac
readmissions, mortality, and self-reported health status post-TAVI.
<br/>Method(s): The study was designed as a randomised controlled trial to
compare an early follow-up intervention with standard care. The
intervention included tailored telephone and in-hospital consultations
within 30 days post-TAVI. The feasibility outcomes were enrolment,
attrition, and completion rates. Efficacy outcomes included all-cause
mortality, cardiac-related hospital readmissions, and self-reported health
status at 30 and 90 days after TAVI. <br/>Result(s): Eighty patients were
randomised to either the intensified or standard follow-up. The
intervention was feasible, achieving a 73 % recruitment rate (target >50
%), 0 % attrition, 93 % questionnaire completion, and 100 % follow-up
during the 30-day intervention and 90-day follow-up period. Detailed
insights into processes, resources, management, and scientific approach of
the intervention were provided. There was no mortality within 90 days in
both groups. Cardiac readmissions within 90 days were 11 (28 %) in the
standard care group vs 4 (10 %) in the intervention group (p = 0.04); this
difference was mostly driven by short (<24-h) cardiac readmissions in the
early post-TAVI period (13 % vs 0 %, respectively). Early improvements in
self-reported health status occurred in both groups with no significant
differences between groups. <br/>Conclusion(s): An intensified follow-up
intervention combining telephone and outpatient consultations after
discharge from TAVI was shown to be feasible with high recruitment and
completion rates. This study indicates that an intensified follow-up
post-TAVI may prevent early cardiac readmissions.<br/>Copyright &#xa9;
2025 The Authors

<11>
Accession Number
2040334642
Title
Urgent surgery vs fibrinolytic therapy for left-sided prosthetic valve
thrombosis: a randomized trial.
Source
European Heart Journal. 46(34) (pp 3373-3381), 2025. Date of Publication:
07 Sep 2025.
Author
Karthikeyan G.; Rajashekar P.; Devasenapathy N.; Biswas S.; Kidambi B.;
Singal A.; Mantoo M.R.; Soni M.; Purohit G.; Hote M.P.; Singh S.;
Velayoudam D.
Institution
(Karthikeyan, Rajashekar, Kidambi, Singal, Mantoo, Purohit, Hote, Singh,
Velayoudam) Cardiothoracic Sciences Centre, All India Institute of Medical
Sciences, Ansari Nagar, New Delhi, India
(Karthikeyan) Translational Health Science and Technology Institute,
Haryana, Faridabad, India
(Devasenapathy, Biswas, Soni) Academic Clinical Trial Unit, The George
Institute of Global Health, India
Publisher
Oxford University Press
Abstract
Background and Aims Left-sided mechanical prosthetic valve thrombosis
(PVT) is common in low-resource settings. Treatment is either by
fibrinolytic therapy (FT) or urgent surgery. This is the first randomized
controlled trial (RCT) comparing urgent surgery with FT for symptomatic
left-sided PVT. Methods This is a single-centre RCT comparing urgent
surgery with FT (low-dose, slow-infusion tissue plasminogen activator
[t-PA]) in patients with symptomatic left-sided PVT. The primary outcome
was complete clinical response, defined as discharge from hospital with
completely restored valve function, without major complications. The
primary safety outcome was a composite of death, non-fatal stroke,
non-fatal major bleed, or systemic embolism, at discharge. Outcomes were
assessed by investigators blinded to treatment allocation. Results Over a
6-year period, 79 patients were randomized to urgent surgery (n = 39) or
FT (n = 40). Patients most often had a thrombosed mitral prosthesis (72%)
with 43% in New York Heart Association class III/IV. All patients
allocated to FT received t-PA. Of the 32 patients who had surgery, 17
(53%) underwent the procedure within 48 h. In the intention-to-treat
population, the primary outcome was not significantly different between
the two arms (odds ratio [OR] 1.22, 95% confidence interval [CI]
0.46-3.19; P = .689). However, the composite safety outcome occurred more
often with surgery (OR 5.14, 95% CI 1.28-20.5; P = .021), driven by the
difference in deaths (7/39 vs 1/40; P = .035). Twenty-five percent of
patients undergoing FT (10/40) had residual valve dysfunction. Conclusions
In symptomatic left-sided PVT, urgent surgery is not more efficacious than
FT. Surgery is associated with a higher risk of complications, including
death, while FT is more often associated with residual valve
dysfunction.<br/>Copyright &#xa9; The Author(s) 2025.

<12>
Accession Number
648593176
Title
Effect of Preoperative Respiratory Training on Perioperative Outcomes in
Thoracic Surgery: A Systematic Review and Meta-Analysis.
Source
Annali italiani di chirurgia. 96(9) (pp 1135-1145), 2025. Date of
Publication: 10 Sep 2025.
Author
Zhu Y.; Du Y.; Zhang M.
Institution
(Zhu, Zhang) Department of Cardiothoracic Surgery, Shengzhou People's
Hospital (Shengzhou Branch of The First Affiliated Hospital of Zhejiang
University School of Medicine, Shengzhou Hospital of Shaoxing University),
Zhejiang, China
(Du) Shengzhou People's Hospital (Shengzhou Branch of The First Affiliated
Hospital of Zhejiang University School of Medicine, Shengzhou Hospital of
Shaoxing University), Department of Gastrointestinal and Vascular Surgery,
Zhejiang, China
Abstract
AIM: Postoperative pulmonary complications (PPCs) commonly ensue after
thoracic surgery and can impair patients' recovery. This study aimed to
evaluate the effectiveness of preoperative respiratory training (PRT) in
various perioperative outcomes in patients undergoing thoracic surgery,
including pulmonary function, exercise capacity, incidence of
postoperative complications, and length of hospital stay. <br/>METHOD(S):
Randomized controlled trials (RCTs) comparing PRT with routine care, that
were published in the period of 1 January 2000 to 30 June 2025, were
identified through PubMed, Embase, Web of Science, and Cochrane Library.
Pooled analyses were performed using RevMan 5.4.1 to calculate odds ratio
(OR) or mean difference (MD) with 95% CI. <br/>RESULT(S): Nine studies
were included in the meta-analysis. The results revealed that PRT
significantly reduces PPCs (OR = 0.31, 95% CI: 0.21 to 0.46) and improved
the change in six-minute walking distance (6MWD) (MD = 20.50, 95% CI:
11.72 to 29.28). No significant effects were observed on absolute 6MWD,
forced expiratory volume in one second (FEV1), peak expiratory flow, or
length of hospital stay. Sensitivity analysis confirmed result stability,
and no substantial publication bias was found. <br/>CONCLUSION(S): PRT
reduces PPCs and improves postoperative functional recovery in patients
undergoing thoracic surgery. Its impact on spirometry-based pulmonary
function and length of hospital stay remains uncertain. Further
large-scale trials are needed to investigate the effect of integrating
perioperative care into routine healthcare, especially for high-risk
patients.<br/>Copyright &#xa9; 2025 The Author(s).

<13>
Accession Number
2038940347
Title
Comparison of left atrial appendage closure and oral anti-coagulation
after catheter ablation for atrial fibrillation: Concomitant and
sequential cohorts of the OPTION randomized controlled trial.
Source
Heart Rhythm. 22(10) (pp 2585-2594), 2025. Date of Publication: 01 Oct
2025.
Author
Saliba W.; Nair D.; Swarup V.; Hall T.; Iyer V.; Perez G.C.; Weiner S.;
Shah M.; Islam N.; Grygier M.; Schuler B.; Ibanez Criado J.L.; Duthoit G.;
Reddy Y.M.; Reddy V.Y.; Mansour M.; Natale A.; Leger K.; Christen T.;
Stein K.; Sutton B.; Wazni O.
Institution
(Saliba, Wazni) Cleveland Clinic, Cleveland, Ohio, United States
(Nair) St. Bernards Medical Center & Arrhythmia Research Group, Jonesboro,
AR, United States
(Swarup) Arizona Arrhythmia Research Center, Phoenix, Arizona, United
States
(Hall) Q Cardiology, East Brisbane, QLD, Australia
(Iyer) MarinHealth Medical Center, Greenbrae, California, United States
(Perez) H. Puerta Del Mar, Cadiz, Spain
(Weiner) Christus Trinity Mother Frances Health System, Tyler, TX, United
States
(Shah) Washington Hospital Center, Washington, DC, United States
(Islam) University of Maryland St. Joseph Medical Group, Towson Maryland,
United States
(Grygier) Poznan University of Medical Sciences, Poznan, Poland
(Schuler) York Hospital, York, Pennsylvania, United States
(Ibanez Criado) Arrhythmia Unit, Cardiology Department, Hospital
Universitario Doctor Balmis, Alicante, Spain
(Ibanez Criado) Instituto de Investigacion Sanitaria y Biomedica de
Alicante (ISABIAL), Alicante, Spain
(Duthoit) Hopital Pitie-Salpetriere, APHP, Paris, France
(Reddy) University of Kansas Hospital, Kansas City, Kansas, United States
(Reddy) Cardiac Electrophysiology, Mount Sinai Fuster Heart Hospital
School of Medicine, New York, United States
(Mansour) Massachusetts General Hospital, Boston, Massachusetts, United
States
(Natale) Texas Cardiac Arrhythmia Institute, St. David's Medical Center,
Austin, Texas, United States
(Natale) Department of Biomedicine and Prevention, Division of Cardiology,
University of Tor Vergata, Rome, Italy
(Natale) Metro Health Medical Center, Case Western Reserve University,
Cleveland, Ohio, United States
(Leger, Christen, Stein, Sutton) Boston Scientific Corporation,
Marlborough, Massachusetts, United States
Publisher
Elsevier B.V.
Abstract
Background: Left atrial appendage closure (LAAC) can be performed in
separate procedures with cardiac ablation (sequentially) or concomitantly
in the same operative session. <br/>Objective(s): The OPTION trial aims to
compare the efficacy and safety of LAAC with oral anticoagulation (OAC) in
patients who have undergone catheter ablation for atrial fibrillation
(AF). The objective of this sub-analysis is to evaluate LAAC vs OAC within
concomitant and sequential ablation timings. <br/>Method(s): OPTION is a
multicenter, prospective randomized clinical trial. Patients with AF and
an elevated CHA<inf>2</inf>DS<inf>2</inf>-VASc score undergoing catheter
ablation were randomly assigned (1:1) to catheter-based LAAC (Device) vs
OAC (Control). Randomization was stratified by AF catheter ablation
procedure timing: Sequential (90-180 days prior to randomization) or
Concomitant (within 10 days of randomization, 99% of procedures happened
the same day). The primary safety end point was non-procedural major or
clinically-relevant non-major bleeding. The primary efficacy end point was
the composite of all-cause death, stroke, or systemic embolism at 36
months. <br/>Result(s): In both the Concomitant (n = 654) and Sequential
(n = 946) groups, the Device arm compared with Control had fewer primary
safety end point events and similar rates of primary efficacy events and
secondary safety events. Rates of acute safety events were low and similar
between the Device and Control arms within the Concomitant group; the
addition of LAAC to cardiac ablation sessions did not result in increased
procedural events. <br/>Conclusion(s): For both Concomitant and Sequential
ablation timing strategies, LAAC has similar efficacy compared with OAC
and a lower risk of clinically important post-procedure bleeding in
high-risk patients following AF ablation.<br/>Copyright &#xa9; 2025 Heart
Rhythm Society

<14>
Accession Number
2040496555
Title
Safety of general anesthesia in patients with unruptured intracranial
aneurysms undergoing non-aneurysm-related surgery: A systematic review.
Source
Journal of Clinical Neuroscience. 142 (no pagination), 2025. Article
Number: 111646. Date of Publication: 01 Dec 2025.
Author
Feng Q.J.; Tham K.J.; Tan C.L.
Institution
(Feng, Tan) Division of Neurosurgery, Department of General Surgery, Ng
Teng Fong General Hospital, Singapore
(Tham) Yong Loo Lin School of Medicine, National University of Singapore,
Singapore
(Tan) Division of Neurosurgery, Department of Surgery, National University
Hospital, Singapore
Publisher
Churchill Livingstone
Abstract
Objective: The increasing utilization of neuroimaging has led to a rising
number of incidental unruptured intracranial aneurysms (UIAs). Most UIAs
carry a low rupture risk, but concerns remain regarding the potential
impact of general anesthesia (GA) on perioperative aneurysm stability.
This systematic review aims to evaluate the incidence of perioperative
aneurysmal rupture in patients with UIAs undergoing GA for
non-aneurysm-related procedures. <br/>Method(s): A search of the PubMed
and EMBASE databases identified studies reporting adult patients with UIAs
undergoing GA for non-aneurysm-related surgeries, detailing aneurysm
characteristics and rupture incidence. The primary outcome was aneurysmal
rupture during or within 48 h of surgery, and the secondary outcome was
aneurysm-rupture-related mortality. Perioperative management strategies
were also reviewed. <br/>Result(s): A total of 21 studies involving 627
patients were included. The majority were case reports or small series,
alongside three larger cohort studies. Across all patients, only one case
of perioperative aneurysmal rupture (0.16 %) was identified, with no
rupture-related mortality. Most aneurysms were small (<7 mm) and located
in the anterior circulation. No specific surgical procedure or anesthetic
technique was associated with an increased rupture risk. Several studies
highlighted the importance of meticulous intraoperative hemodynamic
management, although no standardized protocols were reported.
<br/>Conclusion(s): This systematic review demonstrates that GA is
generally safe for patients with UIAs undergoing non-aneurysm-related
surgery, with an extremely low risk of perioperative rupture and no
associated mortality. Current evidence does not support prophylactic
aneurysm treatment. Individualized risk assessment and vigilant
perioperative blood pressure management are key to maintaining safety in
this population.<br/>Copyright &#xa9; 2025 Elsevier Ltd

<15>
Accession Number
2039904465
Title
2025 SCAI/HRS clinical practice guidelines on transcatheter left atrial
appendage occlusion.
Source
Heart Rhythm. 22(10) (pp e1048-e1063), 2025. Date of Publication: 01 Oct
2025.
Author
Goldsweig A.M.; Glikson M.; Joza J.; Kavinsky C.J.; Khalique O.;
Lakkireddy D.; Mackensen G.B.; Naccarelli G.V.; Nair D.G.; Saw J.; Sharma
R.P.; Sherwood M.; Szerlip M.; Falck-Ytter Y.; Morgan R.L.; Armah C.;
Firestone S.; Fix A.; Senerth E.; Ellis C.R.
Institution
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center
and Division of Cardiovascular Medicine, University of
Massachusetts-Baystate, Springfield, Massachusetts, United States
(Glikson) Jesselson Integrated Heart Center, Shaare Zedek Medical Center
and Hebrew University Faculty of Medicine, Jerusalem, Israel
(Joza) Division of Cardiology, McGill University, Montreal, Quebec, Canada
(Kavinsky) Beth Israel Deaconess Medical Center, Harvard Medical School,
Boston, Massachusetts, United States
(Khalique) Division of Cardiovascular Imaging, St. Francis Hospital and
Heart Center, Roslyn, New York, United States
(Lakkireddy) Kansas City Heart Rhythm Institute and Research Foundation,
Overland Park, KS, United States
(Mackensen) Division of Cardiothoracic Anesthesiology, Department of
Anesthesiology and Pain Medicine, University of Washington, Seattle, WA,
United States
(Naccarelli) Heart and Vascular Institute, Penn State University College
of Medicine, Hershey, Pennsylvania, United States
(Nair) St. Bernard's Heart and Vascular Center, Jonesboro, AR, United
States
(Saw) Division of Cardiology, Vancouver General Hospital, University of
British Columbia, Vancouver, Canada
(Sharma) Stanford University Medical Center, Palo Alto, California, United
States
(Sherwood) Division of Cardiology, Inova Heart and Vascular Institute,
Fairfax, Virginia, United States
(Szerlip) Baylor Scott & White the Heart Hospital - Plano, Plano, Texas,
United States
(Falck-Ytter, Morgan) Case Western Reserve University, Cleveland, Ohio,
United States
(Armah, Firestone) Society for Cardiovascular Angiography & Interventions,
Washington, District of Columbia, United States
(Fix) Heart Rhythm Society, Washington, District of Columbia, United
States
(Morgan, Senerth) Evidence Foundation, Cleveland, Ohio, United States
(Ellis) Division of Cardiovascular Medicine at Vanderbilt University
Medical Center, Nashville, TN, United States
(Morgan) Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
(Falck-Ytter) VA Northeast Ohio Healthcare System, Cleveland, Ohio, United
States
Publisher
Elsevier B.V.
Abstract
Background: Left atrial appendage occlusion (LAAO) devices reduce the risk
of atrial fibrillation-associated stroke relative to no oral
anticoagulation. However, uncertainty and practice variation persist in
the areas of patient selection, periprocedural imaging, adjunctive
antithrombotic therapy, and management of peridevice leak (PDL) and
device-related thrombus. The Society for Cardiovascular Angiography &
Interventions and Heart Rhythm Society developed these evidence-based
guidelines to support clinicians, patients, and other stakeholders in
management decisions regarding LAAO. <br/>Method(s): The Society for
Cardiovascular Angiography & Interventions and Heart Rhythm Society
convened a balanced, multidisciplinary guideline panel with <50% of
members reporting significant conflicts of interest with the industry.
Evidence Foundation, a registered 501(c)(3) nonprofit organization,
provided methodological support for guideline development. The guideline
panel formulated and prioritized clinical questions following the Grading
of Recommendations Assessment, Development, and Evaluation approach in a
population, intervention, comparison, outcome format. A technical review
team of clinical and methodological experts conducted systematic reviews
of the published evidence, synthesized data, and graded the certainty of
evidence across outcomes. The guideline panel then developed
recommendations and supporting statements informed by the technical review
and using the Grading of Recommendations Assessment, Development, and
Evaluation evidence-to-decision framework. <br/>Result(s): The guideline
panel developed 8 evidence-based recommendations to address variations in
care related to LAAO. The panel also identified 2 knowledge gaps.
<br/>Conclusion(s): Key recommendations address patient selection for
LAAO, periprocedural imaging, adjunctive antithrombotic therapy, and
management of PDL and device-related thrombus. The panel also recommended
necessary future research regarding the use of single antiplatelet therapy
following LAAO and regarding the management of PDL.<br/>Copyright &#xa9;
2025 Society for Cardiovascular Angiography & Interventions Foundation and
Heart Rhythm Society

<16>
Accession Number
2040368589
Title
Paclitaxel in the lower limbs: harm outweighs the benefit.
Source
The Lancet. 406(10508) (pp 1064-1065), 2025. Date of Publication: 13 Sep
2025.
Author
Katsanos K.; Spiliopoulos S.
Institution
(Katsanos) Department of Interventional Radiology, Patras University
Hospital, Rion, Greece
(Spiliopoulos) Attikon University Hospital, Athens, Greece
Publisher
Elsevier B.V.

<17>
Accession Number
2040370531
Title
Impact of metabolic syndrome on the prognosis of endometrial cancer: A
systematic review of evidence.
Source
Clinical Nutrition ESPEN. 69 (pp 775-784), 2025. Date of Publication: 01
Oct 2025.
Author
Koutoukoglou P.; Bakaloudi D.R.; Chaloulakou S.; Chourdakis M.
Institution
(Koutoukoglou, Bakaloudi, Chaloulakou, Chourdakis) Laboratory of Hygiene,
Social and Preventive Medicine and Medical Statistics, School of Medicine,
Faculty of Health Sciences, Aristotle University of Thessaloniki,
Thessaloniki, Greece
(Bakaloudi) Division of Hematology and Oncology, Department of Medicine,
University of Washington, Seattle, WA, United States
Publisher
Elsevier Ltd
Abstract
Background & aims: Endometrial cancer (EC) stands out as the 7th most
frequent malignancy among women around the globe and as the most common
gynecologic cancer in the developed world. Metabolic syndrome (MetS), the
silent epidemic of the Western World and a major risk factor for
cardiovascular disease, has already been recognized as a contributor to
the genesis of EC. In this review, we aimed to examine the respective
influence of MetS on the prognosis of EC. <br/>Method(s): A systematic
literature research was conducted in PubMed, Embase and Web of Science
databases up to August 19th, 2024. Observational studies (retrospective
cohorts, prospective cohorts and case-control studies) were included. The
endpoint of our systematic review was the impact of MetS on survival,
recurrence, aggression, perioperative outcomes and generally the prognosis
of EC. <br/>Result(s): A total of 1139 studies were identified in our
initial literature search. 272 duplicates were recognized and subtracted
with 867 studies remaining for screening. Finally, 13 studies including
20.297 women with EC were included in our systematic review. In four
studies, a worse overall survival (OS) had been reported in patients with
MetS and EC compared to patients without MetS while in two studies the
impact of MetS on the survival of patients with EC was found to be
non-significant. A worse cancer-specific survival (CSS) in patients with
MetS was reported in one study while MetS had an unfavorable impact on
recurrence-free survival (RFS) in three studies. In terms of perioperative
outcomes, the rates of outcomes pertinent to an increased morbidity were
higher in patients with MetS while the same population suffered from a
more aggressive disease compared to patients without MetS in three
studies. <br/>Conclusion(s): The coexistence of MetS could be regarded as
a worse prognostic factor for patients with EC based on our findings.
Intervention on prevention and treatment of MetS should be pursued but
further research is needed in the field.<br/>Copyright &#xa9; 2025
European Society for Clinical Nutrition and Metabolism

<18>
Accession Number
2033295562
Title
Vitamin D for the Prevention of Disease: An Endocrine Society Clinical
Practice Guideline.
Source
Journal of Clinical Endocrinology and Metabolism. 109(8) (pp 1907-1947),
2024. Date of Publication: 01 Aug 2024.
Author
Demay M.B.; Pittas A.G.; Bikle D.D.; Diab D.L.; Kiely M.E.;
Lazaretti-Castro M.; Lips P.; Mitchell D.M.; Murad M.H.; Powers S.; Rao
S.D.; Scragg R.; Tayek J.A.; Valent A.M.; Walsh J.M.E.; McCartney C.R.
Institution
(Demay) Department of Medicine, Endocrine Unit, Massachusetts General
Hospital, Harvard Medical School, Boston, MA, United States
(Pittas) Division of Endocrinology, Diabetes and Metabolism, Department of
Medicine, Tufts Medical Center, Boston, MA, United States
(Bikle) Departments of Medicine and Dermatology, University of California
San Francisco, San Francisco VA Medical Center, San Francisco, CA, United
States
(Diab) Department of Internal Medicine, Division of Endocrinology,
Diabetes and Metabolism, University of Cincinnati, Cincinnati, OH, United
States
(Kiely) Cork Centre for Vitamin D and Nutrition Research, School of Food
and Nutritional Sciences, INFANT Research Centre, University College Cork,
Cork, Ireland
(Lazaretti-Castro) Department of Internal Medicine, Division of
Endocrinology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
(Lips) Endocrine Section, Amsterdam University Medical Center, Internal
Medicine, Amsterdam, Netherlands
(Mitchell) Pediatric Endocrine Unit, Massachusetts General Hospital,
Harvard Medical School, Boston, MA, United States
(Murad) Evidence-Based Practice Center, Mayo Clinic, Rochester, MN, United
States
(Powers) Bone Health and Osteoporosis Foundation, Los Gatos, CA, United
States
(Rao) Division of Endocrinology, Diabetes and Bone & Mineral Disorders,
Henry Ford Health, Detroit, MI, United States
(Rao) College of Human Medicine, Michigan State University, Lansing, MI,
United States
(Scragg) School of Population Health, The University of Auckland,
Auckland, New Zealand
(Tayek) Department of Internal Medicine, Harbor-UCLA Medical Center,
Torrance, CA, United States
(Tayek) The Lundquist Institute, Torrance, CA, United States
(Valent) Department of Obstetrics & Gynecology, Oregon Health & Science
University, Portland, OR, United States
(Walsh) Division of General Internal Medicine, Department of Medicine,
University of California San Francisco, San Francisco, CA, United States
(McCartney) Department of Medicine, University of Virginia,
Charlottesville, VA, United States
(McCartney) Department of Medicine, West Virginia University, Morgantown,
WV, United States
Publisher
Endocrine Society
Abstract
Background: Numerous studies demonstrate associations between serum
concentrations of 25-hydroxyvitamin D (25[OH]D) and a variety of common
disorders, including musculoskeletal, metabolic, cardiovascular,
malignant, autoimmune, and infectious diseases. Although a causal link
between serum 25(OH)D concentrations and many disorders has not been
clearly established, these associations have led to widespread
supplementation with vitamin D and increased laboratory testing for
25(OH)D in the general population. The benefit-risk ratio of this increase
in vitamin D use is not clear, and the optimal vitamin D intake and the
role of testing for 25(OH)D for disease prevention remain uncertain.
<br/>Objective(s): To develop clinical guidelines for the use of vitamin D
(cholecalciferol [vitamin D3] or ergocalciferol [vitamin D2]) to lower the
risk of disease in individuals without established indications for vitamin
D treatment or 25(OH)D testing. <br/>Method(s): A multidisciplinary panel
of clinical experts, along with experts in guideline methodology and
systematic literature review, identified and prioritized 14 clinically
relevant questions related to the use of vitamin D and 25(OH)D testing to
lower the risk of disease. The panel prioritized randomized
placebo-controlled trials in general populations (without an established
indication for vitamin D treatment or 25[OH]D testing), evaluating the
effects of empiric vitamin D administration throughout the lifespan, as
well as in select conditions (pregnancy and prediabetes). The panel
defined "empiric supplementation" as vitamin D intake that (a) exceeds the
Dietary Reference Intakes (DRI) and (b) is implemented without testing for
25(OH)D. Systematic reviews queried electronic databases for publications
related to these 14 clinical questions. The Grading of Recommendations,
Assessment, Development, and Evaluation (GRADE) methodology was used to
assess the certainty of evidence and guide recommendations. The approach
incorporated perspectives from a patient representative and considered
patient values, costs and resources required, acceptability and
feasibility, and impact on health equity of the proposed recommendations.
The process to develop this clinical guideline did not use a risk
assessment framework and was not designed to replace current DRI for
vitamin D. <br/>Result(s): The panel suggests empiric vitamin D
supplementation for children and adolescents aged 1 to 18 years to prevent
nutritional rickets and because of its potential to lower the risk of
respiratory tract infections; for those aged 75 years and older because of
its potential to lower the risk of mortality; for those who are pregnant
because of its potential to lower the risk of preeclampsia, intra-uterine
mortality, preterm birth, small-for-gestational-age birth, and neonatal
mortality; and for those with high-risk prediabetes because of its
potential to reduce progression to diabetes. Because the vitamin D doses
in the included clinical trials varied considerably and many trial
participants were allowed to continue their own vitamin D-containing
supplements, the optimal doses for empiric vitamin D supplementation
remain unclear for the populations considered. For nonpregnant people
older than 50 years for whom vitamin D is indicated, the panel suggests
supplementation via daily administration of vitamin D, rather than
intermittent use of high doses. The panel suggests against empiric vitamin
D supplementation above the current DRI to lower the risk of disease in
healthy adults younger than 75 years. No clinical trial evidence was found
to support routine screening for 25(OH)D in the general population, nor in
those with obesity or dark complexion, and there was no clear evidence
defining the optimal target level of 25(OH)D required for disease
prevention in the populations considered; thus, the panel suggests against
routine 25(OH)D testing in all populations considered. The panel judged
that, in most situations, empiric vitamin D supplementation is
inexpensive, feasible, acceptable to both healthy individuals and health
care professionals, and has no negative effect on health equity.
<br/>Conclusion(s): The panel suggests empiric vitamin D for those aged 1
to 18 years and adults over 75 years of age, those who are pregnant, and
those with high-risk prediabetes. Due to the scarcity of natural food
sources rich in vitamin D, empiric supplementation can be achieved through
a combination of fortified foods and supplements that contain vitamin D.
Based on the absence of supportive clinical trial evidence, the panel
suggests against routine 25(OH)D testing in the absence of established
indications. These recommendations are not meant to replace the current
DRIs for vitamin D, nor do they apply to people with established
indications for vitamin D treatment or 25(OH)D testing. Further research
is needed to determine optimal 25(OH)D levels for specific health
benefits.<br/>Copyright &#xa9; The Author(s) 2024. Published by Oxford
University Press on behalf of the Endocrine Society. All rights reserved.

<19>
Accession Number
2039997694
Title
Short- and Long-Term Effects of Pulsed Ultrasound Cavitation Therapy of
Calcified Valvular Interstitial Cells in Culture.
Source
Ultrasound in Medicine and Biology. 51(11) (pp 1936-1944), 2025. Date of
Publication: 01 Nov 2025.
Author
Clift C.L.; Goudot G.; Bogut G.; Kasai T.; van Kampen A.; Negrao Pantaleao
A.; Messas E.; Aikawa M.; Singh S.A.; Levine R.A.; Pernot M.; Aikawa E.
Institution
(Clift, Bogut, Kasai, Aikawa, Singh, Aikawa) Division of Cardiovascular
Medicine, Department of Medicine, Center for Interdisciplinary
Cardiovascular Sciences, Brigham and Women's Hospital, Harvard Medical
School, Boston, MA, United States
(Goudot, van Kampen, Negrao Pantaleao, Aikawa, Levine) Division of
Cardiology, Department of Medicine, Massachusetts General Hospital,
Boston, MA, United States
(Goudot, Messas) Universite Paris Cite, Hopital Europeen Georges Pompidou,
APHP, INSERM PARCC U970, Paris, France
(Pernot) Physics for Medicine Paris, INSERM U1273, ESPCI Paris, CNRS 8063,
PSL University, Paris, France
(Aikawa) Division of Cardiovascular Medicine, Department of Medicine,
Center for Excellence in Vascular Biology, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Objective: Calcific aortic valve disease advances via increased fibrosis
and calcification deposition, leading to progressive narrowing of the
outflow tract, left ventricular hypertrophy and cardiac failure.
Currently, surgical repair and replacement are the only strategies for
intervention. While transcatheter aortic valve replacement offers a less
invasive alternative to surgical intervention, implanted bioprosthetic
valves have limited durability. Non-invasive ultrasound therapy was shown
to not damage normal porcine aortic valve, and successfully reduced
stenosis of calcified bioprosthetic valves in vivo, as well as decrease
stenosis of native severely calcified aortic stenosis in a first-in-human
study. However, critical questions regarding the effect of ultrasound
therapy on valvular cells remain. In this study, we aimed to optimize
pulsed ultrasound cavitation (PUC) treatment for cell culture studies and
evaluate the acute and persistent effects on human valvular interstitial
cells (hVICs) in calcifying conditions. <br/>Method(s): We utilized
viability, metabolism and calcification assays as well as mass
spectrometry-based proteomics to holistically characterize the effects of
PUC treatment in hVICs. <br/>Result(s): hVICs viability and metabolism
were not significantly altered as a function of PUC treatment at short-
(48 hour) or long-term (21 day) time points. Furthermore, PUC treatment
did not increase hVICs calcification in vitro. Proteomic profiling of
hVICs showed that PUC treatment had limited persistent changes to protein
profiles compared with the acute effects of PUC treatment.
<br/>Conclusion(s): These studies suggest that ultrasound therapy,
currently limited to very severe aortic stenosis, could be of interest at
an earlier stage of the disease.<br/>Copyright &#xa9; 2025 The Authors

<20>
Accession Number
2040341337
Title
Patient blood management for patients undergoing cardiac surgery in Middle
Eastern countries: Multicenter survey.
Source
Saudi Journal of Anaesthesia. 19(4) (pp 587-593), 2025. Date of
Publication: 01 Oct 2025.
Author
Abdalwahab A.; Abuzaid A.; Walley H.; Abdelfattah D.F.; Elmetwally S.A.;
Elsherbeny A.
Institution
(Abdalwahab, Abdelfattah, Elmetwally, Elsherbeny) Department of
Anaesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt
(Abdalwahab, Abuzaid, Elsherbeny) Department of Anesthesia, Prince Sultan
Cardiac Centre, Riyadh, Saudi Arabia
(Walley) Department of Anesthesia, Saud Al-Babatin Cardiac Centre, Dammam,
Saudi Arabia
(Elmetwally) Department of Anesthesia, National Heart Centre, Royal
Hospital, Muscat, Oman
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: The purpose of this survey was to delineate and compare
patient blood management (PBM) approaches in cardiac surgery across nine
Middle Eastern countries while identifying the main challenges against the
implementation of the PBM program in cardiac surgery as reported by the
surveyed centers. <br/>Design(s): An online survey was established to
assess current PBM practices in surveyed countries, including risk factors
for bleeding or transfusion, management of preoperative anemia in elective
cases, and antifibrinolytic use. <br/>Setting(s): This questionnaire was
conducted among cardiac anesthesiologists in Middle Eastern countries in
2024. <br/>Participant(s): Only doctors participated voluntarily in this
survey. <br/>Intervention(s): No intervention. Measurements: We assessed
the extent of adoption of PBM practices in surveyed countries for patients
who underwent cardiac surgery with cardiopulmonary bypass. <br/>Main
Result(s): Of 40 survey responses, 26 (60%) were eligible for analysis.
Most respondents were cardiac anesthesiologists. Key risk factors of
bleeding or transfusion identified by over 70% of respondents included
redo cardiac surgery, preoperative anemia, recent clopidogrel use,
thrombocytopenia <100 x 10 9 /L, and oral anticoagulants. More than half
of the centers would correct preoperative anemia using iron. Tranexamic
acid was universally used, though administration regimens varied.
Autologous priming and normothermia were the most common bypass strategies
that would be used by more than 50% of respondents. Viscoelastic testing
was available in more than 70% of centers and used by more than half of
respondents in case of clinical bleeding. <br/>Conclusion(s): PBM
practices in Middle Eastern cardiac centers are heterogeneous, reflecting
inconsistent adoption of guidelines. Enhanced training, institutional
support, and homogenized national protocols are needed to standardize PBM
in the region.<br/>Copyright &#xa9; 2025 Saudi Journal of Anesthesia.

<21>
Accession Number
644901970
Title
Comparative effectiveness of antiplatelet therapies for saphenous venous
graft occlusion and cardiovascular outcomes: a network meta-analysis.
Source
Minerva cardiology and angiology. 73(5) (pp 613-625), 2025. Date of
Publication: 01 Oct 2025.
Author
Hasan S.U.; Pervez A.; Afreen M.; Imam B.; Shah S.D.; Shah A.A.; Siddiqui
S.A.; Zubair M.M.; Osho A.
Institution
(Hasan) Ophthalmology Department, Aga Khan University, Karachi, Pakistan
(Pervez) Center for Clinical Best Practices, Aga Khan University, Karachi,
Pakistan
(Afreen) Department of Neurosurgery, Shifa International Hospital,
Islamabad, Pakistan
(Imam) Department of Cardiology, Dr Ruth KM Pfau Civil Hospital, Karachi,
Pakistan
(Shah, Shah) Department of Cardiology, Dow University of Health Sciences,
Karachi, Pakistan
(Siddiqui) Department of Cardiology, Baqai Medical University, Karachi,
Pakistan
(Zubair) Department of Cardiology, Cedars-Sinai Medical Center, Los
Angeles, CA, United States
(Osho) Department of Cardiology, Massachusetts General Hospital, Boston,
MA, United States
Abstract
INTRODUCTION: The ideal antiplatelet therapy to maintain graft patency
after coronary artery bypass graft surgery (CABG) remains controversial.
This review of randomized controlled trials (RCTs) aims to compare aspirin
monotherapy, ticagrelor monotherapy, dual antiplatelet therapy (DAPT) with
aspirin and ticagrelor (Asp+Tica) or with aspirin and clopidogrel
(Asp+Clopi) to evaluate differences in post-CABG saphenous vein graft
(SVG) occlusion, internal mammary artery (IMA) occlusion, myocardial
infarction (MI), bleeding, and all-cause mortality (ACM) rates. EVIDENCE
ACQUISITION: The literature review was conducted on several electronic
databases, including Medline, Embase, and Cochrane Central, from inception
to August 10, 2022. Data was extracted using a predefined proforma. A
Bayesian random-effects model was used for calculating point effect
estimates (odds ratio and standard deviation). Quality assessment was done
using the Cochrane RoB-2 tool. EVIDENCE SYNTHESIS: Ten RCTs comprising
2139 patients taking anti-platelets post-CABG were included. For
preventing SVG occlusion, Asp+Tica showed the lowest mean AR of
0.144+/-0.068. Asp+Tica also showed a trend toward lesser postoperative MI
risk and lower ACM rates, with a mean AR of 0.040+/-0.053 and
0.018+/-0.029, respectively. For maintaining IMA graft patency, Asp+Clopi
showed the lowest mean AR of 0.092+/-0.053. Ticagrelor had the lowest mean
AR of 0.049+/-0.075, with Asp+Tica showing a similar mean AR of
0.049+/-0.045 for postoperative major bleeding risk. <br/>CONCLUSION(S):
Our analysis demonstrates that Asp+Tica can be the ideal therapy for
patients undergoing CABG using SVG as it decreases the risk of post-CABG
SVG occlusion and is not associated with a significantly higher risk for
major bleeding.

<22>
Accession Number
2040439443
Title
Harnessing the power of nature in surgery: A systematic scoping review of
nature prescribing and measures of benefit.
Source
Surgery (United States). 187 (no pagination), 2025. Article Number:
109657. Date of Publication: 01 Nov 2025.
Author
Nguyen M.; Liu E.; Karimuddin A.A.; Ghuman A.; Conklin A.I.
Institution
(Nguyen, Liu, Conklin) Faculty of Pharmaceutical Sciences, University of
British Columbia, Vancouver, Canada
(Karimuddin, Ghuman) Colorectal Surgery, St. Paul's Hospital, Providence
Health Care, and General Surgery Residency Training Program at the
University of British Columbia, Vancouver, Canada
(Karimuddin, Ghuman) Department of Surgery, Faculty of Medicine,
University of British Columbia, Vancouver, Canada
(Conklin) Centre for Advancing Health Outcomes, Providence Healthcare
Research Institute, Vancouver, Canada
(Conklin) Edwin S.H. Leong Centre for Healthy Aging, Faculty of Medicine,
University of British Columbia, Vancouver, Canada
Publisher
Elsevier Inc.
Abstract
Background: Natural environments can reduce stress and benefit overall
health and nature prescriptions may be a useful adjunct for postoperative
care in surgical patients. We sought to identify characteristics and
health measures of nature prescriptions in surgery. <br/>Method(s): We
undertook a scoping review of 5 bibliometric databases (to February 2024)
and citations of peer-reviewed original studies examining nature
prescription interventions in patients undergoing major surgical
procedures requiring anesthesia and hospital admission. Standardized data
extraction and narrative synthesis were performed. <br/>Result(s): The
search found 2,175 deduplicated eligible records and 20 full-texts for
screening. Ten studies were included and covered auditory (n = 3), visual
(n = 3), experiential (n = 3), or mixed interventions (n = 1), with small
sample sizes (median, 106; interquartile range, 252). About 50% focused on
cardiothoracic surgical patients. Interventions varied from viewing
plants/trees, listening to bird/water/forest sounds or being physically
immersed. Nearly all included studies reported patient-reported outcome
measures (eg, anxiety, pain or mood) that significantly improved across
all intervention types. Cardiovascular (eg, heart rate, blood pressure)
and respiratory (eg, respiratory rate, vital capacity) outcomes were
frequently measured, with greater improvements observed in the
nature-based intervention groups compared with controls. Few included
studies assess other clinical measures (eg, mortality, length of stay,
complications) and only 2 evaluated medications to show reductions in the
amount of analgesic consumption after being exposed to nature
interventions. <br/>Conclusion(s): Nature prescribing in surgery appears
diverse and shows promise for improving postoperative recovery and
well-being through reduced anxiety, pain, cardiorespiratory stress,
medication use, and improved mood. Medical and research attention to
include nature-based therapy in surgery seems warranted.<br/>Copyright
&#xa9; 2025 The Author(s)

<23>
Accession Number
2040336518
Title
The effect of 0.5 mg dose of colchicine on clinical outcomes in patients
with acute myocardial infarction: An updated meta-analysis of randomized
controlled trials.
Source
Current Problems in Cardiology. 50(11) (no pagination), 2025. Article
Number: 103169. Date of Publication: 01 Nov 2025.
Author
Nazmy A.; Sobhy A.; Elshahat A.; Atta K.; Murad M.R.; Ibrahim M.;
El-Shirbiny H.; Ibrahim R.A.; Sayed M.S.; Gomaa M.; Shaban A.Y.; Naeem M.;
Abdelaziz A.
Institution
(Nazmy, Sobhy, Elshahat, Atta, Murad, Ibrahim, Ibrahim, Sayed, Shaban,
Abdelaziz) Medical Research Group of Egypt (MRGE), Negida Academy,
Arlington, MA, United States
(Nazmy, Sobhy, Ibrahim, Shaban) Faculty of Medicine, Kafr-Elsheikh
University, Kafr-Elsheikh, Egypt
(Elshahat, Murad) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Atta) Institute of Medicine, National Research Mordovia State University,
Saransk, Russian Federation
(Ibrahim) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(El-Shirbiny, Gomaa) Cardiology Department, Faculty of Medicine, Kafr
Elsheikh University, Kafr El Sheikh, Egypt
(Sayed) Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
(Naeem) Emergency Department, Faculty of Medicine, Mansoura University,
Mansoura, Egypt
(Abdelaziz) Division of Cardiology, Montefiore Health System/Albert
Einstein College of Medicine, Montefiore Medical Center, 111 E 210th St.,
Bronx, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Inflammation plays a critical role in the progression of
atherosclerosis, and the anti-inflammatory effects on clinical outcomes of
patients with acute myocardial infarction (AMI) are still uncertain.
<br/>Objective(s): We aimed to study the effects of a 0.5 mg dose of
colchicine on clinical outcomes following AMI. <br/>Method(s): We
systematically searched PubMed, Scopus, Web of Science, and Cochrane
Central from inception to January 2025 for randomized controlled trials
(RCTs) assessing 0.5 mg colchicine in AMI patients. The primary outcome
was the incidence of major adverse cardiovascular events (MACE). Secondary
outcomes included individual MACE components, cardiovascular (CV) and
non-CV mortality, atrial fibrillation (AF), hospital readmission, and
gastrointestinal (GIT) adverse events, including diarrhea. <br/>Result(s):
Ten RCTs involving 13,623 patients with a median follow-up of 6 months
(range 5 days-36 months) were included. Low-dose colchicine showed a
non-significant trend toward reducing MACE versus placebo (RR = 0.90, 95%
CI: 0.80-1.01, p = 0.07; I2 = 0%). Hospital readmission was significantly
reduced by 49% (OR = 0.51, 95% CI: 0.26-0.98, p = 0.04; number needed to
treat [NNT] = 25). Colchicine increased the risk of diarrhea (RR = 1.58,
95% CI: 1.06-2.36, p = 0.03; I2 = 71%; number needed to harm [NNH] = 50)
but showed no significant differences in all-cause mortality, CV
mortality, myocardial infarction, stroke, or other GIT events.
<br/>Conclusion(s): Low-dose colchicine had a lower hospital readmission
rate, but with higher rates of diarrhea compared to placebo. Long-term
assessment is indeed to validate the current findings.<br/>Copyright
&#xa9; 2025 Elsevier Inc.

<24>
[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.

<25>
Accession Number
2036676526
Title
Midterm survival, clinical, and hemodynamic outcomes of a novel mechanical
mitral valve prosthesis.
Source
Journal of Thoracic and Cardiovascular Surgery. 170(4) (pp 1060-1068.e3),
2025. Date of Publication: 01 Oct 2025.
Author
Ruel M.; Chu M.W.A.; Graeve A.; Gerdisch M.W.; Damiano R.J.; Smith R.L.;
Keeling W.B.; Wait M.A.; Hagberg R.C.; Quinn R.D.; Sethi G.K.; Floridia
R.; Barreiro C.J.; Pruitt A.L.; Accola K.D.; Dagenais F.; Markowitz A.H.;
Ye J.; Sekela M.E.; Tsuda R.Y.; Duncan D.A.; Swistel D.G.; Harville L.E.;
DeRose J.J.; Lehr E.J.; Alexander J.H.; Puskas J.D.
Institution
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Chu) Division of Cardiac Surgery, London Health Sciences Centre, Western
University, London, ON, Canada
(Graeve) Cardiothoracic Division, MultiCare Health System, Tacoma, Wash,
United States
(Gerdisch) Department of Cardiovascular and Thoracic Surgery, Franciscan
St Francis Health, Indianapolis, Ind, United States
(Damiano) Department of Surgery, Washington University SL, St. Louis, Mo,
United States
(Smith) Robotic Cardiac Surgery, The Heart Hospital Baylor Plano, Plano,
Tex, United States
(Keeling) Division of Cardiothoracic Surgery, Emory University Hospital
Midtown, Atlanta, GA, United States
(Wait) Department of Cardiovascular and Thoracic Surgery, UT Southwestern
Medical Center, Dallas, Tex, United States
(Hagberg) Department of Cardiac Surgery, Hartford Hospital, Hartford,
Conn, United States
(Quinn) Department of Cardiac Services, Maine Medical Center, Portland,
Maine, United States
(Sethi) Division of Cardiothoracic Surgery, University of Arizona, Tucson
Heart Center, Tucson, Ariz, United States
(Floridia) Department of Cardiovascular and Thoracic Surgery, Loma Linda
University Medical Center, Loma Linda, Calif, United States
(Barreiro) Sentara Health Research Center, Sentara Norfolk General
Hospital, Norfolk, Va, United States
(Pruitt) Cardiovascular and Thoracic Surgery, St Joseph Mercy Hospital,
Ann Arbor, Mich, United States
(Accola) Cardiovascular Surgery, Florida Hospital, Orlando, Fla, United
States
(Dagenais) Department of Cardiac Surgery, Institut universitaire de
cardiologie et de pneumologie de Quebec, Quebec City, QC, Canada
(Markowitz) Heart & Vascular Institute, University Hospitals-Cleveland,
Cleveland, Ohio, United States
(Ye) Division of Cardiovascular Surgery, St Paul's and Vancouver General
Hospital, Vancouver, BC, Canada
(Sekela) Division of Cardiothoracic Surgery, University of Kentucky,
Lexington, Ky, United States
(Tsuda) Department of Cardiology, Southern Arizona VA Medical Center,
Tucson, Ariz, United States
(Duncan) Cardiovascular and Thoracic Surgery, Novant Clinical Research
Institute, Winston-Salem, NC, United States
(Swistel) Department of Cardiac Surgery, NYU Langone Hospitals, New York,
NY, United States
(Harville) Department of Surgery, University of Oklahoma Health Sciences
Center, Oklahoma City, Okla, United States
(DeRose) Division of Cardiothoracic Surgery, Montefiore Medical Center,
Bronx, NY, United States
(Lehr) Cardiac Surgery, Swedish Medical Center, Seattle, Wash, United
States
(Alexander) Division of Cardiology, Duke Clinical Research Institute, Duke
University, Durham, NC, United States
(Puskas) Division of Cardiothoracic Surgery, Mount Sinai Saint Luke's, New
York, NY, United States
Publisher
Elsevier Inc.
Abstract
Objective: To evaluate the midterm survival, clinical, and hemodynamic
outcomes of the On-X mechanical mitral valve, based on the 5-year results
of the Prospective Randomized On-X Anticoagulation Clinical Trial
(PROACT). <br/>Method(s): PROACT Mitral was a multicenter study evaluating
401 patients who underwent mitral valve replacement (MVR) with either
Standard or Conform-X On-X mitral valves, comparing low-dose and
standard-dose warfarin. Here we report prespecified secondary outcomes of
survival, New York Heart Association (NYHA) functional classification, and
valve hemodynamics as assessed by core lab-adjudicated echocardiography at
1, 3, and 5 years in the pooled population. <br/>Result(s): Actuarial
survival was 99.7% at 1 year, 95.1% at 3 years, and 92.4% at 5 years, with
no significant difference between the Standard and Conform-X cuffs.
Hemodynamic analysis revealed a mean transvalvular pressure gradient (MG)
of 4.6 +/- 2.0 mm Hg at 1 year, with no interaction between valve size and
patient body surface area. MG values were consistent over time. Quality of
life improved with 96.6% of patients in NYHA class I or II at the latest
available follow-up of 3 or 5 years. There were no significant differences
in survival, clinical, or hemodynamic outcomes between valve sizes.
<br/>Conclusion(s): The On-X mechanical mitral valve demonstrated
favorable survival, stable hemodynamics, and enhanced quality of life up
to 5 years postimplantation. Derived from high-quality, rigorous
randomized trial data, these findings can guide decision making in young
patients requiring MVR.<br/>Copyright &#xa9; 2024 The American Association
for Thoracic Surgery

<26>
[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)

<27>
Accession Number
2036653042
Title
Development of and recovery from acute kidney injury after cardiac
surgery: Randomized phase 2 trial of the hepatocyte growth factor mimetic
ANG-3777.
Source
Journal of Thoracic and Cardiovascular Surgery. 170(4) (pp 1125-1132.e2),
2025. Date of Publication: 01 Oct 2025.
Author
Ayad S.S.; Beaver T.; Corteville D.; Swaminathan M.; Pearl R.G.; Aslam S.;
Csomor P.A.; Alperovich G.; Neylan J.
Institution
(Ayad) Outcomes Research Department, Anesthesiology Institute, Cleveland
Clinic, Cleveland, Ohio, United States
(Beaver) Division of Thoracic and Cardiovascular Surgery, Department of
Surgery, University of Florida, Gainesville, Fla, United States
(Corteville) Department of Cardiology, Sands-Constellation Heart
Institute, Rochester Regional Health, Rochester, NY, United States
(Swaminathan) Department of Anesthesiology, Atrium Health Wake Forest
Baptist, Wake Forest University School of Medicine, Winston-Salem, NC,
United States
(Pearl) Department of Anesthesiology, Perioperative, and Pain Medicine,
Stanford University School of Medicine, Stanford, Calif, United States
(Aslam, Neylan) Angion Biomedica, Uniondale, NY, United States
(Csomor) CSL Vifor, Glattbrugg, Switzerland
(Alperovich) CSL Vifor, Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Objectives: To investigate the safety and efficacy of ANG-3777, a
hepatocyte growth factor mimetic, in mitigating the risk of acute kidney
injury (AKI) in patients undergoing cardiac surgery with cardiopulmonary
bypass. <br/>Method(s): In this double-blind placebo-controlled study
(Guard Against Renal Damage [GUARD]), patients were randomized to receive
intravenous ANG-3777 2 mg/kg or placebo once daily for 4 days. The primary
end point was severity of AKI, measured by mean area under the
concentration-time curve on percent increase in serum creatinine from days
2 to 6. Secondary end points included the proportions of patients who
developed major adverse kidney events by day 30 or 90 and the percentage
of patients diagnosed with AKI through day 5. <br/>Result(s): In total,
259 patients received study treatment (ANG-3777, n = 129; placebo, n =
130). Through day 6, there was no significant difference in least-squares
mean change in serum creatinine between ANG-3777 and placebo (1.1%; 95%
confidence interval, -6.2 to 8.4; P = .77), or in proportions of patients
who developed major adverse kidney events by day 30 (18.6% vs 16.2%; P =
.60) or day 90 (14.7% vs 21.5%; P = .16). Similar proportions of patients
were diagnosed with AKI through day 5 (ANG-3777, 47.3%; placebo, 48.5%);
however, exploratory analysis revealed more patients diagnosed with AKI
postoperatively showed signs of recovery after treatment with ANG-3777
than placebo. Overall, ANG-3777 was well tolerated, with similar
incidences of treatment-emergent adverse events between treatment arms.
<br/>Conclusion(s): Findings from this study do not support the efficacy
of ANG-3777 in preventing the development of AKI after cardiopulmonary
bypass.<br/>Copyright &#xa9; 2024 The Authors

<28>
Accession Number
2039349142
Title
Use of in silico research in the development of abdominal and thoracic
surgical devices: a systematic review.
Source
BMJ Innovations. 11(3) (pp 147-156), 2025. Date of Publication: 01 Jul
2025.
Author
Pattani N.; Sanghera J.; Mills E.; Khan A.; Jauniaux B.; Bolton W.; Harji
D.; Burke J.R.
Institution
(Pattani) St George's University Hospitals NHS Foundation Trust, London,
United Kingdom
(Sanghera, Khan) Walsall Manor Hospital, Birmingham, United Kingdom
(Mills) Mid Essex Hospital Services NHS Trust, Essex, United Kingdom
(Jauniaux, Bolton, Harji, Burke) Institute of Medical Research, University
of Leeds, Leeds, United Kingdom
(Harji, Burke) Department of Colorectal Surgery, Manchester University NHS
Foundation Trust, Manchester, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Objective Surgical innovation has exponentially improved over the past
three decades. However, efficacy assessment of surgical devices through
randomised controlled trials requires significant resources. In silico
modelling may provide a solution, utilising computational simulations to
develop and improve devices. This study aims to evaluate the current use
of in silico modelling for devices used in abdominal and thoracic surgery.
Design A systematic review was conducted following the Preferred Reporting
Items for Systematic Reviews and Meta- Analyses guidelines. Data Resources
PubMed, MEDLINE and Embase databases from January 2019 to August 2024 were
searched. Eligibility criteria for selecting studies Inclusion criteria
were defined as studies using mathematical/computational models to
investigate invasive devices implanted or incorporated in abdominal and
thoracic surgery. Results The search strategy yielded 2968 studies, with
42 included in the final analysis. Core themes identified included proof
of concept (n=19), device improvement (n=22) and in silico clinical trials
with simulated human patients (n=1). Specialities included: general
surgery (n=4); hepato- pancreato- biliary (n=2); vascular (n=5);
paediatric (n=9) and cardiothoracic (n=22). Most studies were at IDEAL
stage 0 (preclinical) and 19 studies validated in silico results with in
vitro/in vivo data. Conclusion In silico modelling can complement
preclinical in vitro and in vivo testing for surgical devices. Its
applications include simulating rare diseases, modelling diverse patient
demographics, and generating early efficacy data for novel or repurposed
devices. Standardising methodologies through a core outcome set and
credibility framework is essential to reduce inter- study heterogeneity.
Global collaboration and clear regulatory guidance are key for its
integration into mainstream surgical device research.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2025. No commercial re-use. See rights
and permissions. Published by BMJ Group.

<29>
Accession Number
2039571755
Title
Physiotherapeutic guidance on functional independence and quality of life
after coronary artery bypass grafting: Clinical trial.
Source
Journal of Bodywork and Movement Therapies. 44 (pp 708-713), 2025. Date of
Publication: 01 Oct 2025.
Author
Gomes Da Silva D.J.; Martins D.O.; Egidio K.F.; Assuncao Carneiro L.C.;
Santos da Silva Santana L.; Franca Guimaraes A.R.; Lisboa Cordeiro A.L.
Institution
(Gomes Da Silva, Martins, Egidio, Assuncao Carneiro, Santos da Silva
Santana, Lisboa Cordeiro) Centro Universitario Nobre, Bahia, Feira de
Santana, Brazil
(Franca Guimaraes) Instituto Nobre de Cardiologia, Bahia, Feira de
Santana, Brazil
(Lisboa Cordeiro) Escola Bahiana de Medicina e Saude Publica, Bahia,
Salvador, Brazil
Publisher
Churchill Livingstone
Abstract
Introduction: Patients undergoing coronary artery bypass graft(CABG) are
exposed to a decline in functional capacity, increasing the risk of
pulmonary complications, worsening the quality of life. Often, this
decline is associated with not understanding the activities that can be
performed postoperatively. In this scenario, orienting patients can be an
effective strategy. <br/>Objective(s): To evaluate the impact of
physiotherapy guidance on functional capacity, functionality,
postoperative complications and quality of life. <br/>Method(s): This is a
randomized controlled trial. Preoperatively and at hospital discharge
patients had their functional capacity assessed by the 6-min walk
test(6MWT), functionality by the functional independence measure(FIM), sit
and stand test(SST), quality of life by the SF-36 and postoperative
pulmonary complications. The patients were to either the Guidance
Group(GO) or the Control Group(CG). During their hospital stay, patients
in the orientation group received verbal guidance and later a booklet
containing instructions to raise awareness about their conditions and how
to prevent immobility by becoming active during their hospital stay.
<br/>Result(s): Were evaluated with 57 in each group. The GO had
superiority in 6MWT95 %CI46(25.53-66.47) meters FIM12(9.30-14.70),
SST-2(-4.31to-1.69) seconds when compared to the preoperative value at
hospital discharge. The quality of life showed no difference between the
groups. Regarding postoperative pulmonary complications, the guidance
group had a lower rate of atelectasis 15(26 %) in GO group versus 26(46 %)
in CG(p = 0.02). <br/>Conclusion(s): Postoperative physiotherapeutic
guidance was effective in reducing the loss of functional capacity,
functionality and the atelectasis rate. On the other hand, quality of life
and other complications had no difference.<br/>Copyright &#xa9; 2025
Elsevier Ltd

<30>
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).

<31>
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.

<32>
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.

<33>
Accession Number
2034705396
Title
Comprehensive analysis of acute kidney injury incidence following
transcatheter versus surgical aortic valve replacement in aortic stenosis:
a systematic review and meta-analysis of 13,777 patients.
Source
Cardiovascular Intervention and Therapeutics. 40(4) (pp 932-942), 2025.
Date of Publication: 01 Oct 2025.
Author
Alazzam A.; Aldroubi Y.; Alhusban T.; said M.
Institution
(Alazzam) The Hashemite University, Zarqa, Jordan
(Aldroubi) Faculty of Medicine, University of Jordan, Amman, Jordan
(Alhusban) Jordanian Royal Medical Services, Prince Hashim Military
Hospital, Zarqa, Jordan
(said) Yarmouk University Faculty of Medicine - Irbid, Aydoun, Jordan
Publisher
Springer
Abstract
This systematic review and meta-analysis evaluate Acute Kidney Injury
(AKI) differences between surgical aortic valve replacement (SAVR) and
transcatheter aortic valve replacement (TAVR) and how surgical risk
stratification and diagnostic criteria influence outcomes. Following the
PRISMA guidelines, we included both non-randomized studies and randomized
clinical trials that reported AKI criteria and patients' surgical risk in
patients with aortic stenosis by searching PubMed, Scopus, and Web of
Science until late September. We executed a random-effects model in Review
Manager to pool effect estimates of AKI incidence or the need for dialysis
as an odds ratio (OR) and I² heterogeneity, and we utilized R
for meta-regression to address any heterogeneity with subgroup analysis
for surgical risk, AKI criteria, and study design. We used the Newcastle
Ottawa Scale (NOS) and the Cochrane Risk of Bias Tool (RoB-1) for risk of
bias assessment and GRADE for certainty assessment. Involving 17 studies
and a total of 13,777 patients, we found that the AKI incidence was
significantly lower in TAVR compared to SAVR (OR = 0.36; 95% CI: [0.30,
0.44], I² = 55%, P = 0.003), along with the need for dialysis
(OR = 0.35; 95% CI: [0.19, 0.63], I² = 0%, P = 0.92). The study
also found that intermediate and low-risk patients had more favorable
outcomes. However, the retrospective study design and VARC-2 criteria were
associated with unfavorable outcomes. TAVR effectively reduced the risk of
AKI in all surgical risk categories and the need for dialysis compared to
SAVR in patients with AS.<br/>Copyright &#xa9; The Author(s) under
exclusive licence to Japanese Association of Cardiovascular Intervention
and Therapeutics 2025.

<34>
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.

<35>
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.

<36>
Accession Number
2035380535
Title
Impact of aortic angulation on outcomes in transcatheter aortic valve
replacement with balloon-expandable and self-expanding valves: a
systematic review and meta-analysis.
Source
Cardiovascular Intervention and Therapeutics. 40(4) (pp 746-766), 2025.
Date of Publication: 01 Oct 2025.
Author
Khalefa B.B.; Gonnah A.R.; Yassin M.N.A.; Fayed H.; Arnaout M.; Elkholy
M.K.A.; Ramadan M.; Elettreby A.M.; Dway A.; Eldeeb H.; Abujabal A.S.;
Roberts D.H.
Institution
(Khalefa, Abujabal) Faculty of Medicine, Ain Shams University, Cairo,
Egypt
(Gonnah) Department of Medicine, Imperial College Healthcare NHS Trust,
London, United Kingdom
(Yassin) Faculty of Medicine, Cairo University, Cairo, Egypt
(Fayed, Eldeeb) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Arnaout) Faculty of Medicine, Aleppo University, Aleppo, Syrian Arab
Republic
(Elkholy) Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
(Ramadan) Faculty of Medicine, Suez University, Suez, Egypt
(Elettreby) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Dway) Faculty of Medicine, Al-Andalus University for Medical Sciences,
Tartus, Syrian Arab Republic
(Roberts) Lancashire Cardiac Centre, Blackpool, United Kingdom
(Roberts) School of Medicine, University of Liverpool, Liverpool, United
Kingdom
Publisher
Springer
Abstract
High aortic angulation (AA) can pose significant challenges during TAVR.
This meta-analysis determines the impact of a horizontal aorta on TAVR
outcomes with balloon-expandable (BEV) and self-expanding valves (SEVs). A
comprehensive search was conducted from inception to June 2024. Thirteen
observational studies assessing the impact of aortic angulation in
patients undergoing TAVR replacement were included. The pooled results
indicated that short-term mortality was significantly lower in patients
with a non-horizontal aorta (RR = 0.76; 95% CI 0.62-0.95, P = 0.01).
Subgroup analysis displayed that BEVs had a lower short-term mortality
with a horizontal aorta than SEVs. The incidence of stroke was not
significantly affected by aortic angulation with either valve type.
However, the overall risk of permanent pacemaker implantation was lower in
patients with a non-horizontal aorta for both valve types. Paravalvular
regurgitation was also reduced in the non-horizontal aorta group, with no
difference between aortic angulations in patients with BEVs. In contrast,
SEVs favored a non-horizontal aorta in reducing paravalvular leak (RR =
0.66; 95% CI 0.46-0.94, P = 0.02). Both BEVs and SEVs show better results
in patients with lower aortic root angulation. The increased incidence of
conduction abnormalities and PPI rates with both valve types in patients
with horizontal aorta is a concern. BEVs could be potentially used
preferentially to SEVs in patients with a horizontal aorta as there was no
difference between horizontal and non-horizontal aorta groups regarding
short-term mortality, moderate-to-severe paravalvular leak, and need for a
second valve.<br/>Copyright &#xa9; The Author(s) 2025.

<37>
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.

<38>
Accession Number
2036109142
Title
Correction: Use of an insulin titration protocol based on continuous
glucose monitoring in postoperative cardiac surgery patients with type 2
diabetes and prediabetes: a randomized controlled trial (Cardiovascular
Diabetology, (2025), 24, 1, (210), 10.1186/s12933-025-02747-z).
Source
Cardiovascular Diabetology. 24(1) (no pagination), 2025. Article Number:
361. Date of Publication: 01 Dec 2025.
Author
Moon S.-J.; Kim M.-S.; Kim Y.T.; Lee H.-E.; Lee Y.-W.; Lee S.-J.; Chung
E.-S.; Park C.-Y.
Institution
(Moon, Lee, Park) Division of Endocrinology and Metabolism, Department of
Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University
School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, South Korea
(Kim, Lee, Lee, Chung) Thoracic and Cardiovascular Surgery, Kangbuk
Samsung Hospital, Sungkyunkwan University School of Medicine, 29
Saemunan-ro, Jongno-gu, Seoul, South Korea
(Kim) Division of Biostatistics, Department of Academic Research, Kangbuk
Samsung Hospital, Seoul, South Korea
Publisher
BioMed Central Ltd
Abstract
In the original publication of this article [1], the authors identified
typographical errors in the<br/>Copyright &#xa9; The Author(s) 2025.

<39>
Accession Number
2040473207
Title
The Effects of Nonpharmacological Interventions on Sleep Quality in
Cardiac Surgical Patients: A Prospective Randomised Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Gayatri A.; Panidapu N.; Neema P.K.; Madathil T.; Poduval D.; Palamattam
D.J.; Varma P.K.
Institution
(Gayatri, Panidapu, Neema, Madathil, Poduval, Palamattam) Department of
Cardiac Anesthesia & Critical Care, Amrita Institute of Medical Sciences,
Kochi, India
(Varma) Department of Cardiac Surgery, Amrita Institute of Medical
Sciences, Kochi, India
Publisher
W.B. Saunders
Abstract
Objectives: The primary objective of the current study was to evaluate
whether the use of eye masks and ear plugs improves postoperative sleep
quality in patients undergoing cardiac surgery. The secondary objectives
include the evaluation of nonpharmacological interventions on daytime
sleepiness, opioid consumption, and postoperative complications Design:
Prospective, randomized, controlled, parallel-group study. Participants
and setting: The study was conducted in 100 adult patients undergoing
elective cardiac surgery in a quaternary care hospital.
<br/>Intervention(s): The intervention group received ear plugs and an eye
mask from 10:00 PM to 6:00 AM. The quality of sleep was assessed on the
morning of the next day using the Richards-Campbell Sleep Questionnaire.
<br/>Measurements and Main Results: The intervention group had
significantly higher Richards-Campbell Sleep Questionnaire scores (78 v
62; p < 0.05) and a significant reduction in daytime sleepiness (30% v
62%; p < 0.05) and opioid consumption (7.35 mg v 12.75 mg; p < 0.05). The
incidence of postoperative atrial fibrillation, delirium, and length of
stay in the intensive care unit were comparable between the groups.
<br/>Conclusion(s): Eye masks and ear plugs improve the quality of sleep
and reduce daytime sleepiness and opioid consumption in patients
undergoing cardiac surgery.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<40>
Accession Number
2040472718
Title
Safety of pre-procedure fasting versus non-fasting protocols before
cardiac catheterization - a Bayesian meta-analysis of randomized clinical
trials.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Chaturvedi A.; Al Qaraghuli A.K.; Verma B.R.; Haberman D.; Cellamare M.;
Zhang C.; Galo J.; Abusnina W.; Lupu L.; Hashim H.D.; Rogers T.; Ben-Dor
I.; Satler L.F.; Waksman R.
Institution
(Chaturvedi, Verma, Haberman, Galo, Abusnina, Lupu, Hashim, Rogers,
Ben-Dor, Satler, Waksman) Section of Interventional Cardiology, MedStar
Washington Hospital Center, Washington, DC, United States
(Al Qaraghuli) Department of Internal Medicine, MedStar Washington
Hospital Center, Washington, DC, United States
(Cellamare, Zhang) MedStar Cardiovascular Research Network, Washington,
DC, United States
(Rogers) Cardiovascular Branch, Division of Intramural Research, National
Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda,
MD, United States
Publisher
Elsevier Inc.
Abstract
Background: Fasting prior to cardiac catheterization is a routine practice
to minimize the risk of complications. Recent studies suggest that
non-fasting protocols may be equally safe and increase patient
satisfaction. We performed a meta-analysis of randomized controlled trials
(RCTs) to examine the safety of fasting versus non-fasting prior to
cardiac catheterization. <br/>Method(s): We searched for eligible RCTs
comparing fasting versus non-fasting protocols prior to cardiac
catheterization from inception through December 21, 2024. Studies were
included if they reported at least one of the outcomes of interest-
nausea/vomiting, aspiration event, new ventilation/oxygen requirements,
hypotension, hypoglycemia, and acute kidney injury. The treatment effect
of each outcome was measured using the logarithmic odds ratios (logOR) and
estimated under the Bayesian paradigm. Under the hierarchical Bayesian
random effect model, we elicited an informative prior for the logOR ~ (0,
0.1), representing the null hypothesis of no treatment effect.
Between-study heterogeneity was elicited with a weakly informative
half-Cauchy prior of a 0.5 scale. All analyses were conducted using R
version 4.0. <br/>Result(s): 9 studies met the inclusion criteria with a
total of 3567 patients (1805 in fasting and 1762 in non-fasting). The
Bayesian meta-analysis yielded a posterior mean OR of 0.99 [95 % credible
interval (CrI): 0.82-1.20] for nausea and vomiting, 0.99 (95 % CrI:
0.82-1.21) for aspiration event, 1.003 (95 % CrI: 0.83-1.22) for new
ventilation and oxygen requirements, 1.04 (95 % CrI: 0.87-1.25) for
hypotension, 1.02 (95 % CrI: 0.85-1.24) for hypoglycemia, and 0.97 (95 %
CrI: 0.81-1.18) for acute kidney injury. All CrI include 1 and the point
estimates are very close to 1, indicating a lack of evidence to drive away
from the prior assumption of no average effect size. Sensitivity analyses
using three distinct prior scenarios (non-informative, optimistic
informative, and skeptical informative) and a subset of studies conducted
in 2023-2024 yielded similar findings. <br/>Conclusion(s): Our study
demonstrates that a non-fasting strategy prior to cardiac catheterization
is as safe as the usual fasting strategy. Pre-procedural fasting should be
individualized based on patient and procedure-related factors, and
guidelines should be updated with regard to pre-cardiac procedure
protocols that minimize fasting and improve patient
satisfaction.<br/>Copyright &#xa9; 2025

<41>
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.

<42>
Accession Number
2035554933
Title
Incidence and Influencing Factors for Steam Pops in Cardiac Ablations: A
Systematic Review.
Source
PACE - Pacing and Clinical Electrophysiology. 48(9) (pp 941-952), 2025.
Date of Publication: 01 Sep 2025.
Author
Elenizi K.; Alharthi R.
Institution
(Elenizi) Department of Internal Medicine, Colleges of Medicine, Prince
Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
(Alharthi) Department of Cardiology, Dr. Sulaiman Al-Habib Hospital,
Riyadh, Saudi Arabia
Publisher
John Wiley and Sons Inc
Abstract
Background: Steam pops (SPs) during cardiac ablations have emerged as a
notable phenomenon with potential implications for procedural safety and
efficacy. This is the first review of SPs, which aims to explore the
current understanding of SPs. The review investigates their incidence,
associations, predictors, clinical significance, and management
strategies. Presently, the factors that give rise to SPs have not been
completely understood, and the root cause of SPs remains elusive. To
achieve this goal, the study conducted a comprehensive review of existing
research on SPs in cardiac ablation procedures to ascertain the prevalence
and predictors of SPs. <br/>Method(s): The research involved an extensive
search of databases from their inception until April 2024 to investigate
the prevalence of SPs during cardiac ablation procedures in humans. The
primary objective of this study was to gather patient demographics,
incidence rates, and potential risk factors and predictors that could
contribute to the occurrence of SPs and determine any significant
correlations between them. The data collected were thoroughly reviewed to
identify any significant associations between the various risk factors,
predictors, and the incidence of SPs. <br/>Result(s): A comprehensive
review of literature sourced from EMBASE and PubMed identified 25 relevant
studies focused on the incidence and clinical significance of steam pops
(SPs) during catheter ablation procedures. The studies reported varying
rates of SPs, ranging from 0% to 26%, with the highest incidence observed
in atrial fibrillation (AFib) and ventricular ablation cases. The
association between SPs and factors such as catheter type, irrigation
methods, and monitoring parameters was assessed. Notably, advanced
catheter technologies, such as the QDOT MICRO and THERMOCOOL SMARTTOUCH,
demonstrated a significant reduction in SP occurrences. Additionally, the
analysis highlighted the role of temperature control and contact force in
minimizing the risk of SPs, with temperature-controlled ablation (TCA)
generally leading to fewer SPs compared to power-controlled ablation
(PCA). Despite the low incidence of severe complications, the review
underscores the importance of careful monitoring of impedance and
real-time feedback during ablation to ensure patient safety.
<br/>Conclusion(s): SPs are not uncommon during ablation procedures with
irrigated catheters. Caution is required to avoid temperature feedback
issues. Advanced catheters are associated with a reduced incidence of
steam pops. The risks can be minimized by decreasing energy settings and
monitoring impedance changes.<br/>Copyright &#xa9; 2025 Wiley Periodicals
LLC.

<43>
Accession Number
2035963200
Title
Comparison of the efficacy of intravascular lithotripsy and rotational
atherectomy as adjunctive therapy before drug-eluting stent implantation
in calcified coronary lesions (CCS- Coronary Calcification Study).
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
648. Date of Publication: 01 Dec 2025.
Author
Pleva L.; Kukla P.; Konde A.
Institution
(Pleva, Kukla) Department of Internal Medicine and Cardiology, University
Hospital Ostrava, Ostrava, Czechia
(Pleva) Faculty of Medicine, University of Ostrava, Ostrava, Czechia
(Konde) Department of Applied Mathematics, Faculty of Electrical
Engineering and Computer Science, VSB-Technical University of Ostrava,
Ostrava, Czechia
(Konde) Department of the Deputy Director for Science, Research and
Education, University Hospital Ostrava, Ostrava, Czechia
Publisher
BioMed Central Ltd
Abstract
Background: This prospective randomized study compares the efficacy of
novel intravascular lithotripsy (IVL) to the standard preparation of
calcified coronary lesions based on rotational atherectomy (RA).
<br/>Method(s): A total of 50 patients with 52 calcified lesions were
enrolled in the study and randomized 1:1 to be treated with IVL or RA
followed by drug-eluting stent (DES) implantation. The procedural success
was chosen as a primary endpoint and the 12-month late lumen loss (LLL) as
measured by quantitative coronarography, the incidence of binary in-stent
restenosis (ISR), 12-month major adverse cardiac events (MACE) and target
lesion failure (TLF) served as secondary angiographic and clinical
endpoints. <br/>Result(s): Procedural success was achieved in 21 patients
(84.0%) in the IVL group and in 24 patients (96%) in the RA group (p =
0.349). The secondary endpoints, including 12-month LLL (0.12 mm [IQR: -
0.06; 0.68] vs. 0.61 mm [IQR: 0.22; 0.72]; p = 0.084), the incidence of
12-month binary ISR (11.1% vs. 8.0%; p >0.999), MACE (18.5% vs. 8.0%; p =
0.422), TLR (14.8% vs. 8.0%; p = 0.670) or TLF (18.5% vs. 8.0%; p = 0.422)
did not show significant differences between the IVL and RA groups.
<br/>Conclusion(s): Despite different approaches to the treatment of
calcified coronary lesions, both therapeutic techniques achieved similar
procedural, angiographic and clinical results. (ClinicalTrials.gov
NCT04428177).<br/>Copyright &#xa9; The Author(s) 2025.

<44>
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.

<45>
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.

<46>
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.

<47>
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.

<48>
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.

<49>
Accession Number
2034972741
Title
Comparative outcomes of Myval versus contemporary transcatheter heart
valves: a systematic review and meta-analysis.
Source
Cardiovascular Intervention and Therapeutics. 40(4) (pp 736-745), 2025.
Date of Publication: 01 Oct 2025.
Author
Ozbay M.B.; Degirmen S.; Gullu A.; Nriagu B.N.; Ozen Y.; Celebi O.O.;
Yayla C.
Institution
(Ozbay) Department of Medicine, Penn Medicine Princeton Medical Center,
Plainsboro, NJ, United States
(Degirmen, Nriagu) Department of Medicine, Metropolitan Hospital Center,
New York, NY, United States
(Gullu) Department of Medicine, North Alabama Medical Center, Florence,
AL, United States
(Ozen) Department of Cardiology, Faculty of Medicine, Selcuk University,
Konya, Turkey
(Celebi, Yayla) Department of Cardiology, Ankara City Hospital, University
of Health Sciences, Ankara, Turkey
Publisher
Springer
Abstract
Transcatheter aortic valve replacement is a key intervention for high-risk
patients with severe aortic stenosis. Myval, a newer transcatheter heart
valve (THV), shows promise, but a comprehensive comparison with other THVs
is lacking. This study evaluates the safety and efficacy of Myval compared
with contemporary THVs. A systematic review and meta-analysis of six
studies involving 2335 patients was performed. Primary outcomes included
all-cause mortality, cardiovascular mortality, new permanent pacemaker
implantation (PPI), device success, early safety, acute kidney injury,
stroke, vascular complications, and valve regurgitation. Myval was
associated with significantly lower rates of new PPI (RR, 0.62; 95% CI
0.45-0.86; P =.004), higher rates of device success (RR, 1.08; 95% CI
1.01-1.16; P =.02), and early safety (RR, 1.15; 95% CI 1.05-1.27; P =.003)
compared with contemporary THVs. No significant differences were observed
in all-cause mortality, cardiovascular mortality, acute kidney injury,
stroke, vascular complications, and valve regurgitation. Myval may offer
better short-term outcomes in terms of new PPI, device success, and early
safety compared with contemporary THVs. Larger, prospective studies with
longer follow-ups are needed to confirm these findings.<br/>Copyright
&#xa9; The Author(s) under exclusive licence to Japanese Association of
Cardiovascular Intervention and Therapeutics 2025.

<50>
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.

<51>
Accession Number
2029025237
Title
Prognostic Role of Neutrophil to Lymphocyte Ratio in Contrast-Induced
Nephropathy: A Systematic Review and Meta-analysis.
Source
Angiology. 76(9) (pp 819-832), 2025. Date of Publication: 01 Oct 2025.
Author
He T.; Mohammadpour B.; Willman M.; Yaghoobpoor S.; Willman J.; Lucke-Wold
B.; Aminizadeh S.; Khanzadeh S.; Bazrgar A.; Ghaedi A.
Institution
(He) Department of Medicine, The Third Affiliated Hospital of Guangzhou
Medical University, Guangzhou City, China
(Mohammadpour) Department of Medicine, Islamic Azad University of Medical
Sciences, Tonekabon Campus, Tonekabon, Iran, Islamic Republic of
(Willman, Willman, Lucke-Wold) Department of Neurosurgery, University of
Florida, Gainesville, FL, United States
(Yaghoobpoor) Student Research Committee, Faculty of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Aminizadeh, Khanzadeh) Student Research Committee, Tabriz University of
Medical Sciences, Tabriz, Iran, Islamic Republic of
(Bazrgar, Ghaedi) Student Research Committee, School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran, Islamic Republic of
Publisher
SAGE Publications Inc.
Abstract
This meta-analysis assessed the use of the neutrophil-to-lymphocyte ratio
(NLR) as a means of early detection of contrast-induced nephropathy (CIN)
following diagnostic or therapeutic procedures. We used Web of Science,
PubMed, and Scopus to conduct a systematic search. There was no limitation
regarding language or date of publication. We reported standardized mean
difference (SMD) with a 95% confidence interval (CI). Due to high
heterogeneity, a random-effects model was used, and the Newcastle-Ottawa
scale was used for quality assessment. Thirty-one articles were included
in the analysis. Patients in the CIN group had elevated levels of NLR
compared with those in the non-CIN group (SMD = 0.78, 95% CI = 0.52-1.04,
P < .001). Similar results were observed in either prospective (SMD =
1.03, 95% CI = 0.13-1.93, P = .02) or retrospective studies (SMD = 0.70,
95% CI = 0.45-0.96, P < .001). The pooled sensitivity of NLR was 74.02%
(95% CI = 66.54%-81.02%), and the pooled specificity was 60.58% (95% CI =
53.94%-66.84%). NLR shows potential as a cost-effective biomarker for
predicting CIN associated with contrast-involved treatments. This could
help implement timely interventions to mitigate CIN and improve
outcomes.<br/>Copyright &#xa9; The Author(s) 2024

<52>
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.

<53>
Accession Number
2029717468
Title
The influence of preoperative or intraoperative methadone on postcardiac
surgery pain and opioid administration: a systematic review and
meta-analysis.
Source
Cardiothoracic Surgeon. 32(1) (no pagination), 2024. Article Number: 8.
Date of Publication: 01 Dec 2024.
Author
Goldblatt J.; Crawford L.; Ross J.; Edelman J.; Pavey W.
Institution
(Goldblatt, Crawford, Ross) Department of Cardiothoracic Surgery, Princess
Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Brisbane, QLD,
Australia
(Edelman) Department of Cardiothoracic Surgery, Fiona Stanley Hospital,
Perth, Australia
(Pavey) Department of Cardiac Anaesthesia, Fiona Stanley Hospital, Perth,
Australia
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Opioid analgesia remains a cornerstone of the management of
perioperative pain in cardiac surgical patients. Emerging evidence
suggests that intermediate and long-term postoperative opioid dependence
is underappreciated and associated with adverse patient outcomes.
Methadone has emerged in the cardiothoracic and non-cardiothoracic
anesthesia literature as an option that may provide lasting analgesic
benefit and may be associated with a reduction in overall perioperative
opioid requirements. Main body: This study was a systematic literature
review and meta-analysis that aimed to provide evidence supporting the use
of perioperative or intraoperative methadone in adult cardiac surgical
patients, particularly with respect to objective measures of postoperative
pain and opioid requirements prior to and at discharge from the hospital.
Electronic searches of three research databases were performed: PubMed
(1972 to October 2023), Ovid MEDLINE (1946 to October 2023), and EMBASE
(1978 to October 2023). This search yielded a total of 190 articles, 7 of
which met the relevant inclusion and exclusion criteria. This included
five randomized controlled trials and two large retrospective cohort
studies. <br/>Conclusion(s): Preoperative or intraoperative methadone led
to reduced pain scores at 24 h postoperatively and reduced opioid
requirements at discharge. Methadone may be effective at reducing
perioperative pain scores and opioid requirements postoperatively,
including at discharge. The literature on this subject has important
limitations, and further research in larger randomized controlled trials
is needed.<br/>Copyright &#xa9; Crown 2024.

<54>
Accession Number
2010578981
Title
Efficacy of heart transplantation in patients with a failing Fontan: a
systematic review and meta-analysis.
Source
Cardiothoracic Surgeon. 29(1) (no pagination), 2021. Article Number: 7.
Date of Publication: 01 Dec 2021.
Author
Hassan W.; Kotak S.; Khatri M.; Ahmed A.; Ahmed J.; Ali S.S.; Khan T.M.
Institution
(Hassan, Kotak, Khatri, Ahmed, Ahmed, Ali) Department of Internal
Medicine, Dow University of Health Sciences, Baba e Urdu Road, Karachi,
Pakistan
(Khan) Pediatrics, Baylor College of Medicine, Houston, United States
(Khan) Pediatrics, Texas Children's Hospital, Houston, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: As the population of patients with Fontan palliation grows, so
does the number of patients with Fontan failure, necessitating heart
transplantation. However, due to mainly small-sized studies, outcomes
after heart transplantation in these patients remain unclear. The
objective of this study was to review the available literature and conduct
a meta-analysis to provide well-powered and generalizable estimates of
outcomes after heart transplantation in patients with a failing Fontan.
Main text: PubMed, Embase, and MEDLINE databases were searched for
original studies of patients with a failing Fontan who underwent heart
transplantation. The outcomes included were 1-year and 5-year survival,
acute rejection, renal dysfunction, sepsis, and multi-organ failure.
Proportions were pooled using random effects models to derive pooled
proportions (PPs) and corresponding 95% confidence intervals (CIs).
Meta-regression analysis was done to study the effects of age and gender
on key outcomes. Sixteen retrospective single-center cohort studies with
426 Fontan patients undergoing heart transplantation were included in this
meta-analysis. Pooled analysis of this study further revealed that 1-year
survival after heart transplantation was 79.9% ([75.8%, 83.7%];
I² = 1.92%), and 5-year survival rate was 72.5% ([62.1%,
81.9%]; I² = 72.12%). Secondary outcomes after heart
transplantation of failed Fontan procedure were acute rejection (PP 20%
[7.4%, 36.8%]; I² = 72.48%), renal dysfunction (PP 31.3%
[10.5%, 57.2%]; I² = 75.42%), multi-organ failure (PP 18.6%
[2.8 to 43.9%]; I²= 69.60%), and sepsis (PP 21.1% [9%, 36.8%];
I² = 61.19%). <br/>Conclusion(s): Cardiac transplantation in
patients with a failing Fontan is associated with acceptable
interventional success and improved survival rates.<br/>Copyright &#xa9;
2021, The Author(s).

<55>
Accession Number
2005794332
Title
Continuous paravertebral block by intraoperative direct access versus
systemic analgesia for postthoracotomy pain relief.
Source
Cardiothoracic Surgeon. 28(1) (no pagination), 2020. Article Number: 17.
Date of Publication: 01 Dec 2020.
Author
Deebis A.; Elattar H.; Saber O.; Elfakharany K.; Elnahal N.
Institution
(Deebis, Saber, Elfakharany, Elnahal) Cardiothoracic Surgery Department,
Faculty of Medicine, Zagazig University, Zagazig, Sharkia Governorate,
Egypt
(Elattar) Anesthesia and Intensive Care Department, Zagazig University,
Zagazig, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Systemic analgesia with paracetamol and nonsteroidal
anti-inflammatory drugs plus opioids as a rescue medication had reported
to be better than that depend mainly on opioids for postoperative pain
relief. Thoracic paravertebral block reported to provide a comparable
postthoracotomy pain relief to epidural analgesia, with fewer side effects
due to its unilateral effect. Thoracic paravertebral catheter can be
inserted intraoperatively under direct vision during thoracic surgery
(Sabanathan's technique). This prospective randomized study was designed
to evaluate the safety and efficacy of this technique with continuous
infusion of lidocaine compared to systemic analgesia for postthoracotomy
pain relief. <br/>Result(s): Sixty-three patients were randomized to
receive a continuous infusion of lidocaine in the paravertebral catheter
for 3 postoperative days (thoracic paravertebral group, n = 32) or
systemic analgesia (systemic analgesia group, n = 31). All patients
underwent standard posterolateral thoracotomy. There were no significant
differences between both groups in age, sex, side, type, and duration of
operation. Pain scores measured on visual analogue scale and morphine
consumption were significantly lower in thoracic paravertebral group in
all postoperative days. Spirometric pulmonary functions were not reaching
the preoperative values in the third postoperative day in both groups, but
restorations of pulmonary functions were superior in paravertebral group.
No complications could be attributed to the paravertebral catheter. Side
effects, mainly nausea and vomiting followed by urinary retention, were
significantly more in systemic analgesia group (P = 0.03). Also, pulmonary
complications were more in systemic analgesia group but not reaching
statistical significance (P = 0.14). <br/>Conclusion(s): Continuous
paravertebral block by direct access to the paravertebral space using a
catheter inserted by the surgeon is a simple technique, with low risk of
complications, provides effective pain relief with fewer side effects, and
reduces the early loss of postoperative pulmonary functions when compared
to systemic analgesia.<br/>Copyright &#xa9; 2020, The Author(s).

<56>
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).

<57>
Accession Number
2035320706
Title
Predicting the depth of insertion of central venous catheters using a
bronchoscopy-based carinal measurement technique or the Peres'
formula-based method in adults undergoing cardiac surgery: A randomised
comparative double-blind study.
Source
Indian Journal of Anaesthesia. 68(11) (pp 978-984), 2024. Date of
Publication: 01 Nov 2024.
Author
Misra S.; Das P.K.; Behera B.K.; Das D.; Patra T.K.
Institution
(Misra, Das, Behera, Das, Patra) Department of Anesthesiology and Critical
Care, AIIMS, Odisha, Bhubaneswar, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Various methods are used to predict the depth of
insertion of central venous catheters (CVCs). We evaluated a
bronchoscopy-based carinal measurement technique to predict this depth.
<br/>Method(s): We randomised adults undergoing cardiac surgery into a
bronchoscopy group or the Peres' formula-based method group. CVCs were
inserted through the right internal jugular vein. The skin insertion
reference point was at the level of the cricoid cartilage lateral to the
carotid artery. In the bronchoscopy group, the depth of insertion was
determined by the total length from the carina to the proximal end of the
tracheal tube (TT) (measured with a flexible bronchoscope) minus (the sum
of the distances from the skin insertion reference point to the TT and the
length of the TT outside the mouth). In the Peres' group, height (cm)/10
determined the depth of insertion. Confirmation of CVCs' distal tip
position was done with transoesophageal echocardiography. The area from 2
cm proximal to 1 cm distal to the superior vena cava-right atrium junction
was considered ideal. The primary outcome was the proportion of correct
CVC placements. The secondary outcome was the alignment of the CVCs.
<br/>Result(s): Forty-one patients in the bronchoscopy group and 40
patients in the Peres' group were enroled. A greater proportion of CVCs
was placed correctly in the bronchoscopy group (87.8% vs. 37.5%; P =
0.001). A more significant proportion of CVC tips was abutting the vessel
wall in the Peres' group (45% vs. 19.5%; P = 0.014). <br/>Conclusion(s):
Bronchoscopy-based carinal measurement technique results in more accurate
placement of CVCs compared to the Peres' method.<br/>Copyright &#xa9; 2024
Indian Journal of Anaesthesia.

<58>
Accession Number
2034570283
Title
Use of an insulin titration protocol based on continuous glucose
monitoring in postoperative cardiac surgery patients with type 2 diabetes
and prediabetes: a randomized controlled trial.
Source
Cardiovascular Diabetology. 24(1) (no pagination), 2025. Article Number:
210. Date of Publication: 01 Dec 2025.
Author
Moon S.-J.; Kim M.-S.; Kim Y.T.; Lee H.-E.; Lee Y.-W.; Lee S.-J.; Chung
E.-S.; Park C.-Y.
Institution
(Moon, Lee, Park) Division of Endocrinology and Metabolism, Department of
Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University
School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, South Korea
(Kim, Lee, Lee, Chung) Thoracic and Cardiovascular Surgery, Kangbuk
Samsung Hospital, Sungkyunkwan University School of Medicine, 29
Saemunan-ro, Jongno-gu, Seoul, South Korea
(Kim) Division of Biostatistics, Department of Academic Research, Kangbuk
Samsung Hospital, Seoul, South Korea
Publisher
BioMed Central Ltd
Abstract
Background: Maintaining optimal glucose control is critical for
postoperative care cardiac surgery patients. Continuous glucose monitoring
(CGM) in this setting remains understudied. We evaluated the efficacy of
CGM with a specialized titration protocol in cardiac surgery patients with
type 2 diabetes (T2D) and prediabetes. <br/>Method(s): In this
randomized-controlled trial, 54 cardiac surgery patients were randomized
one day post-surgery, with 27 CGM and 25 point-of-care (POC) patients
completing the study. The CGM group used Dexcom G6 with a CGM-specialized
titration protocol, while the POC group used standard monitoring with
blinded CGM. The primary outcome was time-in-range (TIR) 100-180 mg/dL for
7 days post-surgery. Secondary outcomes included various glycemic metrics
and surgical outcomes. Multiple comparison adjustments were performed
using false-discovery-rate (FDR). <br/>Result(s): Thirty-one (59.6%) had
diabetes and 21 (40.4%) had prediabetes. While TIR 100-180 mg/dL showed no
difference (74.7% vs. 71.6%, FDR-adjusted p = 0.376), the CGM group
demonstrated improvements in TIR 70-180 mg/dL (83.8% vs. 75.8%,
FDR-adjusted p = 0.026), time-in-tight-range (TITR) 100-140 mg/dL (46.3%
vs. 36.3%, FDR-adjusted p = 0.018), and TITR 70-140 mg/dL (55.3% vs.
40.5%, FDR-adjusted p = 0.003). Both groups maintained very low rates of
time below range (< 70 mg/dL: 0.03% vs. 0.18%, FDR-adjusted p = 0.109).
The CGM group showed lower postoperative atrial fibrillation (AF) (18.8%
vs. 55.6%, FDR-adjusted p = 0.04999). <br/>Conclusion(s): While the
primary outcome was not achieved, CGM with a specialized titration
protocol demonstrated safe glycemic control with improvements in TIR
70-180 mg/dL and TITRs in cardiac surgery patients with T2D and
prediabetes. The observed reduction in postoperative AF warrants further
investigation. Trial Registration: ClinicalTrials.gov
NCT06275971<br/>Copyright &#xa9; The Author(s) 2025.

<59>
Accession Number
2035320711
Title
Efficacy and safety of a generic remifentanil formulation versus fentanyl
and Ultiva during general anaesthesia: A phase III, prospective,
multi-centric, observer-blind, randomised controlled trial.
Source
Indian Journal of Anaesthesia. 68(11) (pp 985-995), 2024. Date of
Publication: 01 Nov 2024.
Author
Hemantkumar I.; Swain A.K.; Mishra M.; Singh S.; Gurudatt C.L.; Giridhar
J.B.
Institution
(Hemantkumar) Department of Anaesthesia, Seth GS Medical College, KEM
Hospital, Parel East, Maharashtra, Mumbai, India
(Swain) Medical Services, Themis Medicare Limited, Goregaon West,
Maharashtra, Mumbai, India
(Mishra) Department of Anaesthesia, Institute of Medical Sciences, Banaras
Hindu University, Uttar Pradesh, Varanasi, India
(Singh) Department of Anaesthesia, Indira Gandhi Institute of Medical
Sciences, Sheikhupura, Bihar, Patna, India
(Gurudatt) Department of Anaesthesia, JSS Hospital, Karnataka, Mysuru,
India
(Giridhar) Department of Anaesthesia, Panimalar Medical College Hospital
and Research Institute, Poonamallee, Tamil Nadu, Chennai, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Remifentanil and fentanyl are potent opioid
analgesics commonly used during surgery due to their distinct
pharmacological profiles. This study aimed to compare the efficacy and
safety of a generic remifentanil (test drug) with fentanyl and Ultiva
(innovator formulation) during general anaesthesia in the Indian
population. <br/>Method(s): This phase III, multi-centre (n = 13),
randomised, three-arm, comparative study was conducted from 24 November
2021 to 31 March 2022. Eligible subjects scheduled for elective
therapeutic and diagnostic surgical procedures (n = 314) were randomised
into generic remifentanil, Ultiva, and fentanyl groups. An independent
anaesthetist blinded to treatment allocation assessed efficacy and safety
parameters. The primary efficacy endpoint was haemodynamic response during
specific activities (endotracheal intubation, skin incision, skin closure,
and extubation). <br/>Result(s): The study groups exhibited no significant
differences in demographic and baseline characteristics. Heart rate was
similar between the remifentanil and Ultiva groups measured during
laryngeal intubation, skin incision, skin closure, and extubation (P >
0.05 in all four procedures). Heart rate was significantly higher in the
fentanyl group in comparison to the remifentanil group during laryngeal
intubation (P = 0.035), skin incision (P = 0.017), skin closure (P =
0.001), and extubation (P = 0.026). The need for vasopressor and
anti-cholinergic drugs was similar between groups, and no subject required
naloxone administration. <br/>Conclusion(s): Our study's findings
demonstrated that generic remifentanil is non-inferior to fentanyl and
equivalent to Ultiva for general anaesthesia in Indian patients undergoing
various surgical and diagnostic procedures. Remifentanil offers advantages
in terms of optimum haemodynamic stability, fast equilibrating analgesia,
and rapid emergence from sedation, making it a suitable alternative to
fentanyl.<br/>Copyright &#xa9; 2024 Indian Journal of Anaesthesia.

<60>
Accession Number
2018412269
Title
Effectiveness of Active Chest Tube Clearance Versus Conventional Chest
Tube in Reducing Postoperative Complications After Cardiac Surgery: a
Systematic Review and Meta-analysis.
Source
SN Comprehensive Clinical Medicine. 4(1) (no pagination), 2022. Article
Number: 177. Date of Publication: 01 Dec 2022.
Author
Hasan M.T.; Hagrass A.I.; Elkhrashy M.N.; Hamouda M.; shada N.M.; Hashem
S.M.; Al-kafarna M.; Almadhoon H.W.; Ragab K.M.; Nourelden A.Z.; Elsnhory
A.B.
Institution
(Hasan, Hagrass, Elkhrashy, Hamouda, Nourelden, Elsnhory) Faculty of
Medicine for Boys, Al-Azhar University, Cairo, Egypt
(Hasan, Hagrass, Elkhrashy, Hamouda, shada, Hashem, Al-kafarna, Almadhoon,
Ragab, Nourelden, Elsnhory) International Medical Research Association
(IMedRA), Cairo, Egypt
(Hagrass) Gamal Abdel Nasser Axis, The 3rd Settlement, New Cairo, Egypt
(shada, Hashem) Faculty of Medicine for Girls, Al-Azhar University, Cairo,
Egypt
(Al-kafarna) Faculty of Pharmacy, Al-Azhar University, Gaza, Palestine
(Almadhoon) Faculty of Dentistry, Al-Azhar University, Gaza, Palestine
(Ragab) Faculty of Medicine, Minia University, Minia, Egypt
Publisher
Springer Nature
Abstract
After heart surgery, the chest tube removes lost mediastinal blood.
Clogging of the chest tube may induce inadequate evacuation of fluids
surrounding the lungs and heart, leading to deadly consequences. This
meta-analysis compared the effectiveness of active chest tube clearance
(ATC) with conventional chest tube (CT) in lowering the incidence of
retained blood complications after heart surgery. We conducted a
systematic search of the available databases to identify cohort studies or
clinical trials that met our inclusion criteria. Studies that compared
active tube clearance and conventional tube in cardiac surgery were
included. The fixed or random-effects model was used to determine the
pooled effect estimates upon the heterogeneity of collected data. This
review included 7003 people from five cohort studies and three clinical
trials. As regard to retained blood, there was no significant difference
between chest tube types in matched group (RR = 0.67, 95% CI = [0.44,
1.04], P = 0.08) or unmatched group (RR = 0.64, 95% CI = [0.39, 1.04], P =
0.07). Re-exploration favored ATC in the matched group (RR = 0.64, 95% CI
= [0.43, 0.95], P = 0.03). The incidence of postoperative atrial
fibrillation was significantly lower in ATC in both matched (RR = 0.73,
95% CI = [0.61, 0.87], P = 0.0005) and unmatched groups (RR = 0.72, 95% CI
= [0.61, 0.84], P = 0.0005). This meta-analysis provides evidence on the
positive effect of active maintenance of chest tube patency during the
first hours of cardiac surgery, which resulted in reducing the incidence
of complications.<br/>Copyright &#xa9; 2022, The Author(s), under
exclusive licence to Springer Nature Switzerland AG.

<61>
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

<62>
Accession Number
2015094291
Title
Long-term Outcomes of Catheter Ablation for Ventricular Arrhythmias in
Post-Myocarditis Patients: Insights from a Meta-Analysis of Current Data.
Source
SN Comprehensive Clinical Medicine. 4(1) (no pagination), 2022. Article
Number: 62. Date of Publication: 01 Dec 2022.
Author
Androulakis E.; Falconer D.; Briasoulis A.; Sohrabi C.; Lim W.-Y.; Siasos
G.; Ahluwalia N.; Graham A.; Papageorgiou N.
Institution
(Androulakis) Royal Brompton & Harefield NHS, Heart Imaging Centre,
London, United Kingdom
(Falconer) Cardiology department, Queens Hospital, Romford, United Kingdom
(Briasoulis) Section of Heart Failure and Transplant Division of
Cardiovascular Diseases, University of Iowa Hospitals and Clinics, Iowa
City, IA, United States
(Sohrabi, Lim, Ahluwalia, Graham, Papageorgiou) Electrophysiology
Department, Barts Heart Centre, St. Bartholomew's Hospital, West
Smithfield, London, United Kingdom
(Siasos) 3Rd Department of Cardiology, Sotiria Hospital University of
Athens Medical School Athens, Athens, Greece
(Papageorgiou) Institute of Cardiovascular Science, University College
London, London, United Kingdom
Publisher
Springer Nature
Abstract
Background: In the past decade, catheter ablation (CA) has become a
rapidly expanding treatment option for ventricular tachycardia (VT);
however it is not commonly utilised for patients with post-myocarditis VT.
We aimed to systematically review up-to-date evidence regarding
feasibility, effectiveness, and safety of CA, with a specific focus on
long-term relapse rate and procedural complications. <br/>Method(s): A
structured electronic database search (PubMed, Embase, Cochrane) of the
scientific literature was performed according to PRISMA guidelines for
studies describing outcomes at up to 7.3 years after CA. The primary
outcome measured was VT recurrence post-ablation. Procedural success was
defined as freedom of ventricular arrhythmias (at the end of follow-up
after an ablation procedure). The secondary outcome was significant
procedural complications which included procedural death, stroke, cardiac
tamponade, acute myocardial infarction, major vascular complications, and
major bleeding, assessed on a study-by-study basis. <br/>Result(s): A
total of 186 patients were included in analysis with most patients (88%)
being male. Over the follow-up period, there was a 18% relapse rate (n =
34) (confidence interval (CI); 0.12-0.24, I²=0, p = 0.77) with
the majority of patients remaining VT free for the duration of follow-up.
The overall procedural complication rate was 3.0% (n = 7) (CI; 0.01-0.07,
I²=0, p = 0.44), and of note, there were no peri-procedural
deaths or heart transplant surgeries reported. However, a single study
reported a mortality of 10% (n = 2) during the follow-up period.
<br/>Conclusion(s): CA is an effective and durable long-term therapeutic
strategy for post-myocarditis VT patients with limited relapse rate and
very low complication rates based on these non-randomised data. Larger
randomised-controlled trials with standardised treatment and long
follow-up are required to compare CA versus conventional treatment in the
post-acute myocardial phase.<br/>Copyright &#xa9; 2022, The Author(s),
under exclusive licence to Springer Nature Switzerland AG.

<63>
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

<64>
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)

<65>
Accession Number
2035392384
Title
Robotic-assisted versus conventional median sternotomy for the surgical
excision of cardiac myxomas: a systematic review and meta-analysis.
Source
Cardiothoracic Surgeon. 33(1) (no pagination), 2025. Article Number: 24.
Date of Publication: 01 Dec 2025.
Author
Santos K.; Albuquerque L.G.; Consoli L.; Gamarra-Valverde N.; Abdelmajeed
A.; Plonek T.
Institution
(Santos) New Vision University School of Medicine, Tbilisi, Georgia
(Albuquerque, Consoli) Faculty of Medicine, Federal University of Bahia,
Bahia, Brazil
(Gamarra-Valverde) Faculty of Medicine, Universidad Peruana Cayetano
Heredia, Lima, Peru
(Abdelmajeed) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Plonek) Medisch Spectrum Twente, Enschede, Netherlands
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Cardiac myxoma constitutes the most prevalent primary heart
tumour, often necessitating surgical resection to prevent complications.
While median sternotomy is the standard approach, it is associated with
significant morbidity. Robotic-assisted myxoma excision (RA-ME) has
emerged as a minimally invasive alternative, but comparative data on their
outcomes remain limited. Our meta-analysis aimed to compare postoperative
outcomes of RA-ME versus conventional median sternotomy myxoma excision
(MS-ME). <br/>Method(s): We systematically searched MEDLINE, Scopus, and
Cochrane Library, focusing on studies that compared RA-ME and MS-ME.
Pooled odds ratios (OR) and mean differences (MD) with 95% confidence
intervals (CI) were calculated using RevMan 8.13.0. <br/>Result(s): Seven
studies comprising 447 patients, with 180 (40.3%) undergoing RA-ME, were
included. RA-ME was associated with significantly longer cardiopulmonary
bypass times [MD 23.0 min; 95% CI 11.1 to 35.00; p = 0.0001] and aortic
cross-clamp times [MD 11.4 min; 95% CI 4.6 to 18.2; p = 0.001]. However,
it demonstrated reduced hospital stay [MD - 2.00 days; 95% CI - 2.6 to -
1.4; p < 0.001], ICU stay [MD - 0.3 days; 95% CI - 0.5 to - 0.01; p =
0.04], blood loss [MD - 115.2 mL; 95% CI - 230.4 to - 0.02; p = 0.05], and
blood transfusion requirements [OR 0.4; 95% CI 0.2 to 0.8; p = 0.01].
Other outcomes, including mechanical ventilation time, surgical
re-exploration, arrhythmias, pneumonia, and surgical wound infections,
were comparable. <br/>Conclusion(s): RA-ME may be a safe and effective
alternative to MS-ME, offering improved recovery metrics with no
compromise in safety despite longer operative times. However, high-quality
prospective trials are needed for further validation. Trial registration:
PROSPERO CRD42025633712.<br/>Copyright &#xa9; The Author(s) 2025.

<66>
Accession Number
2018285367
Title
Effect of preoperative ultrasound mapping of the saphenous vein on leg
wound complications after coronary artery bypass surgery: a systematic
review.
Source
Cardiothoracic Surgeon. 30(1) (no pagination), 2022. Article Number: 21.
Date of Publication: 01 Dec 2022.
Author
Media A.S.; Rajendran R.; Kimose H.H.; El-Akkawi A.I.
Institution
(Media, Rajendran, Kimose, El-Akkawi) Department of Cardiothoracic and
Vascular Surgery, Aarhus University Hospital, Palle Juul-Jensens Blvd 99,
Aarhus N, Denmark
(Kimose) Department of Clinical Medicine, Aarhus University, Aarhus,
Denmark
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The long saphenous vein is one of the most used conduits for
coronary artery bypass graft surgery. The aim of this study was to assess
the existing evidence regarding the effects of preoperative ultrasound
mapping of the long saphenous vein with special attention to leg wound
complications in patients undergoing elective coronary artery bypass graft
surgery. Main text: A systematic literature search was conducted in
PubMed, Cochrane, and Embase databases. Extraction of relevant data was
performed including study characteristics, patient characteristics, and
all reported outcomes. The Cochrane Risk of Bias tool was used to evaluate
the risk of bias of the included studies. The primary outcome measure was
leg wound infections. Of 4514 papers screened in this systematic review,
36 papers underwent full-text assessment with final inclusion of 5
studies; 3 observational studies, and 2 randomized trials. The two
randomized controlled trials showed no effects of preoperative ultrasound.
Data from the three non-randomized studies was pooled in a meta-analysis,
which suggested a significant reduction in the risk of harvest wound
complications by ultrasound mapping prior to surgery (RR 0.32; 95%CI =
[0.19-0.55]). <br/>Conclusion(s): The main findings of this systematic
review showed, that (1) the evidence in this field is limited and of low
quality, i.e., low power or methodology and (2) despite limitations of the
included studies, preoperative ultrasound mapping of the saphenous vein
seems to be beneficial in terms of reducing the risk of postoperative leg
wound complications.<br/>Copyright &#xa9; 2022, The Author(s).

<67>
Accession Number
2038828647
Title
Navigating Family Leave in Cardiothoracic Surgery Training.
Source
Annals of Thoracic Surgery. 120(4) (pp 787-798), 2025. Date of
Publication: 01 Oct 2025.
Author
Russo M.G.; Tompkins A.K.; Akinade O.; Woodard G.A.; Cooke D.T.; Antonoff
M.B.; Erkmen C.P.
Institution
(Russo, Akinade, Erkmen) Lewis Katz School of Medicine at Temple
University, Philadelphia, Pennsylvania, United States
(Tompkins) Center for Asian Health, Lewis Katz School of Medicine at
Temple University, Philadelphia, Pennsylvania, United States
(Woodard) Division of Thoracic Surgery, Department of Surgery, Yale
University School of Medicine, New Haven, Connecticut, United States
(Cooke) Division of General Thoracic Surgery, University of California,
Davis Health, Sacramento, California, United States
(Antonoff) Department of Thoracic and Cardiovascular Surgery, UT MD
Anderson Cancer Center, Houston, Texas, United States
(Erkmen) Department of Thoracic Medicine and Surgery, Temple University
Hospital, Philadelphia, Pennsylvania, United States
Publisher
Elsevier Inc.
Abstract
Background: Cardiothoracic surgery (CTS) training may coincide with family
needs including pregnancy, illness, birth/adoption/fostering of a child,
and care for family members. Certifying bodies set requirements and limits
on family leave, complicating the navigation of family needs during
training. Our goal is to examine policies of medical boards and their
alignment with the 2022 Accreditation Council for Graduate Medical
Education policy and to develop a practical tool to help trainees and
program directors navigate family leave. <br/>Method(s): A literature
review was conducted with PubMed of publications published from July 2022
to September 2024 focusing on family leave within surgical specialties.
This study reviews family leave policies, requirements, and benefits of
certifying bodies. Data from the American Association of Medical Colleges,
American Boards of Surgery and Thoracic Surgery, and Accreditation Council
for Graduate Medical Education were analyzed to understand gender
distribution and policy variations between surgical specialties.
<br/>Result(s): There was no publication discussing family leave in CTS.
Of 40 reviewed publications, 12 concluded that parental leave policies are
unclear or insufficient. Publications were found to focus on perspectives
and experiences but to lack actionable solutions. Family leave policies
vary, with inconsistencies in duration and flexibility. The duration of
leave was not linked with gender representation in specialty.
<br/>Conclusion(s): Comprehensive family leave policies are needed to
assist programs and trainees in navigating family leave in
CTS.<br/>Copyright &#xa9; 2025 The Society of Thoracic Surgeons

<68>
Accession Number
2030829020
Title
The current state of minimally invasive cardiac surgery in Africa: a
systematic review and meta-analysis.
Source
Cardiothoracic Surgeon. 32(1) (no pagination), 2024. Article Number: 15.
Date of Publication: 01 Dec 2024.
Author
Akintoye O.O.; Adu B.G.; Otorkpa M.J.; Olayode O.O.; Fodop S.; Alemede
P.O.; Enyong R.K.; Anele F.C.; Omoregbee B.I.
Institution
(Akintoye, Adu, Otorkpa, Olayode, Fodop, Alemede, Enyong, Anele,
Omoregbee) Cardiothoracic Surgery Community, Surgery Interest Group of
Africa, Lagos, Nigeria
(Omoregbee) Hull University Teaching Hospital NHS, Kingston Upon Hull,
United Kingdom
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Globally, the utilisation of minimally invasive techniques has
become increasingly prevalent. While traditional open-heart procedures
still dominate the landscape, a significant portion of cardiac surgeries
are now performed minimally invasively. The aim of this study is to
provide an insightful overview of the current state of minimally invasive
cardiac surgery in Africa. Main body: A comprehensive database search was
performed on PubMed, African Journal Online, Google Scholar, and Scopus to
identify published data reporting on outcomes of minimally invasive
cardiac surgery in Africa, from inception till June 2024. We used the
Preferred Reporting Items for Systematic Reviews and Meta-analysis
guidelines to undergo this study. The primary outcomes of interest were
in-hospital mortality and overall mortality. Data were pooled together and
analysed using a random effect model for meta-analysis with R software.
Out of a total of 2309 articles identified, only fourteen papers met our
inclusion criteria following deduplication and screening. The four
countries with published research include Egypt, South Africa, Tanzania,
and Morocco, with a total sample size of 1357 patients. The meta-analysis
of the reported outcomes produced a pooled in-hospital mortality
prevalence of 1.18%, while the pooled overall mortality prevalence was
2.23%. There was no statistically significant difference in outcomes
between the mini sternotomy and the full sternotomy group.
<br/>Conclusion(s): The pooled outcomes of minimally invasive cardiac
surgery in Africa are comparable to those in other regions. However, there
are several socio-economic factors limiting its widespread practice in
Africa.<br/>Copyright &#xa9; Crown 2024.

<69>
Accession Number
2020866041
Title
A randomized controlled trial (PAMI trial) on our new trend periareolar
minimally invasive (PAMI) technique versus inframammary approach for
minimally invasive cardiac surgery.
Source
Cardiothoracic Surgeon. 30(1) (no pagination), 2022. Article Number: 29.
Date of Publication: 01 Dec 2022.
Author
El Adel M.; Nady M.A.; Amin A.; Khairy M.
Institution
(El Adel, Nady, Amin, Khairy) Cardiothoracic Surgery Departments, Faculty
of Medicine, Assiut University, Asyut, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: A minimally invasive approach has become standard for mitral
valve surgery. The periareolar approach has grown in popularity regarding
the cosmesis for patients. We have adopted a new modification to the
periareolar approach: the periareolar minimally invasive (PAMI) technique.
The objectives of the current study are to test the hypothesis that the
PAMI approach is more feasible and safer than the inframammary approach in
addition to identify risk factors and assess outcomes of both periareolar
and inframammary approach. <br/>Method(s): A randomized controlled trial
of 3 months compared the PAMI technique to the inframammary approach for
minimally invasive cardiac surgery. <br/>Result(s): A total of 102
patients were enrolled and randomized into two groups: 53 received
minimally invasive cardiac surgery through the periareolar approach, and
49 were the control group using the inframammary approach. Using
intention-to-treat analysis, the periareolar approach was superior to the
inframammary approach in surgical site infection (two cases in comparison
to 8 with P = 0.004), and the number needed to treat for effectiveness was
8. No early deaths occurred, 97 cases (95.1%) needed no reoperation, and 5
cases (4.9%) were reopened for bleeding. The primary endpoints compared
were the duration of procedure, duration of mechanical ventilation, amount
of bleeding, ICU stay, and hospital stay. We found no statistically
significant differences between the groups. At 3 months, the secondary
endpoints evaluated were the rate of surgical site infection, respiratory
complications, groin complications, pericardial effusion, breast hematoma,
and cosmoses using a Likert scale. We found no statistically significant
difference between the groups, except for surgical site infection (P =
0.004) and cosmesis (P< 0.001). <br/>Conclusion(s): The results of this
PAMI trial are suggestive that the PAMI technique is most probably
applicable for the right side of the heart, such as in atrial septal
defect closure, tricuspid disease, and mitral valve surgery. Trial
registration: PAMI Trial NCT04726488 Registered January 27,
2021.<br/>Copyright &#xa9; 2022, The Author(s).

<70>
Accession Number
2033594120
Title
A narrative review on miniaturized extracorporeal technology and circuits:
a revolutionary approach to cardiac surgery.
Source
Cardiothoracic Surgeon. 33(1) (no pagination), 2025. Article Number: 11.
Date of Publication: 01 Dec 2025.
Author
Shetty T.; Darbari A.; Sainath P.
Institution
(Shetty, Darbari) CTVS Department, AIIMS Rishikesh, Rishikesh, India
(Sainath) Perfusion Technology Program, MCHP, MAHE, Manipal, India
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The development of the cardiopulmonary bypass machine for
extracorporeal circulation by Dr. John Gibbon marked a significant
milestone in the advancement of medical technology. Subsequent
enhancements in this equipment and methodologies have refined this
ground-breaking invention for better cardiac surgical results. Main body
of the abstract: The emergence of miniaturized extracorporeal circuits has
demonstrated more promising results in various research studies. This
narrative article explores the impacts of miniaturized extracorporeal
circuits on different organ systems and their potential advantages over
traditional bypass systems, focusing on currently commercially available
devices to enhance our understanding. Short conclusion: Nevertheless,
practical limitations in standard usage and acceptance have hindered its
widespread implementation. Hence, this technique is still in the process
of acceptance as the standard of care. The information presented in this
review has been collected by accessing major databases and recent reviews,
meta-analyses and clinical trials on the internet, adhering to the Revised
Standards for QUality Improvement Reporting Excellence (SQUIRE 2.0)
guidelines.<br/>Copyright &#xa9; The Author(s) 2025.

<71>
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.

<72>
Accession Number
2032778819
Title
Sex-based Disparities in Morbidity and Mortality Following Coronary Artery
Bypass Grafting: an Updated Systematic Review and Meta-analysis.
Source
SN Comprehensive Clinical Medicine. 7(1) (no pagination), 2024. Article
Number: 8. Date of Publication: 01 Dec 2024.
Author
Sebastian S.A.; Vaja H.; Shah Y.; Chitagi P.
Institution
(Sebastian) Department of Internal Medicine, Azeezia Medical College,
Kerala, Kollam, India
(Vaja) Department of Internal Medicine, Byramjee Jeejeebhoy Medical
College & Civil Hospital, Gujarat, Ahmedabad, India
(Shah, Chitagi) Department of Internal Medicine, Trinity Health Oakland/
Wayne State University, Pontiac, MI, United States
(Sebastian) AirdrieCanada
Publisher
Springer Nature
Abstract
Sex is suggested to play a role in influencing outcomes after coronary
artery bypass grafting (CABG). However, the evidence regarding its impact
on long-term mortality and other clinical outcomes remains inconclusive.
Our study aims to comprehensively analyze and elucidate sex differences in
morbidity and mortality among individuals undergoing CABG. A systematic
search was performed of the following databases MEDLINE (via PubMed),
Google Scholar, the Cochrane Library, and ScienceDirect to identify
studies on sex differences in post-CABG outcomes from January 2010 to
April 2024. Statistical analysis was performed using RevMan 5.4, applying
an inverse variance random effects model to pool hazard ratio (HR) and
odds ratio (OR) for primary and secondary outcomes. The study protocol is
registered with PROSPERO (CRD42024516859). The final analysis comprised 35
studies involving 14,740,743 participants, with 34.4% being females. The
average age was 67.2 years for females and 63.7 years for males. Upon
pooled analysis, no statistically significant differences were observed in
the composite outcome of major adverse cardiovascular events (MACE) (HR:
1.03, 95% CI: 0.89 to 1.19, p = 0.69). However, there was a significant
increase in the risk of all-cause mortality in females, with a reported HR
of 1.14 (95% CI: 1.09 to 1.19, p < 0.00001). Similarly, females showed a
statistically significant higher risk of short-term mortality
(in-hospital/30-day mortality) with an OR of 1.73 (95% CI: 1.61 to 1.86, p
< 0.00001) and postoperative stroke with an OR of 1.28 (95% CI: 1.15 to
1.43, p < 0.00001), respectively. In contrast, the incidence of myocardial
infarction (MI) (OR: 1.13, 95% CI: 0.97 to 1.32, p = 0.12), cardiovascular
mortality (OR: 1.67, 95% CI: 0.84 to 3.32, p = 0.14), and repeat
revascularization (OR: 1.42, 95% CI: 0.30 to 6.68, p = 0.66) did not show
statistically significant differences between females and males. In
conclusion, females undergoing CABG exhibited an increased risk of
all-cause mortality, short-term mortality, and postoperative stroke,
underscoring the need for focused efforts to understand and mitigate this
sex-based disparity.<br/>Copyright &#xa9; The Author(s), under exclusive
licence to Springer Nature Switzerland AG 2024.

<73>
Accession Number
2022085557
Title
Treatment Decision in Aortic Stenosis-Look at the Valve but Do Not Forget
the Ventricle.
Source
SN Comprehensive Clinical Medicine. 5(1) (no pagination), 2023. Article
Number: 101. Date of Publication: 01 Dec 2023.
Author
Nuis R.-J.; Ribeiro J.M.; Lopez-Jimenez F.; Vahanian A.; de Jaegere P.P.T.
Institution
(Nuis, Ribeiro, de Jaegere) Department of Cardiology, Thoraxcenter,
Erasmus University Medical Center, Dr Molewaterplein 40, Rotterdam,
Netherlands
(Ribeiro) Department of Cardiology, Centro Hospitalar de Entre o Douro e
Vouga, Santa Maria da Feira, Portugal
(Lopez-Jimenez) Department of Cardiology, Mayo Clinic, Rochester, United
States
(Vahanian) Departement de Cardiologie, UFR Medecine, Universite de Paris,
Paris, France
(Vahanian) LVTS INSERM U1148, GH Bichat, Paris, France
Publisher
Springer Nature
Abstract
In patients with aortic stenosis, current guidelines recommend valve
replacement therapy in case of severe valve narrowing in combination with
symptoms and/or left ventricular dysfunction (ejection fraction < 50%). It
is increasingly recognized that left ventricular ejection fraction offers
a crude interpretation of a complex disease entity that is in need of
refinement to optimize the timing of valve replacement therapy and patient
outcome. In this state-of-the-art review article, we discuss the
pathophysiological transition from left ventricular hypertrophy to other
types of cardiac remodeling and myocardial fibrosis in response to
progressive narrowing of the aortic valve, and how new imaging
developments and biomarkers may help identify patients with a dismal
outcome at earlier stages of disease. Also, the digital transformation of
health care and novel analytical methods such as artificial intelligence
that can help improve treatment decision is evaluated. This is in
combination with the increased use of minimally invasive treatment
modalities that may fulfill the goal of offering valve replacement in
patients with aortic stenosis at earlier stages of disease and prior to
the onset of symptoms but nevertheless at risk of left ventricular
deterioration.<br/>Copyright &#xa9; 2023, The Author(s).

<74>
Accession Number
2022707063
Title
Transcatheter versus surgical closure of ventricular septal defect: a
comparative study.
Source
Cardiothoracic Surgeon. 31(1) (no pagination), 2023. Article Number: 8.
Date of Publication: 01 Dec 2023.
Author
Singab H.; Elshahat M.K.; Taha A.S.; Ali Y.A.; El-Emam A.M.; Gamal M.A.
Institution
(Singab, Taha, Gamal) Department of Cardiothoracic Surgery, Academic
Institute of Cardiac Surgery, Ain-Shams University, Cairo, Egypt
(Elshahat) Department of Cardiac Surgery, National Heart Institute, Giza,
Egypt
(Ali) Department of Cardiology, Ain-Shams University, Cairo, Egypt
(El-Emam) Department of Cardiology, National Heart Institute, Giza, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: In many countries, surgical closure of ventricular septal
defects remains the recommended approach of ventricular septal defect
closure. The aim of this study is to compare the safety, efficacy, and
clinical effects of surgical versus transcatheter closure of a ventricular
septal defect. <br/>Method(s): We conducted a comparative randomized study
on patients undergoing ventricular septal defect closure. Patients were
allocated to undergo either surgical (group I) or catheter (group II)
ventricular septal defect closure. <br/>Result(s): Seventy-two patients
were included. Operation success was achieved in 100% of the surgical
group versus 33 of 36 patients of the percutaneous group (91.6%) (p value
0.076). There was no significant difference regarding the residual
ventricular septal defect. The postoperative echo in group I revealed
severe tricuspid regurgitation in one patient (2.7%), and one patient
needed a permanent pacemaker. On the other hand, in group II, during the
procedure, one patient had severe tricuspid regurge (2.7%). There was a
significant difference in the postoperative data favoring group II over
group I regarding ventilation duration, intensive care unit stay, total
hospital stay, and blood transfusion (P value < 0.001 each).
<br/>Conclusion(s): Both transcatheter device closure and surgical repair
are effective treatments. In contrast, the psychological profile of the
transcatheter device was superior to the surgical repair, especially in
terms of avoiding sternotomy scar, blood loss and transfusion, and
hospital stay. On the other hand, transcatheter intervention is limited
only to the anatomically suitable ventricular septal defects, in addition,
surgical backup is a must in case of complicated transcatheter closure,
which gives the upper hand to surgery to be the recommended approach for
most of the ventricular septal defects. Clinical registration number:
NCT05306483 registered 04/05/2022 (retrospectively registered) at
ClinicalTrials.gov PRS. Graphical Abstract: [Figure not available: see
fulltext.]<br/>Copyright &#xa9; 2023, The Author(s).

<75>
Accession Number
2014716654
Title
Risk and benefits of temporary pacemaker electrodes in adult open-heart
surgery-a systematic review.
Source
Cardiothoracic Surgeon. 30(1) (no pagination), 2022. Article Number: 5.
Date of Publication: 01 Dec 2022.
Author
Enevoldsen M.S.; Nielsen P.H.; Hasenkam J.M.
Institution
(Enevoldsen, Nielsen, Hasenkam) Department of Cardiothoracic and Vascular
Surgery, Aarhus University Hospital, Aarhus, Denmark
(Enevoldsen) Aarhus University, Palle Juul-Jensens Boulevard 99, Aarhus,
Denmark
(Hasenkam) Department of Clinical Medicine, Aarhus University, Aarhus,
Denmark
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: To assess the achieved risk and benefits of inserting
temporary epicardial pacemaker electrodes after open-heart surgery for
potential treatment of postoperative cardiac arrhythmias, and to
investigate the extent of its use in clinical practice. Main text: A
systematic search was conducted in PubMed and repeated in Embase and
Scopus using the PRISMA guidelines. The search identified 905 studies and
resulted in 12 included studies, where the type of surgery, study design,
total number of included patients, number of patients having temporary
pacemaker electrodes inserted, number of patients requiring temporary
pacing, primary reason for pacing, significant factors predicting
temporary pacing, registered complications and study conclusion were
assessed. Eight papers concluded that routine insertion of temporary
pacemaker electrodes in all postoperative patients is unnecessary. One
paper concluded that they should always be inserted, while three papers
concluded that pacing is useful in the postoperative period, but did not
recommend a frequency of which they should be inserted.
<br/>Conclusion(s): The literature suggests that the subgroup of younger
otherwise healthy patients without preoperative arrhythmia having isolated
coronary artery bypass grafting surgery or single valve surgery should not
routinely have temporary pacemaker electrodes inserted.<br/>Copyright
&#xa9; 2022, The Author(s).

<76>
Accession Number
2018969425
Title
Does prophylactic low-dose amiodarone decrease the incidence of
postoperative atrial fibrillation after coronary artery bypass graft
surgery? A randomized controlled trial.
Source
Cardiothoracic Surgeon. 30(1) (no pagination), 2022. Article Number: 24.
Date of Publication: 01 Dec 2022.
Author
Ahmed M.A.; Ghoneim A.E.; Abdel Wahab A.A.E.; Mahmoud A.B.
Institution
(Ahmed, Ghoneim, Abdel Wahab, Mahmoud) Faculty of Medicine, Tanta
University, Tanta, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Postoperative atrial fibrillation (POAF) occurs within 1 to 5
days after coronary artery bypass grafting (CABG), with a peak occurrence
on the second day. This research aimed to assess the role of dose-low
amiodarone in the prevention of POAF after CABG. <br/>Method(s): This
randomized controlled blind-single study was carried out on 150 patients
undergoing elective CABG with sinus rhythm. Cases were randomized into two
equal groups. The placebo group received matching placebo tablets. The
amiodarone group received a prophylactic oral amiodarone 5 mg/kg/day for 6
days before and 6 days after surgery. <br/>Result(s): The incidence of
POAF was significantly lower in the amiodarone group compared to the
placebo group (16% vs 33.3%, P = 0.013) with a relative risk of 0.48 times
(95% confidence interval: 0.26-0.88). The onset of POAF, percent of
patients responded to medication, and time elapsed to respond to
medication were insignificantly different between both groups. The mean
(+/- SD) of ICU stay was 2.51 +/- 1.11 days in the amiodarone group versus
3.31 +/- 1.83 days in the placebo group, and the mean (+/- SD) of hospital
stay duration was 10 +/- 1.99 days in the amiodarone group versus 12.72
+/- 2.23 days in the placebo group. The length of ICU admission and
hospital stay was significantly lower in the amiodarone group than in the
placebo group (P = 0.002 and < 0.001, respectively). <br/>Conclusion(s):
Low-dose oral amiodarone was effective in POAF prevention after CABG with
a lower length of ICU admission and hospital stay. Trial registration: Pan
African Clinical Trials Register PACTR202101651961317. Registered on 21
January 2021<br/>Copyright &#xa9; The Author(s) 2022.

<77>
Accession Number
2010703944
Title
Hyper-oncotic vs. Hypo-oncotic Albumin Solutions: a Systematic Review of
Clinical Efficacy and Safety.
Source
SN Comprehensive Clinical Medicine. 3(5) (pp 1137-1147), 2021. Date of
Publication: 01 May 2021.
Author
Haynes G.R.; Bassiri K.
Institution
(Haynes) Department of Anesthesiology, Tulane University School of
Medicine, 1430 Tulane Ave, New Orleans, LA, United States
(Bassiri) Meridian HealthComms, Plumley Moor Road, Plumley, United Kingdom
Publisher
Springer Nature
Abstract
Several albumin solutions are available for volume expansion.
Hyper-oncotic solutions (>= 20%) are more effective than hypo-oncotic (<=
5%) as they recruit endogenous extracellular fluid into blood vessels
rather than adding volume. The latter may cause volume overload, with
several associated complications. This systematic review aimed to evaluate
evidence on the efficacy and safety of hyper-oncotic vs. hypo-oncotic
albumin solutions across different clinical settings. The review was
conducted according to PRISMA guidelines. Ninety articles were retained
(58 randomized controlled trials). Four studies directly compared albumin
solutions. SWIPE showed that cumulative fluid balance at 48 h was
significantly lower with 20% vs. 5% albumin (mean - 576 mL; P = 0.01).
Twenty percent albumin was also associated with decreased chloride load
vs. 4% albumin in critically ill patients. All 10 pre-/intraoperative
studies evaluated 4-5% solutions; 14 studies evaluated 4-5% albumin in
postoperative patients. Renal injury was reported in some studies;
however, hydroxyethyl starch was associated with higher incidence vs.
albumin. Importantly, 20% albumin preserved cumulative organ function in
liver transplantation, and 25% albumin was more beneficial than saline in
cardiac surgery patients. Thirty-two studies were performed in critically
ill patients. Several studies reported increased risk of positive fluid
balance and chloride load with hypo-oncotic albumin, whereas multiple
benefits were associated with 20% albumin, including improved endothelial
function and perfusion. Of 18 pediatric studies that evaluated <= 10%
albumin, benefits such as correction of hypotension and improved cardiac
output were noted. In conclusion, hyper-oncotic albumin solutions should
be more routinely used to avoid potential risks associated with
hypo-oncotic solutions.<br/>Copyright &#xa9; 2021, The Author(s).

<78>
Accession Number
2029493658
Title
The Preoperative Assessment of Frailty in the Setting of Transcatheter
Aortic Valve Implantation (TAVI): A Systematic Review.
Source
SN Comprehensive Clinical Medicine. 6(1) (no pagination), 2024. Article
Number: 48. Date of Publication: 01 Dec 2024.
Author
Martocchia A.; Vero L.; Pezzella D.; Sciaulino S.; Caracciolo L.; De Biase
L.; Berni A.; Bianchini R.; Martelletti P.; Sesti G.
Institution
(Martocchia, Vero, Pezzella, Sciaulino, Caracciolo, Sesti) Internal
Medicine Unit, S.Andrea Hospital, Sapienza University of Rome, Via Di
Grottarossa 1035, Rome, Italy
(De Biase) Heart Failure Unit, Clinical and Molecular Medicine Department,
S.Andrea Hospital, Sapienza University of Rome, Rome, Italy
(Berni) Hemodynamic Unit, S.Andrea Hospital, Sapienza University of Rome,
Rome, Italy
(Bianchini) Cardiac Surgery Unit, S.Andrea Hospital, Sapienza University
of Rome, Rome, Italy
(Martelletti) Emergency Medicine Unit, S.Andrea Hospital, Sapienza
University of Rome, Rome, Italy
Publisher
Springer Nature
Abstract
Increasing evidence in the literature suggests the assessment of the
frailty in the patients before the transcatheter aortic valve implantation
(TAVI), but there is still a matter of debate about the standardized
method to be used. We searched online the medical literature database
(PubMed) from 2006 to 2023, covering the 17-year period that marked the
development of the minimally invasive approach. We retrieved n.218
articles and 64 studies were evaluated. The preoperative assessment of
frailty in the setting of the TAVI is a key point of the evaluation by the
heart team in order to identify the patients at low or high risk of
complications after surgery and to support the clinical decision in
allocating the health care resources.<br/>Copyright &#xa9; The Author(s),
under exclusive licence to Springer Nature Switzerland AG 2024.

<79>
Accession Number
2024494734
Title
Cardioprotective effect of propofol in cardioplegia compared to systemic
propofol in heart valves surgery; a randomized controlled trial.
Source
Cardiothoracic Surgeon. 31(1) (no pagination), 2023. Article Number: 14.
Date of Publication: 01 Dec 2023.
Author
Attia A.A.; Torky M.A.E.; Abo Elnasr M.M.; Wahby E.A.E.; Taha A.E.M.
Institution
(Attia, Torky, Abo Elnasr, Wahby, Taha) Cardiothoracic Surgery Department,
Faculty of Medicine, Tanta University, Tanta, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Myocardial protection is still a focus of ongoing research.
Propofol is used widely during the induction of anaesthesia in cardiac
surgery. So, this triggers us to investigate the cardioprotective effect
of the propofol when added to the cardioplegia compared to systemic
propofol by measuring the troponin T level. <br/>Method(s): This clinical
randomized controlled trial was carried out on 150 patients operated for
elective valvular heart surgery. Patients were assigned into three equal
groups: Group 1: received propofol in the cardioplegia, Group 2: received
propofol injection in the aortic line before and after the aortic
cross-clamp, and Group 3 (control group): patients without propofol in the
cardioplegia or aortic line. All patients were subjected to full medical
histories, physical examinations, routine tests, and echocardiography.
Cardiac troponin T was measured before surgery and 4 times
postoperatively. <br/>Result(s): In group 1, there was a significant
improvement in troponin T level at the last reading compared with the
control group (mean +/- SD. of group 1 was 246.4 +/- 131.4, mean +/- SD.
of group 3 was 317.0 +/- 117.9, p = 0.031), denoting propofol's
cardioprotective effect when added as a cardioplegia additive. In group 2,
there was a significant improvement of troponin T level at the last
reading compared with the group 1 and control group (mean +/- SD. of group
2 was 202.54 +/- 156.03, mean +/- SD. of group 3 was 317.0 +/- 117.9, p <
0.001), denoting propofol's more cardioprotective effect when used
systemically during cardiopulmonary bypass than when added as a
cardioplegia additive. <br/>Conclusion(s): In valvular cardiac surgery,
propofol has an additional cardioprotective effect and a superior cardiac
outcome when administered systematically during cardiopulmonary bypass
rather than added to cardioplegia. Trial registration: Pan African
Clinical Trials Register PACTR201907764652028. Registered on 01 July 2019,
retrospectively registered, https://pactr.samrc.ac.za/
TrialDisplay.aspx?TrialID = 5726.<br/>Copyright &#xa9; 2023, The
Author(s).

<80>
Accession Number
2015143224
Title
Umbrella Meta-analysis Evaluating the Effectiveness of ViV-TAVI vs Redo
SAVR.
Source
SN Comprehensive Clinical Medicine. 4(1) (no pagination), 2022. Article
Number: 63. Date of Publication: 01 Dec 2022.
Author
Aedma S.K.; Khan N.; Altamimi A.; Ali N.; Jain S.; Raol K.; Madireddy S.;
Rakholiya J.; Raheem A.; Desai R.; Patel U.K.; Rabbani R.; Pothuru S.
Institution
(Aedma) Department of Internal Medicine, Carle Illinois College of
Medicine, Urbana, IL, United States
(Khan) Department of Internal Medicine, Jinnah Sindh Medical University,
Sindh, Pakistan
(Altamimi) Department of Emergency Medicine, Amiri Hospital, Sharq, Kuwait
(Ali) Liaquat University of Medical Health and Science, Sindh, Pakistan
(Jain) Department of Internal Medicine, Gujarat Medical Education and
Research Society Medical College, Gujarat, Gotri, India
(Raol) Department of Internal Medicine, Gujarat Medical Education and
Research Society Medical College and General Hospital, Gujarat,
Gandhinagar, India
(Madireddy) Department of Internal Medicine, Mamata Medical College,
Telangana, Khammam, India
(Rakholiya) Department of Internal Medicine, Mayo Clinic, Rochester, MN,
United States
(Raheem) Department of Internal Medicine, Texas Tech University Health
Sciences Center at Permian Basin, Odessa, TX, United States
(Desai) Department of Internal Medicine, University of North Carolina
Cardiology at Nash, Rocky Mount, NC, United States
(Patel) Department of Public Health and Neurology, Icahn School of
Medicine at Mount Sinai, Gustave L. Levy Pl, New York, NY, United States
(Rabbani) Temple University Hospital, Philadelphia, PA, United States
(Pothuru) Department of Internal Medicine, Ascension Via Christi Hospital,
Manhattan, KS, United States
Publisher
Springer Nature
Abstract
Since almost a decade, the use of bioprosthetic valves (BPV) has been
increasing for the replacement of stenosed aortic valves. With the
increasing use, a rise in the BPV failure is noted considering their
limited durability. Redo-surgical aortic valve replacement (rSAVR) is by
far the only gold standard treatment modality for replacement of
deteriorated BPV. Recently, valve in valve-transcatheter aortic valve
replacement (ViV-TAVR) is explored as the alternative minimally invasive
procedure compared to the gold standard rSAVR. However, its efficacy
remains the major concern. Hence, we aimed to conduct the
meta-meta-analysis to evaluate the safety and efficacy of ViV-TAVI
compared to redo-SAVR. Following PRISMA guidelines, we searched for a
meta-analysis comparing the safety and efficacy of ViV-TAVR vs rSAVR from
PubMed and included 9 analyses which compared the two modalities
head-to-head in terms of outcomes and complications. We included various
complications and outcomes like 30-day mortality, long-term mortality,
procedural mortality, hospital readmission, and complications including
acute MI, stroke, major bleeding, vascular complications, acute kidney
injury, and new pacemaker implantation. We carried out a
meta-meta-analysis by obtaining pooled odds ratio, 95% CI using random
effect models. We found out that there was a significantly low risk of
30-day mortality (pooled OR:0.60; 95%CI:0.53-0.68; p < 0.00001) with no
heterogeneity (p = 0.53; I² = 0%) with ViV-TAVR vs rSAVR. Also,
there was a reduced risk of procedural mortality (pooled OR:0.52;
95%CI:0.27-0.98; p = 0.04) with 0% heterogeneity with ViV-TAVR vs rSAVR.
ViV-TAVI is associated with significantly reduced risk of 30-day mortality
compared to rSAVR. Our meta-meta-analysis reinforces the safety and
efficacy of ViV-TAVR as the procedure of choice for failed bioprosthetic
(BP) valves in high-risk candidates.<br/>Copyright &#xa9; 2022, The
Author(s), under exclusive licence to Springer Nature Switzerland AG.

<81>
Accession Number
2013908612
Title
The Effect of N-acetyl Cysteine Injection on Liver Function After On-Pump
Coronary Artery Bypass Graft Surgery: a Randomized Clinical Trial.
Source
SN Comprehensive Clinical Medicine. 3(12) (pp 2533-2539), 2021. Date of
Publication: 01 Dec 2021.
Author
Javaherforooshzadeh F.; Abbasi Hormozi P.; Akhondzadeh R.; Olapour A.;
Hashemi S.J.
Institution
(Javaherforooshzadeh, Abbasi Hormozi, Akhondzadeh, Olapour, Hashemi)
Department of Anesthesia, Ahvaz Anesthesiology and Pain Research Center,
Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, Islamic
Republic of
(Javaherforooshzadeh) Imam Khomeini Hospital, Azadegan Street, P.O. Box:
6155979939, Ahvaz, Iran, Islamic Republic of
Publisher
Springer Nature
Abstract
Somebody's organ dysfunctions are associated with the cardiopulmonary
bypass in open-heart surgery such as liver dysfunction. This study aimed
at the impact of the N-acetyl cysteine for improvement of liver function
subsequently on-pump coronary artery bypass graft. Following a clinical
trial design, 60 candidates of on-pump CABG, age 30 to 70 years, normal
liver function, and normal renal function were selected. The candidates
were randomly divided into intervention: IV100 mg/kg N-acetyl cysteine in
three doses (2 intraoperative and 1 postoperative) over 24 h, and control
groups (normal saline as placebo) (n = 30 in each group). The main
outcomes were serum alkaline phosphatase, aspartate aminotransferase,
alanine aminotransferase, bilirubin, partial thromboplastin time, and the
international normalized ratio at first and second postoperative day after
surgery. Secondary outcomes were the hemodynamic variables and blood
product transfusion. There were significant differences in ALP (P <
0.001), AST (P = 0.02), ALT (P < 0.001), bilirubin (P = 0.01), PTT (P <
0.001), and INR (P = 0.005) levels between the two groups at the first day
after surgery. There were significant differences in ALP (P = 0.002), AST
(P < 0.001), ALT (P = 0.001), and bilirubin (P = 0.004) levels between the
two groups on the second day after surgery. These levels were
significantly lower in the N-acetyl cysteine group. Significant
differences were observed between the two groups in terms of MAP levels on
the first day (P = 0.002) and the second day after surgery (P < 0/001).
There was a significant difference between the two groups in terms of
packed cell (P = 0.002) and FFP (P < 0.001) transfusion. Based on the
findings, intravenous administration of N-acetyl cysteine in patients with
CABG significantly may be preserved liver function. Registered under No.
Trial registration number IRCT20190506043492N2, date of registration:
2020.05.23. Retrospectively registered.<br/>Copyright &#xa9; 2021, The
Author(s), under exclusive licence to Springer Nature Switzerland AG.

<82>
Accession Number
2035959602
Title
Safety of pericardiocentesis in pulmonary arterial hypertension: a
systematic review.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1610419. Date of Publication: 2025.
Author
Cabada-Garcia M.J.; Rodriguez-Rivera J.; Jerjes-Sanchez C.; Castillo-Perez
M.; Gutierrez-Gallegos P.; Martinez-Rodriguez A.L.; Paredes-Gutierrez E.;
Quevedo-Salazar R.C.; De Leon-Gutierrez H.; Lopez-Cortes O.D.; Panneflek
J.; Monjaras-Alvarado R.; Moron-Mosso J.A.; Gonzalez-Medina J.G.
Institution
(Cabada-Garcia, Rodriguez-Rivera, Jerjes-Sanchez, Castillo-Perez,
Gutierrez-Gallegos, Martinez-Rodriguez, Paredes-Gutierrez,
Quevedo-Salazar, De Leon-Gutierrez, Lopez-Cortes, Panneflek,
Monjaras-Alvarado, Moron-Mosso, Gonzalez-Medina) Tecnologico de Monterrey,
Escuela de Medicina y Ciencias de la Salud, Nuevo Leon, Monterrey, Mexico
(Cabada-Garcia) Fellow of the General Directorate of Quality and Health
Education, Ministry of Health, Mexico City, Mexico
(Jerjes-Sanchez, Panneflek) Instituto de Cardiologia y Medicina Vascular,
TecSalud, Escuela de Medicina y Ciencias de la Salud, Tecnologico de
Monterrey, Nuevo Leon, San Pedro Garza Garcia, Mexico
Publisher
Frontiers Media SA
Abstract
Introduction: Controversy persists regarding the use of pericardial
effusion drainage in patients with pulmonary arterial hypertension (PAH),
as several studies report high rates of post-procedure morbidity and
mortality. <br/>Method(s): We conducted a systematic review to evaluate
the safety of pericardiocentesis (PC) in patients with PAH and a large or
hemodynamically significant pericardial effusion. We focused on studies
involving patients with PAH who presented with a large or hemodynamically
significant pericardial effusion and underwent PH. Our primary objective
was to evaluate the incidence of major periprocedural complications, and
our secondary objectives were to identify the clinical presentation and
echocardiographic findings. <br/>Result(s): We identified 35 patients
across 16 studies. Connective tissue disease was the most common etiology
of PAH. Drainage strategies during PC differed across studies. The overall
mortality rate was 20%, and we identified pericardial decompression
syndrome in 14% of patients. Dyspnea and peripheral edema dominated the
clinical presentation. Echocardiographic findings of cardiac tamponade,
particularly left-sided chamber collapse, appeared more frequently.
<br/>Discussion(s): PC in patients with PAH carries a heightened risk of
pericardial decompression syndrome and mortality. However, careful patient
selection, echocardiographic guidance, gradual decompression, and
continuous hemodynamic monitoring during the procedure may help improve
outcomes. Systematic Review Registration: PROSPERO 585310.<br/>Copyright
2025 Cabada-Garcia, Rodriguez-Rivera, Jerjes-Sanchez, Castillo-Perez,
Gutierrez-Gallegos, Martinez-Rodriguez, Paredes-Gutierrez,
Quevedo-Salazar, De Leon-Gutierrez, Lopez-Cortes, Panneflek,
Monjaras-Alvarado, Moron-Mosso and Gonzalez-Medina.

<83>
Accession Number
2036031767
Title
Robotic surgery in healthcare: current challenges, technological advances,
and global implementation prospects.
Source
Journal of Robotic Surgery. 19(1) (no pagination), 2025. Article Number:
577. Date of Publication: 01 Dec 2025.
Author
Olawade D.B.; Marinze S.; Weerasinghe K.; Egbon E.; Onuoha J.U.; Teke J.
Institution
(Olawade) Department of Allied and Public Health, School of Health, Sport
and Bioscience, University of East London, London, United Kingdom
(Olawade, Weerasinghe, Teke) Department of Research and Innovation, Medway
NHS Foundation Trust, Gillingham, United Kingdom
(Olawade) Department of Public Health, York St John University, London,
United Kingdom
(Olawade) School of Health and Care Management, Arden University, Arden
House, Middlemarch Park, Coventry, United Kingdom
(Marinze) Department of Surgery, Medway NHS Foundation Trust, Gillingham,
United Kingdom
(Egbon) Department of Tissue Engineering and Regenerative Medicine,
Faculty of Life Science Engineering, FH Technikum, Vienna, Austria
(Onuoha) Endoscopy Unit, Medway NHS Foundation Trust, Gillingham, United
Kingdom
(Teke) Faculty of Medicine, Health and Social Care, Canterbury Christ
Church University, Canterbury, United Kingdom
Publisher
Springer Nature
Abstract
Robotic surgery has transformed the field of surgery, offering enhanced
precision, minimal invasiveness, and improved patient outcomes. This
narrative review explores the multifaceted aspects of robotic surgery,
examining the challenges, recent advances, and future prospects for its
integration into healthcare. Our comprehensive analysis of 48 studies
reveals significant geographic disparities in robotic surgery research and
implementation, with 68.8% of studies originating from high-income
countries. Despite its potential, the widespread adoption of robotic
surgery faces significant obstacles, including high costs, training
requirements, limited accessibility, and ethical considerations. Financial
constraints make it difficult for resource-limited healthcare facilities
to afford these systems, whilst the absence of standardised training
restricts the pool of proficient robotic surgeons. Furthermore, ethical
and medico-legal concerns about liability and patient consent complicate
its adoption. Advances in artificial intelligence (AI) and machine
learning (ML) are enhancing robotic systems with real-time decision
support and personalised surgical approaches. In addition, telemedicine
and remote robotic surgery show promise for expanding access to
underserved areas. Looking forward, the development of affordable,
portable robotic systems and integration of data-driven analytics are key
to addressing current challenges and optimising patient care. This review
provides a globally minded analysis of implementation barriers and
identifies critical needs for more inclusive research and culturally
appropriate solutions for diverse healthcare contexts. A multi-stakeholder
approach involving policymakers, healthcare providers, and technology
companies is crucial for overcoming these barriers and realising robotic
surgery's full potential. As solutions to cost, training, and
accessibility emerge, robotic surgery is expected to become a fundamental
component of healthcare, offering substantial improvements in patient
outcomes and operational efficiency.<br/>Copyright &#xa9; The Author(s),
under exclusive licence to Springer-Verlag London Ltd., part of Springer
Nature 2025.

<84>
[Use Link to view the full text]
Accession Number
2039762965
Title
Randomized Controlled: Trial of New Oral Anticoagulants Versus Warfarin
for Postcardiac Surgery Atrial Fibrillation The NEW-AF Trial.
Source
Annals of Surgery. 282(4) (pp 630-638), 2025. Date of Publication: 01 Oct
2025.
Author
Moonsamy P.; Zhao Y.; Makarem A.; Paneitz D.C.; Wolfe S.; Turco I.; Colon
K.M.; Ethridge B.R.; Li S.S.; Leya G.; Verma S.; D'Alessandro D.A.; Jassar
A.S.; Langer N.B.; Tolis G.; Villavicencio M.A.; Melnitchouk S.I.; Bloom
J.P.; Michel E.; Kreso A.; Rabi S.A.; Akeju O.; Sundt T.M.; Osho A.A.
Institution
(Moonsamy, Zhao, Makarem, Paneitz, Wolfe, Turco, Colon, Ethridge, Li,
Leya, Verma, D'Alessandro, Jassar, Langer, Tolis, Villavicencio,
Melnitchouk, Bloom, Michel, Kreso, Rabi, Sundt, Osho) Division of Cardiac
Surgery, Department of Surgery, Massachusetts General Hospital, Boston,
MA, United States
(Akeju) Department of Anesthesia, Critical Care and Pain Medicine,
Massachusetts General Hospital, Boston, MA, United States
Publisher
Wolters Kluwer Health
Abstract
Objective: To determine whether anticoagulation for new onset atrial
fibrillation (AF) with rivaroxaban decreases length of stay compared with
warfarin. Summary of Background Data: Direct Oral Anticoagulants (DOACs)
have been shown to be noninferior to warfarin for stroke prevention in
nonsurgical patients with atrial fibrillation. There are no published
randomized trials comparing DOACs to warfarin in cardiac surgery patients,
and DOACs are yet to be widely adopted in this population. <br/>Method(s):
In a pragmatic, prospective, clinical trial, 100 patients with new-onset
AF after cardiac surgery were randomized to receive rivaroxaban (n = 50)
or warfarin (n = 50). Patients were followed for 30 days postdischarge,
with patient-reported outcomes assessed 2 weeks after discharge using the
Perception of Anticoagulant Treatment Questionnaire and the EuroQol-5D-3L
survey. <br/>Result(s): The primary endpoint, length of stay (LOS) from
day of surgery to discharge (days, IQR), was 7 (6-9) for rivaroxaban and 8
(6-9) for warfarin (P = 0.460). LOS from initiation of anticoagulation to
discharge was 2 (1-4) days for rivaroxaban and 2 (1-3) days for warfarin
(P = 0.738). The mean INR at discharge in the warfarin group was 1.68 (SD
0.5). No major bleeding events, strokes, or other arterial thromboembolism
events occurred in either group. Minor bleeding events were reported in
3/50 (6%) patients in the rivaroxaban group versus 1/50 (2%) in the
warfarin group (P = 0.617), none of which required blood transfusion. One
patient (2%) in the rivaroxaban group developed a pericardial effusion
requiring drainage, compared with none in the warfarin group (P = 1.000).
Patients taking rivaroxaban reported significantly higher scores for
convenience (P < 0.001) and better overall perception of their
anticoagulation experience (P = 0.006), though both groups reported
similar treatment satisfaction (P = 0.494). Mobility issues were reported
by 42.2% of patients taking rivaroxaban compared with 18.6% of those
taking warfarin (P = 0.021). All outcomes were consistent in both the
intention-to-treat and as-treated populations. <br/>Conclusion(s):
Treatment with rivaroxaban in new-onset atrial fibrillation after cardiac
surgery did not decrease length of stay compared with warfarin. However,
patients treated with rivaroxaban reported significantly better
convenience and a more favorable overall perception of their
anticoagulation experience compared with warfarin. Given similar safety
profiles, these findings support incorporating rivaroxaban as an option
for shared decision-making when selecting anticoagulation therapy for this
patient population.<br/>Copyright &#xa9; 2025 Wolters Kluwer Health, Inc.
All rights reserved.

<85>
Accession Number
2040325760
Title
Echocardiographic predictors of right ventricular failure following left
ventricular assist device implantation: Systematic review and
meta-analysis.
Source
Global Cardiology Science and Practice. (4) (no pagination), 2025. Article
Number: 35. Date of Publication: 2025.
Author
Rajendra S.; Salmasi Y.; Khoshbin E.
Institution
(Rajendra, Salmasi, Khoshbin) National Heart & Lung Institute, Imperial
College, London, United Kingdom
(Salmasi, Khoshbin) Harefield Hospital, Royal Brompton, and Harefield as
part of Guys and St Thomas NHS Trust, London, United Kingdom
Publisher
HBKU Press
Abstract
Background: Right ventricular failure (RVF) is a significant complication
following left ventricular assist device (LVAD) implantation, with no
universally accepted predictors. This meta-analysis identifies the most
reliable echocardiographic predictors. <br/>Method(s): OVID Medline was
systematically searched for observational studies reporting ten
preoperative echocardiographic parameters in patients who did and did not
develop RVF post-LVAD. Random-effects meta-analyses were performed.
Subgroup analyses and meta-regression assessed the influence of RVF
definitions and clinical characteristics on predictive capacity. Logistic
regression modeling identified key cutoffs. <br/>Result(s): Thirty-nine
studies involving 2,975 patients were included, with pooled RVF prevalence
of 0.30 (0.26-0.34). Higher right ventricular end-diastolic diameter
(RVEDD) (SMD: 0.368, p<0.0001, I^2: 1.73%) and less negative
right ventricular free wall strain (RVFWS) (SMD: 0.931, p<0.0001,
I^2: 82.9%) were significant predictors. Higher right
ventricular end-diastolic area (RVEDA) was also reliable but weaker (SMD:
0.224, p=0.0282, I^2: 0.00%). Lower tricuspid annular plane
systolic excursion (TAPSE) was a strong predictor (SMD: -0.512, p<0.0001,)
but less reliable due to high heterogeneity (I^2: 86.1%).
Subgroup analyses of TAPSE by RVF definition showed modestly reduced
heterogeneity (43.7%). Predictive capacity was significantly better in
more stable patients (i.e., no inotropes/IABP, higher INTERMACS status).
Logistic regression identified increased RVF risk at RVEDD >=41.5 mm
(sensitivity: 50.0%, specificity: 83.3%) and RVFWS >=- 11.3% (sensitivity:
88.9%, specificity: 88.9%). <br/>Conclusion(s): RVEDD >=41.5 mm and RVFWS
>=-11.3% are the strongest, most reliable predictors of RVF post-LVAD.
Variations in RVF endpoint definitions only partially explain the observed
heterogeneity, while patient characteristics significantly influence
predictive accuracy. Future studies should explore subgroup-specific
cutoffs.<br/>Copyright &#xa9; 2025 HBKU Press. All rights reserved.

<86>
Accession Number
2040577492
Title
Hypoxia Following Mitral Transcatheter Edge-to-Edge Repair: Iatrogenic
Fistula.
Source
JACC: Case Reports. 30(30) (no pagination), 2025. Article Number: 105305.
Date of Publication: 01 Oct 2025.
Author
Almoosa F.J.; Elsmaan M.A.; Rigby M.L.; Mirsadraee S.; Vazir A.H.
Institution
(Almoosa, Elsmaan, Rigby, Mirsadraee, Vazir) Royal Brompton and Harefield
Hospitals, Guys' & St Thomas NHS Trust, London, United Kingdom
(Mirsadraee, Vazir) National Heart & Lung Institute, Imperial College
London, London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Mitral regurgitation (MR) is a common disorder associated with
increased risk of morbidity and mortality. Transcatheter edge-to-edge
repair (TEER) is a minimally invasive option that is increasingly used in
the management of this condition. Randomized controlled trials have
concluded that TEER is safe and effective in reducing secondary MR. Case
Summary: An 81-year-old woman underwent mitral TEER for severe secondary
MR. She suffered from ongoing hypoxia postprocedure because of an
iatrogenic fistula between the right main pulmonary artery and left atrium
with right to left shunt. <br/>Discussion(s): This case represents a
unique and rare complication of mitral TEER. Take-Home Messages: Rare but
life-threatening complications of mitral TEER should be recognized in a
timely manner. Finally, clinicians should consider filter-based cerebral
protection system during TEER; however, further studies on its utility are
warranted.<br/>Copyright &#xa9; 2025 The Authors

<87>
Accession Number
648599365
Title
VARC-HBR criteria validation in TAVI patients on oral anticoagulation.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
21(18) (pp e1081-e1089), 2025. Date of Publication: 15 Sep 2025.
Author
Overduin D.C.; van Ginkel D.J.; Bor W.L.; Kobari Y.; Aarts H.M.; Dubois
C.; De Backer O.; Rooijakkers M.J.P.; Rosseel L.; Veenstra L.; van der
Kley F.; van Bergeijk K.H.; van Mieghem N.M.; Agostoni P.; Voskuil M.;
Schotborgh C.E.; Ijsselmuiden A.J.J.; Van Heyden J.A.S.; Hermanides R.S.;
Barbato E.; Mylotte D.; Fabris E.; Frambach P.; Dujardin K.; Ferdinande
B.; Peper J.; Rensing B.J.W.M.; Timmers L.; Swaans M.J.; Brouwer J.;
Nijenhuis V.J.; Adriaenssens T.; Vriesendorp P.A.; Montero-Cabezas J.M.;
Jattari H.E.; Halim J.; Van den Branden B.J.L.; Leonora R.; Vanderheyden
M.; Lauterbach M.; Wykrzykowska J.J.; van 't Hof A.W.J.; van Royen N.;
Tijssen J.G.P.; Delewi R.; Ten Berg J.M.
Institution
(Overduin, van Ginkel, Bor, Peper, Rensing, Timmers, Swaans, Brouwer,
Nijenhuis, Ten Berg) Department of Cardiology, St. Antonius Hospital,
Nieuwegein, Netherlands
(Kobari, De Backer) Heart Center, Rigshospitalet, Copenhagen University
Hospital, Copenhagen, Denmark
(Aarts, Tijssen, Delewi) Department of Cardiology, Amsterdam, Netherlands
(Aarts, Voskuil) Department of Cardiology, University Medical Center
Utrecht, Utrecht, Netherlands
(Dubois, Adriaenssens) Department of Cardiovascular Medicine, University
Hospital Leuven, Leuven, Belgium
(Rooijakkers, Nijenhuis, van Royen) Department of Cardiology, Radboud
University Medical Center, Nijmegen, Netherlands
(Rosseel, Vanderheyden) Department of Cardiology, Aalst, Belgium
(Veenstra, Ijsselmuiden, Vriesendorp, van 't Hof, Ten Berg) Department of
Cardiology, Maastricht University Medical Center, Maastricht, Netherlands
(Veenstra, Ijsselmuiden, Vriesendorp, van 't Hof, Ten Berg) Cardiovascular
Research Institute Maastricht (CARIM), Maastricht, Netherlands
(van der Kley, Montero-Cabezas) Department of Cardiology, Leiden
University Medical Center, Leiden, Netherlands
(van Bergeijk, Wykrzykowska) Department of Cardiology, University Medical
Center Groningen, Groningen, Netherlands
(van Mieghem) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
(Agostoni, Jattari) Department of Cardiology, Hospital Aan de Stroom (ZAS)
Middelheim, Antwerp, Belgium
(Schotborgh) Department of Cardiology, Haga Hospital, The Hague,
Netherlands
(Van Heyden) Department of Cardiology, Sint-Jan Hospital, Brugge, Belgium
(Hermanides, Leonora) Department of Cardiology, Isala Hospital, Zwolle,
Netherlands
(Barbato) Department of Clinical and Molecular Medicine, Sapienza
University of Rome, Rome, Italy
(Barbato) Department of Cardiology, Sant'Andrea University Hospital, Rome,
Italy
(Mylotte) Department of Cardiology, University Hospital Galway, Galway,
Ireland
(Fabris) Cardiothoracovascular Department, University of Trieste, Trieste,
Italy
(Frambach) Department of Cardiology, Institut National de Chirurgie
Cardiaque et de Cardiologie Interventionnelle, Luxembourg
(Dujardin, Lauterbach) Department of Cardiology, AZ Delta, Roeselare,
Belgium
(Ferdinande) Department of Cardiology, Hospital Oost-Limburg, Genk,
Belgium
(Halim) Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg,
Netherlands
(Van den Branden) Department of Cardiology, Amphia Hospital, Breda,
Netherlands
Abstract
BACKGROUND: Bleeding remains a frequent complication after transcatheter
aortic valve implantation (TAVI). Recently, the Valve Academic Research
Consortium High Bleeding Risk (VARC-HBR) criteria were introduced to
identify patients at (very) high risk of bleeding. AIMS: This study aimed
to evaluate the validity of the VARC-HBR criteria for predicting bleeding
risk in TAVI patients and to compare its performance with other existing
criteria. <br/>METHOD(S): Data were obtained from the POPular PAUSE TAVI
trial, a randomised clinical trial that evaluated the safety and efficacy
of continuation versus interruption of oral anticoagulation during TAVI.
Major and minor bleeding risk criteria were identified at baseline, and
bleeding events were recorded up to 30 days after TAVI. Patients were
classified into three groups: those with <=1 minor criterion (moderate
risk), those with 1 major or 2 minor criteria (high risk), and those with
>=2 major or >=3 minor criteria (very high risk). <br/>RESULT(S): A total
of 856 patients were included: 332 (39%) were classified at moderate
bleeding risk, 337 (39%) at high bleeding risk, and 187 (22%) at very high
bleeding risk. Major bleeding occurred in 4.2% of moderate-risk patients,
9.5% in the high-risk group, and 15.0% in the very high-risk group
(p<0.001). Receiver operating characteristic analysis showed moderate
discriminative performance (area under the curve=0.64, 95% confidence
interval: 0.58-0.70). Despite higher-than-expected event rates, the
VARC-HBR criteria demonstrated good calibration with observed outcomes.
<br/>CONCLUSION(S): The VARC-HBR criteria effectively identified distinct
subgroups with a stepwise increase in major bleeding post-TAVI. However,
their predictive performance for individual risk was moderate.

<88>
Accession Number
648591711
Title
BSCI/BSCCT Annual Meeting 2025.
Source
Heart. Conference: British Society of Cardiovascular Imaging - British
Society of Cardiac Computed Tomography Annual Meeting. Leicester United
Kingdom. 111(Supplement 1) (no pagination), 2025. Date of Publication: 01
Apr 2025.
Author
Anonymous
Publisher
BMJ Publishing Group
Abstract
The proceedings contain 22 papers. The topics discussed include:
correlation between trabecular attenuation, coronary artery calcium score,
and aortic valve calcium score in TAVI patients: a retrospective analysis;
a fully automated predictive model for diagnosing pulmonary hypertension
and left heart disease on routine unenhanced CT; 5 year data review of the
evolution of CTCA dose reduction and image quality within a single trust
across the transition from legacy helical scanners to volume acquisition;
advancements in cardiac structures segmentation: a comprehensive
systematic review of deep learning in CT imaging; AI-enabled CCTA plaque
quantification and the prediction of cardiovascular outcomes; assessing
the role of PET-CT in diagnosing cardiac sarcoid: a retrospective review
of referral pathways and diagnostic outcomes in a newly established
tertiary center service; and complementary diagnostic and prognostic role
of cardiac CT in surgically proven prosthetic valve endocarditis.

<89>
Accession Number
648594212
Title
Autograft Reinforcement in the Ross Procedure: A Systematic Review and
Patient-level Meta-Analysis.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2025. Date of Publication: 13 Sep 2025.
Author
Mylonas K.S.; Zoupas I.; Sarantou S.; Kourampi I.; Meintanopoulos A.S.;
Iliopoulos D.C.; Stavridis G.T.; Avgerinos D.V.; LaPar D.J.
Institution
(Mylonas, Stavridis, Avgerinos) Department of Cardiac Surgery, Onassis
Cardiac Surgery Center, Athens, Greece
(Zoupas) Cardiothoracic and Vascular Surgery Working Group, Society of
Junior Doctors, Athens, Greece; 4th Department of Cardiac Surgery, Hygeia
Hospital, Athens, Greece; Department of Pediatric and Congenital Heart
Surgery, Children's Heart Institute, Memorial Hermann Children's Hospital,
University of Texas Health Science Center at Houston, McGovern Medical
School, Houston, TX, USA
(Sarantou, Kourampi) Cardiothoracic and Vascular Surgery Working Group,
Society of Junior Doctors, Athens, Greece
(Meintanopoulos) Cardiothoracic and Vascular Surgery Working Group,
Society of Junior Doctors, Athens, Greece; Global Health - Disaster
Medicine, National and Kapodistrian University of Athens, Greece
(Iliopoulos) 4th Department of Cardiac Surgery, Hygeia Hospital, Athens,
Greece; Department of Cardiovascular Surgery, University of Texas Health
Science Center at Houston, McGovern Medical School, Houston, TX, USA;
Division of Cardiac Surgery, National and Kapodistrian University of
Athens, Greece
(LaPar) Department of Pediatric and Congenital Heart Surgery, Children's
Heart Institute, Memorial Hermann Children's Hospital, University of Texas
Health Science Center at Houston, McGovern Medical School, Houston, TX,
United States
Abstract
BACKGROUND: The Ross procedure is a well-established option for aortic
valve replacement, although progressive autograft dilation remains a
significant long-term complication. While several reinforcement techniques
have been proposed to address this issue, their effectiveness has yet to
be rigorously evaluated. <br/>METHOD(S): A PRISMA-compliant search was
conducted for studies involving reinforced (RR) and non-reinforced (NR)
Ross procedures. Meta-analysis with individual patient data (IPD) assessed
survival and freedom-from-autograft reoperation rates. Subgroup analyses
were conducted for the various reinforcement methods. <br/>RESULT(S):
Sixteen cohort studies comprising 2,514 reinforced Ross (RR) and 595
non-reinforced (NR) patients were included. Pre- and peri-operative
characteristics were comparable between groups. Individual patient data
analysis of comparative studies demonstrated superior survival in the RR
group, with 5-, 10-, and 15-year survival rates of 100%, 98.8%, and 98.8%,
respectively, compared to 95.0%, 93.7%, and 82.6% in the NR group (HR:
11.9, p=0.016). Similarly, freedom from autograft reoperation at 5, 10,
and 15 years was 96.4%, 94.2%, and 86.6% in the RR group versus 95.8%,
87.6%, and 77.7% in the NR group (HR: 2.06, p<0.001). Subgroup analysis
showed comparable outcomes across different reinforcement techniques.
<br/>CONCLUSION(S): Reinforced Ross procedures are associated with
improved survival and freedom-from-autograft reoperation rates compared to
unsupported pulmonary autografts.<br/>Copyright &#xa9; 2025. Published by
Elsevier Inc.

<90>
Accession Number
2040584638
Title
TIVA vs Volatile Anesthesia in CABG Surgery: Effects on Inflammatory and
Cognitive Outcomes.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Garg V.; Patel G.; Mandal B.; Kahlon S.; Puri G.D.; Kst S.; Rawat A.
Institution
(Garg, Patel, Mandal, Kahlon, Puri) Department of Anesthesia and Intensive
Care, Postgraduate Institute of Medical Education and Research (PGIMER),
Chandigarh, India
(Kst) Department of Cardiovascular and Thoracic Surgery, Postgraduate
Institute of Medical Education and Research (PGIMER), Chandigarh, India
(Rawat) Pediatric Allergy and Immunology Unit, Postgraduate Institute of
Medical Education and Research (PGIMER), Chandigarh, India
Publisher
W.B. Saunders
Abstract
Objectives: To compare the perioperative inflammatory response and early
neurocognitive outcomes in adult patients undergoing elective coronary
artery bypass grafting (CABG) under total intravenous anesthesia (TIVA)
versus volatile anesthesia. <br/>Design(s): Prospective, randomized
controlled trial. <br/>Setting(s): A tertiary care academic medical
center. <br/>Participant(s): Fifty adult patients aged 18 to 65 years
scheduled for elective on-pump CABG surgery. <br/>Intervention(s):
Patients were randomized to receive either propofol-based TIVA (Group P)
or sevoflurane-based volatile anesthesia (group S). Standardized surgical
and cardiopulmonary bypass protocols were followed in all patients.
<br/>Measurements and Main Results: Serum interleukin-6 (IL-6) levels were
measured preoperatively and at 24 and 48 hours postoperatively. Secondary
outcomes included Mini-Mental State Examination scores, ventilation
duration, vasoactive-inotropic score, renal function, and intensive care
unit stay. IL-6 levels had increased significantly at 24 hours and
decreased by 48 hours in both groups, with no significant intergroup
difference at any time point. Mini-Mental State Examination scores at 24
and 48 hours were significantly higher in the TIVA group. TIVA was also
associated with shorter mechanical ventilation duration. VIS, cardiac
function, renal parameters, and intensive care unit stay duration were
comparable between groups. <br/>Conclusion(s): TIVA and volatile
anesthesia resulted in similar perioperative IL-6 responses in patients
undergoing CABG. However, TIVA was associated with better early
postoperative cognitive function and faster emergence from mechanical
ventilation. These findings suggest a potential neurocognitive benefit of
TIVA in this surgical population.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<91>
Accession Number
648594160
Title
FIGHTING OVERUSE OF CARDIAC CATHETERIZATION BY INTRODUCING CT-ANGIOGRAPHY
- WILL IT WORK (THIS TIME)? - INTERNATIONAL PERSPECTIVES AND CASE STUDY
FROM GERMANY.
Source
BMJ Evidence-Based Medicine. Conference: Preventing Overdiagnosis
Conference, 2025. Oxford United Kingdom. 30(Supplement 1) (pp A21-A22),
2025. Date of Publication: 01 Sep 2025.
Author
Storz-Pfennig P.; Dettloff M.; Kuhnt F.
Institution
(Storz-Pfennig, Dettloff, Kuhnt) GKV-Spitzenverband, Berlin, Germany
Publisher
BMJ Publishing Group
Abstract
The overutilization of many invasive procedures in Germany, compared to
many, if not most, healthcare systems of highincome countries, is well
known and well documented. Cardiac catheterization has long been a
prominent example of such an overuse of an invasive diagnostic procedure.
Although this has been well known for a long time in medical and health
policy circles, no measures have been devised or, at least, none had been
effective in Germany up to the present. In the post-pandemic healthcare
systems, however, it is becoming clear that 'business as usual' will not
be sustainable due to increasing resource constraints and cannot continue
indefinitely. The recent, internationally somewhat late, introduction of
coronary CT in Germany into the general benefits catalogue of statutory
health insurance, based on a thorough evidence review, serves as a
starting point to address the problem. Will it achieve its aims in
substituting and thus reducing the number of cardiac catheterizations? -
Initially (1.) an overview of utilization figures of diagnostic coronary
heart procedures in Germany and internationally, and data on the
heterogenous effects the introduction of coronary CT might have caused in
different countries (e.g. Denmark, United Kingdom) will give some
insights. It will show the international nature of the problem, and that
success in catheterization reduction might not be guaranteed. (2.)
Feasible policy approaches, some of which are being implemented in Germany
(e.g. evidence-based knowledge application/shared decision making, 'heart
teams', mandatory care pathways, reimbursement rules) will briefly be
described using the case study, and their potential efficacy discussed.
Based on this, we further suggest to discuss, maybe extended beyond
diagnostic heart interventions, (a) why so many diagnostic interventions
do facilitate overuse, as they are mostly non-exclusive (one can usually
consider alternative or additional tests or images); why (b) the
substitution of existing diagnostic approaches might fail - and how
appropriate research and technology assessment methods (e.g. looking at
entire pathways instead of single technologies) may contribute to success;
and (c) which clinical and health system policy options may be most
promising to address diagnostics overuse, and - assuming that single
approaches may not be sufficiently effective on their own - which systemic
policy approaches could be most effective in implementing appropriate
health care.

<92>
Accession Number
2040556106
Title
Impact of postoperative atrial fibrillation (POAF) on outcomes after
coronary artery bypass grafting: A meta-analysis of unique 247,270
patients from 50 studies.
Source
American Heart Journal Plus: Cardiology Research and Practice. 59 (no
pagination), 2025. Article Number: 100621. Date of Publication: 01 Nov
2025.
Author
Awad A.K.; Elbahloul M.A.; Al-omoush O.; Abdelnasser O.; Hajali M.;
Abdelnasser A.; Saleh O.; Altiti A.; Elgharably H.; El Diasty M.
Institution
(Awad, Abdelnasser) Faculty of Medicine, Ain-Shams University, Cairo,
Egypt
(Elbahloul) Faculty of Medicine, Kafr El-Shaikh University, Kafr
El-Shaikh, Egypt
(Al-omoush) Internal Medicine and Family Medicine Department, The
Hashemite University, Zarqa, Jordan
(Hajali, Saleh, Altiti) Faculty of Medicine, The Hashemite University,
Zarqa, Jordan
(Abdelnasser) Faculty of Medicine, Helwan University, Cairo, Egypt
(Elgharably) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(El Diasty) Department of Biomedical and Molecular Sciences, Queen's
University, Kingston, Canada
(El Diasty) Division of Cardiac Surgery, University Hospitals Cleveland
Medical Centre, Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Background: Postoperative atrial fibrillation (POAF) can occur in up to
53.1 % of patients undergoing cardiac surgery. This serious condition has
been associated with increased risk of morbidity and mortality during the
initial weeks after the procedure. In this updated meta-analysis, we aim
to study the impact of POAF on outcomes in patients undergoing CABG
surgery. <br/>Method(s): We searched PubMed, Scopus, Cochrane Library, and
WOS from inception till April 15, 2024. The pooled effect sizes were mean
difference (MD) for continuous outcomes and odds ratio (OR) for
dichotomous outcomes and a 95 % confidence interval (CI). <br/>Result(s):
A total of 247,270 patients from 50 studies were included. Mean age ranged
between 56.5 and 76 years and mean follow-up time duration ranged from six
months to 15 years. In-hospital, 30-days, and long-term mortality were
significantly higher in patients with POAF compared to patients without
POAF with (OR: 2.37; 95 % CI: 1.45-3.87; P = 0.0033), (OR: 2.33; 95 % CI:
1.74-3.13; P < 0.01), and (OR: 2.15; 95 % CI: 1.8-2.54; P <
0.01respectively. In terms of stroke, both short- and long-term strokes
were significantly higher in patients with POAF with (OR: 2.54; 95 % CI:
2.05-3.15; P < 0.01) and (OR: 1.92; 95 % CI: 1.37-2.68; P < 0.0007),
respectively. Although POAF has significant longer hospital and intensive
care unit stay and higher risk for post-operative renal failure and
myocardial infarction, there was no significant difference in
revascularization and reintubation rates in patients with POAF with (OR:
1.11; 95 % CI: 0.48-2.54; P = 0.656) and (OR: 2.72; 95 % CI: 0.86-8.67; P
= 0.0742), respectively. The need for intra-aortic balloon pump was higher
in POAF group with (OR: 1.84; 95 % CI: 1.42-2.37; P < 0.01) as well as the
risk of developing heart failure with OR: 1.8; 95 % CI: 1.43-2.26; P =
0.0012. <br/>Conclusion(s): Our findings suggest that POAF group may be
associated with higher short-term mortality, long-term mortality, and
length of hospital and ICU stay in patients undergoing CABG. Furthermore,
there was a higher association between POAF and some postoperative
complications such as stroke, acute renal failure, acute heart failure,
and pneumonia. However, POAF did not seem to significantly affect rates of
acute MI and reintubation.<br/>Copyright &#xa9; 2025

<93>
Accession Number
2040487131
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
The Lancet. 406(10509) (pp 1223-1234), 2025. Date of Publication: 20 Sep
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, Teoh, Quan, Elituv, Misner, Yanagawa) Division of Cardiac Surgery,
St Michael's Hospital-Unity Health Toronto, Toronto, ON, Canada
(Leiter, Teoh) Division of Endocrinology and Metabolism, St Michael's
Hospital-Unity Health Toronto, Toronto, ON, Canada
(Mazer) Department of Anesthesia, St Michael's Hospital-Unity Health
Toronto, Toronto, ON, Canada
(Verma, Yanagawa) Department of Surgery, University of Toronto, Toronto,
ON, Canada
(Verma, Yanagawa, Mazer) Department of Pharmacology and Toxicology,
University of Toronto, Toronto, ON, Canada
(Leiter) Department of Medicine, University of Toronto, Toronto, ON,
Canada
(Leiter) Department of Nutritional Sciences, University of Toronto,
Toronto, ON, Canada
(Thorpe) Dalla Lana School of Public Health, University of Toronto,
Toronto, ON, Canada
(Mazer) Department of Anesthesiology and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Mazer) Department of Physiology, University of Toronto, Toronto, ON,
Canada
(Mancini) Division of Cardiology, Centre for Cardiovascular Innovation,
Dilawri Cardiovascular Institute, University of British Columbia,
Vancouver, BC, Canada
(Verma, Elituv) 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, United States
(Szarek) CPC Clinical Research, University of Colorado School of Medicine,
Aurora, CO, United States
(Szarek, Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Saha) Department of Anesthesiology and Perioperative Medicine, Kingston
Health Sciences Centre, Kingston, ON, Canada
(Saha) Department of Anesthesiology and Perioperative Medicine, Queen's
University, Kingston, ON, Canada
(Whitlock) Department of Surgery, McMaster University, Hamilton, ON,
Canada
(Whitlock) Department of Health Research Methodology, Evidence and Impact,
McMaster University, Hamilton, ON, Canada
(Whitlock) Perioperative and Surgery Research Program, Population Health
Research Institute, Hamilton, 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
Publisher
Elsevier B.V.
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. <br/>Finding(s): 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. <br/>Interpretation(s): 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.
<br/>Funding(s): Amgen Canada.<br/>Copyright &#xa9; 2025 Elsevier Ltd

<94>
Accession Number
2040490254
Title
Bentall Versus David Procedure for Aortic Root Replacement in Patients
With Bicuspid Aortic Valve: Systematic Review and Meta-Analysis Using
Reconstructed Time-to-Event Data.
Source
Heart Lung and Circulation. (no pagination), 2025. Date of Publication:
2025.
Author
Zoupas I.; Sarantopoulos A.; Schizas N.; Boultadakis E.; Koukis I.; Manna
I.; Iliopoulos D.C.
Institution
(Zoupas, Sarantopoulos, Schizas, Boultadakis, Koukis, Manna, Iliopoulos)
4^th Department of Cardiac Surgery, Hygeia Hospital, Athens,
Greece
(Sarantopoulos) Medical School, European University Cyprus, Nicosia,
Cyprus
(Iliopoulos) Department of Cardiac Surgery, Faculty of Medicine, National
and Kapodistrian University of Athens, Athens, Greece
(Iliopoulos) Department of Cardiothoracic and Vascular Surgery, UTHealth
Houston, Houston, TX, United States
Publisher
Elsevier Ltd
Abstract
Background: There is little evidence comparing the effectiveness of
valve-sparing aortic root replacement with the David procedure and
replacement with a composite graft (Bentall procedure) for patients with
bicuspid aortic valves (BAV). This systematic review and meta-analysis
compared the overall survival and the freedom from re-intervention in BAV
patients who underwent root replacement with either the David or Bentall
procedure. <br/>Method(s): Two databases were searched for studies
including BAV patients who underwent either the David or Bentall
operation. This review was performed in accordance with the
recommendations of the PRISMA (Preferred Reporting Items for Systematic
Reviews and Meta-analyses) statement. One-stage and two-stage
meta-analyses were conducted with Kaplan-Meier-derived individual patient
data and a random-effects model. <br/>Result(s): Thirteen studies were
included, providing data about 1,264 BAV patients who underwent a Bentall
procedure and 602 patients who underwent a David procedure. During a
follow-up period of 8 years, overall survival rates were significantly
improved in the David group compared with the Bentall group (hazard ratio
[HR] 0.19, 95% confidence interval [CI] 0.08-0.42; p<0.001). This was
confirmed by the two-stage meta-analysis (HR 0.22, 95% CI 0.09-0.55;
p=0.00, I²=0.00%). Regarding freedom from re-intervention,
splitting timepoint analysis revealed that no arm offered a statistically
significant advantage (HR 1.24, 95% CI 0.58-2.63; p=0.575). Finally, the
David operation was associated with fewer postoperative complications.
<br/>Conclusion(s): The David operation is associated with improved
survival and lower complication rates than the Bentall procedure for
patients with BAV. However, freedom from re-operation rates were
comparable between the two procedures.<br/>Copyright &#xa9; 2025
Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<95>
Accession Number
2036144045
Title
Predictors and Prognosis of Right Bundle Branch Block Following Heart
Transplantation: A Systematic Review and Meta-Analysis.
Source
Clinical Transplantation. 39(9) (no pagination), 2025. Article Number:
e70322. Date of Publication: 01 Sep 2025.
Author
Mostafa N.; Almaadawy O.; Elshahat A.; Dervis M.; Mohamed Hamed B.; Asad
A.; Zreigh S.; Soliman E.M.; Mostafa H.A.; Elbenawi H.; Ahmed M.
Institution
(Mostafa) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Almaadawy) Department of Internal Medicine, MedStar Health, Baltimore,
MD, United States
(Elshahat, Mohamed Hamed, Mostafa) Faculty of Medicine, Al-Azhar
University, Cairo, Egypt
(Dervis, Asad, Zreigh) Faculty of Medicine, Ankara Yilidirim Beyazit
University, Ankara, Turkey
(Soliman) Faculty of Medicine, Zagazig University, Zagazig, Egypt
(Elbenawi) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Ahmed) Department of Cardiovascular Medicine, University of Florida,
Gainesville, FL, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Right bundle branch block (RBBB) has a high prevalence among
heart transplant recipients and could influence outcomes. Crucially, the
predictors of RBBB development after heart transplantation are not
well-established. Our study aims to evaluate the preoperative predictors
and outcomes of RBBB following heart transplantation. <br/>Method(s):
PubMed, Scopus, Web of Science, and Cochrane Library were searched up to
November 15, 2024, to identify studies comparing heart transplant
recipients with RBBB and without RBBB. Random-effects models were used to
estimate the pooled mean difference (MD) and risk ratios (RRs) with 95%
confidence intervals (95% CIs). <br/>Result(s): Nine studies incorporating
1507 patients were included. Patients who developed RBBB had higher graft
ischemia time [MD: 10.0; 95% CI: 2.00-17.91; p = 0.01] and pulmonary
vascular resistance (PVR) (MD: 0.44; 95% CI: 0.21-0.68; p < 0.001). There
was no significant difference between RBBB and non-RBBB patients in terms
of pulmonary artery pressure (MD: 1.83; 95% CI: -0.86-4.53; p = 0.18) or
donor age (MD: 1.51; 95% CI: -0.30- 3.31; p = 0.10). There was no
significant difference in the prognosis of RBBB patients in terms of acute
rejection (RR: 1.06; 95% CI: 0.70-1.61; p = 0.78), chronic rejection (RR:
0.92; 95% CI: 0.60-1.41; p = 0.70), or mortality (RR: 1.87; 95% CI:
0.81-4.31; p = 0.14). <br/>Conclusion(s): Despite the association of RBBB
with graft ischemia time and PVR, post-transplant RBBB had no significant
impact on mortality or graft rejection. Further research focusing on the
identification period and applied definition of RBBB is
recommended.<br/>Copyright &#xa9; 2025 John Wiley & Sons A/S. Published by
John Wiley & Sons Ltd.

<96>
Accession Number
2036123848
Title
Single- versus Multiple-Injection Intertransverse Process Block for VATS:
A Randomized Trial on Dermatomal Sensory Blockade.
Source
Journal of Pain Research. 18 (pp 4791-4800), 2025. Date of Publication:
2025.
Author
Supphapipat K.; Samerchua A.; Leurcharusmee P.; Lapisatepun P.;
Pipanmekaporn T.; Konkarn N.; Prapussarakul K.; Jinadech T.; Wanvoharn M.
Institution
(Supphapipat, Samerchua, Leurcharusmee, Lapisatepun, Pipanmekaporn,
Konkarn, Prapussarakul, Jinadech, Wanvoharn) Department of Anesthesiology,
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Publisher
Dove Medical Press Ltd
Abstract
Purpose: While the intertransverse process (ITP) block can enhance chest
wall analgesia, the optimal injection technique remains unclear. This
study compared the efficacy of single versus multiple injections of the
ITP block, hypothesizing that multiple injections would provide superior
sensory blockade. <br/>Patients and Methods: Forty patients undergoing
video-assisted thoracic surgery were randomized to receive single or
multiple ultrasound-guided ITP block injections with 30 mL of 0.25%
bupivacaine and 1% lidocaine with epinephrine (5 mug/mL). The
single-injection group received 30 mL at the T4-5 level, while the
multiple-injection group received 10 mL/injection at the T3-4, T4-5, and
T5-6 levels. The primary outcome was dermatomal sensory changes on the
anterolateral chest wall. Secondary outcomes included block performance
time, complications, and postoperative analgesia. <br/>Result(s): The
median (interquartile range [IQR]) dermatomal sensory levels were 2 (2-4)
for single-injection and 3 (1.5-3.5) for multiple-injection (median
difference: 0, 95% confidence interval [CI]: -1 to 1, p = 0.91). The
single-injection group had a shorter median (IQR) block performance time
than the multiple-injection group [7 (5.2-8.4) min versus 9.1 (7.8-11.2)
min; median difference: -1.9 min; 95% CI: -4 to -0.1 min; p = 0.01].
Intraoperative hypotension occurred in 63.2% of the single-injection group
and 65% of the multiple-injection group (p = 0.91). There was no
statistically significant difference in postoperative pain intensity
between groups. <br/>Conclusion(s): Single- and multiple-injection ITP
blocks showed no significant difference in sensory changes or analgesic
effect. The shorter performance time of the single-injection technique
suggests it may be a more practical option. However, larger, higher
powered studies are required to confirm equivalence and establish
definitive recommendations.<br/>Copyright &#xa9; 2025 Supphapipat et al.

<97>
Accession Number
2040468170
Title
Erector Spinae Plane Block Versus Retrolaminar Block for Perioperative
Analgesia in Pediatric Cardiac Surgery: A Randomized, Double-blinded,
Noninferiority Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Gopalakrishnan R.M.; Shinde N.; Meghalakshmi A.R.; Gutjahr G.;
Krishnakumar M.; Leeladharan S.P.; Thomas D.; Padmanabhan S.; Krishnakumar
R.
Institution
(Gopalakrishnan, Padmanabhan) Department of Pediatric Cardiac Anesthesia
and Intensive Care, Amrita Institute of Medical Sciences and Research
Centre, Kerala, Kochi, India
(Shinde, Meghalakshmi, Leeladharan, Thomas) Department of Cardiac
Anesthesia, Amrita Institute of Medical Sciences and Research Centre,
Kerala, Kochi, India
(Gutjahr, Krishnakumar) Department of Health Science Research, Amrita
Institute of Medical Sciences and Research Centre, Kerala, Kochi, India
(Krishnakumar) Department of Pediatric Cardiology, Amrita Institute of
Medical Sciences and Research Centre, Kerala, Kochi, India
Publisher
W.B. Saunders
Abstract
Objective: To compare the efficacy and safety of retrolaminar block (RLB)
with erector spinae plane block (ESPB) for perioperative analgesia in
pediatric cardiac surgery. <br/>Design(s): Prospective, randomized,
double-blinded, controlled, noninferiority trial. <br/>Setting(s): A
pediatric cardiac surgical unit at a tertiary care referral center in
South India. <br/>Participant(s): Children aged between 1 day and 18 years
who were scheduled for elective cardiac surgery (Risk adjustment for
congenital heart surgery categories 1-6) were enrolled in the study. A
total of 298 patients were randomly assigned to receive either an ESPB or
RLB, with 149 patients in each group. <br/>Intervention(s): Myofascial
blocks were performed by one of four anesthesiologists, each administering
either ESPB or RLB under ultrasound guidance according to the assigned
group. The treating anesthesiologist and intensive care unit (ICU)
intensivist were blinded to group allocation. <br/>Measurements and Main
Results: This study compared RLB, a safer and less commonly used posterior
myofascial block, with ESPB, a widely adopted technique with few reported
complications, to establish the noninferiority of RLB. The primary outcome
was hemodynamic response to surgical incision, defined as a greater than
10% rise in heart rate. Secondary outcomes included block administration
time; intraoperative inhalational anesthetic; dexmedetomidine and opioid
use; postoperative pain and sedation scores at 2, 6, and 12 hours; and ICU
outcomes such as duration of mechanical ventilation, ICU length of stay,
reintubation rate, and cost of ventilator disposables and oxygen. The
groups were comparable in baseline characteristics. A rise in heart rate
of more than 10% was observed in 46% of patients in the ESPB group and 50%
in the RLB group (p = 0.3). Intraoperative drug consumption, pain and
sedation scores, as well as ICU outcomes, were similar between the groups.
<br/>Conclusion(s): RLB is noninferior to ESPB in pediatric cardiac
surgery, providing comparable analgesic efficacy, safety, and
postoperative recovery outcomes.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<98>
Accession Number
648573916
Title
Revascularisation strategies for non-acute myocardial ischaemic syndromes.
Source
Heart (British Cardiac Society). (no pagination), 2025. Date of
Publication: 14 Sep 2025.
Author
Kawczynski M.J.; Barili F.; Brophy J.M.; De Caterina R.; Biondi Zoccai G.;
Anselmi A.; Boden W.E.; Parolari A.; Heuts S.
Institution
(Kawczynski, Heuts) Department of Cardiothoracic Surgery, Maastricht
University Medical Center, Maastricht, Netherlands
(Kawczynski, Heuts) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht University, Maastricht, Netherlands
(Barili, Parolari) Universita Degli Studi Di Milano, Milan, Italy
(Barili) IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
(Barili) Harvard T.H. Chan School of Public Health, Boston, MA, United
States
(Brophy) McGill University, Montreal, QC, Canada
(De Caterina) Cardiology Division, Pisa University Hospital, Pisa, Italy
(Biondi Zoccai) Department of Medical Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Rome, Italy
(Biondi Zoccai) Maria Cecilia Hospital, GVM Care & Research, Cotignola,
Italy
(Anselmi) Department of Thoracic and Cardiovascular Surgery, University
Hospital Centre Rennes, Rennes, France
(Boden) VA Boston Healthcare System, Boston University School of Medicine,
Boston, MA, United States
Abstract
BACKGROUND: Contemporary guidelines by the European Society for Cardiology
and American College of Cardiology/American Heart Association for the
treatment of non-acute myocardial ischaemic syndromes dispute the value of
revascularisation and differ in their recommendation to perform
revascularisation. A Bayesian network meta-analysis was performed,
evaluating the strength of evidence for the comparative incremental
effectiveness of coronary artery bypass grafting (CABG) versus
percutaneous coronary intervention (PCI) over medical therapy on long-term
outcomes. <br/>METHOD(S): A hierarchical Bayesian network meta-analysis
was designed (PROSPERO CRD42024541215, date 20 May 2024), including
randomised controlled trials (RCTs) published between 2005 and 10 June
2025, which consisted of three initial treatment modalities: optimal
medical therapy (OMT), PCI+OMT and CABG+OMT. The primary outcome was
all-cause mortality at maximum follow-up; secondary outcomes were trates
of the rates of myocardial infarction, stroke and re-revascularisation at
maximum follow-up, expressed in HRs and 95% credible intervals (CrIs),
accompanied by surface under the cumulative ranking curve (SUCRA) scores.
<br/>RESULT(S): 10 RCTs, comprising 10 742 patients, were included. For
all-cause mortality, the estimated median HR of CABG+OMT versus OMT was
0.84 (95% CrI 0.68-1.07); the HR of PCI+OMT versus OMT was 0.93
(0.79-1.16); and the HR of CABG+OMT versus PCI+OMT was 0.91 (0.71-1.13).
The SUCRAs of a CABG+OMT strategy ranking as the optimal revascularisation
treatment regarding mortality, myocardial infarction, stroke and
re-revascularisation were 88.1%, 99.7%, 17.5% and 99.5%, respectively.
Results were consistent across sensitivity analyses, including in the
node-splitting models. <br/>CONCLUSION(S): This Bayesian network
meta-analysis found that an initial CABG (+OMT) revascularisation strategy
was associated with higher probabilities of optimal outcomes, with the
exception of stroke, compared with an initial PCI (+OMT) revascularisation
strategy, although CrIs overlapped, suggesting that some uncertainty
remains. PROSPERO REGISTRATION NUMBER: CRD42024541215.<br/>Copyright
&#xa9; Author(s) (or their employer(s)) 2025. No commercial re-use. See
rights and permissions. Published by BMJ Group.

<99>
Accession Number
648584474
Title
Relation of post-operative atrial fibrillation aftfter coronary bypass
surgery with vitamin D deficiency and vitamin D supplementation: A
meta-analysis.
Source
Eurobiotech Journal. Conference: European Biotechnology Congress 2024.
Istanbul Turkey. 9(1) (pp 56-57), 2025. Date of Publication: 01 Jan 2025.
Author
Moula A.; Perivoliotis K.; Janho M.; Moulas A.
Institution
(Moula, Perivoliotis) Achilopouleion General Hospital of Volos, Greece
(Janho) Department of Pharmacology, Faculty of Medicine, University of
Thessaly Larissa, Greece
(Moulas) General Department, University of Thessaly, Larissa, Greece
Publisher
Sciendo
Abstract
The correlation between vitamin D (VD) deficiency and post-operative
atrial fibrillation (POAF) after coronary artery bypass grafting (CABG)
surgery and the possible prophylactic effect of VD supplementation before
the operation have not yet been clarified. We conducted a meta-analysis
according to the PRISMA guidelines on studies containing data on the
pre-operative levels of 25- hydroxyvitamin D (25(OH)D) and the incidence
of POAF after CABG as well as on studies containing data on the incidence
of POAF after CABG with and without VD supplementation before surgery.
Pubmed, Scopus and Web of Science were searched, and 15 articles were
selected. 7 articles with 1025 patients contained POAF data in patients
that received VD supplements before CABG versus placebo. POAF occurred in
79 (15.7%) of 502 patients that received VD and 131 (25.0%) of 523
patients that received placebo (p<0.001). 8 studies with 1126 patients
contained data about 25(OH)D in patients that developed POAF after CABG vs
patients that did not. The concentrations of 25(OH)D were not
significantly different between the two groups. Our data suggest that VD
supp lementation should be examined as an option for the reduction of POAF
after CABG surgery..

<100>
Accession Number
2040475548
Title
The Impact of Perioperative Hemodynamic and Blood Pressure Variability in
Outcomes and Mortality: A Comprehensive Systematic Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Saputra P.B.T.; Widiarti W.; Siahaan P.P.; Putra R.M.; Kriswidyatomo P.;
Faizah N.N.; Alkaff F.F.
Institution
(Saputra) Specialist Study Program of Cardiology and Vascular Medicine,
Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
(Saputra) Department of Cardiology and Vascular Medicine, Dr. Soetomo
General Academic Hospital, East Java, Surabaya, Indonesia
(Widiarti, Siahaan) Faculty of Medicine, Universitas Airlangga, East Java,
Surabaya, Indonesia
(Putra) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, Universitas Airlangga, East Java, Surabaya, Indonesia
(Putra) Universitas Airlangga Hospital, East Java, Surabaya, Indonesia
(Kriswidyatomo) Department of Anesthesiology and Reanimation, Faculty of
Medicine, Universitas Airlangga - Universitas Airlangga Hospital, East
Java, Surabaya, Indonesia
(Faizah) Division of Cardiovascular Medicine, of Medicine, Kobe
University, Kobe, Japan
(Alkaff) Division of Nephrology, Department of Internal Medicine,
University of Groningen, University Medical Center Groningen, Groningen,
Netherlands
(Alkaff) Division of Pharmacology and Therapy, Department of Anatomy,
Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga,
East Java, Surabaya, Indonesia
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate the impact of perioperative blood pressure
variability (BPV) on cardiovascular outcomes and mortality in cardiac
surgery patients. <br/>Method(s): Literature searches were performed
across scientific databases up to December 31, 2024. Studies reporting
perioperative BPV in patients undergoing cardiac surgery and its
association with mortality and clinical outcomes were included.
<br/>Result(s): Fifteen studies with 16,407 patients were included.
Increased BPV was significantly associated with higher rates of 30-day
mortality, acute kidney injury (AKI), prolonged intensive care unit stay,
and cognitive dysfunction. Among patients with fewer comorbidities and
perioperative risk, 30-day mortality ranged from 0.2% to 0.5%, while in
patients with higher risk, it increased from 42.4% to 60.7% (p < 0.001).
Elevated BPV was linked to a 23.2% higher risk of AKI per unit increase in
blood pressure (BP) standard deviation (SD) and a 15% increased incidence
of postoperative delirium. The findings emphasize the critical need for
precise perioperative BP control, with advanced metrics like BP
fragmentation providing valuable insights into patient risk.
<br/>Conclusion(s): Perioperative BPV appears to be a crucial factor
influencing postoperative outcomes in cardiac surgery patients. Effective
management of BPV may help reduce complications and improve patient
outcomes, highlighting the potential benefits of tailored hemodynamic
strategies. However, further research is needed to establish standardized
BPV thresholds and optimal management approaches.<br/>Copyright &#xa9;
2025 The Authors

<101>
Accession Number
2040474621
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: 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, Sakai) Division of Rehabilitation Medicine, Kobe University
Graduate School of Medicine, Hyogo, Japan
(Ogawa) Department of Public Health, Kobe University Graduate School of
Health Sciences, Hyogo, Japan
(Satomi-Kobayashi, Yoshida, Hirata) Division of Cardiovascular Medicine,
Department of Internal Medicine, Kobe University Graduate School of
Medicine, Hyogo, Japan
(Yoshida) 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
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
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. Registration number of Clinical Trial:
UMIN000030490
(https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000034
773)<br/>Copyright &#xa9; 2025 The Authors

<102>
Accession Number
2040475696
Title
Machine perfusion across different donor pathways in heart
transplantation: A systematic review and network meta-analysis.
Source
Journal of Heart and Lung Transplantation. (no pagination), 2025. Date of
Publication: 2025.
Author
Kim D.-Y.; Kang M.; Kim J.; Choi D.; Lee S.-J.
Institution
(Kim, Kang, Kim, Choi) Department of Surgery, Hanyang University College
of Medicine, Seoul, South Korea
(Choi) Research Institute of Regenerative Medicine and Stem Cells, Hanyang
University, Seoul, South Korea
(Choi) Hanyang Institute of Bioscience and Biotechnology, Hanyang
University, Seoul, South Korea
(Choi) Department of HY-KIST Bio-convergence, Hanyang University, Seoul,
South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Dongtan
Sacred Heart Hospital, Hallym University, Hwaseong, South Korea
Publisher
Elsevier Inc.
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
2014-2023 were identified through previous systematic reviews and
reference lists. Included were randomized clinical trials and
nonrandomized 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 the 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 noninferior to those of the conventional SCS,
proving its potential to broaden the donor pool.<br/>Copyright &#xa9; 2025
International Society for the Heart and Lung Transplantation

<103>
Accession Number
2036103321
Title
The Importance of Dental Treatment in Patients Before Radiotherapy,
Chemotherapy, and Cardiac Surgeries: A Narrative Review.
Source
Journal of Clinical Medicine. 14(17) (no pagination), 2025. Article
Number: 6330. Date of Publication: 01 Sep 2025.
Author
Mostafavi S.; Wyszynska M.; Skucha-Nowak M.
Institution
(Mostafavi) Division of Medical Sciences in Zabrze, Doctoral's School,
Medical University of Silesia in Katowice, 15 Poniatowskiego Street,
Katowice, Poland
(Wyszynska) Department of Dental Materials, Division of Medical Sciences
in Zabrze, Medical University of Silesia in Katowice, 15 Poniatowskiego
Street, Katowice, Poland
(Skucha-Nowak) Department of Dental Propedeutics, Division of Medical
Sciences in Zabrze, Medical University of Silesia in Katowice, 15
Poniatowskiego Street, Katowice, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Oncological patients or the individuals scheduled for cardiovascular
surgeries are at risk of both oral and systemic complications when
existing dental pathologies are not addressed before these therapies. This
narrative review explores the current literature on the role of
pre-treatment dental care in reducing unfavorable outcomes and promoting
treatment efficacy in medically compromised patients. The data show that
early dental intervention, particularly prior to head and neck
radiotherapy, considerably reduces the risk of osteoradionecrosis, rampant
radiation caries, and xerostomia. Chemotherapy-associated mucositis,
infections, and microbial imbalance are similarly worsened by untreated
oral disease but may be managed through early sanitation and hygiene
reinforcement. In cardiac patients, conditions such as apical
periodontitis and periodontitis may lead to bacteremia, infective
endocarditis, or prosthetic valve infections, highlighting the systemic
relevance of oral health. Tooth extractions, restorative treatment of
carious lesions, and control of active oral infections performed before
systemic therapy can reduce complication rates, improve treatment
continuity, and enhance patients' quality of life. Integrating
comprehensive dental assessment into routine pre-treatment planning allows
early identification of oral health risks and supports a multidisciplinary
approach that optimizes overall clinical outcomes.<br/>Copyright &#xa9;
2025 by the authors.

<104>
Accession Number
2036118878
Title
Early Aortic Valve Replacement vs. Conservative Therapy in Asymptomatic
Severe Aortic Stenosis Patients: A Meta-Analysis.
Source
Journal of Cardiac Surgery. 2025(1) (no pagination), 2025. Article Number:
7981651. Date of Publication: 2025.
Author
Alayidh M.; Ibrahim A.A.; Alharthi N.M.; Emara A.G.; Alamri J.A.; Almazyad
Y.F.; Alshammari T.G.; Alharbi A.M.; Mustafa E.H.; Alzaher R.Z.; Turkmani
M.; Shadoul E.
Institution
(Alayidh) Faculty of Medicine, King Khalid University, Abha, Saudi Arabia
(Ibrahim) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Alharthi) Faculty of Medicine, Taif University, Taif, Saudi Arabia
(Emara) Department of Cardiology, Menoufia University, Menoufia, Egypt
(Alamri) Faculty of Medicine, King Faisal University, Al-Ahsa, Saudi
Arabia
(Almazyad) Faculty of Medicine, Qassim University, Buraidah, Saudi Arabia
(Alshammari, Alharbi) Faculty of Medicine, Princess Nourah Bint
Abdulrahman University, Riyadh, Saudi Arabia
(Mustafa) Faculty of Medicine, Omdurman Islamic University, Khartoum,
Sudan
(Alzaher) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Turkmani) Faculty of Medicine, Michigan State University, East Lansing,
MI, United States
(Turkmani) Division of Pulmonary and Critical Care, University of Toledo,
Toledo, OH, United States
(Shadoul) Department of Cardiology, King Salman Hospital, Riyadh, Saudi
Arabia
Publisher
John Wiley and Sons Inc
Abstract
Background: Aortic stenosis (AS) is frequently seen in elderly
individuals. However, the preferred strategy for asymptomatic severe AS
remains unclear. We compared early aortic valve replacement (eAVR) with
conservative care. <br/>Method(s): We conducted a systematic review and
meta-analysis of RCTs from major databases until December 20, 2024. Risk
ratios (RRs) and mean differences (MDs) were pooled with 95% confidence
intervals (CIs) using R version 4.3. <br/>Result(s): Four RCTs (1427
patients) showed no substantial difference in all-cause mortality between
the early intervention and conservative care (RR: 0.69 [95% CI:
0.42-1.11]; p = 0.13). However, early intervention was markedly associated
with a lower incidence of cardiovascular mortality (RR: 0.65 [95% CI:
0.44-0.96]; p = 0.03), hospitalization for heart failure (RR: 0.27 [95%
CI: 0.13-0.54]; p < 0.01), and stroke (RR: 0.62 [95% CI: 0.40-0.95]; p =
0.03) compared to that of conservative care. Moreover, there was no
significant difference between the two groups in myocardial infarction
(RR: 0.22 [95% CI: 0.04-1.24]; p = 0.09), repeated aortic-valve surgery
(RR: 0.74 [95% CI: 0.12-4.78]; p = 0.75), and thromboembolic complications
(RR: 0.72 [95% CI: 0.23-2.21]; p = 0.56). <br/>Conclusion(s): In
asymptomatic severe AS, early AVR did not mitigate overall mortality but
substantially lowered cardiovascular mortality, heart failure
hospitalizations, and stroke risks compared to conservative management.
Perioperative complications were similar in both groups.<br/>Copyright
&#xa9; 2025 Mazen Alayidh et al. Journal of Cardiac Surgery published by
John Wiley & Sons Ltd.

<105>
Accession Number
2040489627
Title
Efficacy and Safety of Pulmonary Vasodilator and Inodilator Drugs in
Congenital Heart Disease Surgery: A Systematic Review and Network
Meta-Analysis of Randomized Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Ollosu M.; Tripodi V.F.; Aresu C.; Ledda G.; Manai F.; Marini C.; Musu M.;
Ippolito M.; Cortegiani A.; Finco G.; Sardo S.
Institution
(Ollosu, Aresu, Ledda, Manai, Marini, Musu, Finco, Sardo) Department of
Medical Sciences and Public Health, University of Cagliari, Monserrato,
Italy
(Tripodi) Anesthesia and Intensive Care, Human Pathology Department,
"Gaetano Martino" University Hospital, Messina, Italy
(Ippolito, Cortegiani) Department of Anesthesia, Analgesia, Intensive Care
and Emergency, University Hospital Policlinico Paolo Giaccone, Palermo,
Italy
(Ippolito, Cortegiani) Department of Precision Medicine in Medical,
Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Italy
Publisher
W.B. Saunders
Abstract
Background: Perioperative management of congenital heart disease (CHD)
surgery presents a unique challenge due to significant pathophysiological
alterations, with pulmonary hypertension contributing substantially to
morbidity and mortality. Although pulmonary vasodilators and inodilators
are commonly used, evidence of their efficacy and safety remains limited.
<br/>Objective(s): To evaluate the effectiveness and safety of
vasodilators and inodilators in pediatric patients undergoing CHD surgery.
<br/>Design(s): Systematic review with network meta-analysis. <br/>Data
Sources: PubMed, CENTRAL, and Embase. Eligibility Criteria: We included
single- or double-blind, parallel-group, randomized controlled trials
comparing the perioperative use of vasodilators and inodilators in
pediatric CHD surgery. We selected only English-language studies. We
excluded crossover, non randomized trials and trials comparing the same
drugs in all study arms. <br/>Result(s): We included 28 randomized
controlled trials involving 3118 patients. Intravenous levosimendan ranked
highest in decreasing postoperative mortality, although the effect was not
statistically significant. Intravenous sildenafil and inhaled nitric oxide
(NO) significantly reduced the duration of mechanical ventilation, and
inhaled NO also significantly shortened the length of intensive care unit
stay. Inhaled iloprost, NO, and enteral sildenafil reduced mean pulmonary
artery pressure. No intervention significantly affected the incidence of
acute kidney injury. <br/>Conclusion(s): Vasodilators and inodilators did
not significantly decrease perioperative mortality in pediatric CHD. Some
agents, such as intravenous sildenafil and inhaled NO, demonstrated modest
benefits of questionable clinical significance regarding duration of
mechanical ventilation, intensive care unit stay, and pulmonary pressure.
The results are limited by small sample sizes, study heterogeneity,
variability in standard care, and risk of bias, requiring cautious
interpretation. Registration: CRD42024552531.<br/>Copyright &#xa9; 2025
The Authors

<106>
Accession Number
2040480467
Title
DAPAgliflozin for renal protection in heart transplant recipients.
Rationale and design of the randomized controlled DAPARHT trial.
Source
American Heart Journal. 291 (pp 128-135), 2026. Date of Publication: 01
Jan 2026.
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, Ravnestad, Gude, Bjorkelund, Andreassen, Gullestad, Broch)
Department of Cardiology, Oslo University Hospital, Oslo, Norway
(Holmen) Department of Medicine, Innlandet Hospital Trust, Hamar, Norway
(Holmen, Ravnestad, Gullestad, Broch) Institute of Clinical Medicine,
Faculty of Medicine, University of Oslo, Norway
(Manintveld) Department of Cardiology, Cardiovascular Institute, Erasmus
Medical Center, Rotterdam, Netherlands
(Manintveld) Erasmus MC Transplant Institute, Erasmus University Medical
Center Rotterdam, Rotterdam, 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
Publisher
Elsevier Inc.
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/1.73 m², 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 18, 2024, 300 patients were enrolled. The mean baseline
creatinine was 104 +/- 28 micromol/L with corresponding eGFR of 66 +/- 22
mL/min/1.73 m². 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. Trial Registration: Dapagliflozin
for Renal protection in Heart Transplant recipients (DAPARHT),
NCT05321706, clinicaltrials.gov.<br/>Copyright &#xa9; 2025 The Authors

<107>
Accession Number
2036130013
Title
The impact of comorbidities on surgical outcome and mortality in minimally
invasive mitral valve surgery: a systematic review.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1638217. Date of Publication: 2025.
Author
Zwaans V.I.T.; Stein J.; Goecke S.; Pitts L.; Akansel S.; Kofler M.;
Jacobs S.; Falk V.; Kempfert J.; Wert L.
Institution
(Zwaans, Stein, Goecke, Pitts, Akansel, Kofler, Jacobs, Falk, Kempfert,
Wert) Deutsches Herzzentrum der Charite, Department of Cardiothoracic and
Vascular Surgery, Berlin, Germany
(Zwaans, Stein, Goecke, Pitts, Akansel, Kofler, Jacobs, Falk, Kempfert,
Wert) Charite - Universitatsmedizin Berlin, Corporate Member of Freie
Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany
(Falk) DZHK (German Center for Cardiovascular Research), Partner Site
Berlin, Berlin, Germany
(Falk) Department of Health Sciences and Technology, ETH Zurich, Zurich,
Switzerland
Publisher
Frontiers Media SA
Abstract
Background: We sought to outline perioperative patient data to analyse
surgical, clinical and echocardiographic outcomes and mortality of
patients undergoing minimally invasive mitral valve surgery.
<br/>Method(s): Systematic literature research was performed in
MEDLINE/PubMed according to PRISMA guidelines. Our research considered
original works published until January 31, 2025. A pooled meta-analysis of
studies reports early and late follow-up data of mitral valve repair for
complex mitral valve regurgitation. In order to outline possible adverse
events and comorbidities, we compared patients' mortality by
differentiating preoperative, intraoperative and postoperative data.
<br/>Result(s): This review analysed publications involving 222,947
patients, of which 43.4% were female and 56.6% were male, who underwent
minimally invasive mitral valve surgery (MIMVS). The patients had a median
age of 63.40 years (IQR: 60.42, 68.00), an average BMI of 25.1
kg/m² (+/-7.9) and BSA of 1.7 m² (+/-0.2). Severe
mitral insufficiency was present in 86.4% of patients, 10% showed mild to
moderate mitral insufficiency and 3.8% had mitral stenosis. The average
EuroSCORE II showed a median value of 1.75% (IQR: 1.20, 2.95) and NYHA
class III was most frequent. Comorbidities such as pulmonary hypertension
were present in 35.37% of patients, diabetes mellitus in 8.57% (IQR: 4.76,
19.41), arterial hypertension was seen in 57.58% (IQR: 40.66, 68.79) with
a significantly increased risk of mortality (p = 0.018). Coronary artery
disease exhibited a prevalence of 17.41% (IQR: 10.78, 34.04),
hypercholesterolaemia of 29.13% (IQR: 23.12, 49.74) and chronic kidney
disease of 8.93% (IQR: 1.90, 20.00). New-onset atrial fibrillation
occurred in 19.2% of patients. Besides this, 4% of patients required
postoperative pacemaker implantation. Left atrial (LA) diameter decreased
significantly from 50.37 mm preoperatively to 40.41%mm postoperatively (p
< 0.001), LVDD was significantly reduced after MIMVS (p < 0.001). Mitral
valve repair (75.83%) was considerably more common than replacement
(21.09%). Applied techniques included annuloplasty (67.87%) and neochordal
reconstruction (42.71%). Average mechanical ventilation was 540.8 min
(+/-439.8), with a significant positive correlation between 30-day
mortality and ventilation duration. In-hospital death occurred in 8
patients (+/-25), the average length of stay was 8.6 days (+/-3.9) and the
mean postoperative ICU stay was 35.1 h (+/-15.9). Revision surgery was
necessary in 4.1% of patients due to postprocedural bleeding.
Postoperatively, 92% of patients showed no signs of MR, whereas 8%
exhibited residual MR. Of those with residual MR, 78% continued to have
mild MR, 14.9% had moderate MR and 7.1% showed severe mitral regurgitation
after MIMVS. <br/>Conclusion(s): Postoperative mortality was associated
with comorbidities like chronic kidney disease, diabetes mellitus and
hypercholesterolaemia. Patients with a history of smoking, arterial
hypertension or coronary artery disease showed variable risks, indicating
that these factors may be associated with elevated in-hospital death or
death within the first postoperative month. MIMVS shows favourable
outcomes concerning echocardiographic measurements and haemodynamics such
as LVEF, as well as length of hospital stay, ICU stay, postprocedural
bleeding and complications such as wound infection or the need for blood
transfusions.<br/>Copyright 2025 Zwaans, Stein, Goecke, Pitts, Akansel,
Kofler, Jacobs, Falk, Kempfert and Wert.

<108>
Accession Number
648574883
Title
Catheter-based left atrial appendage CLOSURE in patients with Atrial
Fibrillation at high risk of stroke and bleeding as compared to best
medical therapy: Rationale and design of the prospective randomized
CLOSURE-AF trial.
Source
American heart journal. (no pagination), 2025. Date of Publication: 12
Sep 2025.
Author
Landmesser U.; Skurk C.; Kirchhof P.; Lewalter T.; Hartung J.-J.; Rroku
A.; Pieske B.; Brachmann J.; Akin I.; Jacobshagen C.; Meder B.; Zeiher A.;
Anker S.D.; Thiele H.; Blankenberg S.; Massberg S.; Schunkert H.; Frey N.;
Joost A.; Bergmann M.; Haeusler K.G.; Endres M.; Wegscheider K.; Boldt
L.-H.; Eitel I.
Institution
(Landmesser, Skurk, Hartung) Department of Cardiology, Angiology and
Intensive Care Medicine, Deutsches Herzzentrum der Charite;
Charite-University Medicine Berlin, Campus Benjamin Franklin, Berlin,
Germany; German Center for Cardiovascular Research (DZHK), partner site
Berlin, Berlin, Germany
(Kirchhof) Department of Cardiology, University Heart and Vascular Center
Hamburg, Hamburg, Germany; Institute of Cardiovascular Sciences,
University of Birmingham, Birmingham, UK
(Lewalter) Department of Cardiology and Intensive Unit Care, Peter Osypka
Heart Center, Hospital Munich South, Munich, Germany
(Rroku) Department of Cardiology, Angiology and Intensive Care Medicine,
Deutsches Herzzentrum der Charite; Charite-University Medicine Berlin,
Campus Benjamin Franklin, Berlin, Germany
(Pieske) Division of Cardiology, Department of Internal Medicine,
University Medicine Rostock, Rostock, Germany
(Brachmann) Department of Cardiology, Klinikum Coburg, Coburg, Germany
(Akin) Department of Cardiology, University Medical Centre Mannheim,
Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
(Jacobshagen) Department of Cardiology, Intensive Care Medicine and
Angiology, Vincentius-Diakonissen Hospital, Karlsruhe, Germany
(Meder, Frey) Precision Digital Health, Department of Internal Medicine
III, Cardiology, University Heidelberg, Heidelberg, Germany; German Centre
for Cardiovascular Research (DZHK), partner site Heidelberg, Heidelberg,
Germany(.)
(Zeiher) Department of Medicine III, Goethe University, Frankfurt am Main,
Germany; German Center for Cardiovascular Research (DZHK) Partner Site
Rhein Main Frankfurt Germany
(Anker) Institute of Health Center for Regenerative Therapies, German
Center for Cardiovascular Research partner site Berlin, Charite -
Universitatsmedizin, Berlin, Germany
(Thiele) Heart Center at Leipzig University, Department of Internal
Medicine/Cardiology, Leipzig, Germany
(Blankenberg) Department of Cardiology, University Heart and Vascular
Center Hamburg, Hamburg, Germany; German Center for Cardiovascular
Research (DZHK) Partner Site Hamburg/Kiel/Lubeck, Lubeck, Germany
(Massberg) Department of Medicine I, LMU University Hospital, Ludwig
Maximillian University of Munich, Germany; German Center for
Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart
Alliance, Germany
(Schunkert) German Center for Cardiovascular Research (DZHK), Partner Site
Munich, Munich Heart Alliance, Germany; Department of Cardiovascular
Diseases, German Heart Centre, School of Medicine and Health, TUM
University Hospital, Technical University of Munich, Munich, Germany
(Joost, Eitel) German Center for Cardiovascular Research (DZHK) Partner
Site Hamburg/Kiel/Lubeck, Lubeck, Germany.; University Heart Center
Lubeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine),
Lubeck, Germany
(Bergmann) Department of Cardiology, Asklepios Klinik Altona, Hamburg,
Germany
(Haeusler) Department of Neurology, Universitatsklinikum Ulm, Ulm, Germany
(Endres) German Center for Cardiovascular Research (DZHK), partner site
Berlin, Berlin, Germany; Department of Neurology, Charite-University
Medicine Berlin, Berlin, Germany
(Wegscheider) German Center for Cardiovascular Research (DZHK) Partner
Site Hamburg/Kiel/Lubeck, Lubeck, Germany.; Department of Medical Biometry
and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg,
Germany
(Boldt) German Center for Cardiovascular Research (DZHK), partner site
Berlin, Berlin, Germany; Department of Cardiology, Angiology and Intensive
Care Medicine, Deutsches Herzzentrum der Charite; Charite-University
Medicine Berlin, Campus Virchow, Berlin, Germany
Abstract
BACKGROUND: Percutaneous catheter-based left atrial appendage (LAA)
closure is a potential alternative to oral anticoagulation for stroke
prevention in patients with atrial fibrillation (AF). The effectiveness
and safety of LAA closure in patients with AF at high risk of stroke
(CHA2DS2-VASc Score >= 2) and high risk of bleeding compared to best
medical care including a non-vitamin K antagonist oral anticoagulant
[NOAC] when considered eligible is not known. METHODS/DESIGN: The
prospective, multicenter, randomized clinical Left atrial appendage
CLOSURE in patients with Atrial Fibrillation at high risk of stroke and
bleeding compared to medical therapy (CLOSURE-AF) trial compared
catheter-based LAA closure to best medical care (including NOAC therapy if
considered eligible) in patients with AF at high risk of stroke and with
either a history of bleeding or a high estimated bleeding risk (HASBLED
>3). The primary endpoint is time to a composite of first stroke (ischemic
or hemorrhagic), systemic embolism, cardiovascular or unexplained death or
major bleeding (Bleeding Academic Research Consortium 3-5). Secondary
outcomes include components of the primary outcome and total mortality.
The primary efficacy analysis will be performed in the intention-to-treat
population using Cox regression models for non-inferiority with an option
to test for superiority once non-inferiority has been proven.
<br/>RESULT(S): The first patient in the CLOSURE-AF trial was enrolled in
March 2018. By April 2025 the complete study cohort of n=912 patients had
been enrolled in 46 sites. <br/>CONCLUSION(S): CLOSURE-AF will contribute
evidence on the effectiveness and safety of LAA occlusion compared to
optimal medical therapy in patients with AF at high risk of stroke and
bleeding. The trial results will help to define the clinical use of
catheter-based LAA closure in the future. TRIAL REGISTRATION:
clinicaltrials.gov Identifier: NCT03463317.<br/>Copyright &#xa9; 2025.
Published by Elsevier Inc.

<109>
Accession Number
2040476182
Title
Effects of Volatile Sedation Versus Propofol on Time to Extubation in the
Intensive Care Unit After Cardiac Surgery: A Systematic Review and
Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Garo M.L.; Rinaldi P.; Galderisi A.; Di Folco M.; Ruggiero A.; Mattei A.;
Schiavoni L.; Nasso G.; Pascarella G.; Chello M.; Lusini M.; Cataldo R.;
Carassiti M.; Agro F.E.; Strumia A.
Institution
(Garo, Rinaldi, Galderisi, Di Folco, Ruggiero, Mattei, Schiavoni,
Pascarella, Cataldo, Carassiti, Agro, Strumia) Anesthesia and Intensive
Care Research Unit, Campus Bio-Medico University, Rome, Italy
(Rinaldi) Department of Anesthesiology, Unit of Emergency Anesthesia, Burn
Intensive Care and Poison Control Center, AORN Antonio Cardarelli, Naples,
Italy
(Mattei, Schiavoni, Pascarella, Cataldo, Carassiti, Agro, Strumia)
Anesthesia and Intensive Care Operative Unit, Fondazione Policlinico
Universitario Campus Bio-Medico, Rome, Italy
(Nasso) Anthea Hospital, GVM Care & Research, Bari, Italy
(Chello, Lusini) Research Unit of Cardiac Surgery, Department of
Cardiovascular Surgery, Campus Bio-Medico University, Rome, Italy
(Chello, Lusini) Operative Unit of Cardiac Surgery, Fondazione Policlinico
Universitario Campus Bio-Medico, Rome, Italy
Publisher
W.B. Saunders
Abstract
Background: Optimal sedation management is critical in the postoperative
care of cardiac surgery patients admitted to the intensive care unit
(ICU), where sedative choice may influence respiratory, hemodynamic, and
recovery outcomes. Propofol is the most widely used sedative, but volatile
anesthetics are gaining interest due to their pharmacologic advantages.
This systematic review and meta-analysis was designed to compare volatile
anesthetics with propofol for ICU sedation after cardiac surgery, focusing
on time to extubation as the primary outcome, and ICU and hospital length
of stay, hemodynamic support, and postoperative complications as secondary
outcomes. <br/>Method(s): PubMed, Web of Science, and Scopus were searched
from July to October 2024 without language or date restrictions. Eligible
studies were randomized controlled trials comparing volatile anesthetics
with propofol for postoperative ICU sedation in adult cardiac surgery
patients. Studies without extractable data were excluded. Risk of bias was
assessed using the Cochrane risk-of-bias 2.0 tool. Meta-analyses were
performed using random-effects models. <br/>Result(s): Five randomized
controlled trials involving 384 patients were included. Sedation with
volatile anesthetics significantly reduced time to extubation compared
with propofol (weighted mean difference [WMD] = -55 minutes, 95% CI -93 to
-17, p < 0.001), although heterogeneity was high (I2 = 95.9%, tau2 =
1,731.95, p < 0.001). No significant differences were observed for ICU
(WMD = -4.26 hours, 95% CI: -17.07 to 8.55, I² = 89.9%,
t² = 143.76, z = -0.65, p = 0.51) or hospital (WMD = -1.94
days, 95% CI: -4.17 to 0.30, I² = 65.1%, t² = 2.53)
length of stay. Secondary outcomes (use of vasopressors and/or positive
inotropes, postoperative atrial fibrillation, and nausea and/or vomiting)
were inconsistently reported and showed no clear pattern.
<br/>Discussion(s): Volatile anesthetics reduce extubation time compared
with propofol in adult cardiac surgery patients sedated in the ICU.
However, evidence on secondary outcomes remains inconclusive due to
limited and heterogeneous data.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<110>
Accession Number
2040508036
Title
Beating Heart Versus Arrested Heart for Isolated Tricuspid Valve Surgery:
A Kaplan-Meier-Derived Meta-Analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2025. Article Number: 15569845251375959. Date
of Publication: 2025.
Author
Baudo M.; Sicouri S.; Yamashita Y.; Magouliotis D.; Cabrucci F.; Ramlawi
B.
Institution
(Baudo, Sicouri, Yamashita, Magouliotis, Cabrucci, Ramlawi) Department of
Cardiac Surgery Research, Lankenau Institute for Medical Research, Main
Line Health, Wynnewood, PA, United States
(Yamashita, Ramlawi) Department of Cardiac Surgery, Lankenau Heart
Institute, Main Line Health, Wynnewood, PA, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: The aim of the current study was to analyze the clinical and
surgical outcomes of patients undergoing isolated tricuspid valve surgery
(ITVS) from the available literature. It currently remains uncertain
whether arrested heart (AH) surgery has superior postoperative outcomes
over beating heart (BH) for ITVS. <br/>Method(s): A systematic review and
meta-analysis were conducted by searching PubMed, ScienceDirect, Scopus,
DOAJ, SciELO, and Cochrane databases from 2000 until November 2024. The
protocol was registered with the International Prospective Register of
Systematic Reviews under the PROSPERO registration number CRD42024622618.
<br/>Result(s): A total of 22 studies met the inclusion criteria. These
studies were published between 2012 and 2023 and included a combined total
of 1,627 patients, with 1,053 in the BH group and 574 in the AH group. The
present analysis showed that patients undergoing BH surgery were generally
more comorbid and more frequently underwent minimally invasive procedures
as compared with patients undergoing AH surgery. The BH and AH groups
reported no significant differences in postoperative outcomes. At
follow-up, BH was associated with higher recurrent &gt;2+ tricuspid
regurgitation rates (P = 0.048), but this did not affect late survival
(hazard ratio [HR] = 0.90, 95% confidence interval [CI]: 0.68 to 1.19, P =
0.457) or reintervention for TV (HR = 1.18, 95% CI: 0.61 to 2.29, P =
0.622) rates. <br/>Conclusion(s): A consensus between BH and AH for ITVS
is still lacking. However, BH ITVS procedures appear to be the preferred
surgeon choice for higher-risk patients. At follow-up, the BH group showed
higher rates of recurrent tricuspid regurgitation &gt;2+, without
affecting late survival or rates of TV reintervention.<br/>Copyright
&#xa9; The Author(s) 2025

<111>
Accession Number
2036103158
Title
A Review of Current Insights in Fungal Endocarditis.
Source
Journal of Clinical Medicine. 14(17) (no pagination), 2025. Article
Number: 6149. Date of Publication: 01 Sep 2025.
Author
Akritidou O.; Peristeri A.-M.; Lymperatou D.; Prokopidou A.; Christaki E.;
Nikopoulou A.
Institution
(Akritidou, Peristeri, Nikopoulou) Department of Internal Medicine, G.
Papanikolaou General Hospital of Thessaloniki, Thessaloniki, Greece
(Lymperatou, Prokopidou, Christaki) First Department of Internal Medicine
and Infectious Diseases Unit, University General Hospital of Ioannina,
Faculty of Medicine, University of Ioannina, Ioannina, Greece
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Fungal endocarditis (FE), is a rare yet
life-threatening disease, which predominantly affects immunocompromised
individuals, prosthetic valve recipients, and injection drug users. The
purpose of this review is to summarize the evolving epidemiological
trends, diagnostic challenges, and treatment strategies, by identifying
evidence that supports the optimal clinical approach. <br/>Method(s): A
literature search was performed, drawing from sources such as PubMed and
Google Scholar and included articles published between January 2015 and
March 2025. Clinical studies, case series, and meta-analyses reporting on
FE epidemiology, diagnostics, or treatment were included. <br/>Result(s):
The majority of FE cases is caused by Candida species, predominantly C.
albicans, while Aspergillus accounted for a lesser percentage of cases.
While blood cultures showed limited sensitivity, adjunctive diagnostic
tools such as serum biomarkers (beta-D-glucan, galactomannan) and advanced
imaging modalities (18F-FDG PET/CT) are increasingly used to guide the
diagnostic process. Early surgical intervention combined with antifungals
improved survival, particularly for Aspergillus, although comprehensive
data regarding this approach remains limited due to the rarity of the
disease. <br/>Conclusion(s): Fungal endocarditis requires an aggressive
treatment strategy, integrating early surgery, targeted antifungals, and
long-term suppression, especially for prosthetic valves. Despite advances,
the complexity of the condition and the variety of the pathogens involved,
continue to impede progress towards effective management of FE. Future
research must prioritize rapid diagnostics, standardized treatment
protocols, and novel antifungals to address this critical
condition.<br/>Copyright &#xa9; 2025 by the authors.

<112>
Accession Number
648568644
Title
Menopausal Hormone Therapy and Cardiovascular Diseases in Women With
Vasomotor Symptoms: A Secondary Analysis of the Women's Health Initiative
Randomized Clinical Trials.
Source
JAMA internal medicine. (no pagination), 2025. Date of Publication: 15
Sep 2025.
Author
Rossouw J.E.; Aragaki A.K.; Manson J.E.; Szmuilowicz E.D.; Harrington
L.B.; Johnson K.C.; Allison M.; Haring B.; Saquib N.; Shadyab A.H.;
Rexrode K.M.; Liu L.; Mouton C.P.; LaCroix A.Z.
Institution
(Rossouw) Division of Cardiovascular Sciences, National Heart, Lung, Blood
Institute, Bethesda, MD, Liberia
(Aragaki) Division of Public Health Sciences, Fred Hutchinson Cancer
Center, Seattle, WA, United States
(Manson) Division of Preventive Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Szmuilowicz) Division of Endocrinology, Metabolism and Molecular
Medicine, Northwestern University Feinberg School of Medicine, Chicago,
IL, United States
(Harrington) Kaiser Permanente Washington Health Research Institute,
Seattle, United States
(Johnson) Department of Preventive Medicine, University of Tennessee
Health Science Center, Memphis, United States
(Allison) Division of Preventive Medicine, University of California, La
Jolla, San Diego, Mexico
(Haring) Department of Medicine III, Saarland University, Homburg, Germany
(Saquib) College of Medicine, Sulaiman Al Rajhi University, Al Bukayriyah,
Saudi Arabia
(Shadyab) Herbert Wertheim School of Public Health and Human Longevity
Science and Division of Geriatrics, Gerontology, Palliative Care,
Department of Medicine, University of California, La Jolla, San Diego,
Mexico
(Rexrode) Department of Medicine, Brigham and Women's Hospital, Boston,
MA, United States
(Liu) Department of Epidemiology and Biostatistics, Drexel University,
Philadelphia, PA, United States
(Mouton) School of Medicine, University of Texas Medical Branch,
Galveston, United States
(LaCroix) Herbert Wertheim School of Public Health and Human Longevity
Science, University of California, La Jolla, San Diego, Mexico
Abstract
Importance: Identification of appropriate patients for treatment of
vasomotor symptoms (VMS) with menopausal hormone therapy (HT) is
challenging. <br/>Objective(s): To assess risk of cardiovascular disease
(CVD) due to HT in women with VMS. <br/>Design, Setting, and
Participant(s): In this secondary analysis of 2 randomized clinical trials
of HT, postmenopausal women aged 50 to 79 years from 40 US clinical
centers were included. Data were collected from November 1993 to September
2012, and data were analyzed from December 2024 to May 2025.
<br/>Intervention(s): Conjugated equine estrogens (CEE), 0.625 mg per day,
or CEE with medroxyprogesterone acetate (MPA), 2.5 mg per day, vs placebo.
<br/>Main Outcomes and Measures: Atherosclerotic CVD (ASCVD; defined as
composite of nonfatal myocardial infarction, hospitalization for angina,
coronary revascularization, ischemic stroke, peripheral arterial disease,
carotid artery disease, or CVD death). <br/>Result(s): Of 27 347 included
postmenopausal women, the mean (SD) age was 63.4 (7.2) years; a total of
10 739 (39.3%) had a hysterectomy, and 16 608 (60.7%) had an intact
uterus. The median (IQR) follow-up was 7.2 (6.4-8.1) years and 5.6
(4.8-6.5) years for those in the CEE alone trial and the CEE plus MPA
trial, respectively. In the CEE alone trial, moderate or severe VMS were
present at baseline in 905 (27.6%), 705 (14.7%), and 220 (8.7%) women aged
50 to 59 years, 60 to 69 years, and 70 to 79 years, respectively; in the
CEE plus MPA trial, moderate or severe VMS was present in 1225 (22.4%),
649 (8.7%), and 172 (4.8%), respectively. Among women with moderate or
severe VMS at enrollment, 3382 (96.7%) recalled having symptoms near
menopause onset. CEE alone reduced VMS by 41% across all age groups
(overall relative risk [RR], 0.59; 95% CI, 0.53-0.66). However, in the CEE
plus MPA trial, VMS reduction was attenuated with age (age 50-59 years:
RR, 0.41; 95% CI, 0.35-0.48; age 60-69 years: RR, 0.72; 95% CI, 0.61-0.85;
age 70-79 years: RR, 1.20; 95% CI, 0.91-1.59; interaction P for trend <
.001). Both CEE alone and CEE plus MPA appeared to have neutral effects on
ASCVD in women with moderate or severe VMS aged 50 to 59 years (CEE alone:
hazard ratio [HR], 0.85; 95% CI, 0.53-1.35; CEE plus MPA: HR, 0.84; 95%
CI, 0.44-1.57). While the estimated risk was higher for CEE alone in women
with VMS aged 60 to 69 years, there was no clear signal of harm (CEE
alone: HR, 1.31; 95% CI, 0.90-1.90; CEE plus MPA: HR, 0.84; 95% CI,
0.51-1.39). However, women with VMS 70 years and older had increased risks
of ASCVD (CEE alone: HR, 1.95; 95% CI, 1.06-3.59; 217 excess events per 10
000 person-years; interaction P for trend = .03; CEE plus MPA: HR, 3.22;
95% CI, 1.36-7.63; 382 excess events per 10 000 person-years; interaction
P for trend = .02). <br/>Conclusions and Relevance: In this secondary
analysis of 2 randomized clinical trials, among younger postmenopausal
women aged 50 to 59 years, both CEE alone and CEE plus MPA reduced VMS
without significantly affecting ASCVD risk. In women with VMS 70 years and
older, risks for ASCVD were increased in both trials. The findings support
guideline recommendations for treatment of VMS with HT in women aged 50 to
59 years, caution if initiating HT in women aged 60 to 69 years, and
avoidance of HT in women 70 years and older. Trial Registration:
ClinicalTrials.gov Identifier: NCT00000611.

<113>
Accession Number
648551625
Title
A Comparison of two Vascular Closure Strategies in Transcatheter Aortic
Valve Replacement: Suture and Plug versus Suture alone: A Systematic
Review and Meta-Analysis.
Source
Cardiology. (pp 1-25), 2025. Date of Publication: 12 Sep 2025.
Author
Megantara H.P.; Dakota I.; Taofan T.; Indriani S.; Aurora R.G.; Adiarto S.
Abstract
INTRODUCTION: Vascular complications following transcatheter aortic valve
replacement (TAVR) significantly contribute to morbidity and mortality.
Conventional suture-based closure technique has been widely utilized for
large-bore arterial access closure. Recent findings on hybrid strategy
combining plug and suture-based devices has been on spotlight as it may
improve the hemostatic efficacy and lower the access-site related
complications and clinical outcomes. <br/>METHOD(S): We performed a
systematic review and meta-analysis of studies comparing a suture-based
approach with a hybrid closure strategy (suture+plug) in aortic stenosis
patients undergoing TAVR. Included studies were appraised following the
Cochrane Risk of Bias and Newcastle-Ottawa Scale tools. Forest plots were
extracted in Review Manager with a main outcome of pooled-risk ratio (RR).
The primary endpoint was the composite of access-site related vascular
complications as defined by Valve Academic Research Consortium criteria
whilst secondary end-points were in-hospital bleeding, closure device
failure, mortality and unplanned endovascular or surgical intervention
Results: Six eligible studies encompassing 2,064 patients were analyzed.
Compared with suture-based closure, hybrid closure exhibited a lower rate
of vascular complications [pooled-RR 0.46; 95% CI, 0.38-0.57; p <0.001],
closure device failure [pooled-RR 0.35; 95% CI, 0.13-0.96; p=0.04],
in-hospital bleeding events [pooled-RR 0.38; 95% CI, 0.26-0.55; p <0.001]
and mortality [pooled-RR 0.51; 95% CI, 0.26-0.99; p=0.049]. Unplanned
endovascular or surgical intervention was no different among two groups
[pooled-RR 0.42; 95% CI, 0.17-1.06; p=0.07]. <br/>CONCLUSION(S): Hybrid
vascular closure strategy offers better efficacy with lesser complications
amongst patients undergoing TAVR, directing the clinical adoption of
hybrid techniques, although further large-scale multicenter studies are
warranted to confirm the benefit and optimize patient
selection.<br/>Copyright S. Karger AG, Basel.

<114>
Accession Number
648550874
Title
Intraoperative Utilization of Intravenous Methadone for Postoperative Pain
Control.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. (no pagination), 2025. Date of
Publication: 12 Sep 2025.
Author
Laguado D.; Hu J.; Watkins C.; Furstein J.
Institution
(Laguado, Hu, Furstein) Department of Nurse Anesthesia, Virginia
Commonwealth University, Richmond, VA, United States
(Watkins) Division of Pharmacy, Cincinnati Children's Hospital,
Cincinnati, OH, United States
Abstract
PURPOSE: Postoperative pain is a unique experience that can be challenging
to manage. It is imperative that perioperative nursing staff have a sound
understanding of a multitude of pharmacological interventions. When
compared to other intraoperative opioids, intravenous methadone has not
been widely researched as a tool for the prevention of postoperative pain.
The purpose of this systematic review is to provide evidence for its use
and efficacy in preventing postoperative pain. DESIGN: Systematic review.
<br/>METHOD(S): This review used a broad research strategy to seek out
relevant publications from the last decade (2014 to January 2024). The
databases used included MEDLINE (PubMed) and Google Scholar. Out of the
initial 129 studies identified, 7 relevant clinical trials, 2
retrospective reviews, and 1 systematic review were chosen based on the
inclusion criteria. FINDINGS: Patients who received adequate doses of
intraoperative methadone, defined as doses between 0.1 and 0.4 mg/kg ideal
body weight had lower pain scores and decreased opioid consumption in the
PACU compared to patients who received shorter-acting opioids in the
intraoperative phase. Studies demonstrated that methadone use did not
increase time to extubation at the end of surgery and was not associated
with significant respiratory complications during recovery.
<br/>CONCLUSION(S): This review supports that incorporating intravenous
methadone can yield a satisfactory analgesic profile for a wide array of
surgeries, including ambulatory surgery, cardiac surgery, and
intra-abdominal surgery. More clinical trials are needed to determine
specific dosing guidelines and to vet the safety and efficacy in patients
with various comorbidities.<br/>Copyright &#xa9; 2025 The American Society
of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

<115>
Accession Number
2040242366
Title
Direct Oral Anticoagulants Versus Vitamin K Antagonists in Patients with
Atrial Fibrillation and Bioprosthetic Valve Replacement: An Umbrella
Review.
Source
Journal of Innovations in Cardiac Rhythm Management. 16(7) (pp 6355-6373),
2025. Date of Publication: 01 Jul 2025.
Author
Khan A.S.; Lnu A.; Abideen Z.U.; Baig M.U.; Hudaib M.; Rehman H.U.; Haider
N.; Khaliq S.; Batool S.; Bint-E-Hina R.; Azam N.M.; Asif S.S.; Khatri M.;
Kumar S.
Institution
(Khan) Medical College, Liaquat National Hospital and Medical College,
Karachi, Pakistan
(Lnu, Azam) Rawalpindi Medical University, Rawalpindi, Pakistan
(Abideen, Baig) Quaid-e-Azam Medical College, Bahawalpur, Pakistan
(Hudaib) Fazaia Ruth Pfau Medical College, Karachi, Pakistan
(Rehman) Dow Medical College, Karachi, Pakistan
(Haider, Khaliq) King Edward Medical University, Lahore, Pakistan
(Batool) Hamdard College of Medicine and Dentistry, Karachi, Pakistan
(Bint-E-Hina) Dow University of Health Sciences, Karachi, Pakistan
(Asif) Kentucky College of Osteopathic Medicine, Pikeville, KY, United
States
(Khatri) Department of Medicine, Dow University of Health Sciences,
Karachi, Pakistan
(Kumar) Department of Medicine, Shaheed Mohtarma Benazir Bhutto Medical
College, Karachi, Pakistan
Publisher
MediaSphere Medical LLC
Abstract
Atrial fibrillation (AF) is a major sequela after bioprosthetic valve
replacement (BPVR) in patients with valvular heart disease. This study
evaluates the data compiled from different meta-analyses in an umbrella
review. We investigated the anticoagulation efficacy of direct oral
anticoagulants (DOACs) versus vitamin K antagonists (VKAs) in patients
with AF and BPVR. A comprehensive search of the Cochrane Database of
Systematic Reviews, EMBASE, and PubMed was completed to find papers
published up until June 2024 that could be included in this umbrella
review. Randomized controlled trials (RCTs) and retrospective
observational/ cohort studies were primarily identified as the foundation
of meta-analyses and peer-reviewed systematic reviews. The quality of the
included publications was determined using the AMSTAR2 tool and the
Cochrane Collaboration's risk-of-bias tool, while the overall certainty of
the evidence was evaluated using the Grading of Recommendations
Assessment, Development, and Evaluation (GRADE) methodology. A total of 20
systematic reviews and meta-analyses of RCTs and observational studies
were included in this umbrella review. Among the primary outcomes, the
pooled analysis exhibited a significant reduction in all-cause mortality
(risk ratio [RR], 0.95; 95% confidence interval [CI], 0.91-1.00; P = .05;
I²= 0%), risk of major/life-threatening bleeding (RR, 0.73; 95%
CI, 0.66-0.82; P <= .00001; I²= 66%), and
stroke/thromboembolism (RR, 0.74; 95% CI, 0.67-0.82; P = .00001;
I²= 0%) in patients who were administered DOAC pharmacotherapy
as compared to VKAs. The only primary outcome that demonstrated clinically
insignificant results was all-cause stroke (RR, 0.9; 95% CI, 0.79-1.04; P
= .16; I²= 54%). Secondary outcomes such as intracranial
bleeding, any bleeding, and minor or clinically insignificant bleeding all
showed a significantly decreased risk in the DOAC group versus the VKA
group. Only two outcomes revealed an increased risk of cardiovascular
events and risk of ischemic stroke in patients who received DOACs;
however, these outcomes were statistically insignificant. According to our
analysis, DOACs exhibit a superior safety and efficacy profile to that of
VKAs when it comes to treating patients with BPVR. DOACs do not require
continuous monitoring; therefore, they could be an effective substitute
for VKAs in these individuals.<br/>Copyright &#xa9; 2025 Innovations in
Cardiac Rhythm Managemen. CC BY 4.0 license

<116>
Accession Number
648545209
Title
Outcomes of Scar-Related Ventricular Tachycardia Ablation With
Percutaneous Left Ventricular Assist Device Support.
Source
JACC. Clinical electrophysiology. (no pagination), 2025. Date of
Publication: 10 Sep 2025.
Author
Kawamura I.; Koruth J.S.; Kusa S.; Iwasawa J.; Lam J.; Ellsworth B.;
Watanabe K.; Nies M.; Lampert J.; Maan A.; Musikantow D.R.; Turagam M.K.;
Moss N.; Whang W.; Miller M.A.; Reddy V.Y.; Dukkipati S.
Institution
(Kawamura) Helmsley Electrophysiology Center, Department of Cardiology,
Icahn School of Medicine at Mount Sinai, New York, New York, USA;
Department of Cardiovascular Medicine, Institute of Science Tokyo, Tokyo,
Japan
(Koruth, Lam, Ellsworth, Watanabe, Nies, Lampert, Maan, Musikantow,
Turagam, Whang, Miller, Reddy, Dukkipati) Helmsley Electrophysiology
Center, Department of Cardiology, Icahn School of Medicine at Mount Sinai,
NY, United States
(Kusa) Helmsley Electrophysiology Center, Department of Cardiology, Icahn
School of Medicine at Mount Sinai, New York, New York, USA; Cardiovascular
Center, Tsuchiura Kyodo Hospital, Ibaraki, Japan
(Iwasawa) Helmsley Electrophysiology Center, Department of Cardiology,
Icahn School of Medicine at Mount Sinai, New York, New York, USA;
Department of Cardiology, Heart Rhythm Center, International University of
Health and Welfare Mita Hospital, Tokyo, Japan
(Moss) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, NY, United States
Abstract
BACKGROUND: Percutaneous left ventricular assist devices (pLVADs) are
often used in critically ill patients undergoing scar-related ventricular
tachycardia (VT) ablation. However, there are no randomized controlled
trials evaluating their benefits. <br/>OBJECTIVE(S): The goal of this
study was to compare outcomes between pLVAD- and non-pLVAD-supported VT
ablation using a propensity score matching analysis. <br/>METHOD(S): This
retrospective analysis comprised 481 scar-related VT patients who
underwent catheter ablation (175 pLVAD and 306 non-pLVAD). A 1:1
propensity score matching was conducted to balance baseline
characteristics for comparison of procedural and long-term outcomes.
<br/>RESULT(S): A propensity score analysis generated 115 matched pairs in
each group. Baseline characteristics of the matched cohorts were
comparable (mean left ventricular ejection fraction 27%, 40% NYHA
functional class >=III, and 36% electrical storm). Compared with the
non-pLVAD, more patients in the pLVAD group had at least 1 VT termination
during ablation. Despite including a higher use of advanced ablation
strategies and a longer procedure time, the pLVAD group had a
postprocedural VT inducibility similar to that of the non-pLVAD group. The
incidence of periprocedural major complications was higher among pLVAD
patients (29.6% vs 13.9%; P = 0.004), largely driven by vascular
complications requiring intervention and periprocedural heart failure.
During a median follow-up of 326 days, Kaplan-Meier curves showed no
statistically significant differences in composite outcome
(hospitalization for VT or worsening heart failure requiring
hospitalization, LVAD implantation, orthotopic heart transplantation, and
all-cause mortality), and VT recurrence. <br/>CONCLUSION(S): The use of
pLVADs during VT ablation is associated with longer procedures and higher
procedural complications without any benefit in acute or long-term
outcomes.<br/>Copyright &#xa9; 2025 American College of Cardiology
Foundation. Published by Elsevier Inc. All rights reserved.

<117>
Accession Number
648546522
Title
Effect of vitamin D on postoperative atrial fibrillation in patients
undergoing coronary artery bypass grafting: a systematic review and
meta-analysis.
Source
Minerva cardiology and angiology. (no pagination), 2025. Date of
Publication: 12 Sep 2025.
Author
Nisa F.; Nauman H.M.; Lal P.K.; Assad A.A.; Arain M.; Ali R.; Saleem H.M.;
Shafiq F.; Farooq A.U.; Zeb M.A.; Ijaz H.; Laeeq F.; Ibrahim M.; Arshad
M.S.
Institution
(Nisa) Department of Medicine, Fatima Jinnah Medical University, Lahore,
Pakistan
(Nauman) Department of Medicine, Shaikh Khalifa Bin Zayed Al-Nahyan
Medical and Dental College, Lahore, Pakistan
(Lal) Department of Medicine, Dow International Medical College, Dow
University of Health Sciences, Karachi, Pakistan
(Assad, Saleem) Department of Medicine, Allama Iqbal Medical College,
Lahore, Pakistan
(Arain, Arshad) Department of Medicine, Dow University of Health Sciences,
Karachi, Pakistan
(Ali) Department of Medicine, People University of Medical and Health
Sciences SBA, Nawabshah, Pakistan
(Shafiq) Department of Medicine, Karachi Medical and Dental College,
Karachi, Pakistan
(Farooq, Ijaz) Department of Medicine, King Edward Medical University,
Lahore, Pakistan
(Zeb) Department of Medicine, Swat Medical College, Khyber Pakhtunkhwa,
Pakistan
(Laeeq) Department of Medicine, Shalamar Medical and Dental College,
Lahore, Pakistan
(Ibrahim) Department of Medicine, Ziauddin University, Karachi, Pakistan
Abstract
INTRODUCTION: The aim of this paper was to determine whether vitamin D
supplementation reduces the incidence of postoperative atrial fibrillation
(POAF) in patients undergoing coronary artery bypass grafting (CABG).
EVIDENCE ACQUISITION: PubMed and Cochrane Central Register of Controlled
Trials were systematically searched from inception through May 2023 for
randomized controlled trials (RCTs) assessing the effectiveness of Vitamin
D in preventing atrial fibrillation among postoperative patients after
CABG. EVIDENCE SYNTHESIS: The primary outcome extracted was the incidence
of atrial fibrillation after Vitamin D in CABG patients. Secondary outcome
included the length of hospital stay. Data were pooled using a
random-effect model. A total of 4 RCTs, involving 694 patients, were
included in the final analysis. The results showed that Vitamin D
supplementation significantly reduced the incidence of POAF in CABG
patients (RR: 0.55; 95% CI: 0.40 to 0.76; P=0.0003; I2=1%). However,
administration of Vitamin D did not lead to significant reduction in the
length of hospital stay (WMD: -0.14; 95% CI: -0.82 to 0.53; P=0.68;
I2=34%). <br/>CONCLUSION(S): Our updated pooled analysis concludes that
vitamin D reduces the incidence of POAF in CABG patients. Future
large-scale studies should focus on more diverse patient populations and
explore a broader range of outcomes to better understand the full impact
of Vitamin D supplementation in this context.

<118>
Accession Number
2040432228
Title
Percutaneous Coronary Intervention in Multivessel Disease and
Infarct-Related Cardiogenic Shock: A DanGer Shock Substudy.
Source
JACC: Cardiovascular Interventions. 18(18) (pp 2226-2237), 2025. Date of
Publication: 22 Sep 2025.
Author
Marquard J.M.; Beske R.P.; Lonborg J.T.; Zako S.; Memisevic N.;
Konstantinou K.; Schrage B.; Moller J.E.; Jensen L.O.; Junker A.; Tange
Veien K.; Udesen N.L.J.; Schmidt H.; Hassager C.; Engstrom T.; Holmvang
L.; Kjaergaard J.; Sorensen R.; Lonborg J.; Fryldand M.; Paulin Beske R.;
Boesgaard S.; Eiskjaer H.; Christensen S.; Christiansen E.H.; Terkelsen
C.J.; Schafer A.; Linke A.; Woitek F.J.; Hommel J.; Mangner N.; Polzin A.;
Westenfeld R.; Schulze C.; Moebius-Winkler S.; Skurk C.; Nordbeck P.;
Clemmensen P.; Westermann D.; Panoulas V.; Zimmer S.; Werner N.
Institution
(Marquard, Beske, Hassager, Holmvang, Lonborg, Moller, Engstrom)
Department of Cardiology, Rigshospitalet, Copenhagen University Hospital,
Copenhagen, Denmark
(Hassager, Holmvang, Lonborg, Engstrom) Department of Clinical Medicine,
University of Copenhagen, Copenhagen, Denmark
(Jensen, Udesen, Junker, Moller) Department of Cardiology, Odense
University Hospital, Odense, Denmark
(Jensen, Moller) Department of Clinical Research, University of Southern,
Odense, Denmark
(Eiskjaer, Terkelsen) Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark
(Mangner, Linke) Department of Internal Medicine and Cardiology, Heart
Center Dresden, University Hospital, Technische Universitat Dresden,
Dresden, Germany
(Polzin, Zako) Department of Cardiology, Pulmonology and Vascular
Medicine, University Hospital Dusseldorf, Medical Faculty of the Heinrich
Heine University Dusseldorf, Dusseldorf, Germany
(Polzin, Zako) Cardiovascular Research Institute Dusseldorf, Dusseldorf,
Germany
(Schulze, Memisevic) Department of Internal Medicine I, Cardiology,
Angiology and Intensive Medical Care, University Hospital Jena, Jena,
Germany
(Skurk) Department of Cardiology, Angiology and Intensive Care Medicine,
Deutsches Herzzentrum der Charite, Campus Benjamin Franklin, Berlin,
Germany
(Skurk) Deutsches Zentrum fur Herz-Kreislauf-Forschung, Berlin, Germany
(Nordbeck) Department of Internal Medicine I, University Hospital
Wurzburg, Wurzburg, Germany
(Panoulas, Konstantinou) Department of Cardiology, Royal Brompton and
Harefield Hospitals, Guy's and St. Thomas' NHS Foundation Trust, Harefield
Hospital, Harefield, United Kingdom
(Zimmer) Department of Cardiology, University Hospital Bonn, Bonn, Germany
(Schafer) Department of Cardiology and Angiology, Hannover Medical School,
Hannover, Germany
(Werner) Department of Internal Medicine III, Heart Center Trier,
Krankenhaus der Barmherzigen Bruder, Trier, Germany
(Schmidt) Department of Anesthesiology and Intensive Care, Odense
University Hospital, Odense, Denmark
(Schrage, Clemmensen) Department of Cardiology, University Heart and
Vascular Center, University Clinic Hamburg-Eppendorf, Center for
Population Health Research, Hamburg, Germany
(Clemmensen) Department of Cardiology, Zealand University Hospital,
Roskilde and Nykobing Falster, Denmark
Publisher
Elsevier Inc.
Abstract
Background: The optimal percutaneous coronary intervention (PCI) strategy
in ST-segment elevation myocardial infarction (STEMI)-related cardiogenic
shock and multivessel disease remains uncertain. <br/>Objective(s): The
aim of this study was to investigate the association between PCI strategy
and outcomes in STEMI-related cardiogenic shock and multivessel disease.
<br/>Method(s): This exploratory substudy of the DanGer Shock
(Danish-German Cardiogenic Shock) multicenter trial included patients with
STEMI-related cardiogenic shock and multivessel disease, excluding
comatose patients resuscitated from cardiac arrest. Multivessel disease
was defined by >=1 nonculprit angiographic stenosis >=70%. Patients with
an isolated left main culprit were excluded. The planned PCI strategy was
registered before randomization. All analyses were performed according to
as-treated PCI strategy (immediate multivessel PCI or culprit-only PCI).
The primary outcome was all-cause mortality within 180 days; secondary
outcomes included renal replacement therapy and acute kidney injury.
<br/>Result(s): Of 355 patients included in the DanGer Shock trial, 221
(72%) had multivessel disease; of these, 118 (53%) were treated with
culprit-only PCI and 103 (47%) with immediate multivessel PCI. The median
pre-PCI SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery) scores
were 28 (Q1-Q3: 22-32) and 29 (Q1-Q3: 22-34), respectively. Chronic total
occlusion PCI was performed in 6 of 103 patients (6%) treated with
immediate multivessel PCI. All-cause mortality was 72 (61%; 95% CI:
52%-70%) in the culprit-only group and 52 (50%; 95% CI: 41%-60%) in the
immediate multivessel PCI group (adjusted OR: 0.40; 95% CI: 0.19-0.83)
over a median follow-up period of 45 days (Q1-Q3: 2-180 days). Immediate
multivessel PCI was not associated with the secondary outcomes. There was
no interaction according to randomization allocation and PCI strategy (P =
1.00). <br/>Conclusion(s): Immediate multivessel PCI was associated with
60% lower odds of all-cause mortality compared with culprit-only
PCI.<br/>Copyright &#xa9; 2025 American College of Cardiology Foundation

<119>
Accession Number
2039904457
Title
Efficacy of intravenous acetaminophen as adjunct analgesia in patients
undergoing cardiovascular surgery: a systematic review and meta-analysis.
Source
Korean Journal of Pain. 38(3) (pp 320-331), 2025. Date of Publication:
2025.
Author
Lee S.; Koo C.-H.; Bae Y.K.; Ryu J.-H.
Institution
(Lee, Koo, Bae, Ryu) Department of Anesthesiology and Pain Medicine, Seoul
National University Bundang Hospital, Seongnam, South Korea
(Lee, Koo, Ryu) Department of Anesthesiology and Pain Medicine, Seoul
National University College of Medicine, Seoul, South Korea
Publisher
Korean Pain Society
Abstract
Background: Although intravenous (IV) acetaminophen (AAP) may help reduce
severe postoperative pain and opioid use after cardiovascular surgery, its
effectiveness must be further validated. Therefore, the authors aimed to
evaluate the analgesic efficacy of perioperative IV AAP in patients
undergoing cardiovascular surgery by conducting this meta-analysis.
<br/>Method(s): A comprehensive literature search was conducted of PubMed,
Embase, CENTRAL, CINAHL, Scopus, and Web of Science databases for studies
published up to March 21, 2024. Six randomized controlled trials comparing
IV AAP with a placebo in cardiovascular surgery were included. The mean
difference (MD) was calculated to estimate pooled effect sizes. The
primary outcome was opioid consumption, measured in morphine equivalent
dose, and the secondary outcome was postoperative pain score.
<br/>Result(s): Postoperative opioid consumption was significantly reduced
with IV AAP than it was with a placebo (MD: -21.68, 95% confidence
interval [CI]: -38.41 to -4.95, P = 0.011). Significant reductions in
postoperative pain scores were observed at 6 hours (MD: -0.76, 95% CI:
-1.43 to -0.10, P = 0.025) and 24 hours (MD: -0.63, 95% CI: -1.02 to
-0.25, P = 0.001) after surgery. However, these reductions did not meet
clinically meaningful thresholds. No significant differences were observed
at 12, 18, and 48 hours postoperatively. <br/>Conclusion(s): IV AAP was
more effective than a placebo for postoperative adjunct analgesia in
patients who underwent cardiovascular surgery.<br/>Copyright &#xa9; The
Korean Pain Society. This is an Open Access article distributed under the
terms of the Creative Commons Attribution Non-Commercial License
(https://creativecommons.org/licenses/by-nc/4.0), which permits
unrestricted non-commercial use, distribution, and reproduction in any
medium, provided the original work is properly cited.