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<1>
Accession Number
2040876112
Title
Transcatheter versus surgical treatment in aortic stenosis with coronary
artery disease: A meta-analysis of time-to-event data on 162,305 patients.
Source
Heart and Lung. 75 (pp 184-197), 2026. Date of Publication: 01 Jan 2026.
Author
Emara A.; Emara M.; Gadelmawla A.F.; Murad M.R.; Aboeldahab H.; Elgendy
M.S.; Hassanin M.S.; Aldemerdash M.A.; Othman A.M.; Khaled M.; Shubietah
A.; Assaassa A.; Bapat V.N.
Institution
(Emara, Emara, Murad, Hassanin) Faculty of Medicine, Al-Azhar University,
Cairo, Egypt
(Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Gadelmawla, Murad, Aboeldahab, Hassanin) Medical Research Group of Egypt
(MRGE), Negida Academy, Arlington, MA, United States
(Aboeldahab) Clinical Research Department, El-Gomhoria General Hospital,
Ministry of health and population, Alexandria, Egypt
(Elgendy) Faculty of Medicine, Tanta University, Tanta, Egypt
(Aldemerdash) Faculty of Medicine, Sohag University, Sohag, Egypt
(Othman) Faculty of Medicine, Kafr El Sheik University, Kafr El Sheik,
Egypt
(Khaled) Faculty of Medicine, Alexandria University, Alexandria, Egypt
(Shubietah) Department of Medicine, Advocate Illinois Masonic Medical
Center, Chicago, IL, United States
(Assaassa) Department of Cardiology, Thomas Jefferson University Hospital,
Philadelphia, PA, United States
(Bapat) Department of Cardiac Surgery, Minneapolis Heart Institute, Abbott
Northwestern Hospital, Minneapolis, MN, United States
Publisher
Elsevier Inc.
Abstract
Background: Severe aortic stenosis (AS) often coexists with coronary
artery disease (CAD), present in about 50 % of patients undergoing valve
intervention. Surgical aortic valve replacement (SAVR) with coronary
artery bypass graft (CABG) has been the traditional standard, providing
revascularization and durability, whereas transcatheter aortic valve
replacement (TAVR) with percutaneous coronary intervention (PCI) offers a
less invasive option. PCI + TAVR may lower perioperative risk, but SAVR +
CABG may confer superior survival, with conflicting evidence.
 Objective(s): This meta-analysis of time-to-event data aimed to
compare PCI + TAVR with CABG + SAVR in patients with concomitant AS and
CAD. Method(s): We systematically searched PubMed, Web of Science,
Scopus, and Cochrane databases up to March 2025. Individual patient data
(IPD) were reconstructed from published Kaplan-Meier curves to estimate
hazard ratios (HRs) for all-cause mortality. Dichotomous outcomes were
analyzed using risk ratios (RR) with 95 % confidence intervals (CI).
 Result(s): Fifteen studies including 162,305 patients were analyzed.
PCI + TAVR was associated with higher all-cause mortality at 48 months (HR
1.29, 95 % CI 1.23-1.35, p < 0.001), but lower in-hospital acute kidney
injury (RR 0.37, 95 % CI 0.21-0.66, p = 0.0007), short-term (<=30 days)
major adverse cardiovascular events (RR 0.67, 95 % CI 0.50-0.91, p =
0.0093), and new-onset atrial fibrillation (RR 0.23, 95 % CI 0.17-0.32, p
< 0.0001). Conversely, long-term (>30 days) myocardial infarction risk was
higher (RR 1.61, 95 % CI 1.08-2.39, p = 0.01). Conclusion(s):
PCI+TAVR was associated with higher mortality or adverse event rates
compared to CABG+SAVR, but lower perioperative complications. High-quality
randomized trials are warranted to confirm these findings. Copyright
© 2025 Elsevier Inc.

<2>
Accession Number
2034459476
Title
Role of nicorandil in preventing contrast-induced nephropathy in patients
undergoing cardiac catheterization procedures: an updated systematic
review and meta-analysis.
Source
International Urology and Nephrology. 57(11) (pp 3671-3685), 2025. Date of
Publication: 01 Nov 2025.
Author
Khan A.A.; Tahir M.Z.; Maryam K.U.E.; Uzair M.; Haram; Faheem M.S.B.;
Zainab; Abdullah A.; Anwer A.; Ashraf D.A.; Ahmed A.K.; Rahim S.; Arshad
M.S.
Institution
(Khan, Maryam, Ashraf) Department of Internal Medicine, Foundation
University Medical College Islamabad, Islamabad, Pakistan
(Tahir) Department of Internal Medicine, Punjab Medical College,
Faisalabad, Pakistan
(Uzair) Ziauddin Medical College, Karachi, Pakistan
(Haram) Rehman Medical College, Peshawar, Pakistan
(Faheem) Department of Internal Medicine, Karachi Institute of Medical
Sciences, KIMS, Sindh, Karachi, Pakistan
(Zainab) Allama Iqbal Medical College, Lahore, Pakistan
(Abdullah, Anwer) Amna Inayat Medical College, Sheikhupura, Pakistan
(Ahmed) Jinnah Medical and Dental College, Karachi, Pakistan
(Rahim) King Edward Medical University, Lahore, Pakistan
(Arshad) Dow University of Health Sciences, Islamabad, Pakistan
Publisher
Springer Science and Business Media B.V.
Abstract
Background: Contrast-induced nephropathy (CIN) is a major risk for
patients undergoing coronary angiography (CAG) and percutaneous coronary
intervention (PCI). Method(s): PubMed, MEDLINE, Embase, Google
Scholar, and Web of Science were searched through May 2024 to include
randomized controlled trials (RCTs) assessing the efficacy and safety of
nicorandil administration in patients following CAG or PCI. Outcomes of
interest included the CIN incidence, major adverse events, serum
creatinine, serum cystatin C, BUN and eGFR. Risk ratios (RRs) and standard
mean differences (SMDs) with 95% confidence intervals (CIs) were
calculated using random-effects model. Statistical heterogeneity was
assessed using I2 statistics. Result(s): Twelve studies (n = 2931
patients) were included in the final analysis. Nicorandil significantly
reduced the CIN incidence (RR: 0.40 [0.31,0.52]; p < 0.00001), with
consistent results for oral (RR: 0.35 [0.25,0.48]; p < 0.00001) and
intravenous administration (RR: 0.52 [0.30,0.92]; p = 0.02) (p-interaction
= 0.22). Oral nicorandil reduced the risk of major adverse events (RR:
0.71 [0.51,0.99]; p = 0.05). Among patients on nicorandil, serum
creatinine levels were significantly lower at 48 h (SMD: -0.30
[-0.52,-0.07]; p = 0.009), and 72 h post-intervention (SMD: -0.42
[-0.71,-0.13]; p = 0.004). Nicorandil significantly reduced serum cystatin
C levels at 48 h post-intervention (SMD: -0.56 [-1.01,-0.01]; p = 0.02).
However, nicorandil did not significantly affect eGFR values at 24-h (SMD:
0.12 [-0.21,0.45]; p = 0.46), 48-h (SMD: 0.08 [-0.19,0.35]; p = 0.58), and
72-h (SMD: 0.34 [-0.13,0.81]; p = 0.16). Conclusion(s): Nicorandil
administration reduces the CIN incidence and improves renal biomarkers in
patients undergoing CAG and PCI. Large-scale trials with longer follow-up
periods are warranted to confirm renoprotective effects of
nicorandil. Copyright © The Author(s), under exclusive licence to
Springer Nature B.V. 2025.

<3>
Accession Number
2040844300
Title
Intravascular Imaging vs Angiography Guidance for PCI of Severely
Calcified Lesions: The ECLIPSE Trial.
Source
JACC: Cardiovascular Interventions. 18(19) (pp 2338-2351), 2025. Date of
Publication: 13 Oct 2025.
Author
Stone G.W.; Genereux P.; Maehara A.; Lewis B.E.; Shlofmitz R.A.; Dohad S.;
Choudary J.; Dahle T.; Pineda A.M.; Shunk K.; Mahmud E.; Weisz G.; Collins
M.B.; Alaswad K.; Kumar G.; Solankhi N.; Dulas D.; Altman J.D.; Kraemer
C.; Stiefel K.M.; Jones D.E.; Buccola J.R.; Kirtane A.J.
Institution
(Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Maehara, Kirtane) Cardiovascular Research Foundation, New York, NY,
United States
(Maehara, Weisz, Collins, Kirtane) Columbia University Medical
Center/NewYork-Presbyterian Hospital, New York, NY, United States
(Lewis) Loyola University Medical Center, Chicago, IL, United States
(Shlofmitz) St. Francis Hospital, Roslyn, NY, United States
(Dohad) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Choudary) Reid Health Physicians Associates, Richmond, IN, United States
(Dahle) CentraCare Heart & Vascular Center, St. Cloud, MN, United States
(Pineda) Duke University Medical Center, Durham, NC, United States
(Shunk) University of California-San Francisco, San Francisco, CA, United
States
(Shunk) San Francisco VA Medical Center, San Francisco, California, United
States
(Mahmud) University of California-San Diego, San Diego, CA, United States
(Alaswad) Henry Ford Hospital, Detroit, MI, United States
(Kumar) Emory Healthcare, Atlanta, GA, United States
(Kumar) Atlanta VA Medical Center, Atlanta, GA, United States
(Solankhi) University of Louisville, Louisville, KY, United States
(Dulas) Metropolitan Heart and Vascular Institute, Coon Rapids, MN, United
States
(Altman) Colorado Heart and Vascular, Lakewood, CO, United States
(Kraemer, Stiefel, Jones, Buccola) Abbott Vascular, Santa Clara,
California, United States
Publisher
Elsevier Inc.
Abstract
Background: Few studies have examined whether intravascular imaging (IVI)
guidance during percutaneous coronary intervention (PCI) of calcified
lesions improves clinical outcomes. Objective(s): The aim of this
study was to determine from a large-scale randomized trial of PCI in
severely calcified lesions whether IVI guidance improves event-free
survival. Method(s): In the ECLIPSE (Evaluation of Treatment
Strategies for Severe Calcific Coronary Arteries: Orbital Atherectomy vs.
Conventional Angioplasty Technique Prior to Implantation of Drug-Eluting
Stents) trial, 2,005 patients with severely calcified lesions were
randomized to orbital atherectomy (OA) vs balloon angioplasty (BA) prior
to drug-eluting stent placement. IVI with optical coherence tomography or
intravascular ultrasound (IVUS) was allowed at operator discretion. The
primary clinical outcome was the 1-year rate of target vessel failure
(TVF). Result(s): IVI guidance was used in 1,246 of 2,005 patients
(62.1%), including optical coherence tomography in 819 and/or IVUS in 513,
while 759 of 2,005 patients (37.9%) underwent PCI with angiographic
guidance alone. Median follow-up duration was 365 days (Q1-Q3: 365-365
days). The 1-year Kaplan-Meier estimated rate of TVF was lower among
patients with IVI guidance compared with angiographic guidance alone (9.3%
vs 13.2%; adjusted HR: 0.74; 95% CI: 0.56-0.97; P = 0.03). The effect of
IVI guidance was consistent in patients randomized to OA vs BA
(P<inf>interaction</inf> = 0.48). The 1-year rate of TVF was 7.7% after
optical coherence tomographic guidance compared with 12.2% after IVUS
guidance (adjusted HR: 0.78; 95% CI: 0.52-1.18; P = 0.24).
 Conclusion(s): IVI guidance during PCI of severely calcified lesions
was associated with improved 1-year clinical outcomes compared with
angiographic guidance alone, whether OA or BA was used for vessel
preparation prior to drug-eluting stent placement. The adjusted difference
in 1-year TVF rates were not significantly different with optical
coherence tomographic guidance and IVUS guidance. Copyright ©
2025 The Authors

<4>
Accession Number
2040642703
Title
Effect of Dapagliflozin on Quality of Life of Patients With Aortic
Stenosis Undergoing Transcatheter Aortic Valve Implantation.
Source
Journal of the American College of Cardiology. 86(15) (pp 1128-1138),
2025. Date of Publication: 14 Oct 2025.
Author
Bonanad-Lozano C.; Garcia Blas S.; Amat-Santos I.; Gonzalez-Manzanares R.;
Sanchis J.; Lopez Otero D.; Nombela Franco L.; Gheorge L.; Sanz-Sanchez
J.; Baladron Zorita C.; Iniguez Romo A.; Munoz Garcia A.J.; Vilalta V.;
Ojeda S.; Veiga Fernandez G.; Cordoba Soriano J.G.; Cepas P.; Sandin
Rollan M.; Rios X.F.; Palma-Carbajal R.; Martin Reyes R.; Romaguera R.;
Avanzas P.; Franco-Pelaez J.A.; Martin Moreiras J.; Gonzalez Juanatey
J.R.; Tirado G.; Calle G.; Diez J.L.; Santos-Martinez S.; Dominguez
Erquicia P.; Garcia E.M.; Fernandez-Nofrerias E.; Lopez Pais J.; Gonzalo
N.; Barri A.G.; Asmarats L.; Lopez Perez M.; Dominguez Rodriguez L.M.;
Cobo M.; Gonzalez Bermudez I.; Garcia Alvarez A.; Garcia Pavia P.; Fuster
V.; Ibanez B.; Raposeiras-Roubin S.
Institution
(Bonanad-Lozano, Garcia Blas, Sanchis) Clinic University Hospital of
Valencia, Valencia, Spain
(Bonanad-Lozano, Garcia Blas, Sanchis) INCLIVA Biomedical Research
Institute, Valencia, Spain
(Bonanad-Lozano, Sanchis) Department of Medicine, Faculty of Medicine,
University of Valencia, Valencia, Spain
(Bonanad-Lozano, Garcia Blas, Amat-Santos, Gonzalez-Manzanares, Sanchis,
Lopez Otero, Baladron Zorita, Ojeda, Gonzalez Juanatey, Ibanez) Centro de
Investigacion Biomedica en Red Enfermedades Cardiovasculares (Center for
Biomedical Network Research for Cardiovascular Diseases; CIBER-CV), Spain
(Amat-Santos, Baladron Zorita, Santos-Martinez) Department of Cardiology,
University Clinical Hospital of Valladolid, Valladolid, Spain
(Gonzalez-Manzanares, Ojeda) Department of Cardiology, University Hospital
Reina Sofia, Cordoba, Spain
(Gonzalez-Manzanares, Ojeda) Instituto Maimonides de Investigacion
Biomedica de Cordoba (Maimonides Institute of Biomedical Ressearch of
Cordoba, IMIBIC), Cordoba, Spain
(Lopez Otero) Department of Cardiology, University Hospital Montecelo,
Pontevedra, Spain
(Lopez Otero, Gonzalez Juanatey, Lopez Pais) Department of Cardiology,
University Clinical Hospital of Santiago de Compostela, Pontevedra, Spain
(Lopez Otero, Iniguez Romo, Dominguez Erquicia, Gonzalez Bermudez,
Raposeiras-Roubin) Instituto de Investigacion Sanitaria Galicia Sur
(Health Research Institute of Southern Galicia), Vigo, Spain
(Nombela Franco, Tirado, Gonzalo) Department of Cardiology, University
Clinical Hospital San Carlos, Madrid, Spain
(Gheorge, Calle, Barri) Department of Cardiology, University Hospital
Puerta del Mar, Cadiz, Spain
(Sanz-Sanchez, Diez) Department of Cardiology, University Hospital La Fe,
Valencia, Spain
(Iniguez Romo, Dominguez Erquicia, Gonzalez Bermudez, Raposeiras-Roubin)
Department of Cardiology, University Hospital Alvaro Cunqueiro, Vigo,
Spain
(Munoz Garcia, Garcia) Department of Cardiology, University Hospital
Virgen de la Victoria, Malaga, Spain
(Vilalta, Fernandez-Nofrerias) Department of Cardiology, University
Hospital German Trias i Pujol, Badalona, Spain
(Ojeda) Universidad de Cordoba, Cordoba, Spain
(Veiga Fernandez) Department of Cardiology, University Hospital Marques de
Valdecilla, Santander, Spain
(Veiga Fernandez) IDIVAL, Santander, Spain
(Cordoba Soriano) Department of Cardiology, University Hospital of
Albacete, Albacete, Spain
(Cepas, Garcia Alvarez) Department of Cardiology, University Clinical
Hospital, Barcelona, Spain
(Sandin Rollan) Department of Cardiology, University General Hospital of
Alicante, Alicante, Spain
(Rios) Department of Cardiology, University Hospital Juan Canalejo, A
Coruna, Spain
(Palma-Carbajal) Department of Cardiology, University Hospital Vall
D'Hebron, Barcelona, Spain
(Martin Reyes) Department of Cardiology, University Hospital Quiron Salud
La Luz, Madrid, Spain
(Romaguera) Department of Cardiology, University Hospital Bellvitge,
Barcelona, Spain
(Avanzas) Department of Cardiology, University Hospital Central de
Asturias, Oviedo, Spain
(Franco-Pelaez, Ibanez) Department of Cardiology, University Hospital
Fundacion Jimenez Diaz, Madrid, Spain
(Martin Moreiras) Department of Cardiology, University Clinical Hospital
of Salamanca, Salamanca, Spain
(Gonzalez Juanatey) Instituto de Investigacion Sanitaria de Santiago
(Santiago Institute of Health Research, IDIS), Santiago de Compostela,
Spain
(Gonzalez Juanatey, Raposeiras-Roubin) University of Santiago de
Compostela, Santiago de Compostela, Spain
(Asmarats) Department of Cardiology, University Hospital Santa Creu i Sant
Pau, Barcelona, Spain
(Lopez Perez) Department of Cardiology, University Hospital San Cecilio,
Granada, Spain
(Dominguez Rodriguez) Department of Cardiology, University Hospital Ramon
y Cajal, Madrid, Spain
(Cobo, Garcia Pavia) Diipartment of Cardiology, University Hospital Puerta
del Hierro, Madrid, Spain
(Fuster, Ibanez, Raposeiras-Roubin) Centro Nacional de Investigaciones
Cardiovasculares Carlos III (Carlos III National Center of Cardiovascular
Research, CNIC), Madrid, Spain
(Fuster) Cardiovascular Institute, Icahn School of Medicine at Mount
Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Patients with aortic stenosis who undergo transcatheter aortic
valve implantation (TAVI) experience a great improvement in health status.
Dapagliflozin has been shown to reduce death and heart failure (HF) in
these patients. However, the impact of dapagliflozin on improving health
status after TAVI is unknown. Objective(s): In this prespecified
analysis of the DapaTAVI (Dapagliflozin After Transcatheter Aortic Valve
Implantation) trial, we examined the effects of dapagliflozin on health
status by using the Kansas City Cardiomyopathy Questionnaire (KCCQ).
 Method(s): The DapaTAVI trial randomized patients undergoing TAVI to
receive or not receive dapagliflozin. We assessed the change in KCCQ score
from baseline to 3 and 12 months by using an ordinal logistic regression
model. Additionally, we analyzed the effect of dapagliflozin on the
composite of death or worsening HF by baseline KCCQ score. Result(s):
A total of 964 patients had baseline KCCQ scores (mean 39.5 +/- 22.2).
Patients in both arms of the study exhibited improvements in KCCQ score,
without significant differences between groups in the change in KCCQ score
at 3 or 12 months (3-month OR for improvement: 0.96; 95% CI: 0.72-1.26; P
= 0.745; 12-month OR: 1.03; 95% CI: 0.83-1.27; P = 0.819). At 12 months,
similar proportions of patients in the dapagliflozin and control groups
showed clinically meaningful improvements, with 43.4% vs 45.4%,
respectively, improving by >50 points. The clinical benefits of
dapagliflozin after TAVI appeared to be similar across the full range of
baseline KCCQ scores. Conclusion(s): TAVI was associated with a
substantial improvement in KCCQ scores. However, the addition of
dapagliflozin following the procedure did not confer an additional benefit
in health status compared with standard care. (Dapagliflozin After
Transcatheter Aortic Valve Implantation [DapaTAVI];
NCT04696185). Copyright © 2025 American College of Cardiology
Foundation

<5>
Accession Number
2034815839
Title
Prophylactic cardiac denervation to prevent post-operative atrial
fibrillation after coronary artery bypass grafting: a systematic review
and meta-analysis.
Source
Journal of Interventional Cardiac Electrophysiology. 68(8) (pp 1671-1682),
2025. Date of Publication: 01 Nov 2025.
Author
Ali J.; Khan M.H.; Majeed Z.; Elsnhory A.B.; Argueta A.E.S.; Afiridi L.;
Nawaz A.; Abuelazm M.; Khan U.; Aamir M.; Dani S.
Institution
(Ali, Argueta, Afiridi) Department of Medicine, Saint Peter's University
Hospital, New Brunswick, NJ, United States
(Khan) Department of Medicine, Saidu Medical College, Swat, Pakistan
(Majeed) Department of Medicine, King Edward Medical University, Lahore,
Pakistan
(Elsnhory) Emergency Medicine Department, Al-Azhar University, Cairo,
Egypt
(Nawaz) Department of Radiology, Pakistan Atomic Energy Commission
Hospital, Islamabad, Pakistan
(Abuelazm) Faculty of Medicine, Tanta University, Tanta, Egypt
(Khan) Division of Cardiology, University of Maryland School of Medicine,
Baltimore, MD, United States
(Aamir) Department of Cardiology, Lehigh Valley Health Network, Allentown,
PA, United States
(Dani) Department of Cardiology, Lahey Hospital & Medical Center,
Burlington, MA, United States
Publisher
Springer
Abstract
Background: Despite revolutionary advances in the field of percutaneous
coronary intervention (PCI), a significant number of patients with
coronary artery disease (CAD) require coronary artery bypass grafting
(CABG), which is associated with postoperative atrial fibrillation (POAF)
risk. This meta-analysis evaluates the efficacy and safety of prophylactic
cardiac denervation (PCD) during CABG to prevent POAF. Method(s): A
systematic search was conducted across PubMed, CENTRAL, Web of Science,
Scopus, and Embase until December 2024. Pooled data were reported using
risk ratio (RR) for dichotomous outcomes and mean difference (MD) for
continuous outcomes, with a 95% confidence interval (CI). This systematic
review and meta-analysis is registered with PROSPERO ID: CRD42025631310.
 Result(s): Five studies with 1266 patients were included in the final
analysis. Compared to CABG alone, CABG plus PCD did not show any
significant difference in the incidence of POAF (RR 0.77, [95% CI 0.38,
1.56], p = 0.47, I2 = 83%) and all-cause mortality (RR 0.70,
[95% CI 0.19, 2.51], p = 0.58, I2 = 0). Additionally, there was
no significant difference between both groups in cross-clamp time (MD:
0.68, [95% CI - 1.22, 2.57], p = 0.48, I2 = 26%),
cardiopulmonary bypass time (MD - 0.04 [95% CI - 5.29, 5.21], p = 0.99,
I2 = 82%), length of hospital stay (MD - 0.13 [95% CI - 0.55,
0.29], p = 0.54, I2 = 59%), blood loss (MD 2.22, [95% CI -
23.60, 28.03], p = 0.87, I2 = 0%), and number of grafts (MD
0.21, [95% CI - 0.07, 0.49], p = 0.13, I2 = 91%).
 Conclusion(s): CABG with adjuvant PCD did not show significant
efficacy in preventing the incidence of POAF compared to CABG alone. This
calls for further research focusing on investigating combined preventive
strategies, rather than relying solely on PCD, and developing risk
stratification tools to identify patients most likely to benefit from
autonomic modulation. Copyright © The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature
2025.

<6>
Accession Number
2036306307
Title
Global challenges of bacterial infections in organ transplantation:
assessment of risk factors and predominant bacterial pathogen profiles
threatening liver, kidney, heart, and lung transplant recipients.
Source
BMC Infectious Diseases. 25(1) (no pagination), 2025. Article Number:
1153. Date of Publication: 01 Dec 2025.
Author
Moradi F.; Bahrami M.; Nasrollahian S.; Shirazi P.S.; Ghoreyshi N.S.;
Ghobadi M.
Institution
(Moradi, Bahrami, Nasrollahian, Shirazi, Ghoreyshi) Department of
Bacteriology & Virology, School of medicine, Shiraz University of Medical
Sciences, Zand St, Imam Hossein Sq, Shiraz, Iran, Islamic Republic of
(Ghobadi) Department of Anesthesia, School of Nursing and Midwifery,
Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
Background: Bacterial infections, especially those caused by
multidrug-resistant organisms, remain a major threat to the survival of
organ transplant recipients. This review aimed to systematically assess
the most common bacterial pathogens, risk factors, and prevention
strategies in solid organ transplantation (SOT), focusing on liver,
kidney, heart, and lung transplants. Method(s): A systematic search
was conducted across PubMed, Scopus, Web of Science, and Google Scholar
databases for studies published between 2015 and 2024. Studies were
selected based on inclusion criteria targeting bacterial infections in
human transplant recipients. Data were extracted on infection types,
bacterial species, risk factors, immunosuppressive regimens, and
antimicrobial prophylaxis. Result(s): Among 75 eligible articles, 26
met the inclusion criteria. Escherichia coli, Klebsiella spp., and
Pseudomonas aeruginosa were the predominant pathogens in most transplant
types. Urinary tract infections were most frequent in kidney transplants,
while lung, heart, and liver transplant recipients exhibited broader
pathogen diversity, including MRSA, VRE, and Acinetobacter. Major risk
factors included immunosuppressive therapy, pre-transplant colonization,
prolonged ICU stay, and donor-derived MDR organisms. Antibiotic
prophylaxis and immunosuppressive regimens varied across studies, with no
universal consensus on optimal protocols. Conclusion(s): Bacterial
infections significantly impact graft survival and patient outcomes,
particularly during the early post-transplant period. Efficient infection
prevention, tailored antimicrobial prophylaxis, and optimized
immunosuppressive management are essential for improving transplant
success rates. Copyright © The Author(s) 2025.

<7>
Accession Number
2040875086
Title
Body Composition and Treatment Response in Heart Failure With Preserved
Ejection Fraction: Interpreting the Adipokine Hypothesis.
Source
Journal of the American College of Cardiology. 86(16) (pp 1256-1259),
2025. Date of Publication: 21 Oct 2025.
Author
Vest A.R.; Ilonze O.J.; Umapathi P.; Harrington J.
Institution
(Vest) Kaufman Center for Heart Failure Treatment and Recovery, Department
of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute,
Cleveland Clinic, Cleveland, OH, United States
(Ilonze) Division of Cardiovascular Medicine, Krannert Cardiovascular
Research Center, Indiana University School of Medicine, Indianapolis, IN,
United States
(Umapathi) Division of Cardiology, Department of Medicine, Johns Hopkins
University School of Medicine, Baltimore, MD, United States
(Harrington) Division of Cardiology, University of Colorado Medical
School, Aurora, CO, United States
(Harrington) Colorado Prevention Center, Aurora, CO, United States
Publisher
Elsevier Inc.

<8>
Accession Number
2040783061
Title
EFFICIENCY OF TAPERING PROGRAMMED INTERMITTENT EPIDURAL ANALGESIA IN
VIDEO-ASSISTED THORACIC SURGERY: A DOUBLE-BLIND, PROSPECTIVE, RANDOMIZED
STUDY.
Source
European Review for Medical and Pharmacological Sciences. 29(9) (pp
434-442), 2025. Date of Publication: 2025.
Author
Matsumoto A.; Satomi S.; Narasaki S.; Kamiya S.; Miyoshi H.; Tsutsumi Y.M.
Institution
(Matsumoto, Satomi, Narasaki, Kamiya, Miyoshi, Tsutsumi) Department of
Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Kasumi,
Japan
Publisher
Verduci Editore s.r.l
Abstract
Objective: Programmed intermittent epidural bolus (PIEB) is an effective
analgesic method owing to the redistribution of the drug solution, which
leads to a gradual improvement in postoperative pain over time. This study
aimed to compare the postoperative analgesic effects of patient-controlled
epidural analgesia (PCEA) with those of tapering PIEB (t-PIEB), in which
the drug dosage is decreased over time, and continuous epidural infusion
(CEI). Material(s) and Method(s): Patients undergoing video-assisted
thoracoscopic surgery (VATS) with general and epidural anesthesia were
randomized in a 1:1 ratio into the t-PIEB and CEI groups. Patients in the
t-PIEB group received 3 mL of 0.2% ropivacaine from the pump every hour,
whereas those patients in the CEI group received the same drug solution
continuously at a rate of 3 mL/h. In both groups, a 2-mL bolus of 0.2%
ropivacaine was administered postoperatively, with additional PCEA as
needed. In the t-PIEB group, the dosage was gradually decreased to 2
mL/dose after 25 h and to 1 mL/dose after 49 h. The primary endpoint was
the number of times the patient pressed the PCA button at 24, 48, and 72
h. Result(s): No significant difference was observed in the frequency
of PCA button pressing between the two groups during the observation
period. The t-PIEB group had a significantly lower usage of ropivacaine.
 Conclusion(s): Nt-PIEB could have analgesic effects comparable to
those of CEI for postoperative pain following VATS with less medication
use. Copyright © This work is licensed under a Creative Commons
Attribution-NonCommercial-ShareAlike 4.0 International License

<9>
Accession Number
2036379942
Title
Effects of pressure-controlled ventilation-volume guaranteed on children
undergoing thoracic surgery: a prospective, randomized controlled trial.
Source
Frontiers in Medicine. 12 (no pagination), 2025. Article Number: 1647682.
Date of Publication: 2025.
Author
Wang L.; Zhu Y.; Zhu S.; Yan L.; Du Z.; Xiao T.; Qu S.
Institution
(Wang, Zhu, Zhu, Yan, Du, Xiao, Qu) Department of Anesthesiology, The
Affiliated Children's Hospital of Xiangya School of Medicine, Central
South University (Hunan Children's Hospital), Changsha, China
Publisher
Frontiers Media SA
Abstract
Background: Children have higher morbidity and mortality than adults
during thoracic surgery with one-lung ventilation (OLV), reducing the
incidence may in part be achieved by the use of appropriate mechanical
ventilation mode. This study evaluated whether pressure-controlled
ventilation-volume guaranteed (PCV-VG) reduces intrapulmonary shunt
(Qs/Qt) and ventilator-induced lung injury (VILI) in pediatric patients.
 Method(s): Eighty children underwent thoracic surgery requiring OLV
were randomly divided into PCV-VG group and volume-controlled ventilation
(VCV) group. The PCV-VG group utilized the PCV-VG during surgery, whereas
the other group employed the VCV. The parameter settings during two-lung
and OLV were consistent between the groups. The primary outcome comprised
the Qs/Qt fraction. The secondary outcomes encompassed respiratory
parameters, blood gas analysis results, the occurrence of postoperative
pulmonary complications (PPCs), and more. Result(s): Following PCV-VG
implementation, the median Qs/Qt during OLV exhibited a significant
improvement (18.2 to 12.7 at T2, 11.4 to 9.1 at T3, p<0.0001).
Additionally, compared with VCV, PCV-VG improved oxygenation during OLV
(higher PaO<inf>2</inf>, PaO<inf>2</inf>/FiO<inf>2</inf>, and other
oxygenation indices), reduced airway pressure during OLV
(25cmH<inf>2</inf>O to 20cmH<inf>2</inf>O at T2, p<0.0001), and lowered
the incidence of PPCs [38.5 to 7.3%, adjusted odds ratio (OR) 0.13, 95%
confidence interval (CI): 0.03-0.50, p=0.001], shortened the duration of
postoperative mechanical ventilation [120min to 110min, difference (95%
CI), 20 (0 to 40), p=0.036]. Conclusion(s): Implementation of PCV-VG
for children undergoing thoracic surgery demonstrated significant
benefits. It can improve Qs/Qt, increase oxygenation, reduce airway
pressure, and alleviate VILI during OLV. Clinical trial registration:
Clinicaltrials.gov, identifier ChiCTR2200065237. Copyright © 2025
Wang, Zhu, Zhu, Yan, Du, Xiao and Qu.

<10>
Accession Number
2036310751
Title
The prognostic role of right ventricular-pulmonary arterial coupling in
aortic stenosis patients undergoing TAVR: a systematic review and
meta-analysis.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
683. Date of Publication: 01 Dec 2025.
Author
Wu F.; Liao Y.
Institution
(Wu, Liao) Department of Cardiology, West China Hospital, Sichuan
University, 37 Guo Xue Street, Chengdu, China
(Wu, Liao) Cardiac Structure and Function Research Key Laboratory of
Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
(Wu, Liao) Laboratory of Cardiac Structure and Function, Institute of
Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu,
China
(Liao) Department of High Altitude Medicine, Center for High Altitude
Medicine, West China Hospital, Sichuan University, Sichuan, Chengdu, China
Publisher
BioMed Central Ltd
Abstract
Background: The predictive role of right ventricular-pulmonary arterial
(RV-PA) uncoupling following transcatheter aortic valve replacement (TAVR)
in patients with aortic stenosis (AS) is inconsistent. Thus, this
meta-analysis aimed to evaluate the prognostic value of RV-PA coupling in
patients undergoing TAVR. Method(s): We systematically searched
PubMed, Embase, and Web of Science databases for studies reporting the
prognostic relevance of RV-PA coupling in patients undergoing TAVR. Fixed-
or random-effects models were employed according to heterogeneity.
Subgroup analyses were conducted to evaluate the influence of study
characteristics on the analyzed results. Result(s): Eighteen studies
involving 5,905 patients were included. The pooled results demonstrated
that RV-PA uncoupling prior to TAVR was associated with the increased
all-cause mortality risk, with a hazard ratio (HR) of 2.36 (95% CI:
1.76-3.16) in univariate analysis and an adjusted hazard ratio (aHR) of
2.01 (95% CI: 1.40-2.89) in multivariate analysis. Moreover, both
non-severe RV-PA (HR = 1.71, 95% CI: 1.02-2.86) and severe RV-PA
uncoupling (HR = 2.73, 95% CI: 1.50-4.95) were associated with elevated
mortality risk in univariate analysis. Multivariate analysis showed
increased all-cause mortality risk in patients with non-severe/severe
uncoupling, but these findings were not statistically significant.
 Conclusion(s): RV-PA uncoupling was identified as a predictor of
adverse outcomes after TAVR. Incorporating assessment of RV-PA coupling
may enhance risk stratification and prognostic prediction in the TAVR
patient population. Copyright © The Author(s) 2025.

<11>
Accession Number
2039714521
Title
Transcatheter edge-to-edge repair in patients with mitral annular
calcification: A systematic review and meta-analysis.
Source
American Journal of the Medical Sciences. 370(5) (pp 452-457), 2025. Date
of Publication: 01 Nov 2025.
Author
Idowu A.; Adebolu O.; Siraj B.; Wattanachayakul P.; Balogun O.; Lo K.B.;
Witzke C.; Akintoye E.; Bozorgnia B.; Pressman G.
Institution
(Idowu, Wattanachayakul) Department of Internal Medicine,
Jefferson-Einstein Hospital, Philadelphia, PA, United States
(Adebolu, Siraj) Division of Hospital Medicine, Jefferson-Einstein
Hospital, Philadelphia, PA, United States
(Balogun) Division of Hospital Medicine, Lankenau Medical Centre, PA,
United States
(Lo) Division of Cardiovascular Medicine, Brigham and Women's Hospital
Heart and Vascular Center, Boston, MA, United States
(Witzke, Bozorgnia, Pressman) Department of Cardiology, Jefferson-Einstein
Hospital, Philadelphia, PA, United States
(Akintoye) Cardiovascular Medicine, Department of Internal Medicine, Yale
University School of Medicine, New Haven, CT, United States
Publisher
Elsevier B.V.
Abstract
Background: Mitral annular calcification (MAC) is common in patients with
functional mitral regurgitation undergoing transcatheter edge-to-edge
mitral valve repair (TEER). However, the safety and effectiveness of TEER
systems in patients with MAC is poorly understood. Method(s): We
systematically reviewed multiple online databases to identify studies that
reported outcomes in patients undergoing TEER with underlying
moderate/severe MAC versus those with no/mild MAC. Random-effect model
meta-analysis at a 95 % confidence interval was done via Cochrane Review
Manager 5.4. Result(s): A total of 6 studies with a pooled 2808
patients (no/mild MAC: 84.5 % vs moderate/severe MAC: 15.5 %) were
included. Compared to those with no/mild MAC, patients undergoing TEER
with moderate/severe MAC have an insignificant trend towards a lower
immediate procedural success (OR: 0.62, 95 % CI: 0.37 - 1.04, p = 0.07).
After one year of TEER, the two groups had similar rates of repeat mitral
valve intervention or surgery (OR: 1.67, 95 %CI: 0.92 - 3.05, p = 0.09),
sustained clinical improvement (NYHA <= 2) (OR: 0.86, 95 %CI: 0.64 - 1.15,
p = 0.30), and heart failure re-admission (OR: 0.84, 95 %CI: 0.52 - 1.36,
p = 0.48). All-cause mortality was, however, higher in the moderate/severe
MAC patients (OR: 1.82, 95 %CI: 1.15 - 2.86, p = 0.01).
 Conclusion(s): TEER appears safe and effective in carefully selected
patients with significant MAC. A standardized selection algorithm is
needed to identify MAC patients that would benefit most from
TEER. Copyright © 2025

<12>
Accession Number
2040887151
Title
Comparative Safety and Efficacy of Transcarotid Artery Revascularization
Versus Transfemoral Carotid Artery Stenting: A Systematic Review and
Meta-Analysis.
Source
Annals of Vascular Surgery. 122 (pp 736-754), 2026. Date of Publication:
01 Jan 2026.
Author
Hassan A.A.; Sharaby S.A.; Elbosraty E.E.; Abdo M.I.; Shaban A.A.; Awad
F.M.; Abbas R.O.; Khalafallah M.A.; Hammoda M.I.; Aboelsaad H.Y.
Institution
(Hassan) Faculty of Medicine, Al-Azhar University in Cairo, Cairo, Egypt
(Sharaby, Elbosraty, Abdo, Shaban, Awad, Abbas, Hammoda, Aboelsaad)
Vascular Surgery Department, Faculty of Medicine, Al-Azhar University,
Cairo, Egypt
(Khalafallah) Faculty of Medicine, Alexandria University, Alexandria,
Egypt
Publisher
Elsevier Inc.
Abstract
Background: Carotid artery stenosis is a significant cause of ischemic
stroke. Transcarotid artery revascularization (TCAR), a newer technique
using dynamic flow reversal, has emerged as a potentially safer
alternative to transfemoral carotid artery stenting (TFCAS). This
systematic review and meta-analysis aimed to compare TCAR and TFCAS in
patients undergoing carotid revascularization. Method(s): We searched
PubMed, Cochrane CENTRAL, Scopus, and Web of Science through June 2025 for
comparative studies evaluating TCAR versus TFCAS. The primary outcomes
included 30-day and in-hospital mortality, stroke, and composite
stroke/death. The secondary outcomes assessed myocardial infarction (MI),
transient ischemic attack (TIA), procedural times, and periprocedural
complications. Risk ratios (RRs) and mean differences were pooled using
random-effects models. Result(s): Thirteen studies involving 142,032
patients were included in the analysis. TCAR significantly reduced 30-day
mortality (RR 0.45; P < 0.001), in-hospital mortality (RR 0.45; P <
0.001), 30-day stroke (RR 0.66; P < 0.001), and composite 30-day
stroke/death (RR 0.57; P < 0.001). TIA (RR 0.72; P < 0.001) and stroke/TIA
(RR 0.66; P < 0.001) were also lower with TCAR. MI rates were similar
overall, although asymptomatic patients had a higher 30-day MI risk with
TCAR. TCAR reduced reperfusion injury (RR 0.38; P < 0.001) and hospital
stay length (RR 0.76; P < 0.001) but had slightly longer operative times.
Long-term data from 2 large cohorts confirmed TCAR's durable stroke risk
reduction up to 3 years. Conclusion(s): This meta-analysis of current
observational data demonstrates that TCAR is associated with superior
perioperative outcomes compared to TFCAS, with significantly lower rates
of stroke and death. These findings support TCAR as a preferred
endovascular treatment for eligible patients with carotid artery
stenosis. Copyright © 2025 Elsevier Inc.

<13>
Accession Number
2040844305
Title
CLASP IID Trial and Registry: 2-Year Outcomes of Transcatheter Repair for
Degenerative Mitral Regurgitation.
Source
JACC: Cardiovascular Interventions. 18(19) (pp 2392-2404), 2025. Date of
Publication: 13 Oct 2025.
Author
Makkar R.; Zahr F.; Chakravarty T.; Chadderdon S.; Makar M.; Ruf T.F.;
Kipperman R.M.; Rassi A.N.; Hausleiter J.; Smith R.L.; Szerlip M.; Goldman
S.; Lim D.S.; Inglessis-Azuaje I.; Yadav P.; Lurz P.; Kister T.; Davidson
C.J.; Mumtaz M.; Gada H.; Kar S.; Kodali S.K.; Laham R.; Hiesinger W.; Fam
N.P.; Kessler M.; O'Neill W.W.; Whisenant B.; Kliger C.; Rudolph V.;
Hermiller J.; Dhoble A.; Smalling R.; Latib A.; Lazkani M.; Choo J.;
Garcia S.; Rodes-Cabau J.; Schofer N.; Baldus S.; Kapadia S.; Koulogiannis
K.; Marcoff L.; Gillam L.D.; von Bardeleben R.S.
Institution
(Makkar, Chakravarty, Makar) Cedars-Sinai Medical Center, Los Angeles, CA,
United States
(Zahr, Chadderdon) Oregon Health & Science University, Portland, OR,
United States
(Ruf, von Bardeleben) University Medical Centre Mainz, Mainz, Germany
(Kipperman, Koulogiannis, Marcoff, Gillam) Atlantic Health System
Morristown Medical Center, Morristown, NJ, United States
(Rassi) Kaiser Permanente San Francisco Medical Center, San Francisco, CA,
United States
(Hausleiter) Klinikum der Universitat Munchen, Munich, Germany
(Smith, Szerlip) Baylor Scott and White, The Heart Hospital Plano, Plano,
TX, United States
(Goldman) Lankenau Medical Center, Wynnewood, PA, United States
(Lim) University of Virginia Health System Hospital, Charlottesville, VA,
United States
(Inglessis-Azuaje) Massachusetts General Hospital, Boston, MA, United
States
(Yadav) Piedmont Heart Institute, Atlanta, GA, United States
(Lurz, Kister) University of Leipzig, Leipzig, Germany
(Davidson) Northwestern University, Chicago, IL, United States
(Mumtaz, Gada) UPMC Pinnacle, Harrisburg, PA, United States
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
(Kodali) Columbia University Medical Center, New York, NY, United States
(Laham) Beth Israel Deaconess Medical Center, Boston, MA, United States
(Hiesinger) Stanford University Medical Center, Palo Alto, CA, United
States
(Fam) St. Michael's Hospital, Toronto, ON, Canada
(Kesler) University of Ulm, Ulm, Germany
(O'Neill) Henry Ford Hospital, Detroit, MI, United States
(Whisenant) Intermountain Medical Center, Salt Lake City, UT, United
States
(Kliger) Northwell-Lenox Hill, New York, NY, United States
(Rudolph) Ruhr-Universitat Bochum, Bad Oeynhausen, Bochum, Germany
(Hermiller) St. Vincent Heart Center of Indiana, Indianapolis, IN, United
States
(Dhoble, Smalling) Memorial Hermann Heart and Vascular Institute/UT
Health, Houston, TX, United States
(Latib) Montefiore Medical Center, Bronx, NY, United States
(Lazkani) UC Health Medical Center of the Rockies, Loveland, CO, United
States
(Choo, Garcia) The Christ Hospital, Cincinnati, OH, United States
(Rodes-Cabau) Quebec Heart & Lung Institute, Laval University, Quebec
City, QC, Canada
(Schofer) University Heart and Vascular Center Hamburg, Hamburg, Germany
(Baldus) University Hospital Cologne, Cologne, Germany
(Kapadia) Cleveland Clinic Foundation, Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Background: One-year outcomes from the CLASP IID Trial (Edwards PASCAL
TrAnScatheter Valve RePair System Pivotal Clinical Trial; NCT03706833) and
Registry established the PASCAL transcatheter valve repair system as a
safe and effective treatment for prohibitive-risk degenerative mitral
regurgitation (DMR). Longer-term follow-up is ongoing. Objective(s):
This paper reports the CLASP IID Trial and Registry 2-year outcomes.
 Method(s): In the CLASP IID Trial, prohibitive-risk patients with
3+/4+ DMR, deemed suitable for both the PASCAL and MitraClip systems, were
randomized 2:1 (PASCAL: n = 204; MitraClip: n = 96). Patients with complex
anatomy deemed ineligible for randomization were enrolled in the CLASP IID
Registry (N = 98) and treated with the PASCAL system. Result(s): In
the randomized cohort, significant and sustained MR reduction was achieved
at 2 years. MR <=2+ rate was 95.0% (96/101) in the PASCAL group vs 91.5%
(54/59) in the MitraClip group (P = 0.500), and MR <=1+ rate was 77.2%
(78/101) vs 67.8% (40/59) (P = 0.198), respectively. Kaplan-Meier
estimates for freedom from all-cause mortality, cardiovascular mortality,
heart failure hospitalization, and nonelective mitral valve
reinterventions were 80.8% vs 86.2% (P = 0.216), 88.6% vs 90.4% (P =
0.666), 86.4% vs 94.3% (P = 0.058), and 97.9% vs 97.9% (P = 0.962),
respectively. In the registry cohort, 91.9% (34/37) achieved MR <=2+ and
64.9% (24/37) achieved MR <=1+. Kaplan-Meier estimates for freedom from
all-cause mortality, cardiovascular mortality, heart failure
hospitalization, and nonelective mitral valve reinterventions were 77.2%,
84.0%, 85.1%, and 99.0%, respectively. Significant improvements in
functional status and quality of life were observed in both cohorts.
 Conclusion(s): Two-year outcomes from the CLASP IID Trial and
Registry show favorable survival, and significant and sustained MR
reduction with functional and quality-of-life improvements, confirming
sustained safety and effectiveness of the PASCAL system in treating a
broad population of DMR patients. Copyright © 2025 American
College of Cardiology Foundation

<14>
Accession Number
2036426178
Title
Effectiveness of the various revascularization techniques in multivessel
coronary artery disease: a systematic review with network meta-analysis.
Source
Annals of Medicine. 57(1) (no pagination), 2025. Article Number: 2566878.
Date of Publication: 2025.
Author
Harta I.K.A.P.; Pertiwi P.F.K.; Julia Arta I.G.; Putu Yasa K.
Institution
(Harta, Putu Yasa) Cardiothoracic and Vascular Surgery Division,
Department of Surgery, Faculty of Medicine, Udayana University, Prof. Dr.
I.G.N.G. Ngoerah General Hospital, Bali, Denpasar, Indonesia
(Pertiwi) Faculty of Medicine, Udayana University, Denpasar, Indonesia
(Julia Arta) Cardiothoracic and Vascular Surgery Residency Program,
Faculty of Medicine, Udayana University, Denpasar, Indonesia
Publisher
Taylor and Francis Ltd.
Abstract
Background: Multivessel coronary artery disease (MVD) often requires
revascularization. However, the effectiveness of various techniques in
reducing stroke and achieving complete revascularization remains
uncertain. This study aimed to address this gap by comparing key
revascularization strategies in terms of early mortality, stroke, complete
revascularization, postoperative atrial fibrillation (POAF), and renal
failure. Method(s): This study is a systematic review and network
meta-analysis of 32 studies including 65,861 patients. Five
revascularization techniques were compared: on-pump coronary artery bypass
(ONCAB), off-pump coronary artery bypass (OPCAB), OPCAB with proximal
anastomotic device (OPCAB-PAD), anaortic OPCAB (anOPCAB), and percutaneous
coronary intervention (PCI). Odds ratios (ORs) with 95% confidence
intervals (CIs) were calculated using a random effects model. Risk of bias
was assessed using the RoB2 and ROBINS-I tools. Result(s): Compared
to ONCAB, early mortality was significantly lower with anOPCAB (OR: 0.57,
95% CI: 0.44-0.73), OPCAB-PAD (OR: 0.61, 95% CI: 0.40-0.92), and OPCAB
(OR: 0.64, 95% CI: 0.47-0.87). Stroke risk was lowest with anOPCAB (OR:
0.29, 95% CI: 0.21-0.40) and OPCAB-PAD (OR: 0.32, 95% CI: 0.21-0.49). All
surgical techniques achieved significantly more complete revascularization
than PCI. Both POAF and renal failure were significantly lower with
anOPCAB compared to ONCAB (POAF: OR: 0.72, 95% CI: 0.59-0.89; renal
failure: OR: 0.63, 95% CI: 0.46-0.86). No significant publication bias was
detected for mortality and stroke, though funnel plot asymmetry was noted
for revascularization. Conclusion(s): Off-pump techniques,
particularly anOPCAB, significantly reduce stroke risk while achieving
comparable revascularization success to ONCAB. PCI remains limited by
incomplete revascularization, supporting its use primarily in patients at
high surgical risk. Copyright © 2025 The Author(s). Published by
Informa UK Limited, trading as Taylor & Francis Group.

<15>
Accession Number
2037172310
Title
Pulmonary hypertension in left heart disease.
Source
ERS Monograph. 2025-September(109) (pp 214-234), 2025. Date of
Publication: 01 Sep 2025.
Author
Vachiery J.-L.; Roussoulieres A.; Valente F.; Dewachter C.
Institution
(Vachiery, Roussoulieres, Valente, Dewachter) Department of Cardiology,
Hopital Universitaire de Bruxelles (H.U.B.) Erasme, Brussels, Belgium
Publisher
European Respiratory Society
Abstract
PH associated with left heart disease (PH-LHD) is the most common cause of
PH and one of the most difficult differential diagnosis challenges. This
chapter reviews the current knowledge on pathobiology, diagnosis and
management of PH-LHD. Novel information includes a proposal to
disaggregate the classification and a new staging process introducing the
concept that PH may be preventable in patients at risk. It also highlights
that the assessment of PH (especially in heart failure) should not only
rely on invasive haemodynamic but also include a broader and
multidimensional evaluation to avoid misclassification. The management of
PH-LHD should focus on the treatment of the underlying condition. Recent
data confirm that PAH-targeted therapies should not be used in this
setting, especially with the emergence of safety signals. Finally, gaps in
evidence and future directions in PH-LHD are also discussed. Copyright
© ERS 2025.

<16>
Accession Number
2035541290
Title
Evaluating Zero-Contrast Transcatheter Aortic Valve Implantation (TAVI)
for Patients With Renal Impairment: A Pooled Meta-Analysis of 1505
Patients.
Source
Catheterization and Cardiovascular Interventions. 106(4) (pp 2147-2159),
2025. Date of Publication: 01 Oct 2025.
Author
Badran A.S.; Gadelmawla A.F.; Khelifa H.; Hasanin E.H.; Gbreel M.I.
Institution
(Badran) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Khelifa) Faculty of Medicine, University of Oran 1, Ahmed Ben Bella,
Oran, Algeria
(Hasanin) Faculty of Medicine, University of Tripoli, Tripoli, Libyan Arab
Jamahiriya
(Gbreel) Faculty of Medicine, October 6 University, Giza, Egypt
(Gbreel) Department of Cardiology, Egyptian Railway Medical Educational
Centre, Cairo, Egypt
Publisher
John Wiley and Sons Inc
Abstract
Transcatheter Aortic Valve Implantation (TAVI) is a well-established
treatment for severe aortic stenosis (AS) but poses risks for chronic
kidney disease (CKD) patients due to contrast-induced nephropathy (CIN).
Zero-contrast TAVI offers a promising alternative, though evidence on its
safety and effectiveness is limited. We aim to evaluate the safety and
effectiveness of zero-contrast TAVI compared to standard TAVI in patients
with AS and CKD. We followed the Cochrane Handbook and PRISMA guidelines,
searching databases until September 2024. We conducted the meta-analysis
using the 'metafor' package with a random-effects model, calculating mean
differences (MDs) and risk ratios (RRs) along with their corresponding 95%
confidence intervals (CIs). We included 1505 patients from six papers. The
single-arm meta-analysis of zero-contrast TAVI showed a significant
implantation success rate (proportion = 0.97; 95% CI: [0.95, 0.99]; p <
0.01). Double-arm analysis revealed no significant difference in
implantation success between both groups (RR = 1.02; 95% CI: [0.97, 1.08];
p = 0.34). The postoperative mean transvalvular gradient was comparable
(MD = 0.19 mmHg; 95% CI: [-0.99, 1.39]; p = 0.75). The initial pooled
analysis found no significant difference in in-hospital AKI (RR = 0.66,
95% CI: 0.20-2.17), though this was confounded by significant
heterogeneity (I2 = 71.26%). Sensitivity analysis resolved this
heterogeneity and revealed a significant reduction in AKI with
Zero-contrast TAVI (RR = 0.47, 95% CI: [0.24, 0.92]; p = 0.03).
Post-procedural permanent pacemaker (PPM) implantation risk was higher in
the zero-contrast group, while Stroke rates were comparable. Zero-contrast
TAVI offers comparable success to contrast-based approaches and potential
renal benefits but carries a higher risk of PPM implantation. Trial
Registration: This meta-analysis was registered on PROSPERO. No.:
CRD42024597951. Copyright © 2025 Wiley Periodicals LLC.

<17>
Accession Number
2039682872
Title
Opioid-sparing Anesthesia in Cardiac Surgery: A Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(11) (pp 3140-3153),
2025. Date of Publication: 01 Nov 2025.
Author
Rauseo M.; Mirabella L.; Carrideo A.A.; Padovano F.P.; Cantatore L.P.;
Vetuschi P.; Da Lima S.; Paternoster G.; Cinnella G.
Institution
(Rauseo, Padovano, Cantatore, Vetuschi, Da Lima) Department of Cardiac
Anesthesia, Policlinico di Foggia, Foggia, Italy
(Rauseo, Mirabella, Carrideo, Cinnella) Department of Anesthesia and
Intensive Care Medicine, Policlinico di Foggia, Foggia, Italy
(Rauseo, Mirabella, Cinnella) Department of Medical and Surgical Science,
University of Foggia, Foggia, Italy
(Paternoster) Department of Health Sciences, School of Medicine,
University of Basilicata, Anesthesia and Intensive Care, San Carlo
Hospital, Potenza, Italy
Publisher
W.B. Saunders
Abstract
This systematic review and meta-analysis evaluated the impact of
opioid-sparing versus opioid-based anesthesia in adult patients undergoing
cardiac surgery. A comprehensive literature search was conducted across
major databases from 2015 to 2025. Eligible studies included randomized
controlled trials and observational cohorts reporting at least one of the
following outcomes: opioid consumption (in morphine milligram equivalents
[MME]), intensive care unit (ICU) length of stay, mechanical ventilation
duration, pain scores, and mortality. A total of 27 studies (8 randomized
controlled trials and 19 observational studies), including 58,998
patients, were analyzed. Opioid-sparing protocols, involving multimodal
analgesia and regional anesthesia, were significantly associated with
reduced intraoperative and postoperative opioid consumption. The pooled
mean difference in opioid consumption was -2.48 MME (95% confidence
interval [CI]: -2.60 to -2.35, p < 0.001). Opioid-sparing strategies were
also associated with shorter ICU length of stay (odds ratio [OR]: 1.32,
95% CI: 1.14-1.51), reduced duration of mechanical ventilation (OR: 1.46,
95% CI: 1.24-1.72), and lower postoperative pain scores at 12 hours (OR:
1.18, 95% CI: 1.07-1.30). No significant difference was observed in
postoperative mortality (OR: 0.20; 95% CI: 0.04-1.14). Narrative outcomes
such as persistent opioid use, postoperative nausea, early mobilization,
and patient satisfaction generally favored opioid-sparing anesthesia,
although reporting was inconsistent. Adverse events related to nonopioid
adjuncts were inconsistently reported. The overall risk of bias was low to
moderate, and heterogeneity was moderate across most outcomes. These
findings support opioid-sparing strategies in selected cardiac surgery
patients as part of multimodal, enhanced recovery protocols, but highlight
the need for standardized definitions and prospective trials with rigorous
safety reporting. Copyright © 2025 The Author(s)

<18>
Accession Number
2038348036
Title
A Systematic Review and Expert Recommendation on the Diagnosis of
Pulmonary Hypertension Associated With Lung Disease: A Position Paper of
the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR).
Source
Archivos de Bronconeumologia. 61(10) (pp 617-625), 2025. Date of
Publication: 01 Oct 2025.
Author
Rodriguez-Chiaradia D.A.; Torres-Castro R.; Piccari L.; Garcia-Ortega A.;
Perez-Penate G.M.; de Miguel-Diez J.; Perez-Rojo R.; Cano-Pumarega I.;
Mora-Cuesta V.; Blanco I.; Figueira-Goncalves J.M.; del Pozo R.;
Lopez-Meseguer M.; Martinez-Menaca A.; Tenes A.; Molina-Molina M.; Barbera
J.A.
Institution
(Rodriguez-Chiaradia, Piccari) Pulmonology Department, Hospital del Mar,
Hospital del Mar Research Institute, Universitat Pompeu Fabra, CIBERES,
(ISCIII), Barcelona, Spain
(Torres-Castro) Pulmonology Department, Hospital Clinic de
Barcelona-FCRB-IDIBAPS, Universitat de Barcelona, Departamento de
Kinesiologia, Universidad de Chile, Santiago, Chile
(Garcia-Ortega) Pulmonology Department, Hospital Doctor Peset, Fundacion
para el Fomento de la Investigacion Sanitaria de la Comunidad Valenciana
(FISABIO), Valencia, Spain
(Perez-Penate) Pulmonary Vascular Unit, Pulmonology Department, Hospital
Universitario de Gran Canaria "Dr Negrin", Spain
(de Miguel-Diez) Pulmonology Department, Hospital General Universitario
Gregorio Maranon, Instituto de Investigacion Sanitaria Gregorio Maranon
(IiSGM), Universidad Complutense de Madrid, CIBER de Enfermedades
Respiratorias (CIBERES), Madrid, Spain
(Perez-Rojo) Pulmonology Department, Hospital Universitario 12 de Octubre,
Fundacion Investigacion Biomedica Hospital Universitario 12 de Octubre,
Madrid, Spain
(Cano-Pumarega, Tenes) Pulmonology Department, Hospital Universitario
Ramon y Cajal, Madrid, Spain
(Cano-Pumarega, Tenes) IRYCIS, Instituto Ramon y Cajal de investigacion
sanitaria, CIBER de Enfermedades Respiratorias (CIBERES), Instituto de
Salud Carlos III, Madrid, Spain
(Mora-Cuesta, Martinez-Menaca) Pulmonology Department, Hospital
Universitario Marques de Valdecilla - IDIVAL, Cantabria, Santander, Spain
(Mora-Cuesta, Lopez-Meseguer, Martinez-Menaca) ERN-LUNG (European
Reference Network on Rare Respiratory Diseases), Spain
(Blanco, Barbera) Pulmonology Department, Hospital Clinic de
Barcelona-FCRB-IDIBAPS, Universitat de Barcelona, Spain
(Blanco, Barbera) CIBERES, ERN-LUNG (European Reference Network on Rare
Respiratory Diseases), Spain
(Figueira-Goncalves) Pulmonology Department, Hospital Universitario
Nuestra Senora de Candelaria, Santa Cruz de Tenerife, Spain
(del Pozo) Pulmonology Department, Hospital Juan Ramon Jimenez, Huelva,
Spain
(Lopez-Meseguer) Pulmonology Department, Hospital Vall d'Hebron,
Barcelona, CIBERES, Spain
(Molina-Molina) Interstitial Lung Diseases Unit (UFIP), Pulmonology
Department, Hospital Universitario de Bellvitge, Instituto de
Investigacion Biomedica de Bellvitge (IDIBELL), CIBER de Enfermedades
Respiratorias (CIBERES), Barcelona, Spain
Publisher
Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR)
Abstract
Pulmonary hypertension (PH) is a common complication of chronic
respiratory diseases (CRD) associated with increased morbidity and
mortality. Early and individualized identification of PH in these patients
is crucial to better understand the evolution of the disease and to assess
the application of therapeutic measures aimed at its control. However,
there is no consensus on how to approach the diagnostic process. The
scarce scientific evidence in this field justifies the creation of this
SEPAR position paper, which aims to become a tool to aid in the diagnosis
of PH associated with CRD that facilitates decision making for the benefit
of patients and the optimization of resources. A panel of 16 SEPAR experts
has identified three critical questions. The answers to these questions
were developed by the panel members, who were divided into three groups
according to their expertise in the underlying disease in question:
chronic obstructive pulmonary disease, interstitial lung disease and
obesity hypoventilation syndrome. Prior to the discussion and drafting of
the document by each group, a systematic review of the literature was
performed according to the guidelines recommended by the Preferred
Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). We
generated a schematic proposal adjusted to the characteristics of each
disease for the diagnostic approach to PH associated with respiratory
disease. Copyright © 2025 SEPAR

<19>
Accession Number
2035918795
Title
The multidisciplinary Heart Team in mitral valve transcatheter
edge-to-edge repair.
Source
Herz. 50(5) (pp 319-325), 2025. Date of Publication: 01 Oct 2025.
Author
Mueller C.S.; Hagl C.; Hausleiter J.; Stocker T.J.
Institution
(Mueller, Hagl) Herzchirurgische Klinik und Poliklinik, LMU Klinikum, LMU
Munchen, Marchioninistrase 15, Munich, Germany
(Hausleiter, Stocker) Medizinische Klinik und Poliklinik I, LMU Klinikum,
LMU Munchen, Munich, Germany
(Hagl, Hausleiter, Stocker) German Center for Cardiovascular Research
(DZHK), Partner Site Munich, Heart Alliance, Munich, Germany
Publisher
Springer Medizin
Abstract
Treatment options for mitral regurgitation (MR) have markedly evolved over
the past few decades, with mitral valve transcatheter edge-to-edge repair
(M-TEER) expanding the clinical armamentarium of guideline-directed
medical therapy and surgical techniques. However, the variety of mitral
valve anatomies, the presence of heart failure (HF), and consideration of
the individual patient risk require a multidisciplinary Heart Team
approach to identify the optimal treatment for MR for each patient.
Despite the growing field of transcatheter mitral interventions and the
longstanding availability of surgical mitral valve repair and replacement,
evidence from randomized clinical trials comparing intervention with
surgery remains scarce. In the meantime, the increasing safety and
experience of surgical and interventional procedures have shifted the
perspective on mitral valve disease in terms of when and how to treat it.
Therefore, the multidisciplinary Heart Team discussion has become of
paramount importance in the evaluation and treatment decisions for
patients with mitral valve disease. Copyright © The Author(s),
under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von
Springer Nature 2025.

<20>
Accession Number
2037142017
Title
Perioperative oxygen therapy in patients undergoing surgical procedures:
an overview of systematic reviews and meta-analyses.
Source
Health Technology Assessment. 29(44) (no pagination), 2025. Date of
Publication: 01 Sep 2025.
Author
Elfeky A.; Chen Y.-F.; Grove A.; Couper K.; Court R.; Tomassini S.; Wilson
A.; Hooper A.; Buckle A.; Vadeyar S.; Thompson M.; Uthman O.; Yeung J.
Institution
(Elfeky, Chen, Grove, Couper, Court, Tomassini, Wilson, Uthman, Yeung)
Warwick Medical School, University of Warwick, Coventry, United Kingdom
(Couper, Hooper, Buckle, Vadeyar, Yeung) University Hospitals Birmingham
NHS Foundation Trust, Birmingham, United Kingdom
(Thompson) UK Public contributor, United Kingdom
Publisher
NIHR Journals Library
Abstract
Background: Perioperative oxygen administration has been proposed as a
strategy to reduce postoperative complications. However, uncertainty
exists as to which strategies are the most clinically effective.
 Objective(s): To provide an overview on the effectiveness of
perioperative oxygen therapy and formulate recommendations to inform
clinical decision-making and research. Method(s): We followed the
Preferred Reporting Items for Overviews of Reviews guidelines. We searched
key databases for systematic reviews (from inception to September 2021)
and randomised controlled trials (from April 2018 to March 2022) comparing
perioperative oxygen strategies. Reviews with the most comprehensive
coverage of literature were chosen as anchoring reviews. We assessed risk
of bias for each anchoring review using the Risk of Bias in Systematic
Reviews tool. We updated meta-analyses from anchoring reviews with data
from recent randomised controlled trials and conducted subgroup analyses
and meta-regression. We assessed the certainty of evidence using grading
of recommendations assessment, development and evaluation framework and
conducted trial sequential analysis. We used grading of recommendations
assessment, development and evaluation informative statements to
communicate our findings. Our advisory panel reviewed mapping of studies
and interpretation of evidence. Result(s): We identified 59
systematic reviews and selected 5 anchoring reviews. A high fraction of
inspired oxygen may result in a slight reduction in surgical site
infection compared with a low fraction of inspired oxygen (risk ratio
0.91, 95% confidence interval 0.78 to 1.05; risk difference 1.2% lower,
2.9% lower to 0.7% higher, low-certainty evidence). This effect may be
modified by type of surgery, oxygen delivery method or study quality. The
evidence suggests that a high fraction of inspired oxygen results in a
large increase in the incidence of atelectasis (risk ratio 1.47, 95%
confidence interval 1.20 to 1.79; risk difference 6.5% higher, 2.8% higher
to 10.9% higher, low-certainty evidence) and may increase postoperative
pulmonary complications slightly (risk ratio 1.06, 0.77 to 1.46; risk
difference 1.1% higher, 4.1% lower to 8.2% higher) but the evidence is
very uncertain. A high fraction of inspired oxygen may result in little to
no difference in mortality, nausea and vomiting, and length of hospital
stay. Postoperative high-flow nasal oxygen may reduce the need to escalate
respiratory support compared with conventional oxygen therapy (risk ratio
0.61, 0.41 to 0.91; risk difference 7.8% lower, 11.7% lower to 1.8% lower)
but the evidence is very uncertain. High-flow nasal oxygen may result in
little to no difference in mortality and reintubation rate. Compared with
conventional oxygen therapy, postoperative non-invasive ventilation may
decrease postoperative pulmonary complications (risk ratio 0.62, 0.44 to
0.87; risk difference 12.2% lower, 18% lower to 4.2% lower) and probably
results in a slight reduction in the incidence of acute respiratory
distress syndrome (risk ratio 0.70, 0.53 to 0.93; risk difference 1.2%
lower, 1.9% lower to 0.3% lower). Non-invasive ventilation results in
little to no difference in mortality, pneumonia or reintubation rate.
Grading of recommendations assessment, development and evaluation
certainty in evidence was low for most outcomes. Trial sequential analysis
revealed further studies are required to provide conclusive evidence on
the effectiveness of perioperative oxygen therapy. Conclusion(s):
There is no clear evidence that either a high or a low fraction of
inspired oxygen improves outcomes in surgical patients. Existing evidence
is insufficient for recommending routine use of non-invasive ventilation
or high-flow nasal oxygen. Copyright © 2025 Elfeky et al.

<21>
Accession Number
2037186766
Title
Impact of a modified discharge program on health outcomes after coronary
bypass surgery: a randomized trial.
Source
Medicinski Glasnik. 22(2) (pp 218-224), 2025. Date of Publication: 2025.
Author
Shaikha H.S.A.; Maghaireh D.A.; Kawafha M.; Alshraideh J.A.
Institution
(Shaikha) Faculty of Nursing, Al. Balqa'a Applied University, As-Salt,
Jordan
(Maghaireh) Faculty of Nursing, Sulaiman Al Rajhi University, Al
Bukayriah, Saudi Arabia
(Kawafha) Faculty of Nursing, Yarmouk University, Irbid, Jordan
(Alshraideh) Faculty of Nursing, University of Jordan, Amman, Jordan
Publisher
Medical Association of Zenica-Doboj Canton
Abstract
Aim To examine the effects of implementing a modified Re-Engineered
Discharge (RED) intervention on major adverse cardiovascular and
cerebrovascular events (MACCE) and readmission rates 30 days after
coronary artery bypass graft (CABG) surgery. Methods A randomized clinical
trial was conducted with 104 patients who underwent elective CABG
sur-gery. Patients were randomly assigned to either an intervention group
or a control group. The intervention group received discharge training
through the modified RED program, while the control group followed the
standard discharge protocol used at the Centre. Data on major adverse
events and readmission rates were collected 30 days after discharge.
Results The results indicated no statistically significant differences
between the intervention and control groups regarding major adverse events
even though the control group experienced death, reopening and readmission
rate slightly more than intervention group (2% vs. 0%; p=0.471 and 2% vs.
1%; p=1.000, respectively (x2=0.273, P=0.603). Both groups
showed similar outcome after the implementation of the modified RED.
Conclusion This study contributes to the growing body of research on
discharge interventions by providing insights into the challenges of
integrating structured programs into routine care. It highlights the
importance of comprehensive planning, resource allocation, and extended
follow-up to enhance patient outcomes in cardiac surgery. Copyright
© 2025, Medical Association of Zenica-Doboj Canton. All rights
reserved.

<22>
Accession Number
2035538348
Title
Efficacy and Safety of Transcatheter Therapy for Patients With Tricuspid
Regurgitation: A Systematic Review and Meta-Analysis of Randomized
Controlled Trials.
Source
Catheterization and Cardiovascular Interventions. 106(4) (pp 2233-2243),
2025. Date of Publication: 01 Oct 2025.
Author
Mojica J.C.; Dandamudi M.; Rehman T.; Faizan M.A.; Giorgi J.
Institution
(Mojica) University of the East Ramon Magsaysay Medical Center, Quezon
City, Philippines
(Dandamudi) Montefiore Medical Center, Moses Campus, Bronx, NY, United
States
(Rehman, Faizan) Gomal Medical College, Dera Ismail Khan, Pakistan
(Rehman, Faizan) Khyber Medical University, Khyber, Pakistan
(Giorgi) Hospital Sirio Libanes, Sao Paulo, Brazil
(Giorgi) Hospital Albert Einstein, Sao Paulo, Brazil
Publisher
John Wiley and Sons Inc
Abstract
Severe tricuspid regurgitation (TR) is a prevalent valvular disorder
associated with significant morbidity, impaired quality of life, and
increased mortality. This meta-analysis evaluates the safety and efficacy
of transcatheter therapies (TCT) that have emerged as promising
alternatives to surgical intervention, especially in the high-risk
population. This study aimed to assess the safety and clinical outcomes of
TCT compared with optimal medical therapy (OMT) for severe TR. Multiple
databases, including MEDLINE, Embase, Scopus, and ClinicalTrials.gov were
searched from inception to March 2025. We assessed the clinical outcomes
of TCT compared with OMT using mean difference (MD) and risk ratio (RR)
with 95% confidence intervals (CI) and I2 for heterogeneity.
Outcomes included all-cause mortality (ACM), cardiovascular death (CV
death), heart failure hospitalizations (HFH), cardiac remodeling,
functional capacity, and quality of life score. We included four RCTs of
TCT on severe TR versus OMT, involving 1292 patients, of whom 710 (55%)
underwent TCT. In the pooled analysis, ACM was not affected by the
intervention therapy compared to OMT (RR = 1.12; 95% CI 0.65-1.93; p =
0.54), nor were CV death (RR = 0.87; 95% CI 0.50-1.51; p = 0.49), stroke
(RR = 1.54; 95% CI 0.27-8.76; p = 0.39), and HFH (RR = 0.86; 95% CI
0.61-1.22; p = 0.21). However, secondary outcomes were robustly affected
in the TCT group, as demonstrated by the six-minute walk distance test
(6MWD) (MD = 33.55 m; 95% CI 17.04-50.07; p < 0.01) and the Kansas City
cardiomyopathy questionnaire (KCCQ) (MD = 14.46; 95% CI 11.42-17.49; p <
0.01). In high-risk patients with severe TR, TCT effectively improves
functional status and enhances quality of life compared with OMT, while
survival benefits remain unproven. Copyright © 2025 Wiley
Periodicals LLC.

<23>
Accession Number
2039749533
Title
Is Prior Cardiac Surgery a Risk Factor for Patients in Aortic Surgery: A
Systematic Review and Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(11) (pp 3163-3172),
2025. Date of Publication: 01 Nov 2025.
Author
Lang Q.; Zhang J.; Li J.; Xiao Z.; Meng W.; Qin C.
Institution
(Lang, Zhang, Xiao, Meng, Qin) Department of Cardiovascular Surgery and
Cardiovascular Surgery Research Laboratory, West China Hospital, Sichuan
University, Sichuan, Chengdu, China
(Li) Department of Thoracic Surgery, West China Hospital, Sichuan
University, Sichuan, Chengdu, China
Publisher
W.B. Saunders
Abstract
Background: The rising global incidence of aortic surgical interventions
has increased demand for complex reoperations. However, surgical outcomes
between primary aortic surgery (PAS) and repeat sternotomy aortic surgery
(RAS) remain poorly characterized. This study was designed to evaluate
whether prior cardiac surgery constitutes a risk factor for patients
undergoing aortic surgery. Method(s): A systematic search of PubMed,
Embase, and Web of Science was conducted to identify studies comparing
surgical outcomes between PAS and RAS. The primary outcome was in-hospital
mortality. Secondary outcomes included the incidence of re-exploration for
bleeding, renal failure, deep sternal wound infection, neurologic events,
cardiopulmonary bypass time, and long-term survival rates at 2-year,
4-year, 8-year, and 10-year follow-ups. Result(s): A total of 19
studies involving 31,631 participants were included in this meta-analysis.
Patients undergoing PAS demonstrated significantly lower rates of
in-hospital mortality (9.3% v 16.0%, odds ratio [OR] 0.55, 95% confidence
interval [CI] 0.50-0.60; I2 = 0.0%, p < 0.001) compared with
the RAS cohort. PAS was also associated with a lower incidence of
re-exploration for bleeding (7.2% v 9.4%, OR 0.76, 95% CI 0.68-0.84, p <
0.001), renal failure (13.3% v 15.8%, OR 0.73, 95% CI 0.65-0.81, p <
0.001), and deep sternal wound infection (0.7% v 2.8%, OR 0.47, 95% CI
0.37-0.60, p < 0.001). In anatomical subgroup analyses, patients
undergoing primary aortic root surgery demonstrated significantly lower
mortality odds compared with repeat sternotomy root procedures (5.0% v
8.4%, OR 0.55, 95% CI 0.50-0.61, p < 0.001); while primary aortic arch
surgery demonstrated a mortality benefit compared with repeat sternotomy
for arch interventions, this advantage was less pronounced than that
observed in root procedures (8.4% v 11.9%, OR 0.60, 95% CI 0.39-0.94, p =
0.026). While short-term survival favored the PAS group (62.6% v 55.2%,
2-year OR 0.74, 95% CI 0.58-0.93, p = 0.01), long-term survival converged
between groups (14.8% v 12.7%, 10-year OR 0.82, 95% CI 0.60-1.13, p =
0.23), particularly after propensity score matching. Conclusion(s):
This study shows that RAS is associated with significantly elevated
in-hospital mortality and increased perioperative risks, particularly
pronounced in repeat sternotomy root replacement procedures. However,
prior cardiac surgery did not diminish the long-term benefits of aortic
surgery. Copyright © 2025 Elsevier Inc.

<24>
Accession Number
2040716753
Title
SAPIEN 3 in type 0 bicuspid aortic valves: Promising early results.
Source
International Journal of Cardiology. 443 (no pagination), 2026. Article
Number: 133918. Date of Publication: 15 Jan 2026.
Author
Alperi A.; Avanzas P.
Institution
(Alperi, Avanzas) Area del Corazon, Hospital Universitario Central de
Asturias, Oviedo, Spain
(Alperi, Avanzas) Instituto de Investigacion Sanitaria del Principado de
Asturias, ISPA, Oviedo, Spain
(Avanzas) Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain
(Avanzas) Centro de Investigacion en Red de Enfermedades Cardiovasculares
(CIBERCV), Spain
Publisher
Elsevier Ireland Ltd

<25>
Accession Number
2037177951
Title
SIMULTANEOUS PULMONARY EMBOLISM WITH CARDIAC TAMPONADE AND REPETITIVE
ISCHEMIC STROKE AS VASCULAR COMPLICATIONS OF LUNG CANCER: A CASE REPORT
AND SYSTEMATIC LITERATURE REVIEW.
Source
Acta Clinica Croatica. 64(1) (pp 166-173), 2025. Date of Publication:
2025.
Author
Kos N.; Vrsalovic M.
Institution
(Kos, Vrsalovic) Department of Cardiovascular Diseases, Sestre milosrdnice
University Hospital Center, Zagreb, Croatia
(Vrsalovic) University of Zagreb, School of Medicine, Zagreb, Croatia
Publisher
Dr. Mladen Stojanovic University Hospital
Abstract
It is known that patients with lung cancer have a considerably higher
incidence of cardiovascular complications that lead to venous or arterial
events, and malignant pericardial effusion can often be observed due to
pericardial metastases. Simultaneous occurrence of cardiac tamponade and
venous thromboembolism almost always happens in patients with lung
malignancy. Our case report describes a patient with concurrent pulmonary
embolism and cardiac tamponade as the initial manifestation of lung
cancer, which, apart from pericardiocentesis and symptomatic therapy, was
treated at long term with a direct oral anticoagulant (apixaban). Therapy
was well tolerated by the patient and there were no bleeding complications
related to primary disease and anticoagulant treatment. The course of the
disease was complicated by repetitive strokes, which were treated with
mechanical thrombectomy. Because of this scenario, a systematic review of
the literature was conducted, listing all available case reports of
patients with the simultaneous occurrence of cardiac tamponade and
pulmonary embolism. In all patients, the underlying condition was lung
malignancy, often as the first manifestation of the disease. This is a
relatively rare event, and the approach to long-term treatment varied from
case to case in the absence of valid guidelines. Our case demonstrated
that, in the light of new studies and guidelines, apixaban represented a
safe and effective treatment option even in patients at a high risk of
bleeding. Copyright © 2025, Dr. Mladen Stojanovic University
Hospital. All rights reserved.

<26>
Accession Number
2040791415
Title
Multivariable risk prediction models for postoperative cardiac injury in
adults undergoing non-cardiac surgery: a systematic review and
meta-analysis protocol.
Source
BMJ Open. 15(10) (no pagination), 2025. Article Number: e108282. Date of
Publication: 02 Oct 2025.
Author
Zhang Z.; Duan Y.; Wang Y.; Gao Z.
Institution
(Zhang, Duan, Wang, Gao) Department of Anesthesiology, Beijing Tsinghua
Changgung Hospital, School of Clinical Medicine, Tsinghua University,
Tsinghua Medicine, Beijing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative cardiac injury, encompassing myocardial
infarction (MI) and myocardial injury after non-cardiac surgery (MINS), is
a major perioperative complication associated with substantial morbidity
and mortality. While numerous prediction models have been developed using
traditional statistical and machine learning approaches, their comparative
performance, calibration quality and methodological rigour remain unclear.
This protocol outlines a systematic review and meta-analysis to
comprehensively evaluate multivariable risk prediction models for
postoperative cardiac injury in adults undergoing non-cardiac surgery.
Methods and analysis Following Preferred Reporting Items for Systematic
Review and Meta-Analysis Protocols guidelines, this PROSPERO-registered
systematic review will search PubMed, Embase, Web of Science, Cochrane
Library, Scopus, grey literature and trial registries for studies
developing, validating or updating multivariable prediction models for
postoperative cardiac injury (MI or MINS) occurring within 72 hours of
non-cardiac surgery. Two reviewers will independently extract data and
assess quality using CHARMS (Critical Appraisal and Data Extraction for
Systematic Reviews of Prediction Modelling Studies) and PROBAST
(Prediction Model Risk of Bias Assessment Tool) tools. The primary outcome
is discriminative performance (area under the receiver operating
characteristic curve), with calibration metrics and diagnostic accuracy
measures as secondary outcomes. Random-effects meta-analyses will pool
performance estimates for models validated in multiple cohorts.
Heterogeneity will be explored through subgroup analyses and
meta-regression, examining factors including model methodology
(regression-based vs machine learning), predictor types and validation
contexts. Sensitivity analyses will test the robustness of findings.
Ethics and dissemination Ethical approval is not required for this study,
as it is a systematic review and meta-analysis based on previously
published data. Copyright © Author(s) (or their employer(s))
2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ Group.

<27>
Accession Number
2035746629
Title
Lessons Learned From the ACURATE IDE Trial for Transcatheter Aortic Valve
Replacement.
Source
Catheterization and Cardiovascular Interventions. 106(4) (pp 2554-2560),
2025. Date of Publication: 01 Oct 2025.
Author
Giordano A.; Biondi-Zoccai G.; Cohen D.J.; Bagur R.; Corcione N.
Institution
(Giordano, Corcione) Unita Operativa di Interventistica Cardiovascolare,
Pineta Grande Hospital, Castel Volturno, Italy
(Biondi-Zoccai) Department of Medical-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
(Biondi-Zoccai) Maria Cecilia Hospital, GVM Care & Research, Cotignola,
Italy
(Cohen) Cardiovascular Research Foundation, New York, NY, United States
(Cohen) St. Francis Hospital, Roslyn, NY, United States
(Bagur) Division of Cardiology, Department of Medicine, London Health
Sciences Centre, Western University, London, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
The recent voluntary withdrawal of the ACURATE neo2 transcatheter aortic
valve replacement device by Boston Scientific offers a compelling case
study in the complex interplay of device design, clinical evidence,
regulatory requirements, and market dynamics in modern structural heart
interventions. Despite promising performance in European and Canadian
registries, the ACURATE neo2 valve failed to demonstrate non-inferiority
compared with commercially available balloon-expandable and self-expanding
platforms in the pivotal ACURATE IDE randomized controlled trial. These
results, coupled with introduction of a new regulatory requirements by the
European notified body ultimately led to the global discontinuation of the
platform. This review critically examines the technological
characteristics of ACURATE neo2, compares it with other leading TAVR
devices, and explores the potential reasons-ranging from clinical to
strategic-that may have led to its market exit. Emphasis is placed on the
role of randomized trials in assessing new structural therapies, including
a discussion of methodological challenges and opportunities for adaptive
trial designs. A structured comparison of device features and withdrawal
rationales is also provided, highlighting lessons relevant to clinicians,
regulators, and industry stakeholders. Ultimately, the ACURATE neo2
experience underscores the need for robust validation strategies,
procedural standardization, and adaptive development pathways in a
saturated and high-stakes market. Lessons learned from this platform
should inform future innovation in TAVR and broader cardiovascular device
development. Copyright © 2025 The Author(s). Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<28>
Accession Number
2039903907
Title
Ultrasound-Guided Stellate Ganglion Block Regulates Inflammatory Cytokines
and Improves Short-Term Outcome after Cardiac Surgery with Cardiopulmonary
Bypass: A Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(11) (pp 3044-3052),
2025. Date of Publication: 01 Nov 2025.
Author
Lv H.; Lv X.; Ai Z.; Huang Z.; Yu H.; Yu X.
Institution
(Lv, Ai, Huang) College of Medicine, Zhejiang University, Hangzhou, China
(Lv, Yu) Department of Anesthesiology, Sir Run Run Shaw Hospital of
Zhejiang University, Hangzhou, China
(Yu) Department of General Surgery, Sir Run Run Shaw Hospital of Zhejiang
University, Hangzhou, China
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate the effectiveness of left stellate ganglion block
(SGB) for inflammatory cytokines and short-term outcomes in cardiac
surgery with cardiopulmonary bypass (CPB). Design(s): Prospective,
randomized, double-blinded clinical trial. Setting(s): Single
academic center hospital. Participant(s): We included patients aged
18 to 70 scheduled for cardiac surgery with CPB. Intervention(s):
Before anesthesia induction, the patients who were allocated to either the
SGB group or the control group received SGB using either 0.5% ropivacaine
or 0.9% saline. Measurements and Main Results: The primary outcome
was the inflammatory cytokine concentration before (T0) and 6 hours (T1),
24 hours (T2), and 5 days (T3) after the block. Secondary outcomes
included the incidence of SIRS 24 hours after surgery, immune function at
each time point, intraoperative and postoperative complications, 30-day
mortality, intensive care unit and hospital stay, and hospitalization
costs. The analysis included 25 SGB and 25 control patients. Compared with
the control group, the SGB group significantly inhibited elevated
TNF-alpha concentration at 6 hours and 24 hours after the block (p <
0.05). SGB significantly reduced the SIRS 24 hours after surgery,
decreased the neutrophil percentage at 6 hours after the block, and
increased the lymphocyte percentage at 5 days after the block.
Additionally, SGB decreased the incidence of ventricular fibrillation
after reperfusion, postoperative delirium, and the occurrence of
Clavien-Dindo grade III-IV. Conclusion(s): SGB effectively improves
short-term outcomes in patients with cardiac surgery and CPB, possibly
through modulating the neuro-endocrine-immune network to normalize
sympathetic nervous system activity and stabilize perioperative tumor
necrosis factor-alpha concentration. Copyright © 2025

<29>
Accession Number
2040718805
Title
RIMA-SVG versus Ao-SVG in coronary artery bypass grafting: protocol for a
prospective, randomised, double-blind, non-inferiority and single-centre
trial.
Source
BMJ Open. 15(9) (no pagination), 2025. Article Number: e104578. Date of
Publication: 28 Sep 2025.
Author
Wei R.; Huang M.; Jiang N.; Zhang R.; He T.; Zhu C.; Wang W.; Piao H.; Yu
S.; Zhu Z.; Wang T.; Liu K.
Institution
(Wei, Huang, Jiang, Zhang, He, Zhu, Wang, Piao, Yu, Zhu, Wang, Liu)
Department of Cardiovascular Surgery, The Second Hospital of Jilin
University, Changchun, China
Publisher
BMJ Publishing Group
Abstract
Introduction Coronary artery bypass grafting (CABG) is a standard
treatment for coronary artery disease, particularly in patients with
multivessel disease. Connecting the saphenous vein graft (SVG) to the
right internal mammary artery (RIMA) instead of the aorta has been
proposed as an alternative approach to minimise aortic manipulation and
potentially improve graft patency. This study aims to determine whether
the RIMA-SVG technique is non-inferior to the conventional Aorta (Ao)-SVG
approach in terms of 1-year graft patency, while also comparing
perioperative complications and short-term clinical outcomes. Methods and
analysis This non-inferiority, single-centre, prospective, double-blind,
randomised clinical trial will enrol 300 patients undergoing CABG.
Participants will be randomised into two surgical groups (RIMA-SVG vs
Ao-SVG). The primary outcome is the 1-year SVG patency rate, assessed
using coronary CT angiography. Secondary outcomes include perioperative
complications, all-cause mortality, major adverse cardiovascular and
cerebrovascular events (MACCE), and surgical site infections occurring
during hospitalisation and up to 1 year postoperatively. Randomisation
will be computer-generated, and all procedures will be performed by
experienced surgeons. Patients will be followed up 12 months post-surgery.
Non-inferiority will be established if the upper bound of the one-sided
97.5% CI for the difference in graft occlusion rates is less than the
prespecified non-inferiority margin of 10%. Ethics and dissemination This
study has been approved by the Ethics Committee of the Second Hospital of
Jilin University (No. 460) and registered at ClinicalTrials. gov
(NCT06787651). All participants will provide written informed consent
before enrolment. To ensure data integrity and minimise bias,
randomisation details will be concealed from researchers until surgery,
and data analysts will remain blinded to group assignments. The findings
will be disseminated through academic journals and conference
presentations to promote knowledge sharing and clinical application in the
field of cardiovascular surgery. Copyright © Author(s) (or their
employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ Group.

<30>
Accession Number
2032095893
Title
Ectopic Calcification in Congenital Heart Surgery: A Material-Centric
Review.
Source
Pediatric Cardiology. 46(7) (pp 1771-1789), 2025. Date of Publication: 01
Oct 2025.
Author
Watanabe T.; Yuhara S.; Leland J.T.; Spiess J.L.; Thodla A.; Ramachandiran
R.; Kelly J.M.; Shinoka T.; Breuer C.K.
Institution
(Watanabe, Yuhara, Leland, Spiess, Thodla, Ramachandiran, Kelly, Shinoka,
Breuer) Center for Regenerative Medicine, Research Institute at Nationwide
Children's Hospital, Columbus, OH, United States
(Kelly, Shinoka) The Heart Center, Nationwide Children's Hospital,
Columbus, OH, United States
(Shinoka) Department of Cardiothoracic Surgery, Nationwide Children's
Hospital, Columbus, OH, United States
(Breuer) Department of Surgery, Nationwide Children's Hospital, Columbus,
OH, United States
(Breuer) Department of Surgery, The Ohio State University College of
Medicine, Columbus, OH, United States
Publisher
Springer
Abstract
The modern congenital heart surgeon has an array of materials available
for cardiovascular repair. With advancements in the surgical outcomes for
pediatric cardiac defects, choice of material has become increasingly
dependent on late-term complications associated with each material.
Calcification is a leading long-term complication and is increasing in
prevalence with materials lasting longer in patients. Material
calcification can impair functionality, lead to subsequent complications,
and require additional interventions. A comprehensive literature review
was conducted to investigate ectopic calcification of commonly used
materials for congenital heart defect repair. Mechanisms of ectopic
calcification among commonly used materials were investigated. Ectopic
calcification is initiated by material-specific immunological reactions.
Recent efforts have focused on developing new materials that are not prone
to calcification. ePTFE was widely used in cardiovascular applications but
still has reported instances of calcification in various situations, such
as long-term use. Tissue engineering techniques have shown reduced
calcification in reports. Calcification can occur in all conventional
materials we reviewed and, in some cases, has led to life-threatening
complications. Favorable outcomes have been reported with
tissue-engineered materials, with the expectation of continued positive
results in future reports. With an array of synthetic and biological
materials now displaying acceptable surgical and short-term outcomes,
there is a pressing need to review the long-term viability of these
materials, especially considering improved patient survival to adulthood.
Furthermore, developing new materials to mitigate calcification remains a
promising avenue of research in this field. Copyright © The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2024.

<31>
Accession Number
2039418631
Title
A Scoping Review of Validated Echocardiographic Methods for Grading Right
Ventricular Dysfunction: Proposal for an Evidence-Based Multiparametric
Framework.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(11) (pp 3107-3119),
2025. Date of Publication: 01 Nov 2025.
Author
Olive J.K.; Yaport M.; Al-Qudsi O.; Cutrone M.; Abramson L.; Ledbetter L.;
Alvin A.; Vatsaas C.J.; Milano C.A.; Bronshteyn Y.S.
Institution
(Olive, Milano) Division of Thoracic and Cardiovascular Surgery,
Department of Surgery, Duke University School of Medicine, Durham, NC,
United States
(Olive, Vatsaas) Division of Trauma, Acute, and Critical Care Surgery,
Department of Surgery, Duke University School of Medicine, Durham, NC,
United States
(Yaport, Al-Qudsi, Cutrone, Bronshteyn) Division of Critical Care
Medicine, Department of Anesthesiology, Duke University School of
Medicine, Durham, NC, United States
(Cutrone) Division of Cardiothoracic Anesthesiology, Department of
Anesthesiology, Duke University School of Medicine, Durham, NC, United
States
(Abramson) Division of Geriatrics, Department of Medicine, Duke University
School of Medicine, Durham, NC, United States
(Abramson) Geriatric Research Education and Clinical Center, Durham
Veterans Affairs Health Care System, Durham, NC, United States
(Ledbetter, Alvin) Duke University Medical Center Library and Archives,
Duke University School of Medicine, Durham, NC, United States
(Bronshteyn) Department of Anesthesiology, Durham Veterans Affairs Health
Care System, Durham, NC, United States
Publisher
W.B. Saunders
Abstract
Assessing the severity of right ventricular (RV) dysfunction using
echocardiography (echo) remains subjective, in part because current
guidelines do not recommend how to synthesize various echo parameters to
form a global assessment of RV dysfunction. To address this unmet need,
this scoping review aimed (1) to identify all multiparametric RV
dysfunction scoring systems that use routine echo parameters and (2) to
synthesize these models with 2025 guidelines to create a multiparametric
framework for RV dysfunction assessment. MEDLINE, EMBASE, and Web of
Science databases were searched for studies in adult patients that propose
and validate a multiparametric scoring system for grading RV dysfunction.
All studies underwent independent review during abstract and full-text
screening. Screening of 2,229 initial citations yielded 10 observational
studies consisting of diverse cohorts, including, but not limited to,
patients with heart failure, undergoing cardiac surgery, and admitted to
the intensive care unit. Six validated echo parameters were identified: RV
dilation, RV systolic dysfunction (represented by tricuspid annular plane
systolic excursion, S', or fractional area change), tricuspid
regurgitation, elevated right atrial pressure, RV-pulmonary artery
uncoupling (ratio of tricuspid annular plane systolic excursion to
pulmonary artery systolic pressure), and paradoxical interventricular
septal motion. The studies demonstrated that multiparametric RV
dysfunction scores had greater clinical prognostic value than did any
individual RV echo parameter alone. Our proposed simple framework for
assessing RV dysfunction enables clinicians to use routinely obtained echo
data to identify high-risk or subtle RV phenotypes and to guide clinical
decision-making in a variety of perioperative, intensive, and emergency
care settings. Copyright © 2025 Elsevier Inc.

<32>
Accession Number
2040123398
Title
Ipsilateral High Thoracic Ultrasound-Guided Erector Spinae Plane Block for
Post-Thoracotomy Shoulder Pain in Thoracic Cancer Surgeries: A Randomized
Controlled Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(11) (pp 3053-3059),
2025. Date of Publication: 01 Nov 2025.
Author
Kotb T.A.; Tantawy A.M.; Mahran E.; Elbosraty O.M.M.; Saad F.S.; Megahed
M.M.; Elshiha R.; Samy S.F.
Institution
(Kotb, Tantawy, Mahran, Elbosraty, Saad, Megahed, Samy) Anesthesia,
Surgical Intensive Care, and Pain Relief Department, National Cancer
Institute, Cairo University, Cairo, Egypt
(Elshiha) Clinical and Chemical Pathology Department, National Nutrition
Institute, Cairo, Egypt
Publisher
W.B. Saunders
Abstract
Objectives: To assess the safety and efficacy of ultrasound-guided high
thoracic erector spinae plane block (HT-ESPB) in the management of
post-thoracotomy ipsilateral shoulder pain (PTISP). Design(s):
Randomized, double-blind, parallel-group, controlled, clinical trial.
 Setting(s): The National Cancer Institute. Participant(s):
Seventy-six adult patients undergoing thoracic cancer surgery.
 Intervention(s): Patients were randomized into two equal groups: A
control group received thoracic epidural analgesia (TEA) alone (TEA
group), and a study group received ultrasound-guided HT-ESPB plus TEA
(ESPB group). Measurements and Main Results: Outcomes included the
incidence of PTISP, time to first rescue analgesia and total rescue
analgesic doses for ISP, intraoperative fentanyl consumption, heart rate,
mean arterial pressure, oxygen saturation, and complications. The ESPB
group had a significantly lower incidence of ISP in the first
postoperative hour compared to the TEA group (60.5% v 97.4%, p < 0.001).
The ESPB group also exhibited lower postoperative visual analog scale
scores, longer time to first rescue analgesia, and a reduced number of
rescue analgesic doses for ISP, as well as lower heart rate and mean
arterial pressure. No significant complications were reported.
 Conclusion(s): Ultrasound-guided HT-ESPB is a safe and efficacious
strategy for the management of PTISP. It demonstrated a significant
reduction in the incidence and severity of ISP and postoperative analgesic
requirements when compared to TEA alone. This approach enhanced
hemodynamic stability without significant complications. Copyright
© 2025 Elsevier Inc.

<33>
Accession Number
2035611895
Title
The Utilization of Superficial Femoral Artery Access for Transcatheter
Aortic Valve Replacement and Peripheral Vascular Interventions: A
Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 106(4) (pp 2414-2426),
2025. Date of Publication: 01 Oct 2025.
Author
Dave P.; Alfaifi A.; Traynor B.; Attumalil T.; Bisleri G.; Latter D.; Deva
D.; Wheatcroft M.; Ong G.; Alhazzani W.; Fam N.P.; Alnasser S.M.
Institution
(Dave, Alfaifi, Traynor, Attumalil, Bisleri, Latter, Deva, Ong, Fam,
Alnasser) Structural Heart Program, St. Michael's Hospital, University of
Toronto, Toronto, ON, Canada
(Wheatcroft) Division of Vascular Surgery, St. Michael's Hospital,
University of Toronto, Toronto, ON, Canada
(Alhazzani) Department of Medicine, St. Joseph's Healthcare, McMaster
University, Hamilton, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
The superficial femoral artery (SFA) is a vascular access alternative for
various cardiovascular interventions, especially when the common femoral
artery CFA is deep, calcified or in high bifurcation. SFA use, however,
was associated with pseudoaneurysms in older literature, and its
utilization for large-bore access is not well established. We conducted a
systematic review, including randomized and observational studies that
reported on SFA vascular access for peripheral arterial disease (PAD), and
transcatheter aortic valve replacement (TAVR) from inception until October
2024. The pooled weighted averages of SFA-related vascular complications
were calculated. In addition, the random-effects model was used to
estimate the pooled odds ratio (OR) comparison between SFA and CFA across
the included studies. The primary endpoint was vascular complications. The
search yielded 1269 articles; 27 (22 in PAD, 5 in TAVR) met our
pre-specified inclusion criteria. Among the PAD studies, 19 were
observational, and three were randomized clinical trials. The weighted
averages for vascular complications and pseudoaneurysms were 9.8% (95% CI
6.1%-15.6%) and 2.7% (95% CI 1.5%-4.9%), respectively. The meta-analysis
included six studies (five observational and one randomized) that compared
outcomes of SFA (838 patients) and CFA (604 patients) and showed no
significant difference in the rates of vascular complications (5.4% in the
SFA group and 6.4% in the CFA group, OR 0.71, 95% CI [0.40-1.27]; p =
0.25%). Among the TAVR studies, SFA was used as the primary access in 18
patients, with no significant bleeding, vascular complications, or
unplanned interventions. In this analysis, SFA access was associated with
good safety in selected patients undergoing peripheral arterial procedures
(low to intermediate risk of bias). It was also feasible as the primary
access route for TAVR in a very small, highly selected group with
unfavorable CFA anatomy (high risk of bias) and therefore is
hypothesis-generating, requiring validation in larger
studies. Copyright © 2025 The Author(s). Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<34>
Accession Number
2040734898
Title
Intravenous thrombolysis before percutaneous coronary intervention in
patients with non-ST-elevation acute coronary syndrome and acute ischaemic
stroke: a subanalysis of the PRAISE study.
Source
Open Heart. 12(2) (no pagination), 2025. Article Number: e003567. Date of
Publication: 29 Sep 2025.
Author
Sedghi A.; Von Rennenberg R.; Petzold G.; Nickenig G.; Kallmunzer B.;
Achenbach S.; Huber R.; Seeger J.; Von Sarnowski B.; Thomalla G.; Ringleb
P.A.; Michalski D.; Laufs U.; Royl G.; Szabo K.; Mangner N.; Puetz V.;
Kellert L.; Kaeaeb S.; Wunderlich S.; Laugwitz K.-L.; Petersen M.; Mengel
A.; Leistner D.M.; Landmesser U.; Endres M.; Nolte C.H.; Siepmann T.
Institution
(Sedghi, Puetz, Siepmann) Department of Neurology, Medical Faculty and
University Hospital Carl Gustav Carus, TUD Dresden University of
Technology, Dresden, Germany
(Von Rennenberg, Nolte) Department of Neurology with Experimental
Neurology, Center for Stroke Research Berlin, Charite -
Universitatsmedizin Berlin, Berlin, Germany
(Petzold) Department for Neurology, Section of Vascular Neurology,
Universitatsklinikum Bonn, Bonn, Germany
(Nickenig) Department of Cardiology, Universitatsklinikum Bonn, Bonn,
Germany
(Kallmunzer) Department of Neurology, University Hospital Erlangen,
Erlangen, Germany
(Achenbach) Medizinische Klinik 2, University Hospital Erlangen, Erlangen,
Germany
(Huber) Department of Neurology, Medical Campus Lake Constance,
Friedrichshafen, Germany
(Seeger) Department of Cardiology and Intensive Care, Medical Campus Lake
Constance, Friedrichshafen, Germany
(Von Sarnowski) Department of Neurology, University Medicine Greifswald,
Greifswald, Germany
(Thomalla) Department of Neurology, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany
(Ringleb) Department of Neurology, University Hospital Heidelberg,
Heidelberg, Germany
(Michalski) Department of Neurology, Leipzig University Hospital, Leipzig,
Germany
(Laufs) Department of Cardiology, Leipzig University Hospital, Leipzig,
Germany
(Royl) Neurovascular Center, Department of Neurology, University Medical
Center Schleswig-Holstein, Campus Lubeck, Lubeck, Germany
(Szabo) Department of Neurology, Mannheim Center for Translational
Neuroscience, Medical Faculty Mannheim, Mannheim, Germany
(Mangner) Department of Internal Medicine and Cardiology, Heart Center
Dresden, Medical Faculty and University Hospital Carl Gustav Carus, TUD
Dresden University of Technology, Dresden, Germany
(Kellert) Department of Neurology, LMU University Hospital, Munich,
Germany
(Kaeaeb) Department of Cardiology, LMU University Hospital, Munich,
Germany
(Wunderlich) Department of Neurology, Klinikum Rechts der Isar, School of
Medicine and Health, Technical University of Munich, Munich, Germany
(Laugwitz) Department of Internal Medicine I, TUM University Hospital,
Technical University of Munich, Munich, Germany
(Petersen) Department of Neurology, Klinikum Osnabruck GmbH, Osnabruck,
Germany
(Mengel) Department of Neurology and Stroke, Eberhard-Karls University of
Tubingen, Tubingen, Germany
(Leistner) Department of Cardiology, Goethe University Frankfurt,
Frankfurt, Germany
(Landmesser) Department of Cardiology, Angiology and Intensive Care
Medicine, Deutsches Herzzentrum Charite, Charite - Universitatsmedizin
Berlin, Berlin, Germany
(Endres) Klinik und Hochschulambulanz fur Neurologie, Charite -
Universitatsmedizin Berlin, Berlin, Germany
(Endres) Center for Stroke Research Berlin, Berlin, Germany
(Endres) German Center for Neurodegenerative Diseases (DZNE), partner site
Berlin, Berlin, Germany
(Endres) German Centre for Cardiovascular Research (DZHK), partner site
Berlin, Berlin, Germany
(Endres) German Center for Mental Health (DZPG), partner site Berlin,
Berlin, Germany
Publisher
BMJ Publishing Group
Abstract
Background In patients with acute ischaemic stroke (AIS) and concomitant
non-ST-elevation acute coronary syndrome (NSTE-ACS), the role of
intravenous thrombolysis (IVT) before percutaneous coronary intervention
(PCI) is unclear. Methods We performed a subanalysis of the PRAISE
(PRediction of Acute coronary syndrome in acute Ischemic StrokE) study, a
multicentre, prospective observational study in 247 patients with AIS and
elevated high-sensitivity cardiac troponin who underwent coronary
angiography based on European Society of Cardiology guidelines. The impact
of IVT prior to PCI on coronary artery flow (Thrombolysis in Myocardial
Infarction (TIMI) score) and myocardial perfusion (TIMI myocardial
perfusion score) was compared using Fisher's exact test and logistic
regression analysis, adjusting for time from stroke onset to PCI. Results
Among 71 patients with AIS undergoing PCI, those who received IVT prior to
PCI for NSTE-ACS (33 women; median age 77 (66-82 IQR)) achieved a TIMI
grade 3 flow more frequently than those undergoing direct PCI (97% vs 79%;
p=0.04). Regression analysis indicated a trend toward improved coronary
artery flow with IVT (adjusted OR 8.5, 95% CI 0.9 to 75.3; p=0.05).
Myocardial perfusion did not differ between groups (p=0.06). Conclusions
This subanalysis suggests that IVT before PCI may enhance coronary artery
flow in selected patients with NSTE-ACS with AIS. The results of this
exploratory subanalysis warrant further investigation, particularly in
patients with delayed access to PCI. Copyright © Author(s) (or
their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ
Group.

<35>
Accession Number
2035636842
Title
Non-invasive goal-directed fluid therapy with the pleth variability index
(PVI): a systematic review and meta-analysis.
Source
Journal of Clinical Monitoring and Computing. 39(5) (pp 917-927), 2025.
Date of Publication: 01 Oct 2025.
Author
Felippe V.A.; Codeceira R.; Irigaray M.; Sckaff M.; Wegner B.; Nascimento
T.; Darcy C.; Dutra L.; Santiago B.; Buchmann J.; Lessa M.A.
Institution
(Felippe) Department of Anesthesiology, Brazilian National Cancer
Institute, Rio de Janeiro, Brazil
(Codeceira) School of Medicine, Federal University of Rio de Janeiro, Rio
de Janeiro, Brazil
(Irigaray) School of Medicine, University of the Region of Joinville
(UNIVILLE), Joinville, Brazil
(Sckaff) School of Medicine, Johns Hopkins University, Baltimore, United
States
(Wegner) School of Medicine, Federal University of Rio Grande do Sul,
Porto Alegre, Brazil
(Nascimento) Department of Anesthesia, University of Iowa, Iowa City,
United States
(Darcy) Translational Medicine, Paulista School of Medicine (EPM-UNIFESP),
Sao Paulo, Brazil
(Dutra) Department of Anesthesiology, Ipanema Federal Hospital, Rio de
Janeiro, Brazil
(Santiago) IDOMED, Institute for Medical Development, Rio de Janeiro,
Brazil
(Buchmann) Department of Surgery, Anesthesia Division, State University of
Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
(Lessa) Department of Anesthesia, Carver College of Medicine, University
of Iowa, 200 Hawkins Dr 6413 JCP, Iowa City, IA, United States
Publisher
Springer Science and Business Media B.V.
Abstract
Optimal intraoperative fluid management is essential to improve surgical
outcomes and reduce complications. The Pleth Variability Index (PVI), a
dynamic and non-invasive indicator of fluid responsiveness, has been
proposed as a tool for goal-directed fluid management. This systematic
review and meta-analysis aimed to evaluate the effectiveness of PVI-guided
fluid therapy compared to conventional fluid management (CFM) in
non-cardiac surgeries. A comprehensive search of PubMed, Embase, and
Cochrane databases up to January 2024 identified eligible studies. Primary
outcomes included total intraoperative fluid volume and crystalloid
administration. Secondary outcomes included hemodynamic parameters, renal
function markers, acid-base balance, and hospital length of stay (LOS).
Random-effects models were applied, and subgroup and sensitivity analyses
were performed. Nine studies comprising 1,105 patients were included.
Compared to conventional fluid management, PVI-guided therapy
significantly reduced total fluid volume (mean difference [MD] - 761.23
mL; 95% CI - 1267.42 to - 255.03) and crystalloid administration (MD -
655.05 mL; 95% CI - 1096.48 to - 213.62), without significant differences
in colloid use, urine output, norepinephrine requirement, arterial
pressure, acid-base balance, or LOS. Subgroup analysis of abdominal
surgeries confirmed the observed reduction in fluid volumes. PVI-guided
fluid management allows for a more restrictive and individualized approach
without compromising hemodynamic or metabolic stability. While the
heterogeneity across studies limits generalizability, these findings
support the clinical value of PVI as a non-invasive tool for perioperative
fluid optimization, especially in settings where invasive monitoring is
not feasible. Further trials are needed to evaluate its impact on
long-term outcomes. Copyright © The Author(s) 2025.

<36>
Accession Number
2039749445
Title
Impact of Electroencephalography-guided Anesthesia in Cardiothoracic
Surgery: A Systematic Review and Updated Meta-analysis of Randomized
Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(11) (pp 3154-3162),
2025. Date of Publication: 01 Nov 2025.
Author
Silva B.D.M.; Alves e Gomes A.D.; Marcolin Miranda L.; Albuquerque L.G.;
Defante M.L.R.; Miranda N.D.C.D.; De Lima P.E.C.; Damiao V.P.
Institution
(Silva) Department of Medicine, Santo Amaro University, Sao Paulo, Brazil
(Alves e Gomes) Department of Medicine, Federal University of Ceara,
Ceara, Brazil
(Marcolin Miranda) Department of Medicine and Health Sciences, Pontifical
Catholic University of Parana, Parana, Brazil
(Albuquerque) Department of Medicine, Federal University of Bahia, Bahia,
Brazil
(Defante) Redentor University Center, Department of Medicine, Itaperuna,
Brazil
(Miranda) Department of Medicine, Bahiana's School of Medicine and Public
Health, Bahia, Brazil
(De Lima) Department of Medicine, Federal University of Latin American
Integration, Parana, Brazil
(Damiao) Department of Medicine and Health Sciences, Pontifical Catholic
University of Campinas, Campinas, Brazil
Publisher
W.B. Saunders
Abstract
Objective: To evaluate the impact of electroencephalography (EEG)-guided
anesthesia versus non-EEG-guided anesthesia on postoperative delirium and
adverse outcomes in patients undergoing cardiothoracic surgeries.
 Design(s): A systematic review and meta-analysis were performed using
PubMed, Embase, and Cochrane Library. Setting(s): All randomized
clinical trials (RCTs). Participant(s): Eight RCTs with 2,666
patients: 1,304 received EEG-guided anesthesia and 1,362 received usual
care. Intervention(s): Anesthesia guided by EEG in cardiothoracic
surgery. Measurements and Main Results: Mean differences (MDs) were
used to pool continuous outcomes while risk ratios (RRs) were used for
binary outcomes, using 95% confidence intervals (CIs). A random-effects
model was used to examine the treatment. Statistical analysis was
performed using R Studio. EEG-guided anesthesia was associated with a
trend toward reduced ventilatory support duration (MD: -25.08, 95% CI:
-50.12 to -0.04, p = 0.05, I2 = 0%). No significant differences were found
in postoperative delirium (RR: 0.93, 95% CI: 0.79-1.09, p = 0.35, I2 =
42.6%), hospital length of stay (MD: -0.22, 95% CI: -0.53 to 0.09, p =
0.17, I2 = 4.7%), intensive care unit length of stay (MD: -0.24, 95% CI
-0.59 to 0.12, p = 0.19, I2 = 71.7%), mortality (RR: 0.82, 95% CI:
0.54-1.25, p = 0.36, I2 = 42%), or intraoperative blood transfusion (RR:
0.96, 95% CI: 0.74-1.25, p = 0.79, I2 = 0%). Conclusion(s): The
findings demonstrated that EEG-guided anesthesia was associated with a
shorter duration of respiratory support. However, this study did not
identify any significant comparative advantage over standard practices for
the other outcomes analyzed. Copyright © 2025 Elsevier Inc.

<37>
Accession Number
2040624336
Title
Relationships Between Cumulative Resting Heart Rate and the Incidence of
Cardiovascular Events and All-Cause Mortality - Post Hoc Analysis of STEP
Trial Data -.
Source
Circulation Journal. 89(10) (pp 1652-1661), 2025. Date of Publication: 25
Sep 2025.
Author
Lin R.; Ling Q.; Wang W.; Li W.; Lin Y.; Chen J.; Tong S.; Cai J.; Li J.;
Chen Y.
Institution
(Lin, Wang, Li, Lin, Chen, Tong, Li, Chen) Department of Cardiology,
Second Affiliated Hospital of Shantou University Medical College,
Guangdong, Shantou, China
(Lin, Li, Lin, Chen, Tong) Shantou University Medical College, Guangdong,
Shantou, China
(Ling, Cai) Hypertension Center, Fuwai Hospital, State Key Laboratory of
Cardiovascular Disease of China, National Center for Cardiovascular
Diseases of China, Chinese Academy of Medical Sciences, Peking Union
Medical College, Beijing, China
Publisher
Japanese Circulation Society
Abstract
Background: The long-term effects of cumulative resting heart rate
(cumRHR) on the incidence of cardiovascular events and all-cause mortality
in older (age >=60 years) hypertensive populations remain unclear.
Therefore, the aim of this study was to investigate the association
between cumRHR and cardiovascular events and all-cause mortality.
 Methods and Results: This post hoc analysis used data from the
Strategy of Blood Pressure Intervention in the Elderly Hypertensive
Patients (STEP) trial of 7,517 patients in whom resting heart rate (RHR)
was measured at 0, 3, 6, 9, and 12 months. "cumRHR" refers to the weighted
mean of the RHR for each time interval. Participants were divided into
quartiles (Q1-Q4) based on cumRHR. After adjustment for potential
confounders and using Q3 (72.19-75.88 [beats/min] x year) as the
reference, patients in Q4 (75.94-109.44 [beats/min] x year) had higher
risks of the primary outcome (a composite of stroke, acute coronary
syndrome, acute decompensated heart failure, coronary revascularization,
atrial fibrillation, and death from any cardiovascular cause) (hazard
ratio [HR] 2.21; 95% confidence interval [CI] 1.42-3.43; P<0.001), major
adverse cardiovascular events (HR 1.93; 95% CI 1.18-3.16; P=0.009), and
stroke (HR 3.55; 95% CI 1.42-8.86; P=0.007) and those in Q1 (44.50-68.44
[beats/min] x year) had an increased risk of the primary outcome (HR 1.71;
95% CI 1.08-2.71; P=0.02). No such trends were observed for all-cause
mortality. A U-shaped relationship was observed with the primary outcome,
with higher risk for both very low or very high cumRHR levels compared
with midrange values. Conclusion(s): Both low and high cumRHR levels
were associated with higher risk of cardiovascular events in older
patients with hypertension. Copyright © 2025 Japanese Circulation
Society. All rights reserved.

<38>
Accession Number
2040691988
Title
Sex Differences in Efficacy of Multidomain Rehabilitation Among Older
Adults With Acute HF: The REHAB-HF Trial.
Source
JACC: Heart Failure. 13(11) (no pagination), 2025. Article Number: 102547.
Date of Publication: 01 Nov 2025.
Author
Pandey A.; Gilbert O.N.; Kitzman D.W.; Bertoni A.G.; Duncan P.W.; Mentz
R.J.; Reeves G.R.; Whellan D.J.; Nelson M.B.; Chen H.; Subramanian V.;
Reed S.D.; Upadhya B.; O'Connor C.M.; Pastva A.M.
Institution
(Pandey, Subramanian) Division of Cardiology, Department of Medicine, UT
Southwestern Medical Center, Dallas, TX, United States
(Gilbert, Kitzman, Reeves, Nelson) Section of Cardiovascular Medicine,
Wake Forest University School of Medicine, Winston-Salem, NC, United
States
(Bertoni) Division of Public Health Sciences, Wake Forest University
School of Medicine, Winston-Salem, NC, United States
(Duncan) Sticht Center on Aging, Gerontology, and Geriatric Medicine, Wake
Forest School of Medicine, Winston-Salem, NC, United States
(Mentz, Upadhya) Department of Medicine, Cardiology Division, Duke
University School of Medicine, Durham, NC, United States
(Reeves) Former affiliation: Novant Health Heart and Vascular Institute,
Charlotte, NC, United States
(Whellan) Department of Medicine, Sidney Kimmel Medical College, Thomas
Jefferson University, Philadelphia, PA, United States
(Chen) Department of Biostatistics and Data Science, Wake Forest
University School of Medicine, Winston-Salem, NC, United States
(Reed, Pastva) Department of Population Health Sciences, Duke University
School of Medicine, Durham, NC, United States
(O'Connor) Inova Heart and Vascular Institute, Fairfax, VA, United States
(O'Connor) Duke Clinical Research Institute, Durham, NC, United States
(Pastva) Department of Orthopedic Surgery, Physical Therapy Division, Duke
University School of Medicine, Durham, NC, United States
(Pastva) Claude D. Pepper Older Americans Independence Center, Duke
University School of Medicine, Durham, NC, United States
Publisher
Elsevier Inc.
Abstract
Background: A multidomain physical rehabilitation intervention (REHAB-HF
[Rehabilitation Therapy in Older Acute Heart Failure Patients]
intervention) has been associated with significant improvements in
physical function and quality of life (QOL) among older patients with
acute decompensated heart failure (ADHF). Objective(s): This study
aims to evaluate sex differences in the treatment effect of a multidomain
rehabilitation intervention among participants of the REHAB-HF trial.
 Method(s): In this prespecified secondary analysis of the REHAB-HF
trial, sex differences in the treatment effect of the REHAB-HF
intervention (vs attention control) on key 3-month outcomes of the Short
Physical Performance Battery (SPPB, primary), frailty burden, 6-minute
walking distance (6MWD), and QOL were assessed. Statistical significance
for treatment effect interaction (sex*intervention) was set at 0.1.
 Result(s): Among the 349 trial participants, female patients (n =
183) had a significantly lower baseline SPPB score and 6MWD and a higher
frailty burden than male patients (n = 166). Female (vs male) participants
had a significantly greater improvement in SPPB (effect size: 1.9 [95% CI:
1.1-2.7] vs 1.0 [95% CI: 0.1-1.8]; P for interaction = 0.1) and frailty
burden, as assessed by Fried phenotype criteria (effect size: -0.5 [95%
CI: -0.9 to -0.2] vs 0.00 [95% CI: -0.4 to 0.4]; P for interaction = 0.04)
with the REHAB-HF intervention. The magnitude of the improvement in 6MWD
and QOL (Kansas City Cardiomyopathy Questionnaire score) with the REHAB-HF
intervention was also greater among female (vs male) participants without
a significant treatment effect interaction by sex. There was no
significant difference in rates of adverse clinical outcomes associated
with the intervention across both sex groups. There was no difference in
intervention adherence by sex. Conclusion(s): Female (vs male)
participants with ADHF had a significantly greater improvement in physical
function in response to the REHAB-HF intervention. Copyright ©
2025 American College of Cardiology Foundation

<39>
Accession Number
2040746739
Title
Ultrasound-detected postoperative diaphragmatic dysfunction and its
association with pulmonary complications. A systematic review and
meta-analysis.
Source
Journal of Clinical Anesthesia. 107 (no pagination), 2025. Article Number:
112027. Date of Publication: 01 Nov 2025.
Author
Jimenez-Santana J.D.; Azzolina D.; Scaramuzzo G.; Mazzinari G.; Dres M.;
Fogagnolo A.; Cammarota G.; Volta C.A.; Spadaro S.
Institution
(Jimenez-Santana) Departament de Medicina, Facultat de Medicina i
Odontologia, Universitat de Valencia, Av. Blasco Ibanez 15, Valencia,
Spain
(Jimenez-Santana, Mazzinari) Department of Anaesthesiology, Hospital
Universitari i Politecnic la Fe, Valencia, Spain
(Azzolina) Biostatistics and Clinical Trial Biometry Unit, Clinical
Research Center DEMeTra, Department of Translational Medicine, University
of Naples Federico II, Naples, Italy
(Scaramuzzo, Fogagnolo, Volta, Spadaro) Department of Translational
Medicine, University of Ferrara, Ferrara, Italy
(Scaramuzzo, Fogagnolo, Volta, Spadaro) Anesthesia and Intensive Care
Unit, Emergency Department, Azienda Ospedaliera Universitaria di Ferrara,
Ferrara, Italy
(Mazzinari) Department of Statistics and Operational Research, University
of Valencia, Valencia, Spain
(Dres) Sorbonne Universite, INSERM, UMRS1158 Neurophysiologie Respiratoire
Experimentale et Clinique, Paris, France
(Dres) Departement R3S (Respiration, Reanimation, Readaptation
Respiratoire, Sommeil), Service de Medecine Intensive-Reanimation
(Departement "R3S"), AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne
Universite, Hopital Pitie-Salpetriere, 47-83 boulevard de l'Hopital,
Paris, France
(Cammarota) Anesthesia and Intensive Care Unit, Azienda Ospedaliero,
Universitaria SS Antonio E Biagio E Cesare Arrigo Di Alessandria,
Alessandria, Italy
(Cammarota) Translational Medicine Department, Universita Degli Studi del
Piemonte Orientale, Novara, Italy
Publisher
Elsevier Inc.
Abstract
Introduction: Postoperative diaphragmatic dysfunction (PDD) is a common
complication following major surgeries, contributing to adverse clinical
outcomes. Ultrasound-based assessment has emerged as the preferred method
for evaluating PDD. We aimed to assess the association between PDD and
postoperative pulmonary complications (PPCs) and their relationship with
pneumonia. Method(s): We systematically searched PubMed, Scopus, and
Embase for clinical studies assessing PDD via ultrasound. The inclusion
period ranged from January 10th, 2025, to March 20th, 2025. Two authors
independently selected the investigations according to the following
criteria: [1] observational study or randomized clinical trials enrolling
adult patients undergoing cardiac, thoracic, or abdominal surgery [2]
evaluation of PDD using diaphragmatic excursion (DE) or diaphragmatic
thickening fraction (DTF) after surgery, and [3] report an association
between PDD and PPCs or pneumonia as clinical outcomes. Preferred
Reporting Items for Systematic Reviews and Meta-analysis (PRISMA)
guidelines were followed. Two authors independently performed data
extraction. The Methodological Index for Nonrandomized Studies (MINORS)
assessed study quality. The primary outcome was the association between
PDD and PPCs. The secondary outcomes evaluated prevalence of PDD and
pneumonia as an individual component of PPCs when it was reported
separately, and its association with PDD. Result(s): The systematic
review included 19 studies, and six studies met the criteria for
meta-analysis. PDD was significantly associated with higher odds of PPCs
(OR 2.99, 95 % CI: 2.01-4.45) and pneumonia (OR 5.41, 95 % CI:
2.36-12.42). No significant publication bias was detected. Heterogeneity
was low for both outcomes. Conclusion(s): Ultrasound-assessed
postoperative diaphragmatic dysfunction is significantly associated with
higher odds of postoperative pulmonary complications, including pneumonia,
highlighting its clinical relevance at the bedside. PDD, assessed via
ultrasound, is strongly associated with an increased risk of PPCs and
pneumonia in postoperative patients. These findings underscore the
importance of routine postoperative diaphragmatic assessment and the
potential for targeted interventions to mitigate PDD-related
complications. However, the current evidence is constrained by
methodological variability and the absence of standardized diagnostic
criteria. Future studies should focus on establishing consensus
definitions for PDD and ensuring consistent assessment of key clinical
outcomes. Copyright © 2025 Elsevier Inc.

<40>
Accession Number
2036408117
Title
Efficacy and safety of colchicine in patients with acute coronary
syndrome: a systematic review and meta-analysis of randomized controlled
trials.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
700. Date of Publication: 01 Dec 2025.
Author
Fallahtafti P.; Farooqi M.; Looha M.A.; Azizpour A.; Mohammadi Y.; Fekri
M.; Jodeiri F.; Hemmati D.N.; Mosayebi F.; Pirmoradian P.; Jenab Y.;
Iskander F.; Kolte D.; Hakim D.; Mohsen A.; Hosseini K.
Institution
(Fallahtafti) Eye Research Center, The Five Senses Health Institute, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Fallahtafti, Mohammadi, Jodeiri, Hemmati, Mosayebi, Pirmoradian, Jenab,
Hosseini) Cardiovascular Disease Research Institute, Tehran Heart Center,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Farooqi) Department of Internal Medicine, Central Michigan University,
MI, United States
(Looha) Gastrointestinal Disorders Research Center, Research Institute for
Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Azizpour) School of Medicine, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Fekri) School of Medicine, Shahid Beheshti University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Jodeiri) School of Medicine, Tehran Medical Branch, Islamic Azad
University, Tehran, Iran, Islamic Republic of
(Iskander) MedStar Union Memorial Hospital, Baltimore, MD, United States
(Kolte) Cardiology Division, Massachusetts General Hospital, Boston, MD,
United States
(Hakim) Department of Cardiology, Brigham and Women's Hospital, Harvard
Medical School, Boston, United States
(Mohsen) Division of Cardiology, Loma Linda University Health, Loma Linda,
United States
Publisher
BioMed Central Ltd
Abstract
Background: The European Society of Cardiology (ESC) recently endorsed
low-dose colchicine for chronic coronary syndrome. However, its role in
acute coronary syndrome (ACS) remains uncertain due to inconsistent trial
outcomes. This systematic review and meta-analysis aimed to assess the
efficacy and safety of colchicine in patients with ACS. Method(s): A
comprehensive search of PubMed, Embase, and the Cochrane Library was
conducted through April 2025 to identify randomized controlled trials
(RCTs) evaluating colchicine in adults with ACS. The primary outcome was
all-cause mortality. Secondary outcomes included cardiovascular mortality,
stroke, myocardial infarction (MI), major adverse cardiovascular events
(MACE), coronary revascularization, and gastrointestinal (GI) adverse
events. Data were pooled using a random-effects model to estimate relative
risks (RRs) with 95% confidence intervals (CIs), using the longest
available follow-up. Result(s): Eleven RCTs encompassing 12,730
patients were included. Among them, 6,844 received colchicine for at least
one month, while 5,886 received placebo or no additional treatment.
Colchicine did not significantly reduce all-cause mortality (RR 0.95, 95%
CI: 0.79-1.14) or cardiovascular mortality (RR 1.03, 95% CI: 0.82-1.29).
No significant reductions were observed in MACE, MI, stroke, or coronary
revascularization. Colchicine was associated with a non-significant trend
toward increased GI adverse events, particularly at higher doses.
 Conclusion(s): This meta-analysis does not support the routine use of
colchicine in ACS management. While generally safe, colchicine did not
confer clear cardiovascular benefits in this setting. However, potential
subgroup effects, such as in longer-term use or among specific high-risk
populations, warrant further investigation in future large-scale,
well-designed trials. Copyright © The Author(s) 2025.

<41>
Accession Number
2040784136
Title
Safety and Feasibility of Lumbar Cerebrospinal Fluid Drainage with
Intrathecal Pressure Monitoring in Acute Severe Spinal Cord Injury: A
Randomized Pilot Trial.
Source
World Neurosurgery. 203 (no pagination), 2025. Article Number: 124441.
Date of Publication: 01 Nov 2025.
Author
Dembour V.; Beloauer A.; Diaz S.; Maeder B.; Germann M.; Rothenfluh D.;
Barges-Coll J.
Institution
(Dembour) Department of Neurosurgery, Hopitaux Universitaires de
Strasbourg, Strasbourg, France
(Beloauer, Diaz, Maeder, Germann, Rothenfluh, Barges-Coll) Department of
Spinal Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne,
Switzerland
Publisher
Elsevier Inc.
Abstract
Background: Spinal cord perfusion impairment is a critical secondary
mechanism in acute spinal cord injury (SCI). Although lumbar cerebrospinal
fluid (CSF) drainage is widely used in cardiothoracic surgery, its use in
SCI remains limited. This study presents an evaluation of the safety and
feasibility of lumbar CSF drainage with intrathecal pressure (ITP) and
spinal cord perfusion pressure (SCPP) monitoring in acute SCI patients.
 Method(s): We conducted a prospective randomized pilot trial
involving 21 patients with acute traumatic SCI (American Spinal Injury
Association [ASIA] A-C). Twelve patients received continuous lumbar CSF
drainage and SCPP monitoring over 72 hours, whereas 9 received standard
care. The primary outcome measured was the change in ASIA scores at 12
months. The secondary outcomes included ITP measurements, mean arterial
pressure requirements, and feasibility and safety data. Result(s):
The initial ITP in the drainage group averaged 15 mmHg and was reduced to
6 mmHg via controlled drainage. This group maintained lower mean arterial
pressures (74 vs. 82 mmHg, P = 0.004) compared to the control group and
required less vasopressor support. Neurologically, 4 patients in the
drainage group improved to ASIA C or D, compared to 1 patient in the
control group. The mean motor score improvement was greater in the
drainage group (DELTA11 vs. DELTA7), although the difference was not
statistically significant. No drainage-related complications occurred.
 Conclusion(s): Lumbar CSF drainage is a safe and feasible
intervention for the treatment of acute SCI, enabling tailored perfusion
management. Although preliminary findings are promising, larger
multicenter trials are needed to validate their clinical efficacy and
define optimal SCPP targets. Copyright © 2025 The Author(s)

<42>
Accession Number
2040775002
Title
Efficacy of ultrasound-guided bilateral pecto-intercostal fascial plane
block as a pre-emptive analgesic adjunct in patients undergoing cardiac
surgery: A randomized, double-blinded study.
Source
Journal of Anaesthesiology Clinical Pharmacology. 41(4) (pp 658-663),
2025. Date of Publication: 01 Oct 2025.
Author
Powers P.A.; Babu S.; Sreedhar R.; Gadhinglajkar S.V.; Dash P.K.; Sukesan
S.
Institution
(Powers, Babu, Sreedhar, Gadhinglajkar, Dash, Sukesan) Division of
Cardiothoracic and Vascular Anaesthesia, Sree Chitra Tirunal Institute for
Medical Sciences and Technology, Kerala, Trivandrum, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: No studies have assessed the pre-emptive analgesic
efficacy of pecto-intercostal fascial plane block (PIFB). We evaluated the
pre-emptive analgesic efficacy of PIFB by comparing with the routine
in-hospital analgesic protocol for sternotomy pain in patients undergoing
cardiac surgery. Material(s) and Method(s): This prospective,
randomized, double-blinded study was conducted on 90 patients undergoing
elective coronary artery bypass grafting surgery. The patients were
randomized into two groups as follows: 1. PIFB group (n = 45): received
bilateral ultrasound-guided bilateral PIFB with 0.5% levobupivacaine and
2. no PIFB (NPIFB) group (n = 45): received routine in-hospital
perioperative analgesic protocol. The primary outcome of the study was to
assess the effectiveness of PIFB on the requirement of intraoperative and
postoperative fentanyl. The secondary outcomes were to assess the
postoperative pain score, sedation alertness, side effects, and
cooperation with incentive spirometry exercises. The Chi-square test and
Student's t-Test were used to compare the data. Result(s): The total
intraoperative fentanyl consumption was significantly less in the PIFB
group (587.8 +/- 165.7 mug) than in the NPIFB group (935.6 +/- 157.2 mug)
(P < 0.0001). The postoperative pain scores, the need for rescue fentanyl,
and the incidence of nausea and vomiting at different time points were
significantly lower in the PIFB group. Patients in the PIFB group
cooperated well with incentive spirometry exercises at various time
points. There was no difference in sedation score at different time points
between the two groups. No complications were noted in either group.
 Conclusion(s): Ultrasound-guided PIFB is very effective as a
pre-emptive analgesic adjunct for sternotomy pain in patients undergoing
cardiac surgery. Copyright © 2025 Journal of Anaesthesiology
Clinical Pharmacology.

<43>
Accession Number
2035129901
Title
The impact of surgeon specialty and technique on outcomes after esophageal
dilation: a systematic review.
Source
Esophagus. 22(4) (pp 506-519), 2025. Date of Publication: 01 Oct 2025.
Author
Wilkins S.G.; Omiunu A.; Haynes C.V.; Simmons K.; Hayashi C.; Malik D.;
Elzamzami A.; Brackett A.; Verma A.; Kohli N.
Institution
(Wilkins, Haynes, Simmons, Hayashi, Malik, Elzamzami, Verma, Kohli) Yale
University School of Medicine, 333 Cedar Street, New Haven, CT, United
States
(Omiunu, Verma, Kohli) Division of Otolaryngology-Head and Neck Surgery,
Department of Surgery, Yale University School of Medicine, New Haven, CT,
United States
(Brackett) Harvey Cushing/John Hay Whitney Medical Library, Yale
University, 333 Cedar Street, New Haven, CT, United States
Publisher
Springer
Abstract
To conduct a systematic review across four article databases to understand
whether outcomes after esophageal dilation are affected by dilator type or
physician specialty. Dilation of the upper esophagus is a commonly used
technique to manage esophageal stenosis, which most commonly manifests as
progressive dysphagia. Strictures arise from a multitude of etiologies; as
such, they are treated by a variety of specialists, including
otolaryngology, gastroenterology, and thoracic surgery. Dilations are
commonly performed using either bougienage or balloon dilators, and there
is a paucity of literature analyzing whether complications differ based on
dilator type or physician specialty. A total of 3491 abstracts were
initially screened using the Covidence reviewer platform. 433 full texts
were assessed, and 15 studies met inclusion criteria. Four studies used
balloon dilators, 8 studies used bougie dilators, and 3 studies used both
techniques. When comparing adverse events between studies using either
balloon or bougie dilators, half of each group (2/4 and 4/8) reported no
perforations. Additional adverse outcomes, such as mediastinitis or
bleeding, remained low with both bougie and balloon dilation; only one
study reported mediastinitis as a complication, and only two studies
reported significant postoperative bleeding (one bougie, one balloon).
While technical success was heterogeneously defined, all studies reported
significant improvement after dilation. While this study was limited by
data heterogeneity, adverse outcomes after esophageal dilation remain low,
regardless of dilation method or physician specialty. Copyright ©
The Author(s) under exclusive licence to The Japan Esophageal Society
2025.

<44>
Accession Number
2036779394
Title
Critique on "Efficacy of Cerebral Embolic Protection Device in
Transcatheter Aortic Valve Replacement: A Systematic Review and
Meta-Analysis".
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Azmat W.
Institution
(Azmat) Fatima Jinnah Medical University, Lahore, Pakistan
Publisher
John Wiley and Sons Inc

<45>
Accession Number
2036217680
Title
Valve-sparing aortic root reimplantation versus aortic root replacement in
bicuspid aortic valve with aortic root aneurysm: a systematic review and
meta-analysis.
Source
Cardiothoracic Surgeon. 33(1) (no pagination), 2025. Article Number: 29.
Date of Publication: 01 Dec 2025.
Author
Santos K.; Bartolozzi H.; Obi O.S.; Habiyambere G.I.; Maris M.I.; Plonek
T.
Institution
(Santos, Plonek) Medisch Spectrum Twente, Enschede, Netherlands
(Santos) New Vision University School of Medicine, Tbilisi, Georgia
(Bartolozzi) Trakia University, Stara Zagora, Bulgaria
(Obi) New York Institute of Technology College of Osteopathic Medicine,
NY, United States
(Habiyambere) University of Global health Equity, Butaro campus, Burera,
Rwanda
(Maris) University of Medicine and Pharmacy Victor Babes Timisoara,
Timisoara, Romania
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Patients with bicuspid aortic valve (BAV) often develop aortic
root aneurysms. While aortic root replacement (Bentall procedure) has been
the standard treatment for combined valvular and root pathology,
valve-sparing root reimplantation (David procedure) has gained popularity
for its potential to preserve the native valve and avoidance of prosthesis
related complications. However, comparative data specific to patients with
BAV and root aneurysm remain limited. Thus, we aimed to systematically
compare the outcomes of the David and Bentall procedures in this
anatomically and clinically distinct population. Method(s): A
literature search was conducted in PubMed, Scopus, and Cochrane Library
for studies comparing David and Bentall in patients with regurgitant BAV
and aortic root aneurysm. Pooled odds ratios (OR) and mean differences
(MD) with 95% confidence intervals (CI) were calculated using RevMan
8.11.0. Result(s): Four observational studies comprising 679 patients
were included, of whom 252 (37.1%) underwent the David procedure. The
David procedure was associated with significantly longer cardiopulmonary
bypass (CPB) [MD 42.2 min; 95% CI 16.7 to 67.6; p = 0.001] and aortic
cross-clamp (ACC) time [MD 50.8 min; 95% CI 22.8 to 78.8; p < 0.001].
However, due to extreme heterogeneity caution is warranted in interpreting
these findings. The David procedure also demonstrated a statistically
significant but clinically uncertain reduction in hospital length of stay
[MD -1.4 days; 95% CI -2.7 to -0.1; p = 0.03] and re-explorations for
bleeding [OR 0.4, 95% CI 0.1 to 0.9; p = 0.04]. Other postoperative
outcomes, including stroke, arrhythmias, 30-day mortality, and ICU length
of stay, were comparable between the two approaches. Conclusion(s):
The David procedure may be a viable option in selected BAV patients with
root aneurysm. Despite longer CPB and ACC time, it is associated with
shorter hospital stays and fewer re-explorations for bleeding, with
similar rates of other postoperative outcomes. However, our findings
should be interpreted with caution due to the retrospective design of the
included studies, strong selection bias, and variability in patient
characteristics and surgical techniques. Prospective, multicentre studies
with extended follow-ups are needed to validate our results and better
define the optimal surgical strategy in this population. Copyright
© The Author(s) 2025.

<46>
Accession Number
2036414593
Title
Circulating biomarkers of vasoplegia: a systematic review.
Source
Annals of Intensive Care. 15(1) (no pagination), 2025. Article Number:
150. Date of Publication: 01 Dec 2025.
Author
Boyer N.; Upadhyay P.; Hicks M.H.; Zarbock A.; Khanna A.K.; Forni L.G.;
Creagh-Brown B.C.
Institution
(Boyer, Forni, Creagh-Brown) Intensive Care Unit, Royal Surrey NHS
Foundation Trust, Guildford, United Kingdom
(Boyer) School of Biosciences, University of Surrey, Surrey, United
Kingdom
(Upadhyay) Smidt Heart Institute, Cedars-Sinai Medical Center, Los
Angeles, CA, United States
(Hicks, Khanna) Department of Anesthesiology, Section on Critical Care
Medicine, Atrium Health Wake Forest Baptist Medical Center, Wake Forest
University School of Medicine, Winston-Salem, United States
(Zarbock) Department of Anesthesiology, Intensive Care and Pain Medicine,
University Hospital Munster, Munster, Germany
(Forni, Creagh-Brown) School of Medicine, University of Surrey, Surrey,
United Kingdom
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Vasoplegia is characterised by persistent hypotension and
reduced systemic vascular resistance despite preserved cardiac output,
commonly arising in sepsis, following major surgery, and within systemic
inflammatory responses. Despite its clinical significance and association
with poor outcomes, there is no universally accepted definition or
standardised biomarker, impeding early diagnosis, stratification, and
targeted therapy. While individual studies have examined biomarkers within
specific clinical contexts such as septic shock or cardiac surgery, no
comprehensive synthesis across all aetiologies of vasoplegia has
previously been undertaken. Objective(s): To systematically evaluate
and synthesise the current evidence regarding circulating biomarkers
associated with the incidence, severity, prediction, and progression of
vasoplegia across diverse critical care and perioperative populations. As
well as review definitions used across literature. Method(s): This
systematic review was conducted in accordance with PRISMA 2020 guidelines
and registered on PROSPERO (CRD42024438786). Studies were included if they
investigated adult patients in critical care or perioperative settings
with vasoplegia defined by reduced vascular resistance and hypotension
requiring vasopressors. Result(s): A total of 43 studies met
inclusion criteria. The included studies examined 39 unique biomarkers,
with renin and adrenomedullin being the most frequently studied.
Heterogeneity in definitions of vasoplegia, outcome measures, and
comparator populations precluded meta-analysis. However, several
biomarkers demonstrated potential clinical utility: elevated renin levels
correlated with vasopressor requirements and haemodynamic instability,
while adrenomedullin levels were predictive of vasoplegia development and
duration. Conclusion(s): The lack of standardisation in biomarker
assay methods and vasoplegia definitions remains a significant barrier to
comparative analysis. Whilst this review highlights renin and
adrenomedullin as promising candidate biomarkers for vasoplegia, the
heterogeneity in study design, biomarker measurement, and diagnostic
criteria underscores the urgent need for a consensus definition of
vasoplegia, standardised sampling protocols, and unified outcome measures.
Future research should focus on biomarker-guided risk stratification and
personalised therapies, with an emphasis on validating predictive and
mechanistic roles across diverse vasoplegic phenotypes. Copyright
© The Author(s) 2025.

<47>
Accession Number
2036411046
Title
The value of evaluating cardiac damage in patients with aortic stenosis: a
systematic review and meta-analysis.
Source
Echo Research and Practice. 12(1) (no pagination), 2025. Article Number:
29. Date of Publication: 01 Dec 2025.
Author
Bennett S.; Holroyd E.; Paton M.F.; Leeson P.; Redfors B.; Pibarot P.;
Genereux P.; Kwok C.S.
Institution
(Bennett, Holroyd) Heart and Lung Clinic, University Hospital of North
Midlands NHS Trust, Stoke-on-Trent, United Kingdom
(Bennett, Leeson) Cardiovascular Clinical Research Facility, University of
Oxford, Oxford, United Kingdom
(Paton) Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
(Paton) Leeds Institute of Cardiovascular and Metabolic Medicine, School
of Medicine, University of Leeds, Leeds, United Kingdom
(Leeson) Oxford University Hospitals NHS Foundation Trust, John Radcliffe,
Oxford, United Kingdom
(Redfors) Department of Molecular and Clinical Medicine, Gothenburg
University, Gothenburg, Sweden
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Redfors) Clinical Trials Centre, Cardiovascular Research Foundation, New
York City, United States
(Pibarot) Laval University, Quebec City, Canada
(Pibarot) Quebec Heart and Lung Institute, Quebec City, Canada
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Kwok) Department of Cardiology, Mid Cheshire Hospitals NHS Foundation
Trust, Crewe, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: Aortic stenosis (AS) is a common valvular heart disease where
aortic valve replacement (AVR) is the only treatment. A novel staging
system based on cardiac damage was developed to assess the
pathophysiological consequence of AS and this has been shown to be
associated with outcomes post AVR. Method(s): We conducted a
systematic review of studies which evaluated cardiac damage in patients
with AS. A search of MEDLINE and EMBASE was performed with data being
extracted from relevant studies. The main outcome of interest were
proportion of AS patients with signs of cardiac damage, all-cause
mortality, cardiovascular mortality, and major adverse cardiovascular
events. Result(s): A total of 18 studies were included with 21,876
patients (mean age 79 years, 52.7% males). Pooled analysis indicated 76%
of symptomatic severe AS patients and 88% of asymptomatic moderate/severe
AS patients had signs of cardiac damage, with stage two being the most
commonly reported (25.1% and 32.3% respectively). For symptomatic severe
AS patients, the pooled all-cause mortality and cardiovascular mortality
rates increased along an increase in cardiac damage stage from 9.4% to
2.0% respectively for stage 0 to 24.2% and 36.1% respectively for stage 4.
In patients with asymptomatic moderate / severe AS, all-cause mortality
ranged from 30.0% in stage 0 to 51.2% in stage 3/4. In patients with
symptomatic severe AS undergoing AVR, meta-analysis indicated an increase
in odds of cardiovascular related mortality for stage 4 cardiac damage
only (OR 6.89, 95% CI: 3.04,15.61, p = 0.003). An increased odds of
all-cause mortality was seen in for cardiac damage stages 1, 3 and 4 (OR
1.4, 95%CI: 1.10,1.77, p = 0.01, OR 2.27, 95%CI: 1.76,2.92, p = 0.0002 and
OR 2.94, 95%CI: 1.97,4.38, p = 0.0006 respectively). Conclusion(s):
Cardiac damage is a common finding amongst patients with AS irrespective
of AS severity or symptomatic status. Mortality rates appear to increase
alongside an increase in cardiac damage staging. Cardiac damage may
provide prognostic valve when considering the timing of AVR with left
ventricular and right ventricular abnormalities being associated with
increased odds of mortality. Clinical trial number: Not
applicable. Copyright © The Author(s) 2025.

<48>
Accession Number
2040831742
Title
The Effect of Thoracic Paravertebral Block on Postoperative Pain After
Coronary Artery Bypass Graft Surgery: A Retrospective Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Nezir Y.; Cengiz G.; Abdurrahman D.
Institution
(Nezir, Abdurrahman) Department of Anesthesiology and Reanimation,
Adiyaman University, Adiyaman, Turkey
(Cengiz) Department of Cardiovascular Surgery, Adiyaman University,
Adiyaman, Turkey
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate the effect of bilateral single-shot thoracic
paravertebral block (PVB) on postoperative analgesia in patients
undergoing coronary artery bypass grafting (CABG) surgery. Design(s):
A retrospective cohort study. Setting(s): A single tertiary
university hospital. Participant(s): Patients who underwent elective
CABG surgery. Intervention(s): Among 110 patients included in the
study, 59 received general anesthesia alone (Group C: control group),
while 51 received general anesthesia combined with a bilateral single-dose
thoracic PVB (Group B: block group). Measurements and Main Results:
Demographic characteristics, intraoperative fentanyl consumption,
postoperative paracetamol requirements, and pain scores-documented in
patient records using the visual analog scale at 2, 4, 16, and 24
hours-along with extubation time, intensive care unit and hospital length
of stay, time to first mobilization, and time to chest drain removal were
retrospectively collected and analyzed. Group B showed significantly lower
intraoperative fentanyl and postoperative paracetamol use compared with
Group C (p < 0.05). Visual analog scale scores were significantly lower in
Group B (p < 0.05). Additionally, extubation time, intensive care unit
length of stay, and time to mobilization were significantly shorter in
Group B (p < 0.05). No significant differences were observed in total
hospital length of stay or chest drain removal time (p > 0.05).
 Conclusion(s): Bilateral single-shot thoracic PVB may be a safe and
effective adjunct to general anesthesia in patients undergoing CABG
surgery. In this retrospective study, PVB was associated with superior
analgesia, decreased opioid consumption, and improved early recovery
parameters. These findings support the integration of PVB into multimodal
analgesia protocols; however, prospective randomized controlled trials are
needed to validate these results. Copyright © 2025 Elsevier Inc.

<49>
Accession Number
2040831322
Title
Empagliflozin Reduces Risk of Hospitalization in Patients With Chronic
Kidney Disease in the EMPA-KIDNEY Trial.
Source
Clinical Therapeutics. (no pagination), 2025. Date of Publication: 2025.
Author
Uster A.; Desai N.; Navaneethan S.D.; Pfarr E.; Mazo A.R.
Institution
(Uster, Pfarr, Mazo) Boehringer Ingelheim International GmbH,
Ingelheim-am-Rhein, Germany
(Desai) Section of Cardiovascular Medicine, Yale School of Medicine, New
Haven, Connecticut, United States
(Navaneethan) Selzman Institute for Kidney Health, Section of Nephrology,
Department of Medicine, Baylor College of Medicine, Houston, Texas, United
States
Publisher
Elsevier Inc.
Abstract
Purpose: Chronic kidney disease (CKD) increases hospitalization risk. In
the randomized, phase III, EMPA-KIDNEY trial, empagliflozin significantly
reduced risk of all-cause hospitalizations (ACH; first and recurrent) vs
placebo. This post hoc analysis of the EMPA-KIDNEY trial examines the
burden of ACH in CKD and the effects of empagliflozin on ACH.
 Method(s): Participants with CKD (n = 6609) were randomized to
empagliflozin 10 mg or placebo. Reasons for hospitalizations were derived
from adverse events leading to hospitalization, assessed by system organ
class. Finding(s): Overall, 1995 participants (1035 placebo, 960
empagliflozin) had >=1 ACH (1895 ACH in placebo and 1611 in the
empagliflozin 10-mg groups). The estimated mortality rate after first
hospitalization in participants with >=1 hospitalization was 12% after 1
year and 18% after 2 years, and risk of death was ~10 times higher vs
those without (hazard ratio [HR] 9.53; 95% confidence interval [CI],
7.18-12.64; P < 0.0001). The most common reasons for hospitalization were
infections and infestations, surgical and medical procedures,
investigations, cardiac disorders, renal and urinary disorders, and
metabolic disorders. Risk of ACH was significantly reduced for
empagliflozin vs placebo (HR: 0.86, 95% CI, 0.78-0.95, P = 0.003). This
was consistent regardless of baseline diabetes status, estimated
glomerular filtration rate, or urinary albumin-to-creatinine ratio. Mean
cumulative incidence of ACH in empagliflozin and placebo groups diverged
shortly after randomization and separated further over time. Risk of
hospital admissions from cardiovascular (CV), renal, or metabolic
conditions was significantly lower with empagliflozin vs placebo (P <
0.05). Implications: Treatment with empagliflozin significantly reduced
risk of ACH, including those attributed to CV, renal, or metabolic
conditions. ClinicalTrials.gov number: NCT03594110 Copyright ©
2025 The Author(s)

<50>
Accession Number
2032862301
Title
Registries on transcatheter edge-to-edge repair in heart failure: Current
evidence and future perspectives.
Source
European Journal of Heart Failure. 27(8) (pp 1523-1538), 2025. Date of
Publication: 01 Aug 2025.
Author
Savarese G.; Basile C.; Adamo M.; Anker S.D.; Bayes-Genis A.; Bohm M.;
Donal E.; Filippatos G.S.; Maisano F.; Ponikowski P.; Rosano G.M.C.; von
Bardeleben R.S.; Metra M.; Butler J.
Institution
(Savarese, Basile) Department of Clinical Science and Education,
Sodersjukhuset, Karolinska Institutet, Stockholm, Sweden
(Basile) Department of Advanced Biomedical Sciences, University of Naples
'Federico II', Naples, Italy
(Adamo, Metra) Cardiology, ASST Spedali Civili of Brescia, Department of
Medical and Surgical Specialties, Radiological Sciences, and Public
Health, University of Brescia, Brescia, Italy
(Anker) Department of Cardiology and Berlin Institute of Health Center for
Regenerative Therapies, German Center for Cardiovascular Research Partner
Site Berlin, Charite Universitatsmedizin, Berlin, Germany
(Bayes-Genis) Heart Institute, University Hospital Germans Trias i Pujol,
CIBERCV, Badalona, Spain
(Bayes-Genis) Department of Medicine, Universitat Autonoma de Barcelona,
Barcelona, Spain
(Bohm) Internal Medicine Clinic III, Cardiology, Angiology and Intensive
Care Medicine, Saarland University, Homburg, Germany
(Donal) Universite de Rennes, CHU Rennes, Inserm, LTSI-UMR, Rennes, France
(Filippatos) Department of Cardiology, Attikon University Hospital,
National and Kapodistrian University of Athens, Athens, Greece
(Maisano) Department of Cardiac Surgery, IRCCS San Raffaele Hospital,
Vita-Salute San Raffaele University, Milan, Italy
(Ponikowski) Institute of Heart Diseases, Wroclaw Medical University,
Wroclaw, Poland
(Rosano) Department of Medical Sciences, IRCCS San Raffaele Roma, Rome,
Italy
(von Bardeleben) Department of Cardiology, University Medical Center of
the Johannes Gutenberg-University Mainz, Mainz, Germany
(Butler) Department of Medicine, University of Mississippi Medical Center,
Jackson, MS, United States
(Butler) Baylor Scott and White Research Institute, Dallas, TX, United
States
Publisher
John Wiley and Sons Ltd
Abstract
Aims: Secondary mitral regurgitation (SMR) and tricuspid regurgitation
(TR) are the most common valvular heart diseases in patients with heart
failure (HF). Transcatheter edge-to-edge repair (TEER) devices designed
for treating MR and TR have been successfully tested in randomized
controlled trials, but methodological issues have often challenged their
interpretation. This manuscript aimed to provide an overview of TEER
registries on SMR and TR in HF, highlighting their key features,
describing clinical characteristics and outcomes of patients receiving
these devices, and exploring the available data limitations. Methods
and Results: PubMed, Web of Science, and EMBASE were searched for
registries reporting on TEER in SMR or TR. Registries were excluded if
single-centre and with <100 patients. Twenty-six registries (46%
prospective, 12% ongoing), including a total cohort of 18 925 patients,
were retrieved for TEER in SMR, and six registries (50% retrospective, 33%
ongoing) reported on the use of TEER for TR in a total cohort of 1412
patients. Limited geographical representativity outside North America and
Europe, high number of missing values, and inconsistency in data reporting
were the main existing evidence limitations. Conclusion(s):
Registries on TEER represent a key data source in a setting where it is
difficult to conduct randomized controlled trials. However, limitations in
design, patient characterization, and outcomes reporting restrain their
use. A novel conceptual framework for future prospective TEER registries,
as proposed in this document, might inform current practice, address
relevant clinical questions and future trial design. Copyright ©
2025 The Author(s). European Journal of Heart Failure published by John
Wiley & Sons Ltd on behalf of European Society of Cardiology.

<51>
Accession Number
2038818242
Title
Anxiety during transcatheter aortic valve replacement under local
anesthesia - the ART-VR trial.
Source
Cardiovascular Revascularization Medicine. 79 (pp 71-77), 2025. Date of
Publication: 01 Oct 2025.
Author
Chatterjee S.; Ooms J.; de Ronde M.; van Gorsel S.; Mattace-Raso A.M.;
Goudzwaard J.; Mattace-Raso F.; Kardys I.; Nuis R.-J.; Daemen J.; Van
Mieghem N.
Institution
(Chatterjee, Ooms, de Ronde, van Gorsel, Mattace-Raso, Kardys, Nuis,
Daemen, Van Mieghem) Department of Interventional Cardiology,
Thoraxcenter, Erasmus MC University Medical Center, Rotterdam, Netherlands
(Goudzwaard, Mattace-Raso) Department of Internal Medicine, Section of
Geriatrics, Erasmus MC University Medical Center, Rotterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: The use of local anesthesia during transcatheter aortic valve
replacement (TAVR) could result in patient discomfort. Application of
immersive virtual reality (VR) during TAVR might distract the patient and
enhance the overall experience. Objective(s): To evaluate the effect
of an immersive VR environment on periprocedural anxiety and patient
discomfort, compared to standard of care in patients undergoing
transfemoral (TF) TAVR under local anesthesia. Method(s): In this
single-center, randomized controlled pilot study, patients were randomized
to either VR immersion during TAVR or standard of care. The intervention
was a VR headset to create 3D experiences during percutaneous transfemoral
TAVR. The main outcome was patient-reported procedural anxiety assessed
directly after the procedure on a visual analog scale (VAS). Secondary
outcomes were procedural satisfaction, pain, and change in anxiety.
Personality scores were obtained at baseline to explore associations
between personality types and relevant outcomes. Result(s): A total
of 75 patients (VR = 37, control = 38) were included between September
2021 and January 2023. The median age was 79 (25th-75th: 75-84) years and
32 patients (43 %) were female. Overall procedural anxiety VAS was 1.0
(0.0-3.0) and satisfaction was 9.0 (8.0-10.0). There was no difference in
procedural anxiety between VR and control (VAS: 1.0 [25th-75th: 0.0-3.0]
versus 1.0 [25th-75th: 0.0-3.0], p = 0.59). Procedural satisfaction, pain
perception and change in anxiety were not affected by VR use.
 Conclusion(s): Patients undergoing TF-TAVR under local anesthesia
experienced mild procedural anxiety and high satisfaction levels.
Procedural VR use did not affect procedural anxiety or pain
perception. Copyright © 2025 The Authors

<52>
Accession Number
2038673566
Title
Defining centres of expertise for minimally invasive mitral valve surgery:
a systematic review and volume-outcome meta-analysis.
Source
Heart. 111(20) (pp 984-991), 2025. Date of Publication: 01 Oct 2025.
Author
Heuts S.; Hjij W.; Kawczynski M.J.; Olsthoorn J.R.; Tjon Joek Tjien A.;
van Kuijk S.M.J.; Maessen J.G.; Sardari Nia P.
Institution
(Heuts, Hjij, Kawczynski, Maessen, Sardari Nia) Maastricht University
Medical Centre (MUMC+), Maastricht, Netherlands
(Heuts, Kawczynski, Maessen) Cardiovascular Research Institute Maastricht
(CARIM), Maastricht University, Maastricht, Netherlands
(Olsthoorn, Tjon Joek Tjien) Catharina Hospital, Eindhoven, Netherlands
(Olsthoorn) Isala Hospital Zwolle, Zwolle, Netherlands
(van Kuijk) Maastricht University Medical Centre (MUMC+), Maastricht,
Netherlands
Publisher
BMJ Publishing Group
Abstract
Background Minimally invasive mitral valve surgery (MIMVS) is increasingly
performed, but outcomes such as repair rate, mortality and survival likely
depend on expertise. Still, the definition of a high-volume centre varies
in the literature and lacks an evidence-based substantiation.
Consequently, this study aims to determine the volume-outcome relation in
MIMVS in conjunction with a volume threshold, in order to define
'high-volume centres', applying a novel statistical concept. Methods The
study was preregistered in PROSPERO (CRD42022376293, registered 26
November 2022). A systematic search was applied to three databases,
including consecutive patients undergoing MIMVS. Studies describing
patients undergoing transcatheter procedures were excluded. Restricted
cubic spline analyses were applied and the elbow method was used to
retrieve the threshold volume. Long-term outcomes were analysed using
reconstructed Kaplan-Meier curves and a novel statistical concept to
assess the volume-outcome relation for time-to-event outcomes was applied.
The primary outcome was early mortality, secondary outcomes were repair
rate, stroke, and long-term survival, freedom from reoperation, and
freedom from more than moderate mitral regurgitation. Leave-one-out
analyses were performed for sensitivity purposes. Results Data from 68
unique centres were included (n=23495 patients). Early mortality was 1.3%
(95% CI 1.1% to 1.6%), without a statistically significant non-linear
relation for this endpoint, nor for stroke. There was a statistically
significant volume-outcome relation for mitral valve repair rate
(p=0.018). Based on the repair rate, the threshold to define a high-volume
centre was 60 cases/year (number needed to treat to prevent a replacement
<=7). A significant volume-outcome relation was observed for long-term
outcomes as well, with a threshold of 53 and 54 cases/year for long-term
survival and freedom from reoperation, respectively. These results were
robust across the sensitivity analyses for the various endpoints.
Conclusions The threshold to define a high-volume centre ranges between 53
and 60 cases/year based on repair rate, long-term survival and
freedom-from reoperation. These findings have the potential to facilitate
centralisation of MIMVS. Copyright © Author(s) (or their
employer(s)) 2025. No commercial re-use. See rights and permissions.
Published by BMJ Group.

<53>
Accession Number
2036363775
Title
Unilateral vs. Bilateral Selective Cerebral Perfusion for Acute Type A
Aortic Dissection with Frozen Elephant Trunk: Systematic Review and
Meta-Analysis.
Source
Journal of Clinical Medicine. 14(18) (no pagination), 2025. Article
Number: 6392. Date of Publication: 01 Sep 2025.
Author
Baudo M.; D'Alonzo M.; Muneretto C.; Benussi S.; Di Bacco L.; Rosati F.
Institution
(Baudo) Department of Cardiac Surgery Research, Lankenau Institute for
Medical Research, Main Line Health, Wynnewood, PA, United States
(D'Alonzo) Cardiac Surgery Unit, Poliambulanza Foundation Hospital, Via
Bissolati 57, Brescia, Italy
(Muneretto, Benussi, Di Bacco, Rosati) Department of Cardiac Surgery,
Spedali Civili di Brescia, University of Brescia, Brescia, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Previous studies failed to demonstrate the best
cerebral perfusion option during total aortic arch replacement surgery. We
therefore sought to investigate clinical results of patients who received
unilateral (u) versus bilateral (b) selective antegrade cerebral perfusion
(SACP) during total aortic arch replacement by means of the frozen
elephant trunk (FET) technique for acute type A aortic dissections
(ATAADs). Method(s): A systematic review and meta-analysis was
performed by including relevant studies reporting outcomes of patients
with ATAADs undergoing total arch replacement with the FET technique using
either unilateral or bilateral SACP. Pubmed, ScienceDirect, SciELO, DOAJ,
and Cochrane library databases were searched until May 2023.
 Result(s): A total of 44 papers with 5983 patients were included,
3872 for unilateral SACP and 2111 for bilateral SACP. Although patients
undergoing bSACP presented a higher incidence of preoperative
comorbidities compared to uSACP, there was not a significant difference in
terms of mortality and major postoperative complications between the two
groups. Distal body circulatory arrest time was not associated with any
outcome at meta-regression, while longer SACP times in the whole
population were significantly associated with higher neurological
complications. Significant increased mortality was found in long uSACP.
 Conclusion(s): Our analysis showed that centers already apply the
appropriate perfusion strategy tailored to the complexity of the patient's
condition. It is therefore crucial to tailor the approach to the
complexities of individual patients rather than seeking a definitive
superiority between the two perfusion techniques to optimize outcomes
during FET for ATAAD. Further studies are warranted to confirm these
results. Copyright © 2025 by the authors.

<54>
Accession Number
2039110979
Title
When absence of evidence equates to evidence of absence: the case of
routine use of cerebral embolic protection devices in transcatheter aortic
valve implantation.
Source
Heart. 111(20) (pp 947-951), 2025. Date of Publication: 01 Oct 2025.
Author
Heuts S.; Kawczynski M.J.; Maesen B.; Vriesendorp P.A.
Institution
(Heuts, Kawczynski, Maesen) Department of Cardiothoracic Surgery,
Maastricht University Medical Center, Maastricht, Netherlands
(Heuts, Kawczynski, Maesen, Vriesendorp) Cardiovascular Research Institute
Maastricht, Maastricht University, Maastricht, Netherlands
(Vriesendorp) Department of Cardiology, Maastricht University Medical
Center, Maastricht, Netherlands
Publisher
BMJ Publishing Group
Abstract
Objectives This updated hierarchical Bayesian meta-analysis aims to
integrate the latest randomised controlled trials (RCTs) on the use of
cerebral embolic protection (CEP) in transcatheter aortic valve
implantation (TAVI) into previously available data, providing a definite
answer to the clinical effectiveness of CEP in TAVI patients. Methods A
systematic search was updated on 31 March 2025. RCTs were included when
comparing transfemoral TAVI with use of CEP versus transfemoral TAVI
without CEP. The primary outcome was all stroke, while the secondary
outcome was disabling stroke. A hierarchical Bayesian meta-analysis was
performed on the (log) relative risk (RR) scale and transformed to
absolute risk differences (ARDs) and numbers needed to treat (NNTs). The
threshold for clinical relevance was based on published expert consensus
and established on 1.1% ARD (NNT 91). Results The study was updated with
one new RCT, totalling a number of eight RCTs (n = 11590, CEP n = 5921
patients, control n = 5669 patients). The prevalence of all stroke and
disabling stroke was 2.9% and 1.4% in the control group. The median RR for
all stroke was 0.94 (95% credible interval (CrI) 0.72-1.25), translating
to a mean of -0.17% ARD (NNT 588), and a posterior probability of a
clinically relevant CEP effect of <1%. The median RR for disabling stroke
was 0.76 (95% CrI 0.44-1.23), translating to a mean of -0.36% ARD (NNT
278), and a posterior probability of a clinically relevant CEP effect of
<1%. Conclusion Current-generation CEP devices are ineffective in reducing
periprocedural TAVI-stroke risk to a clinically relevant degree, rendering
future trials with these devices futile. Copyright © Author(s)
(or their employer(s)) 2025. No commercial re-use. See rights and
permissions. Published by BMJ Group.

<55>
Accession Number
647596977
Title
Effect of Watching Nature-based Videos With Virtual Reality Glasses on
Surgical Fear and Anxiety in Patients Scheduled for Open Heart Surgery.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. 40(5) (pp 1260-1267), 2025. Date of
Publication: 01 Oct 2025.
Author
Gul S.; Yalcinturk A.A.
Institution
(Gul) Department of Nursing, Institute of Health Sciences, University of
Uskudar, Istanbul, Turkey; Operating Room Department, Haydarpasa Number
Training and Research Hospital, Istanbul, Turkey
(Yalcinturk) Department of Psychiatric Nursing, Hamidiye Faculty of
Nursing, Health Sciences University, Uskudar, Istanbul, Turkey
Abstract
PURPOSE: The purpose of the study was to examine the effect of watching
nature-based videos with virtual reality (VR) glasses on surgical fear and
anxiety in patients scheduled for open heart surgery. DESIGN: The present
study used a randomized-controlled experimental design. METHOD(S):
The study was conducted between December 2023 and February 2024 at a
cardiovascular surgery training and study hospital in Istanbul. The
patients were randomly divided into 2 groups as the experimental (n = 30)
and control groups (n = 30). After the experimental group was informed
about the preoperative preparation, they watched a nature-based video with
VR glasses. The control group was informed only about preoperative
preparation. The data were collected by using the "Personal Information
Form," "Surgical Fear Questionnaire," and "State-Trait Anxiety Inventory."
FINDINGS: When the post-test mean scores of Surgical Fear Questionnaire
were evaluated, they were found to be 35.80 +/- 12.26 in the experimental
group and 55.60 +/- 10.91 in the control group. The post-test mean scores
of the patients in the experimental group were significantly lower than
those of the patients in the control group (P < .05). The post-test mean
scores of the patients on State-Trait Anxiety Inventory-I were were 42.03
+/- 6.99 in the experimental group and 63.80 +/- 6.65 in the control
group. The post-test mean scores of the patients in the experimental group
were significantly lower than those of the control group (P < .05).
 CONCLUSION(S): Watching nature-based videos with VR glasses reduced
both surgical fear and anxiety in patients scheduled for open heart
surgery. Copyright © 2025 The American Society of PeriAnesthesia
Nurses. Published by Elsevier Inc. All rights reserved.

<56>
Accession Number
2040951027
Title
Intertransverse process block to improve quality of recovery and pain
management in cardiac surgery: Protocol for a double-blinded randomized
controlled trial.
Source
PLOS ONE. 20(9 September) (no pagination), 2025. Article Number: e0328954.
Date of Publication: 01 Sep 2025.
Author
Wong H.M.K.; Sivakumar R.K.; Wong W.T.; Chan A.K.M.; Yeung Z.H.S.; Chen
P.Y.; Tang S.T.W.; Chu M.H.M.; Wong R.H.L.; Ho K.M.
Institution
(Wong, Sivakumar, Wong, Chu, Ho) Department of Anaesthesia and Intensive
Care, The Chinese University of Hong Kong, Hong Kong
(Chan, Yeung, Chen, Tang) Department of Anaesthesia, Pain and
Perioperative Medicine, Prince of Wales Hospital, Hong Kong, Hong Kong
(Wong) Department of Surgery, Division of Cardiothoracic Surgery, Prince
of Wales Hospital, Hong Kong, Hong Kong
Publisher
Public Library of Science
Abstract
Background Chronic postsurgical pain (CPSP) after cardiac surgery is
significant. Despite the known association between acute pain and CPSP,
advanced pain management strategies have not reduced its incidence.
Preventing CPSP requires optimizing acute pain control and disrupting
central sensitization. The side effects and risks associated with chronic
use of current opioid-based cardiac anesthesia necessitate the adoption of
multimodal analgesia. Regional anesthesia is a promising alternative,
though existing techniques in cardiac surgery have notable limitations.
The intertransverse process block (ITPB) is a novel regional technique
that offers potential somatic and visceral analgesia. Recent studies
demonstrate consistent local anesthetic spread to the intercostal,
paravertebral, and epidural spaces, suggesting broader pain control. ITPB
may provide a simpler, safer approach in cardiac surgery, reducing the
risks of pleural puncture and bleeding. We hypothesize that ITPB will
improve quality of recovery, pain control, and health-related quality of
life, thereby mitigating chronic postsurgical pain. Methods This is a
single-center, randomized, double-blinded, placebo-controlled trial with
intention-to-treat analysis. Elective patients awaiting coronary artery
bypass grafting, with or without valvular repair or replacement, will be
recruited. Ninety-six participants will be randomly assigned to either
ITPB or control group. The ITPB group will receive bilateral ITPBs with
20ml 0.25% levobupivacaine on each side at the T4-5 level under ultrasound
guidance, administered before anesthesia induction. Sham blocks, with
equal volume of normal saline, will be performed in the control group. The
primary outcome is the quality of recovery, assessed using the 15-item
Quality of Recovery questionnaire, at 24 hours after tracheal extubation.
Secondary outcomes include Numerical Rating Scale pain scores, patient
satisfaction, and opioid consumption within 72 hours post-extubation,
duration of mechanical ventilation, length of stay in the ICU and
hospital, and opioid-related side effects. The incidence of CPSP at 3, 6,
and 12 months will be measured, along with pain interference via the Brief
Pain Inventory and the Short-Form McGill Questionnaire-2. Discussion
Current pain management strategies often rely heavily on opioids, which
can have significant side effects and may not adequately address chronic
postsurgical pain. This study investigates the efficacy of the
intertransverse process block, a novel regional anesthesia technique, in
reducing both acute and chronic postsurgical pain in cardiac surgery.
Randomized controlled trials on intertransverse process block in cardiac
surgery are limited. The results of this study will help define the role
of intertransverse process block on the recovery process, and generate
vital preliminary data on its potential long-term benefits in reducing
chronic postsurgical pain in cardiac surgical population. Copyright
© 2025 Wong 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.

<57>
Accession Number
648780829
Title
The impact of remote ischemic preconditioning on postoperative outcomes in
pediatric cardiac surgery: an updated systematic review and meta-analysis.
Source
European journal of pediatrics. 184(11) (pp 668), 2025. Date of
Publication: 08 Oct 2025.
Author
Campos L.R.; Carpi G.C.; da Silva A.B.N.; Carneiro J.V.; Luchese S.
Institution
(Campos) Universidade de Ribeirao Preto (UNAERP), Av. Costabile Romano,
Ribeirao Preto, Sao Paulo, Brazil
(Carpi, Luchese) Hospital de Clinicas de Porto Alegre (HCPA), Porto
Alegre, Rio Grande Do Sul, Brazil
(da Silva) Department of Medicine, Federal University of Para (UFPA),
Belem, Para, Brazil
(Carneiro) Pontifical Catholic University of Parana (PUCPR), Curitiba,
Parana, Brazil
Abstract
Remote ischemic preconditioning (RIPreC) has been regarded as a promising
strategy to reduce ischemia-reperfusion injury to the heart and other
organs caused by cardiopulmonary bypass. While RIPreC has demonstrated
potential benefits in adult cardiac surgery, particularly in reducing
postoperative kidney and cardiac dysfunction, evidence in pediatric
populations remains limited and inconsistent. This updated systematic
review and meta-analysis aims to address these gaps and clarify the
efficacy of RIPreC in children undergoing cardiac surgery. A comprehensive
search was conducted across PubMed, EMBASE, Cochrane Library, Web of
Science, and ClinicalTrials.gov for randomized controlled trials (RCTs)
comparing RIPreC with placebo or standard care in pediatric cardiac
surgery. Primary outcomes included all-cause mortality, duration of
mechanical ventilation, ICU length of stay, aortic cross-clamp time, and
postoperative arrhythmia. Meta-analyses were performed using
random-effects models to calculate standardized mean differences (SMDs) or
risk ratios (RRs), with 95% confidence intervals (CIs). Risk of bias was
assessed using the Cochrane RoB 2.0 tool. Fifteen RCTs involving 1570
pediatric patients were included, and 14 were eligible for meta-analysis.
RIPreC significantly reduced the duration of mechanical ventilation
compared to control (SMD = -0.42; 95% CI -0.79 to -0.06; p = 0.02),
although heterogeneity was high (I2 = 85.7%). No significant differences
were found for ICU length of stay (MD = -0.17 days; 95% CI -0.55 to 0.20),
aortic cross-clamp time (MD = 3.22 min; 95% CI -0.52 to 6.97),
postoperative arrhythmia (RR = 0.69; 95% CI 0.39 to 1.20), or all-cause
mortality (RR = 1.11; 95% CI 0.34 to 3.64). CONCLUSION(S): RIPreC may
reduce the duration of mechanical ventilation in pediatric cardiac
surgery, but its effects on other outcomes remain uncertain. Further,
high-quality trials are warranted to strengthen the evidence base and
guide clinical application. WHAT IS KNOWN: * Remote ischemic
preconditioning (RIPreC) is a promising technique to protect organs from
ischemia-reperfusion injury during cardiac surgery. While its benefits
have been more consistently observed in adult populations, evidence
regarding its efficacy in pediatric cardiac surgery remains limited and
inconclusive. WHAT IS NEW: * This updated systematic review and
meta-analysis provides the most comprehensive evaluation to date of RIPreC
in children undergoing cardiac surgery, clarifying its potential effects
on postoperative cardiac and renal outcomes. * Our findings support
further investigation of RIPreC in pediatric patients through high-quality
trials and suggest it may be a beneficial adjunct to improve postoperative
outcomes in pediatric cardiac surgery settings. Copyright © 2025.
The Author(s), under exclusive licence to Springer-Verlag GmbH Germany,
part of Springer Nature.

<58>
Accession Number
2036431490
Title
Antithrombotic Management for Interventional Pain Procedures.
Source
Current Anesthesiology Reports. 15(1) (no pagination), 2025. Article
Number: 48. Date of Publication: 01 Dec 2025.
Author
Abrahams E.
Institution
(Abrahams) Department of Anesthesiology and Pain Medicine, University of
Oklahoma Health Sciences Center, 825 NE 10thSt, Suite 2B, Oklahoma City,
OK, United States
Publisher
Springer
Abstract
Purpose of Review: The number and complexity of minimally invasive pain
procedures is rising and so is the number of patients undergoing these
procedures who have cardiovascular comorbidities. A lot of these patients
are on antithrombotic therapy. This review article evaluates management of
anticoagulant therapy during interventional pain procedures. Recent
Findings: Multiple guidelines with revisions have been reported with
management of anticoagulants when performing interventional pain
procedures. There is lack of consensus amongst professional pain societies
with certain anticoagulants and their bleeding risk. There have been case
reports of adverse outcomes even when guidelines have been followed.
 Summary: Guidelines from professional societies are helpful when
managing anticoagulation in the setting of interventional pain
procedures.The incidence of procedural complications is influenced by each
patient's unique anatomical challenges, medical comorbidities, and the
technical complexity of the procedure. Pain physicians should engage in
shared decision-making with the prescriber, carefully balancing the risks
and benefits of the procedure. Copyright © The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2025.

<59>
[Use Link to view the full text]
Accession Number
648779381
Title
Postoperative atrial fibrillation after cardiac surgery: what is new?.
Source
Current opinion in cardiology. (no pagination), 2025. Date of
Publication: 09 Oct 2025.
Author
Lee J.G.; Ha A.C.T.
Institution
(Lee, Ha) Peter Munk Cardiac Centre, University Health Network
(Ha) Department of Medicine, University of Toronto, Toronto, ON, Canada
Abstract
PURPOSE OF REVIEW: Since postoperative atrial fibrillation (POAF) after
cardiac surgery remains a common clinical problem and is associated with
adverse clinical outcomes, considerable research efforts are spent to
better understand and inform its management. This review highlights recent
studies on this topic. RECENT FINDINGS: A PubMed review of published
research on POAF after cardiac surgery over the past two years was
conducted. Papers were selected on the basis of their potential value to
enhance clinical practice. This search yielded studies which have advanced
our understanding on the incidence of late-onset POAF after cardiac
surgery and its predictive factors. This information may be useful for
clinicians on the optimal timing for atrial fibrillation detection after
cardiac surgery. Due to a lack of dedicated randomized trial data, the
optimal stroke prevention approach remains uncertain in this patient
population. SUMMARY: POAF after cardiac surgery is an active area of
research. Recent studies have provided additional insights on the risk of
late-onset atrial fibrillation (>3 months) after cardiac surgery. This
information may help clinicians identify patients who are more likely to
experience recurrent atrial fibrillation after cardiac surgery. Ongoing
randomized trials will help clarify the optimal stroke prevention strategy
in this patient population. Copyright © 2025 Wolters Kluwer
Health, Inc. All rights reserved.

<60>
Accession Number
648793573
Title
Effect of Mobile Augmented Reality Counseling on Improving Shared
Decision-Making in Thoracic Surgery: A Randomized Clinical Crossover
Trial.
Source
JMIR mHealth and uHealth. (no pagination), 2025. Date of Publication: 09
Oct 2025.
Author
Chen Y.-S.; Hsu Y.-C.; Romalee W.; Wang D.-H.; Lai J.; Huang T.-W.; Lin
K.H.
Institution
(Chen) Surgery, School of Medicine, National Defense Medical University,
Tri-Service General Hospital, TW, Taipei, Taiwan (Republic of China)
(Chen) Taichung Armed Forces General Hospital, TW, Taichung, Taiwan
(Republic of China)
(Hsu, Wang) College of Dentistry, National Yang Ming Chiao Tung
University, TW, Taipei, Taiwan (Republic of China)
(Romalee) Department of Community Dentistry & Gerodontology, Faculty of
Dentistry, Thammasat University, TH, Pathum Thani, Thailand
(Lai) National Defense Medical University, Tri-Service General Hospital,
TW, Taipei, Taiwan (Republic of China)
(Huang, Lin) Surgery, National Defense Medical University, Tri-Service
General Hospital, No. 325, TW, Chenggong Rd. ,Neihu District, Sec. 2,
Taipei, Taiwan (Republic of China)
Abstract
BACKGROUND: Augmented reality (AR) superimposes virtual objects onto the
real-world environment, allowing users to interact in real-time. Since AR
has become widely used, it also leverages the efficiency advantages of
smartphones or tablets to enable mobile augmented reality (MAR)
experiences. AR has been adopted in many industries, and literature has
highlighted its applications in academic and clinical settings,
particularly for enhancing visualization, communication, and learning.
 OBJECTIVE(S): This study investigates the potential of mobile
augmented reality as mHealth tools to enhance shared decision-making (SDM)
in thoracic surgery by increasing patient understanding and engagement
during medical consultations. METHOD(S): A randomized crossover
clinical trial was conducted at Tri-Service General Hospital in Taiwan.
Participants scheduled for thoracic surgery were enrolled and randomized
in a crossover design. The MAR intervention incorporated patient-specific
three-dimensional (3D) anatomical models that were reconstructed from CT
imaging to facilitate understanding and support SDM. The impact of each
counseling approach on SDM was evaluated using post-intervention
questionnaires. RESULT(S): A total of forty-seven participants were
effectively incorporated into the research. After analyzing the data, we
found that patients in the MAR group showed significantly higher scores
compared to those in the traditional counseling group (p < 0.05) during
the SDM process. Moreover, patients reported higher satisfaction levels
and found the visual objects helpful in understanding tumor location and
surgical procedures. CONCLUSION(S): The study demonstrates that MAR
counseling significantly enhances patients' comprehension of thoracic
conditions and increases their active engagement in the SDM process. The
integration of patient-specific 3D anatomical models into MAR technology
provided an intuitive method for critical medical information. This
digital approach not only enhances personalization in medical
communication but also reinforces patient education in their own
healthcare conditions. The findings suggest that MAR counseling represents
a promising approach for promoting patient-centered care in thoracic
surgery and has potential applications across various clinical domains.
CLINICALTRIAL: ClinicalTrials.gov Identifier: NCT07062393.
https://clinicaltrials.gov/study/NCT07062393.

<61>
Accession Number
2036422691
Title
Prognostic value of left atrial strain in significant aortic valve
disease: a systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1667871. Date of Publication: 2025.
Author
Chen N.; Gu W.; Wu J.
Institution
(Chen) Department of Echocardiography, The First Affiliated Hospital of
Dalian Medical University, Dalian, China
(Gu, Wu) Department of Echocardiography, The Second Affiliated Hospital of
Dalian Medical University, Dalian, China
Publisher
Frontiers Media SA
Abstract
Background: Previous studies on aortic valve disease have mainly focused
on the left ventricle, but increasing evidence suggests that left atrial
strain also has prognostic value in significant aortic valve disease.
 Objective(s): To systematically evaluate the prognostic value of left
atrial strain in significant aortic valve disease. Method(s):
Multiple electronic databases were searched for studies evaluating
significant aortic stenosis (AS) or aortic regurgitation (AR) using peak
left atrial longitudinal strain (PALS) from the inception of each database
to 1 February 2025. There were no language or regional restrictions. The
primary endpoint was a composite outcome comprising all-cause mortality,
hospitalization for heart failure, aortic valve replacement, pulmonary
hypertension, and postoperative new-onset atrial fibrillation.
 Result(s): A total of 25 studies were included, involving 7,195
patients, with 2,039 (28%) patients experiencing primary endpoint events.
The PALS was lower in the positive group (EVENT+) compared to the negative
group (EVENT-) (SMD = -1.03, 95% CI [-1.22, -0.84], p < 0.05). For each
unit increase in PALS, the risk of the primary endpoint event decreased by
7% (HR = 0.93, 95% CI [0.91, 0.96], p < 0.001). PALS exhibited consistent
incremental predictive value in both the AR and AS cohorts, although the
strength of its effect and the underlying mechanisms varied between
groups. Conclusion(s): PALS is an independent predictor of adverse
cardiovascular events in patients with significant aortic valve disease.
PALS has certain value in the prognosis of significant aortic valve
disease. Systematic Review Registration: [www.crd.york.ac.uk/prospero/],
identifier [CRD 42024623883]. Copyright 2025 Chen, Gu and Wu.

<62>
Accession Number
648778932
Title
EACTS Expert Consensus Statement on the Ross Procedure in Adult Patients.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2025.
Date of Publication: 09 Oct 2025.
Author
Vojacek J.; Gofus J.; Andreas M.; Bavaria J.E.; Berdajs D.; Casselman
F.P.A.; El-Hamamsy I.; Holubec T.; de Kerchove L.; Milojevic M.; Mulinari
L.; Ouzonian M.; Skillington P.; Takkenberg J.J.M.; Verbrugghe P.
Institution
(Vojacek, Gofus) Department of Cardiac Surgery, Charles University,
Faculty of Medicine and University Hospital in Hradec Kralove, Hradec
Kralove, Czechia
(Andreas) Division of Cardiac Surgery, Department of Surgery, Medical
University Graz, Austria
(Bavaria) Department of Surgery, Thomas Jefferson University,
Philadelphia, PA, United States
(Berdajs) Department of Cardiac Surgery, University Hospital of Basel,
Switzerland
(Casselman) Department of Cardiac Surgery, Heart Center Azorg, Aalst,
Belgium
(El-Hamamsy) Department of Cardiovascular Surgery. Mount Sinai Hospital
and Icahn School of Medicine at Mount Sinai, New York, NY, USA
(Holubec) Department of Cardiovascular Surgery, University Heart and
Vascular Centre, University Hospital Frankfurt and Goethe University
Frankfurt, Frankfurt/Main, Germany
(de Kerchove) Division of Cardiothoracic and Vascular Surgery, Pole de
Recherche Cardiovasculaire, Institut de Recherche Experimentale et
Clinique, Cliniques Universitaires Saint-LucUniversite Catholique de
Louvain, Brussels, Belgium
(Milojevic) Department of Cardiac Surgery and Cardiovascular Research,
Dedinje Cardiovascular Institute, Belgrade, Serbia
(Milojevic) Department of Cardiac Surgery, University Hospital Zurich,
Zurich, Switzerland
(Mulinari) Pediatric and Congenital Cardiac Surgery, Department of
Surgery, Miller School of Medicine, University of Miami, Miami, FL, United
States
(Ouzonian) Peter Munk Cardiac Centre, Department of Surgery, University of
Toronto, University Health Network, ON, Canada
(Skillington) Department of Cardiothoracic Surgery, Royal Melbourne
Hospital, Epworth Hospital, Melbourne, VIC, Australia
(Takkenberg) Department of Cardio-Thoracic Surgery, Erasmus University
Medical Center, Rotterdam, Netherlands
(Verbrugghe) Department of Cardiac Surgery, UZ Leuven, Leuven, Belgium
Abstract
The Ross procedure, which involves replacing a diseased aortic valve with
the patient's own pulmonary valve (pulmonary autograft), has gained
renewed attention in adult patients due to mounting evidence of excellent
long-term outcomes. With increasing data demonstrating restoration of life
expectancy and improved valve-related outcomes, it is now considered a
viable first-line option for selected young and middle-aged adults with
non-repairable aortic valve disease. Nonetheless, its adoption remains
inconsistent across institutions, partly due to concerns about surgical
complexity, long-term durability, and the need for structured follow-up.
This expert consensus document, commissioned by the European Association
for Cardio-Thoracic Surgery, synthesizes the current evidence and offers
clinical statements for using the Ross procedure in adults. Developed
through a systematic review and informed by the collective experience of a
multidisciplinary panel of internationally recognized experts, the
document addresses key topics including patient selection, technical
refinements, and perioperative management. Emphasis is also placed on the
need for procedural standardization, high-volume surgical expertise, and
longitudinal imaging-based follow-up. Moreover, comparative outcome data
and subgroup considerations are critically appraised, and areas for future
investigation are outlined. This clinical practice document is intended to
assist clinicians and Heart Teams in making informed treatment decisions,
support harmonized implementation across centres, provide technical
considerations to optimize procedural success, and substantially improve
outcomes for patients considered for this complex but promising
procedure. Copyright © The Author(s) 2025. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved. For commercial re-use, please contact
reprints@oup.com for reprints and translation rights for reprints. All
other permissions can be obtained through our RightsLink service via the
Permissions link on the article page on our site-for further informat

<63>
Accession Number
648782452
Title
Comparison of post-operative inflammatory biomarkers between minimal
invasive extracorporeal circulation and conventional extracorporeal
circulation in cardiac surgery. A meta-analysis of 15 randomized control
trials.
Source
Perfusion. (pp 2676591251385872), 2025. Date of Publication: 08 Oct 2025.
Author
Motawea K.R.; Ibrahim M.; Amer A.E.; Kandil O.; Abourady Y.; Pelletier M.;
Abu-Omar Y.; El-Diasty M.
Institution
(Motawea, Abourady, Abu-Omar, El-Diasty) Division of Cardiac Surgery,
Harrington Heart and Vascular Institute, University Hospitals Cleveland
Medical Centre, Cleveland, OH, United States
(Ibrahim) Banner University Medical Center, Phoenix, AZ, United States
(Amer, Kandil) Faculty of Medicine, Alexandria University, Alexandria,
Egypt
(Pelletier) Division of Cardiac Surgery, Yale School of Medicine, New
Haven, CT, United States
Abstract
Background/AimRecent literature suggested that the use of Minimal Invasive
Extracorporeal Circulation (MIECC) may mitigate the inflammatory response
in patients undergoing cardiac surgery. We aimed to perform a
meta-analysis to compare post-operative inflammatory biomarkers between
MIECC and conventional cardiopulmonary bypass in cardiac surgery.MethodsWe
searched PubMed, Web of Science, Scopus, and Cochrane Library for
randomized control trials (RCTs) that quantified systemic inflammatory
mediators after the use of MIECC compared to conventional extracorporeal
circulation (CECC).ResultsFifteen RCTs with a total of 1189 patients were
identified. The inflammatory markers that were investigated included Tumor
Necrosis Factor alpha (TNF-alpha), Interleukin 6 (IL-6), Interleukin 8
(IL-8), Interleukin 10 (IL-10), Elastase, C-Reactive protein (CRP) in
addition to leucocyte count. No significant difference between both groups
was detected for TNF-alpha and IL-6 at (30 minutes, 1 to 2 hours, 6 hours,
24 hours, and 48 hours), IL-8 at (30 minutes and 48 hours), Interleukin 10
at 6 hours, Elastase at (30 minutes to 1 hour, and 24 hours), CRP at 48
hours, and leucocytic count at (2 hours, 6 hours, 24 hours, and 48 hours).
Pooled analysis showed a significant association between MIECC group and
lower levels of TNF-alpha at 6 hours (p-value <.0001), IL-8 at 6 hours
(p-value = .0005) and 24 hours (p-value = .005), IL-10 at 24 hours
(p-value <.00,001), and Elastase at 6 hours (p-value = .04). However, CRP
was lower, at 24 hours, in the CECC group (MD = 1.42, 95% CI = 0.13 to
2.71, p-value = .03).ConclusionOur findings suggest that MIECC may be
associated with lower levels of systemic inflammatory mediators early
after cardiac surgery. However, the impact of this reduction on clinical
outcomes needs to be defined to justify the use of MIECC in the routine
clinical practice.

<64>
Accession Number
648782129
Title
Aortic Dissection Following Endovascular Aneurysm Repair - A Systematic
Review and Management Algorithm.
Source
Vascular and endovascular surgery. (pp 15385744251387791), 2025. Date of
Publication: 08 Oct 2025.
Author
Pegler A.; Sivakumaran Y.
Institution
(Pegler, Sivakumaran) Department of Vascular Surgery, Princess Alexandra
Hospital, Brisbane, Australia
Abstract
BackgroundAortic dissection following endovascular aneurysm repair (EVAR)
may be iatrogenic or a de-novo event. This study aims to systematically
review all cases of dissection following EVAR to identify complications
specific to each scenario and develop a management algorithm depending on
the clinical presentation.MethodsA comprehensive literature search of
MEDLINE, Embase, and CENTRAL databases was performed for all studies
relating to dissection following EVAR or fenestrated/branched EVAR
(F/BrEVAR). Data collected included timing (differentiating iatrogenic and
de-novo events), entry tear location, endograft involved, complications,
management, and subsequent outcomes. Due to limited data availability,
descriptive data was collected and outcomes compared depending on
dissection type and timing. Risk of bias was assessed using a standardised
tool for case reports.Results46 patients in 37 studies were included.
Complications included endograft compression (52.2%), endoleak (15.2%),
and rupture (13.0%). Compression was less likely in endografts with
proximal fixation (41.9%), compared to those without (69.2%). Type A
dissection after EVAR required cardiac surgery with a high mortality
(20.0%). In Type B dissection, 2 cases were diagnosed intra-operatively
during F/BrEVAR, 1 died. 8 were diagnosed <4 weeks post-operatively, all
managed medically with no complications or mortality. 31 were diagnosed >4
weeks, with mortality of 25.8% and high rates of endograft compression
(58.1%), endoleak (16.1%), and rupture (19.4%).ConclusionAortic dissection
following EVAR may cause endograft compression, endoleak, or rupture, with
significant mortality. Complications are more frequent following Type A
dissection and late Type B dissection. Early Type B dissection may be
amenable to medical management.

<65>
Accession Number
2040876743
Title
Pulmonary Valve Replacement in Adults and Adolescents with Congenital
Heart Disease: A United Kingdom and Ireland Survey.
Source
Interdisciplinary Cardiovascular and Thoracic Surgery. 40(10) (no
pagination), 2025. Article Number: ivaf214. Date of Publication: 01 Oct
2025.
Author
Bond C.J.; Jones T.J.; Hoschtitzky J.A.; Viola N.; Danton M.H.D.; Drury
N.E.
Institution
(Bond, Jones) Department of Cardiac Surgery, Queen Elizabeth Hospital
Birmingham, Birmingham, United Kingdom
(Jones, Drury) Department of Paediatric Cardiac Surgery, Birmingham
Children's Hospital, Birmingham, United Kingdom
(Jones, Drury) Department of Cardiovascular Sciences, School of Medical
Sciences, College of Medicine and Health, University of Birmingham,
Birmingham, United Kingdom
(Hoschtitzky) Department of Congenital Cardiac Surgery, Royal Brompton
Hospital, Evelina London Children's Hospital, London, United Kingdom
(Viola) Department of Congenital Cardiac Surgery, Southampton Children's
Hospital, Southampton, United Kingdom
(Danton) Department of Congenital Cardiac Surgery, Royal Hospital for
Children, Glasgow, United Kingdom
Publisher
Oxford University Press
Abstract
Objectives Many models of bioprosthesis are available for pulmonary valve
replacement in adults with congenital heart disease, but there is a lack
of randomized evidence to guide practice. We surveyed congenital cardiac
surgeons to establish current practice and willingness to change within a
clinical trial. Methods An online survey was sent to all consultant
congenital cardiac surgeons in adult congenital centres in the United
Kingdom and Ireland. Information was sought on preferred prostheses,
factors influencing decision-making, implant technique, postoperative
anticoagulation, practice variations in adolescents, and willingness to
randomize patients to different prostheses within a trial. Results
Responses were obtained from 27 (69%) surgeons. A total of 19 (70%)
preferred an Edwards bovine pericardial valve, most commonly the Inspiris
Resilia (7, 26%). Only 2 (7%) favoured the Hancock II valve; the remaining
6 (22%) preferred pulmonary homografts. Data regarding long-term freedom
from reintervention (23, 85%) was the most important factor influencing
prosthesis choice. A total of 22 (81%) surgeons were willing to randomize
adult patients to either a bovine pericardial valve or a porcine xenograft
in a clinical trial, with Perimount Magna Ease and Hancock II being the
most acceptable, respectively. Willingness to randomize dropped to 11
(41%) surgeons for adolescent patients. Conclusions This survey
demonstrates heterogeneity in the choice of pulmonary valve prosthesis.
Combined with a lack of evidence from clinical trials, our findings
support the presence of clinical equipoise. Most surgeons are willing to
change practice, suggesting that a pragmatic, multicentre, randomized
controlled trial comparing bovine pericardial versus porcine xenograft for
pulmonary valve replacement in adults is feasible. Copyright ©
2025 The Author(s). Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery.

<66>
Accession Number
2037207291
Title
Response to "Comment on Hypotension after induction of anesthesia with
remimazolam or etomidate: a non-inferiority randomized controlled trial in
patients undergoing coronary artery bypass grafting".
Source
Korean Journal of Anesthesiology. 78(5) (pp 509-510), 2025. Date of
Publication: 01 Oct 2025.
Author
Min J.-J.; Oh E.J.; Cho H.; Kim C.; Lee J.-H.
Institution
(Min, Cho, Kim, Lee) Department of Anesthesiology and Pain Medicine,
Samsung Medical Center, Seoul, South Korea
(Oh) Department of Anesthesiology and Pain Medicine, Kangbuk Samsung
Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
Publisher
Korean Society of Anesthesiologists

<67>
Accession Number
2040912276
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. 292 (no pagination), 2026. Article Number: 107273.
Date of Publication: 01 Feb 2026.
Author
Landmesser U.; Skurk C.; Kirchhof P.; Lewalter T.; Hartung 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, Rroku) Department of Cardiology, Angiology
and Intensive Care Medicine, Deutsches Herzzentrum der Charite,
Charite-University Medicine Berlin, Campus Benjamin Franklin, Berlin,
Germany
(Landmesser, Skurk, Hartung, Anker, Endres, Boldt) German Center for
Cardiovascular Research (DZHK), Berlin, Germany
(Boldt) Department of Cardiology, Angiology and Intensive Care Medicine,
Deutsches Herzzentrum der Charite, Charite-University Medicine Berlin,
Campus Virchow, Berlin, Germany
(Kirchhof, Blankenberg) Department of Cardiology, University Heart and
Vascular Center Hamburg, Hamburg, Germany
(Blankenberg, Joost, Wegscheider, Eitel) German Center for Cardiovascular
Research (DZHK), Partner Site Hamburg/Kiel/Lubeck, Lubeck, Germany
(Kirchhof) Institute of Cardiovascular Sciences, University of Birmingham,
Birmingham, United Kingdom
(Lewalter) Department of Cardiology and Intensive Unit Care, Hospital
Munich South, Peter Osypka Heart Center, Munich, Germany
(Pieske) Division of Cardiology, Department of Internal Medicine,
University Medicine Rostock, Rostock, Germany
(Brachmann) Department of Cardiology, Sana-Klinikum Coburg, Coburg,
Germany
(Akin) Department of Cardiology, Haemostaseology and Medical Intensive
Care, 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
(Meder, Frey) German Centre for Cardiovascular Research (DZHK), partner
site Heidelberg, Heidelberg, Germany
(Zeiher) Department of Medicine III, Goethe University, Frankfurt, Germany
(Zeiher) 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
(Massberg) Department of Medicine I, LMU University Hospital, Ludwig
Maximillian University of Munich, Munich, Germany
(Massberg, Schunkert) German Center for Cardiovascular Research (DZHK),
Partner Site Munich, Munich, Germany
(Schunkert) Department of Cardiovascular Diseases, German Heart Centre,
School of Medicine and Health, TUM University Hospital, Technical
University of Munich, Munich, Germany
(Joost, Eitel) 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) Department of Neurology, Charite-University Medicine Berlin,
Berlin, Germany
(Wegscheider) Department of Medical Biometry and Epidemiology, University
Medical Center Hamburg-Eppendorf, Hamburg, Germany
Publisher
Elsevier Inc.
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 nonvitamin 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 noninferiority with an option to test for
superiority once noninferiority has been proven. 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 42
sites. 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 Copyright © 2025

<68>
Accession Number
648761072
Title
Impact of Flow-status on Effective Orifice Area in Transcatheter Heart
Valves: a COMPARE-TAVI 1 Substudy.
Source
Journal of the American Society of Echocardiography : official publication
of the American Society of Echocardiography. (no pagination), 2025. Date
of Publication: 04 Oct 2025.
Author
Krasniqi L.; Terkelsen C.J.; Nissen H.; Freeman P.; Frederiksen C.A.; Vase
H.; Hejlesen K.; Fur C.B.; Thim T.; Eftekhari A.; Uttenthal F.; Ellert J.;
Borg Mogensen N.S.; Haujir A.; Christiansen E.H.; Dahl J.S.
Institution
(Krasniqi) Department of Cardiothoracic Surgery, Odense University
Hospital, Odense, Denmark; Department of Clinical Research, University of
Southern Denmark, Odense, Denmark
(Terkelsen, Thim, Christiansen) Department of Cardiology, Aarhus
University Hospital, Aarhus, Denmark; Department of Clinical Medicine,
Aarhus University Hospital, Aarhus, Denmark
(Nissen, Ellert, Borg Mogensen, Haujir) Department of Cardiology, Odense
University Hospital, Odense, Denmark
(Freeman, Eftekhari, Uttenthal) Department of Cardiology, Aalborg
University Hospital, Aalborg, Denmark
(Frederiksen, Vase, Hejlesen, Fur) Department of Cardiology, Aarhus
University Hospital, Aarhus, Denmark
(Dahl) Department of Cardiology, Odense University Hospital, Odense,
Denmark; Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
Minnesota, USA; Department of Clinical Research, University of Southern
Denmark, Odense, Denmark
Abstract
OBJECTIVE: The aim of this study was to study the impact of flow-status on
Effective Orifice Area (EOA) in patients treated with the
balloon-expandable Myval and Sapien transcatheter heart valves (THVs).
 METHOD(S): We collected the core laboratory measured effective
orifice area (EOA), mean and peak gradients, Doppler velocity index (DVI)
and stroke volume index (SVi) from the 30-day echocardiograms in patients
treated with the balloon-expandable Myval and Sapien THVs in the
COMPARE-TAVI 1 trial. Patients were stratified according to flow in
low-flow (SVi <35 ml/m2) normal-flow (SVi 35-50 ml/m2) and high-flow (SVi
>50 ml/m2). RESULT(S): A total of 1031 patients were included in
COMPARE-TAVI 1. Myval THVs (20.0mm to 32.0mm) exhibited overall higher
mean EOA and lower mean gradients (1.99 +/- 0.55 cm2, 9.46 +/- 3.84 mmHg)
compared to Sapien THVs (20-29 mm) (1.81 +/- 0.56 cm2, 11.47 +/- 4.47
mmHg). Compared to normal-flow patients, low-flow exhibited smaller EOA
(p<0.001) and lower DVI (p<0.001) in all valve sizes irrespective of THV
platform, while high-flow patients had larger EOA (p<0.001) and higher DVI
(p<0.001). Female sex was associated with lower stroke volume resulting in
lower mean and peak gradients independent of valve size and platform
(p<0.001). CONCLUSION(S): The study indicates that EOA may be
underestimated after TAVI in patients with low-flow status which can
impact assessment of prosthesis patient mismatch. Copyright ©
2025. Published by Elsevier Inc.

<69>
Accession Number
2036394581
Title
Opioid-free anaesthesia based on paravertebral block for thoracotomic
paediatric congenital cardiac surgery-effectiveness of postoperative
analgesia: a protocol for a prospective, single-blinded, randomised
controlled trial (OPTION trial).
Source
Trials. 26(1) (no pagination), 2025. Article Number: 374. Date of
Publication: 01 Dec 2025.
Author
Zou Z.; Shi S.; Song J.; Guo J.; Zhao Y.; Yang J.; Dai Z.; Yan F.; Yang
K.; Jia Y.
Institution
(Zou, Song, Dai, Yang) Department of Anesthesiology, Fuwai Yunnan
Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular
Hospital of Kunming Medical University, Yunnan province, Kunming, China
(Shi, Guo, Yan, Jia) Department of Anesthesiology, Fuwai Hospital,
National Center for Cardiovascular Diseases, Peking Union Medical College
and Chinese Academy of Medical Sciences, Beijing, China
(Zhao) Department of Medical Research & Biometrics Center, National Center
for Cardiovascular Diseases, Chinese Academy of Medical Sciences and
Peking Union Medical College, Beijing, China
(Yang) Department of Pediatric Intensive Care Unit, Fuwai Yunnan Hospital,
Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of
Kunming Medical University, Yunnan province, Kunming, China
Publisher
BioMed Central Ltd
Abstract
Background: Opioids were considered the main analgesics for pain
management during and after cardiac surgery. There are many complications
associated with the use of opioids. Paravertebral block (PVB) is injecting
Anaesthetics into the paravertebral space. We designed a randomised
controlled trial to investigate whether PVB-based opioid-free general
Anaesthesia, as compared to traditional low-dose opioid-based fast-track
anaesthesia, can reduce opioid consumption within 24 h after thoracotomy
incision cardiac surgery with cardiopulmonary bypass (CPB) in paediatric
patients. Method(s): This is a single-centre, single-blinded,
randomised controlled trial with a 1:1 allocation ratio. Patients will be
randomised into two groups (control group and PVB group); 20 children will
be enrolled in this trial, with 10 subjects in each group. Block
randomisation will be performed. Patients aged 1-6 years, with the
diagnosis of atrial and/or ventricular septal deficient And scheduled for
cardiac surgery via a right thoracotomic incision, will be eligible for
enrolment. The primary outcome is opioid consumption during the first 24 h
after surgery. The main secondary outcomes include the perioperative
stress response, inflammatory level, and intraoperative haemodynamics.
 Discussion(s): This is the first randomised clinical study
investigating opioid-free anaesthesia based on PVB for paediatric
congenital thoracotomy surgery with CPB. If the OPTION trial proves that
opioid-free anaesthesia based on PVB is safe for children undergoing
thoracotomic cardiac surgery, we would be glad to provide an OPTION for
the perioperative management of these children, especially in the era of
ERAS. Trial registration: Chinese Clinical Trial Registry:
ChiCTR2200066517 (www.chictr.org.cn), Registered on December 7,
2022. Copyright © The Author(s) 2025.

<70>
Accession Number
2036394773
Title
A synthetic cohort analysis of postoperative management of primary cardiac
angiosarcoma and a case report.
Source
Frontiers in Oncology. 15 (no pagination), 2025. Article Number: 1625049.
Date of Publication: 2025.
Author
Cai Y.; Yang H.; Yuan D.; Jin S.-H.; Xu J.; Hu W.; Bai Y.; Li X.; Wang Z.;
Zhang D.; Guo K.; Wang S.; Gaipl U.S.; Liu Y.; Ma H.; Zhou J.-G.
Institution
(Cai, Yang, Xu, Hu, Bai, Ma, Zhou) Department of Oncology, The Second
Affiliated Hospital of Zunyi Medical University, Zunyi, China
(Yuan) Department of Pathology, Affiliated Hospital of Zunyi Medical
University, Zunyi, China
(Jin) Department of Orthodontics, Affiliated Stomatological Hospital of
Zunyi Medical University, Zunyi, China
(Li) Department of Imaging, The Second Affiliated Hospital of Zunyi
Medical University, Zunyi, China
(Wang) Department of Ultrasound, The Second Affiliated Hospital of Zunyi
Medical University, Zunyi, China
(Zhang, Guo) Department of Cardiac Macrovascular Surgery, Affiliated
Hospital of Zunyi Medical University, Zunyi, China
(Wang) Department of Biomedical Informatics, School of Life Sciences,
Central South University, Changsha, China
(Gaipl, Zhou) Translational Radiobiology, Department of Radiation
Oncology, Universitatsklinikum Erlangen, Friedrich-Alexander-Universitat
Erlangen-Nurnberg, Erlangen, Germany
(Liu) Department of Clinical Pharmacy, Liaocheng Cancer Hospital,
Liaocheng, China
Publisher
Frontiers Media SA
Abstract
Background: Primary cardiac angiosarcoma is a rare and aggressive
malignancy originating from the endothelial lining of cardiac blood
vessels. The prognosis remains extremely poor. The study was to evaluate
postoperative survival in patients with primary cardiac angiosarcoma after
treated with adjuvant therapy. Method(s): A systematic review of
PubMed from January 1985 to December 2023 was performed to establish a
synthetic cohort of patients undergoing surgery for primary cardiac
angiosarcoma. Survival analysis was used to assess the relationship
between postoperative adjuvant therapy and prognosis. Univariable and
multivariable cox regression analyses were used to identify prognostic
factors. We then established and validated a nomogram by receiver
operating characteristic (ROC) curves, calibration curves and decision
curve analysis (DCA). Moreover, we present a case of 49-year-old patient
with primary cardiac angiosarcoma. Result(s): In the synthetic
cohort, the patients with postoperative adjuvant therapy reached longer
overall survival (OS) and progression-free survival (PFS) than those
without postoperative adjuvant therapy (median OS: 14 VS 8 months, HR =
5.62, 95%CI: 1.66-19.08, P<0.001; median PFS: 12 VS 6 months, HR = 2.98,
95%CI: 1.03-8.66, P = 0.007; Log rank test). Radiotherapy (HR = 0.14, 95%
CI: 0.04-0.54, P = 0.004) and chemotherapy (HR = 0.03, 95% CI: 0.00-0.27,
P = 0.002) were significantly correlated with better OS. DCA and ROC
curves confirmed the nomogram can predict postoperative 6-month survival
in patients with primary cardiac angiosarcoma. OS was indistinguishable
between patients with R0 or R1 resection (10 VS 10 months, HR = 0.99;
95%CI: 0.34-2.86; P = 0.986). However, compared to patients underwent R1
resection, patients undergoing R0 resection have longer but not
statistically significant PFS (10 VS 7 months, HR = 2.16; 95%CI:
0.83-5.61; P = 0.090). Conclusion(s): The prognosis of patients with
primary cardiac angiosarcoma remains extremely poor, even with surgical
resection. Postoperative adjuvant therapy was associated with
significantly better survival in a small cohort of patients with primary
cardiac angiosarcoma. Further studies are warranted to guide future
recommendations. Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/, identifier
CRD420251139779. Copyright © 2025 Cai, Yang, Yuan, Jin, Xu, Hu,
Bai, Li, Wang, Zhang, Guo, Wang, Gaipl, Liu, Ma and Zhou.

<71>
Accession Number
648765064
Title
Look under the covers! A systematic approach to assessing the cardiac
surgical patient's condition.
Source
British Journal of Surgery. Conference: Swedish Surgical Week 2025.
Linkoping Sweden. 112(Supplement 11) (pp xi33), 2025. Date of Publication:
01 Aug 2025.
Author
Jonsson A.; Tabbakh E.
Institution
(Jonsson, Tabbakh) Thoraxkirurgen vardavdelning, Karolinska
Universitetssjukhuset, Stockholm, Sweden
Publisher
Oxford University Press
Abstract
Introduction: Accurate and safe assessments promote trust and security
between the patient and nursing staff. The department lacked a systematic
approach to assessing patient's condition. The nurse's assessments were
mainly based on medical records and previous verbal reports. Usually,
nurses do several diffrent assessments throughout the day. Head to toe
(HTTA) is a physical examination with inspection, palpation and
auscultation combined with a patient dialogue. The primary aim is for
conditions and complications to be detected earlier or even avoided. The
aim was to make all assessments of the patient at one time, to increase
patient safety, to make assessments bedside to increase person-centered
care. Method(s): This was an improvement work, where an extensive
literature search was conducted. An introduction plan was made. A
questionnaire was conducted to be used before and after the implementation
of HTTA. A documentation template was constructed in the charting system.
 Result(s): After the intervention nurses largely perform HTTA on
patients. They feel that it is a good way of working that helps them to
get a good status on the patients. The nurses felt more prepared for the
rounds when HTTA is done than before. 72% stated that they perform HTTA on
patients who come from other units. The patients experience the assessment
as 'someone is looking at me the whole me' and 'it felt good and that they
probably took my body seriously'. Discussion(s): Adjustments in other
working methods (medications are distributed, adjusting times for pain
relief administration) is necessary to facilitate the implementation of
HTTA.

<72>
Accession Number
2040879615
Title
Comparison of conventional and modified ultrafiltration on perioperative
clinical outcome in neonates undergoing arterial switch operation.
Source
Annals of Pediatric Cardiology. 18(3) (pp 236-243), 2025. Date of
Publication: 01 May 2025.
Author
Masaniya J.; Patel J.; Kumar J.S.; Prajapati M.; Shah P.
Institution
(Masaniya, Patel, Kumar, Prajapati) Department of Cardiac Anesthesia, U.
N. Mehta Institute, Cardiology and Research Center, Gujarat, Ahmadabad,
India
(Shah) Department of Research, U. N. Mehta Institute, Cardiology and
Research Center, Gujarat, Ahmadabad, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Objective: The aim of this prospective, randomized study is to compare the
effects of conventional ultrafiltration (CUF) versus combined CUF and
modified ultrafiltration (MUF) in neonates undergoing an arterial switch
operation (ASO) for transposition of great arteries. Method(s): We
conducted a prospective randomized study on 80 neonates undergoing ASO.
They were randomized into two groups as follows: Group C (n = 40) received
CUF during bypass and Group M (n = 40) received both CUF and MUF during
and after the cessation of the bypass, respectively. The hemodynamic
parameters, respiratory variables, hematological, inflammatory, and tissue
injury parameters were compared at various time points. Result(s): At
the post-MUF phase (T2), there was a statistically significant increase in
mean arterial pressure (P < 0.05) in Group M, and the vasoactive inotrope
score (VIS) was higher in Group C than in Group M. MUF also reduces peak
airway pressure and improves the ratio of arterial oxygen tension to
fraction inspired oxygen (PaO 2 /FiO 2) compared to CUF, and this
difference was statistically significant (P < 0.05). MUF resulted in a
significant increase in hemoglobin (Hb) and platelet levels and
significantly reduced the chest tube output and transfused blood and blood
products. The mean values of interleukin-6, C-reactive protein, and
lactate dehydrogenase between the two groups did not show any significant
difference postsurgery. No statistically significant difference was
observed in the duration of postoperative mechanical ventilation time and
length of intensive care unit (ICU) stay between the two groups.
 Conclusion(s): Administration of MUF following surgery leads to an
increase in Hb and platelet levels, reduces blood transfusion requirement,
and decreases chest tube output postoperatively. It improves the
hemodynamic status of patients and requires less inotropic support. We
also found that MUF does not affect the duration of mechanical ventilation
time, ICU stay, or outcome, despite improvements in hemodynamics and
pulmonary function. Copyright © 2025 Wolters Kluwer Medknow
Publications. All rights reserved.

<73>
Accession Number
648759306
Title
EXPRESS: Impact of anesthesia precision intervention on perioperative
serum myocardial injury markers and major adverse cardiac events in
high-risk cardiovascular patients undergoing non-cardiac surgery.
Source
Journal of investigative medicine : the official publication of the
American Federation for Clinical Research. (pp 10815589251388962), 2025.
Date of Publication: 07 Oct 2025.
Author
Zhang L.; Zhai H.; Zeng H.; Qiu L.; Huang R.
Institution
(Zhang, Zhai, Zeng, Qiu, Huang) Anesthesia Surgery Center, First People's
Hospital, Guangyuan, Sichuan, China
Abstract
This study aims to unravel the impact of anesthesia precision intervention
on perioperative serum myocardial injury markers and major adverse cardiac
events in high-risk cardiovascular patients undergoing non-cardiac
surgery. One hundred and sixty high-risk cardiovascular disease patients
were randomly allocated into two groups. The control group received
conventional empirical management, while the observation group underwent
precise anesthesia interventions. We compared the general data, the levels
of myocardial injury markers, including cardiac troponin (cTn), creatine
kinase isoenzyme (CK-MB), and myoglobin (Mb). Furthermore, the levels of
cardiac function markers, such as brain natriuretic peptide (BNP) and
N-terminal pro-B-type natriuretic peptide (NT-proBNP), as well as the
levels of inflammatory factors and the incidence of adverse cardiac events
were compared between the two groups. Postoperatively, the observation
group exhibited significantly lower levels of cTn, CK-MB, Mb, BNP,
NT-proBNP, c-reactive protein (CRP). Additionally, the total incidence of
adverse cardiac events in the observation group was noticeably lower than
that in the control group. The application of precise anesthetic
intervention in the perioperative period of non-cardiac surgery for
high-risk cardiovascular patients can further mitigate cardiac injury and
reduce the incidence of adverse cardiac events, making it worthy of
clinical application.

<74>
Accession Number
648754977
Title
The Use of In-Silico Research in the Development of Abdominal and Thoracic
Surgical Devices: A Systematic Review.
Source
British Journal of Surgery. Conference: Annual Congress of the Association
of Surgeons of Great Britain and Ireland. Edinburgh United Kingdom.
112(Supplement 13) (pp xiii32), 2025. Date of Publication: 01 Aug 2025.
Author
Pattani N.; Sanghera J.; Mills E.; Bolton W.; Harji D.; Burke J.
Institution
(Pattani) St George's Hospital, St George's University Hospitals, NHS
Foundation Trust, London, United Kingdom
(Sanghera) Walsall Manor Hospital, Walsall Healthcare NHS Trust,
Birmingham, United Kingdom
(Mills) Mid and South Essex NHS Trust, Essex, United Kingdom
(Bolton) Leeds Institute Medical Research, University of Leeds, West
Yorkshire, United Kingdom
(Harji) Department of Colorectal Surgery, Manchester University NHS
Foundation Trust, Manchester, United Kingdom
(Burke) Christie NHS Foundation Trust, Manchester, United Kingdom
Publisher
Oxford University Press
Abstract
Background: Research and innovation in surgery has exponentially improved
over the past three decades. However, safety and efficacy assessment
through randomised controlled trials require significant time and
resource. In-silicomodelling may provide a solution, utilising
computational simulations to develop and improve medical devices. To date,
its potential in testing surgical devices is underexplored. This
systematic review aims to evaluate the use of in-silico modelling for
devices used in abdominal and thoracic surgery. Method(s): PubMed
databases were interrogated from 01/01/2019-01/ 08-2024. Inclusion
criteria were defined as studies using mathematical or computational
models to investigate invasive devices implanted or incorporated in the
abdomen and thorax. Result(s): The search strategy yielded 2968
studies. 42 included in the final analysis. Core themes identified
included proof-of-concept (n=19), device improvement (n=22), and in-silico
clinical trials (ISCTs) 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 (pre-clinical) and 19 studies validated in-silico results
with in-vitro or in-vivo data. Conclusion(s): In-silicomodelling has
the potential to replace components of pre-clinica in-vitro and in-vivo
testing of surgical devices. Applications include, the modelling of rare
diseases and patient demographics, generating efficacy data for novel
devices in the pre-clinical stage, and developing/repurposing existing
devices to reduce known complications. A core outcome set and unified
credibility framework will help standardise methodologies and reporting of
results, minimising inter-study heterogeneity. Global collaboration and
appropriate regulation will help bring in-silicomodelling to the forefront
of surgical device research.

<75>
[Use Link to view the full text]
Accession Number
648759067
Title
Class 1 Indications for Coronary Revascularization Identified in Prekidney
Transplant Screening.
Source
Journal of the American Society of Nephrology : JASN. (no pagination),
2025. Date of Publication: 07 Oct 2025.
Author
Israni A.; Sandorffy B.L.; Liu C.S.; Fraticelli Ortiz D.I.; Gross H.M.;
Nicholson J.; Cazes M.; Soomro Q.H.; Zhang X.; Wu W.; Charytan D.M.
Institution
(Israni, Sandorffy, Liu, Fraticelli Ortiz, Gross, Cazes, Soomro, Wu,
Charytan) Nephrology Division, Department of Medicine
(Nicholson) Health Sciences Library
(Zhang, Wu) Biostatistics Division, Department of Population Health, New
York University Grossman School of Medicine, New York, NY, United States
Abstract
BACKGROUND: Cardiovascular disease is the most common cause of morbidity
and mortality in kidney transplant recipients. Screening for coronary
disease is frequently required prior to kidney transplantation, but
coronary intervention has not been shown to be beneficial except in
complex coronary artery disease. The likelihood of finding significant
coronary artery disease and the benefits of routine pre-transplant
screening are uncertain. METHOD(S): We performed a systematic review
and meta-analysis. Medline & Embase were searched to identify manuscripts
published between 1998 and 2024 reporting the results of pre-transplant
screening. The primary endpoints were the frequency of detecting
significant coronary lesions for which there are AHA class 1 indications
for revascularization: a) >50% left main stenosis; or b) multi-vessel
disease with ejection fraction < 35% during pre-kidney transplant
screening. Secondary endpoints included frequency of detecting multivessel
disease, proximal left anterior descending artery (LAD) disease, and
number of patients who underwent invasive coronary angiography.
Meta-regression was used to explore outcome heterogeneity according to the
presence of hypertension, diabetes, and age. RESULT(S): We identified
1273 studies out of which 44 met eligibility criteria. The mean prevalence
of class 1 indications was 2%, although the heterogeneity was high with
estimates ranging from 0% to 17%. Estimated prevalence of proximal LAD
disease was 2% and left main stenosis was 1%, whereas 10% of patients had
multi-vessel coronary artery disease, and 35% were referred for invasive
angiography. There was no evidence of significant heterogeneity according
to sex of the population or prevalence of diabetes or hypertension.
 CONCLUSION(S): Identification of class I indications for
revascularization during pre-transplant coronary screening was
rare. Copyright © 2025 by the American Society of Nephrology.

<76>
Accession Number
648754843
Title
Is there a place for Robotics in Vascular Surgery? - A Review of Current
Literature.
Source
British Journal of Surgery. Conference: Annual Congress of the Association
of Surgeons of Great Britain and Ireland. Edinburgh United Kingdom.
112(Supplement 13) (pp xiii41-xiii42), 2025. Date of Publication: 01 Aug
2025.
Author
Oskui Y.
Institution
(Oskui) Wrightington, Wigan and Leigh NHS Foundation Trust, United Kingdom
Publisher
Oxford University Press
Abstract
The following literature review examines the role of robotic-assisted
surgery in the field of vascular surgery within the United Kingdom,
focusing on its benefits, challenges, and future applications. While
endovascular techniques have been widely adopted due to their minimal
invasiveness and reduced recovery times, robotic systems such as the da
Vinci, which claim the same advantages, have not seen similar uptake in
the vascular field. The existing literature base suggests that robotic
surgery confers additional benefits, alongside increased surgical
precision and greater longevity than its endovascular counterparts,
particularly in complex abdominal and thoracic procedures. However,
barriers, such as the steep learning curve for robotic surgery, the lack
of laparoscopic training among vascular surgeons, and limited high-quality
clinical evidence to support the resource intensive endeavour of robotics,
have hindered its integration. Early reports indicate promise in combining
robotic technology with endovascular techniques to improve the precision
and safety of procedures, while reducing operator radiation exposure.
Despite the preliminary promise, significant gaps in research remain,
including the need for more randomized controlled trials coupled with
economic analyses to validate the benefits of robotic-assisted vascular
surgery. Collaboration is required between bioengineering firms, surgical
leaders, and trusts to develop specialized training pathways and overcome
the financial and practical challenges associated with robotic systems
within the United Kingdom. Addressing these issues could pave the way for
a broader adoption of robotic-assisted techniques in vascular surgery,
offering safer and more effective treatment options for patients, and
surgeons, in the future.

<77>
Accession Number
648758908
Title
Worsening tricuspid regurgitation after mitral valve surgery: a
meta-analysis and meta-regression.
Source
International journal of cardiology. (pp 133931), 2025. Date of
Publication: 04 Oct 2025.
Author
Aviel G.; Hirsh-Raccah B.; Idais I.; Ghannam R.A.; Komodei M.;
Lipey-Dyamant A.; Wald O.; Korach A.
Institution
(Aviel, Idais, Ghannam, Komodei, Lipey-Dyamant, Wald, Korach) Department
of Cardiothoracic Surgery, Hadassah Medical Center, Jerusalem, Israel
(Hirsh-Raccah) Department of Cardiology, Hadassah Medical Center,
Jerusalem, Israel; Division of Clinical Pharmacy, Institute for Drug
Research, School of Pharmacy, Faculty of Medicine, Hebrew University of
Jerusalem, Jerusalem, Israel
Abstract
OBJECTIVES: Reports of tricuspid valve regurgitation (TR) following mitral
valve (MV) surgery are unclear. This study aims to estimate the prevalence
of worsening TR (WTR) following MV surgery for non-rheumatic mitral
regurgitation and the benefit of concomitant tricuspid annuloplasty.
 METHOD(S): Electronic databases including Embase, PubMed,
GoogleScholar, and Cochrane Library were searched between 2013 and 2024. A
systematic review of the literature was conducted to include cohort
studies, case-control studies and randomized-controlled trials. WTR was
defined as >= moderate TR or an increase in TR severity of >=2 grades on
follow-up echocardiography. A random effects meta-analysis was performed.
Subgroup analysis was conducted to estimate the benefit of a concomitant
TV annuloplasty. A meta-regression was conducted to identify potential
variables accounting for between-study heterogeneity. Sensitivity analyses
were used to confirm the robustness of the reported results.
 RESULT(S): Of 8923 studies identified, 8 studies were included in the
final analysis involving 2978 patients and 14,592 patient years (MV
surgery-only group = 1991 patients, TV annuloplasty group = 987). WTR
occurred in 9 % (95 %CI:4-22) of patients after MV surgery over a pooled
follow-up of 4.9 [3.1-6.7] years. A concomitant TV annuloplasty resulted
in a significant reduction in the prevalence of WTR (OR = 0.27, 95 %CI:
0.13-0.57, p = 0.0079). A trend for lower overall mortality was detected
in the TV annuloplasty group (OR = 0.73, 95 %CI: 0.5-1.08). The pooled
estimates were not significantly affected using a leave-one-out analysis
meta-analysis. CONCLUSION(S): Despite surgical treatment of
non-rheumatic mitral regurgitation, TR progresses in a considerable number
of patients. Concomitant tricuspid annuloplasty significantly decreases
the prevalence of WTR without affecting mortality. Copyright ©
2025. Published by Elsevier B.V.

<78>
Accession Number
648755274
Title
Comparison of perioperative outcomes between video-Assisted and
robotic-assisted thoracic Surgery: A Systematic review and meta-Analysis.
Source
British Journal of Surgery. Conference: Annual Congress of the Association
of Surgeons of Great Britain and Ireland. Edinburgh United Kingdom.
112(Supplement 13) (pp xiii40), 2025. Date of Publication: 01 Aug 2025.
Author
Bhaskaran P.; Khan N.; Singh A.; Bhaskaran I.P.; Subramanian A.M.;
Anastasiou N.
Institution
(Bhaskaran) Hammersmith Hospital, Imperial College London, Brighton,
United Kingdom
(Khan, Subramanian) Royal Sussex County Hospital, Brighton, United Kingdom
(Singh) Tameside General Hospital, United Kingdom
(Bhaskaran) Imperial College London, United Kingdom
(Anastasiou) General Oncology Hospital of Kifissia Agioi Anargyroi,
Athens, Greece
Publisher
Oxford University Press
Abstract
Objective: This meta-analysis aims to compare the perioperative outcomes
of video-assisted thoracic surgery (VATS) and robotic-assisted thoracic
surgery (RATS). Method(s): Randomized controlled trials (RCTs)
reporting perioperative outcomes in patients undergoing VATS and RATS were
identified from electronic medical databases. The meta-analysis was
conducted following Cochrane Collaboration guidelines using RevMan version
5 software. A total of three RCTs, comprising 483 patients, were included
in the analysis. Using a random-effects model, the operation duration
showed no significant difference between video-assisted thoracoscopic
surgery (VATS) and robotic-assisted thoracoscopic surgery (RATS). The mean
difference (MD) was -4.98 minutes, with a 95% confidence interval (CI)
ranging from -35.18 to 25.22 (Z = 0.32; P = 0.75). However, there was
significant heterogeneity among the studies. Similarly, the length of
hospital staywas comparable between the two approaches, with an MD of 0.39
days (95% CI: -0.45 to 1.23; Z = 0.90; P = 0.37). Postoperative
complications were also statistically similar, with an odds ratio (OR) of
1.11 (95% CI: 0.47 to 2.62; Z = 0.23; P = 0.82), but high heterogeneity
was observed in this analysis. The risk of conversion to open surgery did
not differ significantly between RATS and VATS, with an OR of 1.20 (95%
CI: 0.51 to 2.83; Z = 0.43; P = 0.67). Importantly, no heterogeneity was
observed in this comparison. Conclusion(s): RATS does not demonstrate
superiority over VATS across the analysed perioperative variables. The
observed heterogeneity underscores the need for a large, multicentre RCT
to validate these findings.

<79>
Accession Number
648754666
Title
The Safety, Feasibility and Effect of the APOE Mimetic Peptide CN-105 on
Neuroinflammation and Delirium after Major Non-cardiac/Non-neurologic
Surgery in Older Adults: Results from the Phase II, Triple Blind,
Escalating Dose,MARBLE Randomized Clinical Trial.
Source
Alzheimer's and Dementia. Conference: Alzheimer's Association
International Conference, AAIC 2024. Philadelphia, PA United States.
20(Supplement 8) (no pagination), 2024. Date of Publication: 01 Dec 2024.
Author
Berger M.; Timko N.J.; Boykin P.C.; Emerson J.M.; Woldorff M.G.; Wright
M.C.; Herbert J.T.; Moretti E.W.; Devinney M.J.; Ryu D.; VanDusen K.W.;
Bunning T.; Hsia B.J.; Browndyke J.N.; Blennow K.; Zetterberg H.;
Laskowitz D.T.
Institution
(Berger, Timko, Boykin, Wright, Herbert, Moretti, Devinney, VanDusen,
Bunning, Hsia) Anesthesiology Department, Duke University, School of
Medicine, Durham, NC, United States
(Berger, Devinney) Duke/UNC Alzheimer's Disease Research Center, Duke
University, School of Medicine, Durham, NC, United States
(Berger) Center for the Study of Aging and Human Development, Duke
University, Durham, NC, United States
(Berger, Woldorff) Center for Cognitive Neuroscience, Duke Institute for
Brain Sciences (DIBS), Duke University, Durham, NC, United States
(Emerson, Ryu) Duke University, School of Medicine, Durham, NC, United
States
(Woldorff, Browndyke) Department of Psychiatry and Behavioral Sciences,
Duke University Medical Center, Durham, NC, United States
(Browndyke) Durham VA Medical Center, Durham, NC, United States
(Blennow, Zetterberg) University of Gothenburg, Gothenburg, Sweden
(Laskowitz) Neurology Department, Duke University, Durham, NC, United
States
Publisher
John Wiley and Sons Inc
Abstract
Background: APOE4 leads to increased neuroinflammation, neurocognitive
decline, increased risk of Alzheimer's disease, and may be associated with
increased delirium risk. However, the safety and feasibility of
pharmacologic modulation of APOE to prevent neuroinflammation and
postoperative delirium is unclear. Method(s):We performed a Phase II,
triple blind, escalating dose, randomized controlled trial to determine
the safety, feasibility, and efficacy of the APOE mimetic peptide CN-105
for preventing postoperative neuroinflammation and delirium. We enrolled
older adults (age >= 60 years) undergoing major non-cardiac/non-neurologic
surgery with a planned overnight hospital stay. Patients were randomized
1:3 to placebo or intravenous CN-105 (0.1, 0.5 or 1 mg/kg) starting within
1 hour before surgery and continuing every 6 hours (+/- 90 minutes)
afterwards, until 13 doses were received or hospital discharge (whichever
occurred first). The primary outcome was the number of Grade 2 or higher
adverse events (AEs) among patients randomized to CN-105 vs. placebo.
Secondary outcomes included percent of drug doses administered within the
correct time window, and postoperative delirium incidence and severity.
 Result(s): 203 patients were enrolled; 186 patients (mean [SD] age,
68.7 [5.3] years; 119 male) completed surgery on protocol (49 [26%]
Placebo, 137 [74%] CN-105; Figure 1). The groups were generally
well-matched (Table 1). Patients administered CN-105 vs. placebo had less
Grade 2 or higher AEs (median per patient [Q1, Q3] 1 [1, 3] vs. 2 [1, 5];
p = 0.025), and a lower rate of severe AEs (8.0% vs. 22.4%, p = 0.007;
Table 2). The rate of doses administered within window was 95.3% (95% CI:
93.7%-96.6%) for CN- 105-treated patients and 93.8% (95% CI: 90.8%-96.0%)
for placebo-treated patients. CN-105 (vs. placebo) treated patients had a
lower delirium incidence (19.3% vs 27.1%, relative risk = 0.71 [95% CI:
0.40-1.27], p = 0.26), and lower median delirium severity (1 vs. 2;
proportional odds ratio [95% CI] 0.66 [0.37, 1.20]; p = 0.178), though
these effects were not statistically significant. Conclusion(s):
CN-105 is safe and feasible to administer to older
non-cardiac/nonneurologic surgery patients, and led to fewer postoperative
Grade 2 or higher AEs and severe AEs. The 95% CIs for the effects of
CN-105 included clinically relevant reductions in delirium incidence and
severity.

<80>
Accession Number
648755987
Title
Prevalence and course of depression in older people with aortic stenosis
undergoing transcatheter aortic valve implantation - a systematic review
and meta-analysis.
Source
BMC geriatrics. 25(1) (pp 756), 2025. Date of Publication: 06 Oct 2025.
Author
Maschke V.; Mons U.; Lohner V.
Institution
(Maschke, Mons, Lohner) Department of Cardiology, Cardiovascular
Epidemiology of Aging, Faculty of Medicine and University Hospital
Cologne, University of Cologne, Kerpener Strase 62, Cologne, Germany
Abstract
BACKGROUND: Depression is the most prevalent psychiatric disorder in older
people with cardiovascular disease and an independent risk factor for
cardiac surgery outcomes. Given the rising number of older people with
aortic stenosis in need of transcatheter aortic valve implantation (TAVI)
and the increasingly recognized role of depression as a prognostic factor,
this systematic review and meta-analysis aimed to derive a global estimate
of the prevalence of depression and to examine its course from pre- to
post-TAVI. METHOD(S): We included articles reporting prevalence of
depression (diagnosed or assessed using validated instruments) or change
in depressive symptoms in people undergoing TAVI. We performed three main
meta-analyses: (1) prevalence of diagnosed depression, (2) prevalence of
assessed depression and (3) standardized mean change (SMC) of depressive
symptoms from pre- to post-TAVI. RESULT(S): We included 32 studies in
this systematic review, 26 of which were suitable for meta-analysis. The
pooled prevalence of diagnosed and assessed depression was 6.0%
[95%-Confidence interval: 3.3, 10.6] and 18.5% [13.0, 25.6], respectively.
We observed a small, albeit non-significant trend towards a decrease in
depressive symptoms from pre- to post-TAVI (SMC: -0.08 [-0.37, 0.22]).
 CONCLUSION(S): A relevant proportion of people undergoing TAVI
experiences depression, and the discrepancy in prevalence estimates of
diagnosed and assessed depression indicates a potential under-diagnosis of
depression. Disease management strategies should be adapted to include
screening for and adequate treatment of depression in this population.
Improvement of depressive symptoms after TAVI should not be taken for
granted. Copyright © 2025. The Author(s).

<81>
Accession Number
648757895
Title
Racial Disparities in Access, Utilization, and Outcomes of Transcatheter
Mitral Valve Repair in the United States: A Literature Review.
Source
Journal of racial and ethnic health disparities. (no pagination), 2025.
Date of Publication: 07 Oct 2025.
Author
Adeyemi B.A.; Anthony C.S.; Ajekiigbe V.O.; Ogieuhi I.J.; Ishola F.;
Odukudu G.-D.O.; Damilola A.O.; Emmanuel A.C.; Samuel O.; Nwaezeapu K.I.;
Ogunniyi K.; Fatunmbi O.O.; Oparaocha V.E.
Institution
(Adeyemi, Ogieuhi, Fatunmbi) Northwestern Medicine McHenry Hospital,
McHenry, IL, United States
(Anthony) University of Calabar, Calabar, Nigeria
(Ajekiigbe) Ladoke Akintola University of Technology, Oyo, Nigeria
(Ishola) Ascension St. Vincent Hospital Indianapolis, Indianapolis, IN,
United States
(Odukudu) Morehouse School of Medicine, Atlanta, GA, United States
(Damilola) Montefiore St. Luke's Cornwall, Newburgh, NY, United States
(Emmanuel) University of Nigeria, Nsukka, Enugu, Nigeria
(Samuel) Lagos State Health Service Commission, Lagos, Nigeria
(Nwaezeapu) Trinity Health Ann Arbor, Ann Arbor, MI, United States
(Ogunniyi) Richmond University Medical Center/Mount Sinai, Staten Island,
NY, United States
(Oparaocha) Avalon University School of Medicine, Willemstad, Netherlands
Abstract
Racial and ethnic disparities in cardiovascular care are well-documented;
however, their impact on transcatheter mitral valve interventions,
including transcatheter mitral valve repair (TMVr), remains underexplored.
This review synthesizes the existing literature on racial and ethnic
disparities in TMVr access, utilization, and outcomes to identify
contributing factors, proposed solutions, and critical knowledge gaps. A
comprehensive search of PubMed, EMBASE, and Cochrane databases from 2014
to 2024 yielded nine studies for final inclusion. Across studies, minority
patients-particularly African American and Hispanic individuals-were
consistently underrepresented among TMVr recipients relative to disease
burden. They tended to present at younger ages, were more likely to be
female, and more often underwent non-elective procedures at lower-volume
centers. Minority patients experienced longer hospital stays, greater
procedural costs, and higher healthcare resource utilization. While some
studies reported higher post-procedural mortality or readmission rates
among minorities, findings on complication rates were mixed. Contributing
factors included socioeconomic stressors, Medicaid coverage, limited
referrals to specialized centers, provider bias, and geographic barriers.
Newer studies also highlighted disparities in TMVr access even within
equal-access systems and identified income-related disparities independent
of race. Proposed interventions included Medicaid expansion, coverage with
evidence development, culturally competent care delivery, improved
referral pathways, and community outreach. All included studies were
retrospective and predominantly relied on administrative data.
Prospective, longitudinal studies are needed to clarify causal drivers of
disparity and inform equity-focused policies in structural heart
interventions. Copyright © 2025. W. Montague Cobb-NMA Health
Institute.

<82>
Accession Number
648758343
Title
Non-amyloid specific treatment for transthyretin cardiac amyloidosis: a
clinical consensus statement of the ESC Heart Failure Association.
Source
European heart journal. (no pagination), 2025. Date of Publication: 07
Oct 2025.
Author
Garcia-Pavia P.; Gonzalez-Lopez E.; Anderson L.J.; Cappelli F.; Damy T.;
Fontana M.; Gonzalez-Costello J.; Jurcut R.; Lairez O.; van der Meer P.;
Merlo M.; Perlini S.; Bayes-Genis A.
Institution
(Garcia-Pavia, Gonzalez-Lopez) Department of Cardiology, Hospital
Universitario Puerta de Hierro Majadahonda, Manuel de Falla, Madrid, Spain
(Garcia-Pavia, Gonzalez-Lopez, Bayes-Genis) CIBER Cardiovascular,
Instituto de Salud Carlos III, Madrid, Spain
(Garcia-Pavia) Centro Nacional de Investigaciones Cardiovasculares (CNIC),
C. de Melchor Fernandez Almagro, Madrid, Spain
(Anderson) Cardiology Clinical Academic Group, St George's Hospital,
London, United Kingdom
(Cappelli) Tuscan Regional Amyloidosis Centre, Careggi University
Hospital, Florence, Italy
(Damy) Referral Center for Cardiac Amyloidosis and Department of
Cardiology, Paris, France
(Fontana) National Amyloidosis Centre, UCL, Division of Medicine, Royal
Free Hospital, London, United Kingdom
(Gonzalez-Costello) Department of Cardiology, Hospital Universitario de
Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
(Gonzalez-Costello) Bio-Heart, Instituto de Investigacion Biomedica de
Bellvitge, Barcelona, Spain
(Jurcut) University of Medicine and Pharmacy 'Carol Davila', Bucharest,
Romania
(Jurcut) Expert Center for Rare Cardiovascular Diseases, Emergency
Institute for Cardiovascular Diseases 'Prof.dr.C.C.Iliescu', Bucharest,
Romania
(Lairez) Toulouse University, HealthAge University Hospital Institute,
Toulouse, France
(van der Meer) Experimental Cardiology University Medical Center
Groningen, Netherlands
(Merlo) Cardiothoracovascular Department, Azienda Sanitaria Universitaria
Giuliano Isontina (ASUGI), Trieste, Italy
(Merlo) Center for Diagnosis and Treatment of Cardiomyopathies,
Cardiovascular Department, Azienda Sanitaria Universitaria
Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy
(Perlini) Department of Internal Medicine, Emergency Medicine and
Amyloidosis Research and Treatment Center, IRCCS Policlinico San Matteo
Foundation, Universita degli Studi, Pavia, Italy
(Bayes-Genis) l'Institut del Cor. Hospital Universitari Germans Trias i
Pujol, Badalona, Spain
(Bayes-Genis) Department of Medicine, Universitat Autonoma de Barcelona,
Barcelona, Spain
Abstract
This clinical consensus statement, developed by the Heart Failure
Association of the European Society of Cardiology, offers a detailed
review of the non-specific management of transthyretin amyloid
cardiomyopathy (ATTR-CM). This progressive and often fatal condition is
increasingly recognized as a major contributor to heart failure. This
document provides advice on symptom management and enhancing quality of
life, with a focus on volume management, neurohormonal modulation, and
tailored use of diuretics and other supportive therapies that address the
distinct pathophysiology of ATTR-CM. It also explores advanced treatment
modalities such as heart transplantation and mechanical circulatory
support, which play crucial roles in managing advanced stages of the
disease. Furthermore, it addresses the management of aortic stenosis in
the context of ATTR-CM, advising transcatheter aortic valve replacement as
the preferred treatment for these patients. The advice provided in this
document relies primarily on expert opinion and retrospective studies due
to a notable lack of randomized clinical trials, which underscores a
critical research gap and the pressing need for evidence-based treatment
protocols. Copyright © The Author(s) 2025. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved. For commercial re-use, please contact reprints@oup.com
for reprints and translation rights for reprints. All other permissions
can be obtained through our RightsLink service via the Permissions link on
the article page on our site-for further information please contact

<83>
Accession Number
2040841775
Title
Entropy-guided sevoflurane administration during cardiopulmonary bypass
surgery in the paediatric population.
Source
Perfusion (United Kingdom). (no pagination), 2025. Article Number:
02676591251386601. Date of Publication: 2025.
Author
Ankur A.; Kumar A.; Paret M.L.; Joshi S.; Parikh B.
Institution
(Ankur, Kumar, Joshi) Department of Anaesthesia & Critical Care, Armed
Forces Medical College, Pune, India
(Paret) Department of Anaesthesia & Critical Care, Institute of Naval
Medicine, INHS Asvini, Mumbai, India
(Parikh) Department of Anaesthesia & Critical Care, Command Hospital (CC),
Lucknow, India
Publisher
SAGE Publications Ltd
Abstract
Background: Maintaining optimal anesthetic depth during cardiopulmonary
bypass (CPB) in pediatric patients is challenging due to altered
physiology and unreliable conventional monitoring. Entropy, a processed
electroencephalogram metric, offers a potential solution. This study aimed
to evaluate the relationship between end oxygenator sevoflurane
concentration and entropy values during pediatric CPB using fixed-dose
versus entropy-guided sevoflurane administration. Methodology: A
prospective, randomized study was conducted on 62 pediatric patients
undergoing congenital heart surgery with CPB. Patients were allocated into
two groups: Group A received fixed-dose sevoflurane (1% v/v), and Group B
received sevoflurane titrated to maintain entropy values between 40 and
60. Parameters such as end oxygenator sevoflurane concentration, entropy
(Response and State entropy, RE and SE), and sevoflurane consumption were
recorded intraoperatively. Postoperative hemodynamic data, length of stay,
and complication rates were assessed. Result(s): Entropy-guided
patients showed significantly higher end oxygenator sevoflurane
concentrations [1.64 (1.51-1.85)% versus 1.0%, p = .001] and sevoflurane
consumption (1.26 +/- 0.12 vs 0.645 +/- 0.03 mL/min, p = .001). RE and SE
values were significantly lower in the entropy group (p = .001),
indicating better anesthetic depth control. A negative correlation was
found between entropy and sevoflurane concentration (r = -0.6987, p =
.02). Despite higher postoperative inotropic scores in the entropy group
(p = .001), no significant differences were found in length of stay,
mechanical ventilation duration, or morbidity and mortality rates between
groups. Conclusion(s): Entropy-guided sevoflurane administration
during pediatric CPB provides improved anesthetic depth control at the
cost of higher anesthetic and inotropic requirements. However, it does not
adversely affect clinical outcomes, supporting its safety and potential
utility in refining pediatric anesthesia practices. Copyright ©
The Author(s) 2025

<84>
Accession Number
648739377
Title
A randomised pilot study evaluating music therapy and virtual reality
mindfulness sessions for reducing anxiety and stress in patients
undergoing first-time elective cardiac surgery.
Source
Journal of perioperative practice. (pp 17504589251370291), 2025. Date of
Publication: 04 Oct 2025.
Author
Krishnamoorthy B.; Abdelghafar M.; Air R.; Halyckyj-Smith J.; Citarella
A.; McLaughlin E.; Iles-Smith H.; Elliott R.; Barnard J.; Rajai A.;
Venkateswaran R.
Institution
(Krishnamoorthy, Iles-Smith) Directorate of Nursing and Midwifery and
School of Health and Society, University of Salford, Salford, United
Kingdom
(Krishnamoorthy, Abdelghafar, Air, Halyckyj-Smith, Citarella, McLaughlin,
Barnard, Venkateswaran) Department of Cardiothoracic Surgery, Manchester
Foundation Trust, Wythenshawe Hospital, Manchester, United Kingdom
(Krishnamoorthy) Faculty of Health, Department of Cardiovascular Sciences,
Biology and Medicine, University of Manchester, Manchester, United Kingdom
(Elliott) Faculty of Biology, Division of Psychology and Mental Health,
Medicine and Health, University of Manchester, Manchester, United Kingdom
(Rajai) Manchester University NHS Foundation Trust, Manchester Academic
Health Science Centre, Manchester, United Kingdom
(Rajai) Centre for Biostatistics, Division of Population Health,
University of Manchester, Manchester, United Kingdom
Abstract
Cardiac surgery patients may experience stress and anxiety, negatively
impacting recovery. Pharmacological treatments are frequently used but may
result in side effects. We aimed to assess the effectiveness of immersive
virtual reality mindfulness and music therapy in reducing preoperative and
postoperative anxiety. Between March and July 2024, 36 participants were
randomised to 15 min of either virtual reality (n = 19) or music therapy
(n = 17) preoperatively and on postoperative day 3. Primary endpoints were
anxiety levels and salivary cortisol, assessed before and after
intervention using the paired Wilcoxon test. Median age was 66
(interquartile range = 58-73); 64% were male. Both music therapy and
virtual reality groups showed significant preoperative Spielberger
State-Trait Anxiety Inventory score reductions after intervention: music
therapy from 40 (30-48) to 23 (21-24) and virtual reality from 40 (31-54)
to 23 (20-35) (both p < 0.001); there was no significant difference
between groups (p = 0.7). Median virtual reality immersion and absorption
scores were 90/100 (interquartile range = 80-90; 80-94). Cortisol levels
did not significantly change. Postoperatively, 21 patients participated
(virtual reality n = 11, music therapy n = 8), showing reduced anxiety:
music therapy from 31 (26-32) to 23 (20-27), virtual reality from 33
(23-41) to 24 (22-30). Results show feasibility, tolerability, and
preliminary evidence of anxiety reduction, supporting further research
into music therapy and virtual reality for cardiac surgery patients. The
trial was registered with the International Standard Randomised Controlled
Trial Number Registry (ISRCTN51014051)
(https://doi.org/10.1186/ISRCTN51014051).

<85>
Accession Number
2040866329
Title
Left Bundle Branch Versus Apical Pacing in Atrioventricular Block and
Normal Cardiac Function Post-transcatheter Aortic Valve Implantation:
PhysTAVI Trial.
Source
CJC Open. (no pagination), 2025. Date of Publication: 2025.
Author
Pujol-Lopez M.; Regueiro A.; Graterol F.R.; Garcia-Ribas C.; Uribe L.;
Jimenez-Arjona R.; Borras R.; Guasch E.; Guichard J.B.; Carballeira L.;
Falzone P.V.; Regany-Closa M.; Casal R.; Poza M.; Arbelo E.; Porta-Sanchez
A.; Roca-Luque I.; Sitges M.; Doltra A.; Tolosana J.M.; Mont L.
Institution
(Pujol-Lopez, Regueiro, Graterol, Uribe, Jimenez-Arjona, Borras, Guasch,
Guichard, Carballeira, Falzone, Regany-Closa, Poza, Arbelo, Porta-Sanchez,
Roca-Luque, Sitges, Doltra, Tolosana, Mont) Institut Clinic
Cardiovascular, Hospital Clinic, Universitat de Barcelona, Catalonia,
Spain
(Pujol-Lopez, Regueiro, Graterol, Garcia-Ribas, Borras, Guasch, Guichard,
Falzone, Regany-Closa, Casal, Poza, Arbelo, Porta-Sanchez, Roca-Luque,
Sitges, Doltra, Tolosana, Mont) Institut d'Investigacions Biomediques
August Pi i Sunyer, Catalonia, Barcelona, Spain
(Borras) Centro de Investigacion Biomedica en Red, Salud Mental, Instituto
de Salut Carlos III, Madrid, Spain
(Guasch, Guichard, Arbelo, Roca-Luque, Sitges, Tolosana, Mont) Centro de
Investigacion Biomedica en Red, Enfermedades Cardiovasculares (CIBERCV),
Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Background: There is currently no evidence of the best pacing mode for
high-degree atrioventricular (AV) block occurring after transcatheter
aortic valve implantation (TAVI). The objective of this pilot study was to
compare a clinical combined endpoint achieved by left bundle branch pacing
(LBBP) vs right ventricular (RV) pacing in patients with preserved left
ventricular ejection fraction (LVEF) post-TAVI at 12-month follow-up.
 Method(s): Consecutive patients post-TAVI with high-degree AV block
and LVEF >= 50% were randomized to LBBP or RV pacing. The primary endpoint
was survival with an improvement of >= 1 point in New York Heart
Association functional class or a >= 25% increase in distance covered on
the 6-minute walking test. Secondary endpoints were change in LVEF, septal
flash, mitral regurgitation, N-terminal pro-brain natriuretic peptide,
heart failure hospitalization, score on symptoms, and QRS duration.
 Result(s): Twenty-four patients were included in the study, 12 in
each arm. Both groups showed a similar incidence of the primary endpoint:
33.3% (n = 4) in the LBBP group vs 25% (n = 3) in the RV group (P = 1.0).
In relation to secondary endpoints, significant shortening in the QRS was
observed in the LBBP group compared with the RV group (median: -39 ms vs 0
ms, P < 0.001). Septal flash excursion was significantly lower for the
LBBP group (median: 0 mm vs 2 mm, P = 0.03). There was no difference
between groups on any other endpoint. Conclusion(s): Similar midterm
outcomes were obtained with LBBP and RV pacing in an elderly population
with high-degree AV block and preserved LVEF after TAVI. The pilot
Phys-TAVI trial showed the feasibility of LBBP in this population. Larger
randomized clinical trials with longer follow-up are needed to test for
differential clinical outcomes between pacing modalities. Clinical Trial
Registration: NCT04482816 Copyright © 2025 The Authors

<86>
Accession Number
2036469162
Title
Robotic-assisted thoracic surgery versus video-assisted thoracic surgery
for patients undergoing lung resection: a systematic review and
meta-analysis of randomized controlled trials.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2025. Date
of Publication: 2025.
Author
Lamas F.M.; Lech G.E.; Maboni L.R.; Silveira P.A.Z.; da Silva P.B.E.;
Alberti A.M.; Loss N.V.; Camargo S.M.; Soder S.A.
Institution
(Lamas, Maboni, Silveira, da Silva, Alberti, Loss) Universidade Federal de
Ciencias da Saude de Porto Alegre (UFCSPA), 245 Sarmento Leite Street, RS,
Porto Alegre, Brazil
(Lech) Pontificia Universidade Catolica Do Rio Grande Do Sul (PUC-RS),
6681 Ipiranga Ave, RS, Porto Alegre, Brazil
(Camargo, Soder) Department of Thoracic Surgery, Santa Casa de Porto
Alegre, 295 Professor Annes Dias Street, RS, Porto Alegre, Brazil
Publisher
Springer
Abstract
Background: Minimally invasive techniques have mostly replaced open
thoracotomy for lung resection, yet their comparative benefits remain
unclear. We performed a systematic review and meta-analysis to evaluate
clinical outcomes associated with robot-assisted (RATS) and video-assisted
thoracic surgery (VATS). Method(s): We searched PubMed, Embase, and
Cochrane Central for randomized controlled trials (RCTs) comparing RATS to
VATS in patients undergoing lung resection. Primary outcomes were
conversion to thoracotomy and overall complications. Risk ratios (RR) and
mean differences (MD) were used for categorical and continuous outcomes,
respectively, considering as significant p-values < 0.05. Trial sequential
analysis was also conducted. Result(s): We included five RCTs
comprising 712 patients, of whom 338 (47.5%) underwent RATS, and 374
(52.5%) underwent VATS. No differences were found between groups in
conversion to thoracotomy (RR 0.65; 95% CI 0.36-1.20; p = 0.17) and
overall complications (RR 0.91; 95% CI 0.69-1.21; p = 0.49). RATS
presented a higher number of lymph node stations resected (p < 0.00001)
and a shorter length of hospital stay after performing sensitivity
analysis (p < 0.00001). There were no differences between RATS and VATS in
any of the other secondary outcomes. Conclusion(s): Our study results
reassure the safety and potential benefits associated with RATS lung
resections, demonstrating a significantly higher number of lymph node
stations resected and a possible trend toward shorter hospital stays, with
similar rates of complications and conversion in comparison to
VATS. Copyright © The Author(s), under exclusive licence to The
Japanese Association for Thoracic Surgery 2025.

<87>
Accession Number
648745754
Title
Network Meta-Analysis of Axillary, Femoral, and Central Arterial
Cannulation In Minimally Invasive Cardiac Surgery.
Source
The American journal of cardiology. (no pagination), 2025. Date of
Publication: 03 Oct 2025.
Author
Comanici M.; Khoshdel N.; Farmidi A.A.; Ayaz G.; Sabashnikov A.; Bhudia
S.K.; Bahrami T.; Raja S.G.
Institution
(Comanici, Khoshdel, Farmidi, Ayaz, Sabashnikov, Bhudia, Bahrami, Raja)
Department of Cardiac Surgery, Harefield Hospital, United Kingdom
Abstract
The optimal arterial cannulation site in minimally invasive cardiac
surgery (MICS) remains debated. While axillary, femoral, and central
approaches each offer distinct advantages, no prior network meta-analysis
has compared all three. We conducted a Bayesian network meta-analysis of
11 retrospective studies including 11,353 patients to evaluate their
impact on postoperative outcomes. The analysis examined mortality, stroke,
acute kidney injury (AKI), aortic dissection, atrial fibrillation,
reoperation for bleeding, and length of stay, reporting odds ratios (ORs)
with 95% credible intervals (CrIs) and ranking strategies using SUCRA
probabilities. Central cannulation was associated with the lowest odds of
stroke and aortic dissection, whereas axillary cannulation carried
significantly higher odds of stroke compared with central (OR 4.66; 95%
CrI 1.60-17.08) and ranked lowest across most outcomes. Femoral
cannulation demonstrated favourable trends in in-hospital mortality (OR
0.61; 95% CrI 0.13-1.69 vs. central) and AKI (OR 0.65; 95% CrI 0.35-1.19),
although not statistically significant. SUCRA rankings identified central
as most favourable for neurologic and vascular complications, and femoral
as strongest for mortality and renal outcomes. In conclusion, central
cannulation may provide the most balanced risk profile in MICS,
particularly in minimizing neurologic and vascular events, while femoral
cannulation remains a valid alternative in patients without significant
aortic disease. Axillary cannulation, despite its theoretical benefits,
was associated with higher complication rates and warrants further
prospective evaluation. Copyright © 2025. Published by Elsevier
Inc.

<88>
Accession Number
648749162
Title
Propofol-supplemented cardioplegia: a multi-center blinded three-group
randomized trial (ProMPT2).
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2025. Date of Publication: 02 Oct 2025.
Author
Angelini G.D.; Smartt H.J.M.; Joyce K.; Heys R.; Maishman R.; Culliford
L.; de Jesus S.E.; Fitzgerald B.M.; Suleiman M.S.; Punjabi P.; Nwaejike
N.; Downes R.; Gibbison B.; Rogers C.A.
Institution
(Angelini, Suleiman, Gibbison) Bristol Heart Institute, University of
Bristol, Bristol, United Kingdom
(Smartt, Joyce, Heys, Maishman, Culliford, de Jesus, Fitzgerald, Rogers)
Bristol Trials Centre, Bristol Medical School, University of Bristol,
Bristol, United Kingdom
(Punjabi) National Heart and Lung Institute, Imperial College London,
Hammersmith Hospital, Imperial College Healthcare NHS Trust, London,
United Kingdom
(Nwaejike) Manchester University NHS Foundation Trust, Manchester, United
Kingdom
(Downes) University Hospitals Bristol and Weston NHS Foundation Trust,
Bristol, United Kingdom
Abstract
OBJECTIVE: Coronary artery bypass grafting using cardiopulmonary bypass
and cardioplegic arrest is an effective treatment for coronary artery
disease. Research suggests supplementing the cardioplegia solution with
propofol may be cardioprotective. The aim was to compare the safety and
efficacy of supplementing the cardioplegia solution with different doses
of propofol in adults undergoing first-time surgery. METHOD(S): A
blinded, parallel group randomized controlled trial conducted in 3
hospitals in the UK comparing a cardioplegia solution supplemented with
high-dose propofol (concentration 12mcg/mL), low-dose propofol
(concentration 6mcg/mL) or placebo (saline). Primary outcome was cardiac
troponin T measurements over the first 48 hours after surgery.
Participants were followed-up for 12 months. RESULT(S): 240
participants, median age 66 years, 90% male, were randomly allocated; 78
to high-dose propofol, 80 to low-dose propofol and 82 to placebo. 239
participants were included in the primary analysis. Geometric mean cardiac
troponin release at 48 hours (95% confidence interval) was 145ng/L
(125-168), 162ng/L (138-191) and 150ng/L (125-180) in the high-dose
propofol, low-dose propofol and placebo groups respectively (adjusted
geometric mean ratio 1.06; 95% confidence interval 0.97-1.15; P=0.20, for
pairwise comparisons between high and low-dose propofol and between
low-dose propofol and placebo). 96 adverse events which prolonged the
hospital stay, or were life-threatening were reported (33, 26 and 37 in
the high-dose propofol, low-dose propofol and placebo groups respectively)
and four deaths (1 low-dose propofol group, 3 placebo group).
 CONCLUSION(S): Propofol supplementation of warm blood cardioplegia at
both the lower and higher concentrations is safe but there is no evidence
to suggest either dose is cardioprotective. Copyright © 2025.
Published by Elsevier Inc.

<89>
Accession Number
648746494
Title
Incidence of staphylococcus aureus infections after surgical
interventions: a systematic review and meta-analysis.
Source
Expert review of anti-infective therapy. (no pagination), 2025. Date of
Publication: 06 Oct 2025.
Author
Elezbawy B.; Abaza N.; Fasseeh M.; Elshahawy R.; Saeed Y.; Hendawy H.;
Konstantinov S.R.; Ruiz-Guinazu J.; Willame C.; Geurtsen J.; Poolman J.;
Voko Z.; Nagy D.; Zelei T.; Kovacs S.; Lohner S.
Institution
(Elezbawy) Semmelweis University Doctoral School, Budapest, Hungary
(Elezbawy, Abaza, Fasseeh, Elshahawy, Saeed, Hendawy) Syreon Middle East,
Alexandria, Egypt
(Konstantinov, Geurtsen, Poolman) Janssen Vaccines and Prevention B.V,
Leiden, Netherlands
(Ruiz-Guinazu, Willame) Janssen Research and Development, Beerse, Belgium
(Voko, Nagy, Zelei, Kovacs, Lohner) Syreon Research Institute, Budapest,
Hungary
(Voko, Nagy) Center for Health Technology Assessment, Semmelweis
University, Budapest, Hungary
(Lohner) Department of Public Health Medicine, University of Pecs Medical
School, Pecs, Hungary
Abstract
INTRODUCTION: Postoperative Staphylococcus aureus (S. aureus) infections
are associated with increased morbidity and mortality. This systematic
review and meta-analysis aimed to summarize the incidence of postoperative
S. aureus infections. METHOD(S): We searched MEDLINE, CENTRAL, and
Embase (2008-2023) for studies reporting S. aureus infections after hip or
knee replacement, spinal surgery, craniotomy, coronary artery bypass
surgery (CABG), open colon surgery, abdominal hysterectomy, cesarean
section, peripheral vascular bypass, or elective plastic surgery in
selected developed countries were considered. We conducted meta-analysis
with a generalized linear mixed model and assessed risk of bias. This
study is registered with PROSPERO,CRD42023416876. RESULT(S): Data
from 224 studies indicated a cumulative incidence of deep S. aureus
infection after hip surgery 5.05 infections/1000 procedures (95%CI
3.29-7.74), 5.59 (95%CI 3.62-8.63) after knee surgery, 11.74 (95% CI
9.08-15.16) after spinal surgery, and 7.23 (95%CI 1.63-31.86) after CABG
surgery. S. aureus infections were associated with increased all-cause
mortality among CABG, hip, knee and spinal surgeries. Patients cohorts who
received antibiotic prophylaxis and/or underwent decolonization
demonstrated lower incidence of S. aureus infections. CONCLUSION(S):
The incidence of S. aureus infections varies by procedure, with highest
rates seen after spinal surgeries and hysterectomies. Findings highlight
the importance of standardized prevention across surgical settings.

<90>
Accession Number
648737197
Title
Sutureless versus transcatheter valves for the treatment of aortic valve
stenosis: a systematic review and meta-analysis.
Source
Scientific reports. 15(1) (pp 34540), 2025. Date of Publication: 03 Oct
2025.
Author
Minten L.; Lamberigts M.; Van Langenhoven L.; Verbrugghe P.; Bennett J.;
Dubois C.; Meuris B.
Institution
(Minten, Lamberigts, Verbrugghe, Bennett, Dubois, Meuris) Department of
Cardiovascular Sciences, KU Leuven, Herestraat 49, Leuven, Belgium
(Minten, Bennett, Dubois) Department of Cardiovascular Medicine,
University Hospitals Leuven (UZ Leuven), Leuven, Belgium
(Lamberigts, Verbrugghe, Meuris) Department of Cardiac Surgery, University
Hospitals Leuven (UZ Leuven), Leuven, Belgium
(Van Langenhoven) I-BioStat, KU Leuven & University of Hasselt, Leuven,
Belgium
Abstract
An important limitation of the pivotal randomized controlled trials that
compared transcatheter aortic valve replacement (TAVR) to surgical aortic
valve replacement (SAVR) is that the SAVR arm scarcely included sutureless
bioprosthetic valves. We identified 13 retrospective propensity-matched
studies in low (n = 2), intermediate (n = 8), and high-risk (n = 3)
patients, using EuroSCORE and STS score to assess perioperative risk. One
large registry drove the outcome in low-risk patients, showing better
early survival with TAVR, lower rates of stroke and acute kidney injury.
Intermediate-risk patients showed improved early and medium-term survival
with SU-AVR, whilst in high-risk patients, no significant differences were
seen between treatment options. Overall, across all risk categories, the
rates of moderate and severe aortic regurgitation and permanent pacemaker
implantation were significantly lower with SU-AVR, while transprosthetic
gradients and duration of hospital stay were higher compared to TAVR. The
differences in survival in the intermediate risk group are not in line
with conclusions of pivotal randomized trials comparing TAVR with SAVR.
Specific features of SU-AVR may account for these survival differences,
positioning SU-AVR as a valid and safe alternative for patients at
intermediate risk. Awaiting confirmation in randomized trials, careful
patient selection and consideration of either of the AVR options in the
heart team remain crucial. Copyright © 2025. The Author(s).

<91>
[Use Link to view the full text]
Accession Number
648733696
Title
Development of a Three-dimensional Spacer Mattress for Pressure Relief in
Cardiac Surgery and Evaluation of Its Efficacy: A Feasibility Study.
Source
Advances in skin & wound care. (no pagination), 2025. Date of
Publication: 30 Sep 2025.
Author
Isler Isildak Y.; Eti Aslan F.; Korkmaz E.; Comez L.; Toygar I.
Institution
(Isler Isildak) Bahcesehir University, Institute of Postgraduate
Education, Istanbul, Turkey
(Eti Aslan, Korkmaz) Nursing Department, Faculty of Health Sciences,
Bahcesehir University, Istanbul, Turkey
(Comez) Sancaktepe Sehit Prof Dr Ilhan Varank Teaching and Research
Hospital, Istanbul, Turkey
(Toygar) Gerontology Department, Faculty of Health Sciences, Mugla Sitki
Kocman University, Mugla, Turkey
Abstract
OBJECTIVE: To develop a three-dimensional (3D) spacer mattress for
pressure relief and to evaluate its effectiveness during cardiac surgery.
 METHOD(S): This study consisted of 3 phases: development, initial
assessment, and randomized controlled trial (ClinicalTrials.gov,
NCT06071039). Sixty patients underwent cardiac surgery divided into 2
groups, 30 patients each. The data were collected in a public hospital in
Istanbul Provincial Health Directorate Sancaktepe Sehit Prof Dr Ilhan
Varank Training and Research Hospital between February and September 2023.
A 3D spacer mattress was used for the intervention group, and a standard
operating theatre mattress (foam) was used for the control group.
Pressures on the sacrum, left heel, and right heel were measured
throughout surgery using a continuous pressure measurement system.
 RESULT(S): The mean pressure values were 49.73 +/- 17.40, 15.65 +/-
5.19, and 18.01 +/- 9.34 mm Hg for sacrum, left heel, and right heel,
respectively, in the control group, whereas the mean pressure values were
28.21 +/- 11.70, 5.88 +/- 1.88, and 6.56 +/- 2.81 mm Hg for the sacrum,
left heel, and right heel, respectively, in the intervention group. The
means of the maximum pressure values were 90.36 +/- 8.63, 62.51 +/- 13.77,
and 54.19 +/- 16.71 mm Hg for sacrum, left heel, and right heel,
respectively, in the control group, whereas the means of the maximum
pressure values were 49.31 +/- 12.61, 28.82 +/- 13.56, and 31.17 +/- 16.65
mm Hg for the sacrum, left heel, and right heel, respectively, in the
intervention group. There were statistically significant differences
between the groups for mean and maximum pressure on the sacrum, left heel,
and right heel (P < .05). CONCLUSION(S): The use of a 3D spacer
mattress is an effective method to relieve pressure during cardiac
surgery. Copyright © 2025 Wolters Kluwer Health, Inc. All rights
reserved.

<92>
Accession Number
2040736206
Title
ROLE OF ANTICOAGULATION IN SECONDARY ATRIAL FIBRILLATION: SYSTEMATIC
REVIEW AND META-ANALYSIS.
Source
Canadian Journal of Cardiology. Conference: Canadian Journal of
Cardiology. Quebec Canada. 41(10 Supplement) (pp S78-S79), 2025. Date of
Publication: 01 Oct 2025.
Author
Ji D.; Haichin K.; Wang G.; Paparella A.; Verma A.
Institution
(Ji, Haichin, Wang, Paparella, Verma) MontrealQuebecCanada
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Secondary atrial fibrillation (AF), triggered by reversible
conditions such as hyperthyroidism, non-cardiac surgery and sepsis, is a
common clinical challenge among hospitalized patients and is associated
with considerable morbidity and mortality. However, the optimal
anticoagulation strategy remains uncertain. Anticoagulation offers
potential stroke prevention benefits, but carries a risk of bleeding,
underscoring the need for clear, evidence-based recommendations. This
systematic review and meta-analysis aimed to evaluate the risks and
benefits of anticoagulation in patients with secondary AF related to
hyperthyroidism, non-cardiac surgery and sepsis. METHODS AND RESULTS:
Methods Following PRISMA guidelines, we systematically searched four
databases (Cochrane, Embase, MEDLINE, PubMed) using a combination of text
words and indexed terms. Search strategies were peer-reviewed by two
independent librarians. Eligible studies included randomized controlled
trials and observational studies involving adults with new-onset secondary
AF due to non-cardiac surgery, sepsis, or hyperthyroidism. Primary
outcomes included thromboembolic events, bleeding, and mortality. Three
reviewers (KH, DJ, GW) independently screened studies, performed quality
assessment using the NIH study quality assessment tool, and extracted
data. Pooled risk ratios (RRs) were calculated using a random-effects
model in SPSS statistical analysis software. Results The search yielded
13,921 articles. Ultimately, 13 studies met inclusion criteria, with 3
additional studies identified using forward and backward citation
tracking, resulting in a total of 16 studies encompassing 75,894 patients.
All studies were observational in nature: one was prospective, and the
remaining were retrospective. To minimize the risk of bias, 7 studies that
did not adjust their outcomes for confounding variables, such as age, sex,
comorbidities, etc., were excluded from the meta-analysis. Anticoagulation
was associated with a significant reduction in stroke, transient ischemic
attack (TIA), or systemic embolism (RR 0.76; 95% CI, 0.64-0.90), with
consistent findings across subgroups (hyperthyroidism, post non-cardiac
surgery, sepsis). Anticoagulation was also linked to reduced mortality in
all groups (RR 0.53, 95% CI, 0.45-0.62). Bleeding risk was not
significantly increased in both the sepsis (RR 1.0, 95% CI, 0.85-1.16) and
postoperative (RR 1.36, 95% CI, 0.96-1.92) cohorts. However, important
heterogeneity was observed across studies, as indicated by I2 testing.
 CONCLUSION(S): In patients with secondary AF, anticoagulation appears
to confer significant reductions in both thromboembolic events and
all-cause mortality without a corresponding increase in bleeding risk.
Nevertheless, due to the observational nature and heterogeneity of the
current evidence, high-quality randomized controlled trials are essential
to establish definitive treatment recommendations for this diverse and
high-risk population. [Formula presented] Copyright © 2025

<93>
Accession Number
648733865
Title
Updated Evidence on Perioperative Neutrophil-to-Lymphocyte Ratio in
Cardiac Surgery: A Dual Analysis of Prognostic and Diagnostic Value for
Postoperative Atrial Fibrillation.
Source
Heart rhythm. (no pagination), 2025. Date of Publication: 30 Sep 2025.
Author
Awad M.K.A.; Ali A.E.; Mazroua M.S.; Ali K.; Awad R.K.; Mohamed T.R.;
Abdelmaksoud M.; Hashim M.A.; Nikollari R.; Vardas P.N.; Abu-Daya H.
Institution
(Awad) Division of Critical Care, Department of Anesthesia and Critical
Care, Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Ali) Department of Internal Medicine, Crestwood Medical Center,
Huntsville, AL, United States
(Mazroua) Department of Surgery, University of Pittsburgh, Pittsburgh, PA,
United States
(Ali) Department of Medicine, Hennepin Healthcare, Minneapolis, MN, United
States
(Awad) Department of Critical Care, Cairo University, Cairo, Egypt
(Mohamed) Division of Critical Care, Department of Anesthesia and Critical
Care, Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Abdelmaksoud) Division of Critical Care, Department of Anesthesia and
Critical Care, Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Hashim) Department of Internal medicine, Mercy st. Vincent Medical center
-Toledo, OH, United States
(Nikollari) Department of Internal medicine, St. Barnabas Hospital Health
system, Bronx, United States
(Vardas) Division of Cardiothoracic Surgery, University of Alabama at
Birmingham Heersink School of Medicine, Birmingham, AL, United States
(Abu-Daya) Division of Cardiovascular Disease, Department of Medicine,
University of Alabama at Birmingham Heersink School of Medicine,
Birmingham, AL, United States
Abstract
BACKGROUND: Post-operative atrial fibrillation (POAF) is a frequent
complication after cardiac surgery, increasing morbidity. The
neutrophil/lymphocyte ratio (NLR), a simple marker of systemic
inflammation, has been studied as a predictor. OBJECTIVE(S): Assess
association between NLR and new-onset POAF. METHOD(S): We
systematically searched PubMed, Scopus, Web of Science, and Embase through
June 2025 for studies reporting preoperative or postoperative NLR and
incidence of POAF in adult cardiac surgery patients. Diagnostic test
accuracy (DTA) was assessed to evaluate the predictive performance of
preoperative NLR for postoperative atrial fibrillation, using pooled
sensitivity, specificity, and likelihood ratios. Subgroup analyses and
meta-regression were conducted to explore sources of heterogeneity.
 RESULT(S): Thirty-two studies (20,056 patients) were included. In 27
studies excluding preoperative AF (13,630 patients), POAF was associated
with significantly higher preoperative NLR (SMD = 0.51; 95% CI: 0.34-0.67;
p < 0.001; I2 = 94.0%). Postoperative NLR was also elevated in POAF
patients (SMD = 0.30; 95% CI: 0.13-0.47; p < 0.001; I2 = 70.7%). Among
four studies including patients with prior AF (6,364 patients), no
significant association was observed (SMD = 0.04; p = 0.21). DTA analysis
of 12 studies showed pooled sensitivity of 0.52, specificity of 0.71, and
diagnostic odds ratio of 3.74 (AUC = 0.713), indicating moderate
diagnostic accuracy. CONCLUSION(S): Elevated NLR is associated with
increased risk of POAF. Distinguishing new-onset POAF and accounting for
surgical type are essential when evaluating NLR as a predictive
biomarker. Copyright © 2025. Published by Elsevier Inc.

<94>
Accession Number
2040736440
Title
LEFT ATRIAL APPENDAGE OCCLUSION DURING CARDIAC SURGERY TO PREVENT STROKE
(LAAOS-III): SEX DIFFERENCES SUB STUDY.
Source
Canadian Journal of Cardiology. Conference: Canadian Journal of
Cardiology. Quebec Canada. 41(10 Supplement) (pp S13), 2025. Date of
Publication: 01 Oct 2025.
Author
Um K.; Whitlock R.; Kim K.; Fournier R.; Spence J.; Eikelboom R.;
Belley-Cote E.
Publisher
Elsevier Inc.
Abstract
BACKGROUND: l fibrillation (AF) is a leading cause of ischemic stroke. The
Left Atrial Appendage Occlusion Study (LAAOS) III showed that surgical
left atrial appendage occlusion (LAAO) during cardiac surgery reduces
stroke risk by one-third in patients with AF. Given the higher baseline
stroke risk among women with AF, the benefit of surgical LAAO may differ
based on sex. This secondary analysis of LAAOS III aimed to assess whether
sex modifies the effect of LAAO on patient outcomes. METHODS AND RESULTS:
In LAAOS III, adults scheduled for on-pump cardiac surgery with a history
of AF and a CHA2DS2 -VASc score >=2 were randomized to concomitant LAAO
during cardiac surgery versus no LAAO. Patients were excluded if they
underwent mechanical-valve implantation, heart transplantation, surgery
for congenital heart disease or implantation of a left ventricular assist
device, or had had previous surgical opening of the pericardium or
percutaneous LAAO. We built a multivariable logistic regression model with
the following predictor variables: LAAO, female sex, age, heart failure,
hypertension, diabetes, cerebrovascular event or systemic thromboembolism,
and vascular disease. An interaction term between female sex and LAAO
treatment was included to compare the full model with a reduced model
(without the interaction) using a likelihood ratio test. Our outcomes of
interest included ischemic stroke or systemic thromboembolism (primary),
myocardial infarction, death from any cause, and major adverse
cardiovascular events. We performed a landmark analysis for the primary
outcome at <=30 days after surgery and >30 days. Baseline characteristics
were not balanced between men and women; more women had a history of heart
failure, but more men had diagnoses of hypertension, diabetes, and
vascular disease (Table 1). When adjusting for CHA2DS2 -VASc, female sex
did not modify the effect of LAAO on ischemic stroke and systemic arterial
embolism (p for interaction = 0.51), myocardial infarction (p for
interaction = 0.31), death (p for interaction = 0.77) or major adverse
cardiac events (p for interaction = 0.31) (Table 2). The landmark analysis
for the primary outcome yielded consistent results. CONCLUSION(S):
Sex does not significantly alter the effects of surgical LAAO on stroke
reduction or other secondary outcomes. [Formula presented] [Formula
presented] Copyright © 2025

<95>
Accession Number
648729710
Title
Scoping Review of Early Mobility in the Intensive Care Unit Following
Cardiac Surgery.
Source
Anaesthesia, critical care & pain medicine. (pp 101603), 2025. Date of
Publication: 29 Sep 2025.
Author
Phillips E.K.; Hay J.L.; Monnin C.; Gregora A.; Smith K.; Shaski C.; Bozek
G.; Gilchrist S.; Fagan A.; Ashe M.C.; Chudyk A.M.; Schultz A.S.H.;
O'Keefe-McCarthy S.; Arora R.C.; Duhamel T.A.
Institution
(Phillips) Applied Health Sciences, Faculty of Graduate Studies,
University of Manitoba, Winnipeg, MB, Canada
(Hay) Applied Health Sciences, Faculty of Graduate Studies, University of
Manitoba, Winnipeg, MB, Canada; Faculty of Kinesiology and Recreation
Management, University of Manitoba, Winnipeg, MB, Canada; Institute of
Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research
Centre, Winnipeg, MB, Canada
(Monnin) Neil John Maclean Health Sciences Library, University of
Manitoba, Winnipeg, MB, Canada
(Gregora, Smith) Person with lived experience partner
(Shaski, Bozek, Gilchrist, Fagan) St Boniface Hospital, Winnipeg, MB,
Canada
(Ashe) Department of Family Practice, University of British Columbia,
Vancouver, Canada
(Chudyk) College of Pharmacy, Rady Faculty of Health Sciences, University
of Manitoba, Winnipeg, MB, Canada
(Schultz) Institute of Cardiovascular Sciences, St. Boniface Hospital
Albrechtsen Research Centre, Winnipeg, MB, Canada; College of Nursing,
Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB,
Canada
(O'Keefe-McCarthy) Department of Nursing, Faculty of Applied Health
Sciences, Brock University, St. Catharines, ON, Canada
(Arora) Harrington Heart and Vascular Institute University Hospitals -
Cleveland Medical Center/Case Western Reserve University, Cleveland, OH,
United States
(Duhamel) Faculty of Kinesiology and Recreation Management, University of
Manitoba, Winnipeg, MB, Canada; Institute of Cardiovascular Sciences, St.
Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada
Abstract
INTRODUCTION: Early mobility in the intensive care unit (ICU) within 24
hours following cardiac surgery (CS) is guideline-recommended, safe, and
supports improved patient outcomes. The evolution of early mobility
following CS research has not been explored. Prior reviews have not
included non-randomized controlled trials nor assessed the quality of
intervention reporting using standard guidelines. OBJECTIVE(S): This
scoping review addresses these gaps and maps CS ICU early mobility
literature to understand the extent, range, and nature of the extant
literature. DESIGN: The databases Medline, Embase, PsycINFO, Scopus,
CINAHL, ClinicalTrials.org, and CS association websites were searched from
inception to January 2025. Extracted details included early mobility
definitions and modes, outcome measures, alignment of intervention
reporting with the Consensus of Exercise Reporting Template (CERT), and
the inclusion of sex/gender in results/discussions. RESULT(S): A
total of 109 studies were included. 43 studies defined early mobility,
ranging from the day of surgery to within 2 weeks post-operatively. Many
early mobility modes were noted, most commonly ambulation. Primary
outcomes varied, with hospital length of stay and pulmonary function the
most often studied. There was a consistent lack of reporting of CERT
items. Only two studies presented findings disaggregated by sex/gender,
and only 13 studies considered sex/gender in the discussion.
 CONCLUSION(S): There is inconsistency in the extant CS ICU early
mobility literature, specifically in early mobility definitions and modes,
outcome measures, quality of intervention reporting, and consideration of
sex/gender. Improvements to research design and reporting should be
encouraged to support the advancement of the science. Copyright ©
2025. Published by Elsevier Masson SAS.

<96>
Accession Number
2040736290
Title
ASSOCIATION BETWEEN LIPOPROTEIN(A), OXIDIZED PHOSPHOLIPIDS AND
BIOPROSTHETIC VALVE DYSFUNCTION FOLLOWING TRANSCATHETER AORTIC VALVE
IMPLANTATION.
Source
Canadian Journal of Cardiology. Conference: Canadian Journal of
Cardiology. Quebec Canada. 41(10 Supplement) (pp S175), 2025. Date of
Publication: 01 Oct 2025.
Author
Giuliani C.; Hecht S.; Zanuttini A.; Avvedimento M.; Bernard J.; Tastet
L.; Abu-Alhayja'a R.; Beaudoin J.; Cote N.; Beaupre F.; Poulin A.;
DeLarochelliere R.; Paradis J.; Clavel M.; Arsenault B.; Capoulade R.;
Rodes-Cabau J.; Tsimikas S.; Pibarot P.
Institution
(Giuliani, Hecht, Zanuttini, Avvedimento, Bernard, Tastet, Abu-Alhayja'a,
Beaudoin, Cote, Beaupre, Poulin, DeLarochelliere, Paradis, Clavel,
Arsenault, Capoulade, Rodes-Cabau, Tsimikas, Pibarot) QuebecQuebecCanada
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Lipoprotein(a) [Lp(a)] and oxidized phospholipids (OxPL) are
involved in the initiation and progression of aortic stenosis (AS). Their
association with Valve Academic Research Consortium-3 (VARC-3) criteria
for bioprosthetic valve dysfunction (BVD) after transcatheter aortic valve
implantation (TAVI) remains unclear. The objective of the present study
was to investigate the association between Lp(a) and OxPL levels and the
development of BVD following TAVI. METHODS AND RESULTS: This analysis
included 210 patients with severe AS treated with TAVI between January
2017 and 2020, enrolled in the TAVI-B study. Clinical and
echocardiographic data were collected before the procedure and at one
year. Lp(a), OxPL-apoB, OxPL-apo(a) were measured using chemiluminescent
immunoassays, and their association with BVD was assessed using logistic
regression. The mean age of the study population was 79.7+/-8.2 years and
120 (57.1%) were males. 25 (12%) patients developed BVD at 1 year
following TAVI. Of these 25 patients, 9 (36%) had BVD stage 1
(morphological deterioration), 14 (56%) Stage 2 (moderate hemodynamic
valve deterioration), and 2 (8%) stage 3 (severe hemodynamic valve
deterioration). The etiology of BVD was SVD in 9/25 (36%), subclinical
leaflet thrombosis (SLT) in 6/25 (24%) and undetermined in 10/25 (40%).
Lp(a) (38.9 [8.5-123.6] nmol/L) and OxPL-apoB (9.0 [4.7-16.4] nmol/L)
levels were significantly higher in patients with BVD. At 1 year
post-TAVI, patients with Lp(a) >=30 nmol/L had a higher incidence of: i)
overall BVD (25 [18.5%] vs. 10 [7.8%], p=0.027; OR [95% CI]: 2.77
[1.08-7.08], p=0.033), ii) Stage 2 or 3 BVD (12 [8.6%] vs. 4 [2.3%],
p=0.002); OR [95% CI]: 5.43 [1.58-17.48], p= 0.005, and iii) SLT (5 [6.2%]
vs. 1 [0.8%], p=0.022). However, during a median follow-up of 2.6 years
(IQR 2.2-3.6), neither Lp(a) >=30 nmol/L nor BVD was associated with an
increased risk of all-cause mortality (HR [95% CI]: 1.04 [0.54-2.00],
p=0.89 and HR [95% CI]: 0.99 [0.35-2.82], p=0.99) respectively.
 CONCLUSION(S): Elevated plasma levels of Lp(a) and OxPL-apoB were
associated with an increased risk of BVD at 1-year follow-up. These
findings emphasize the need for randomized clinical trials to determine
whether Lp(a)-lowering therapies can reduce the risk of BVD and SVD,
thereby improving valve durability and clinical outcomes after
TAVI. Copyright © 2025

<97>
Accession Number
2040736218
Title
REAL-WORLD ANTI-THROMBOTIC STRATEGIES OF PATIENTS AFTER A LEFT ATRIAL
APPENDAGE OCCLUSION.
Source
Canadian Journal of Cardiology. Conference: Canadian Journal of
Cardiology. Quebec Canada. 41(10 Supplement) (pp S136), 2025. Date of
Publication: 01 Oct 2025.
Author
Brouillard P.; Diallo E.; Monet-Alarcia R.; Masson J.; Raymond J.; Riahi
M.; Potter B.; Kouz R.; Potvin J.
Publisher
Elsevier Inc.
Abstract
BACKGROUND: While randomized controlled trials have demonstrated the
efficacy of percutaneous left atrial appendage occlusion (pLAAO) in
preventing stroke among patients with atrial fibrillation (AF), real-world
adoption of the procedure often targets a distinct and more vulnerable
population. In clinical practice, pLAAO is frequently performed on frail,
elderly patients with multiple comorbidities and a history of major
bleeding, often as a last-resort intervention when long-term oral
anticoagulation (OAC) is no longer viable. This discrepancy between trial
populations and real-world recipients highlights the need for
observational data to guide clinical decision-making in this high-risk
group, particularly regarding patient selection and post-procedural
antithrombotic regimens. METHODS AND RESULTS: This retrospective
single-center study analyzed 285 patients who underwent pLAAO at the
Centre hospitalier de l'Universite de Montreal (CHUM) from 2011 to 2023.
Patients were included if they had non-valvular AF and no other indication
for systemic anticoagulation. The cohort had a mean age of 73.8 +/- 8.0
years and was characterized by a significant comorbidity burden:
hypertension (78.6%), dyslipidemia (63.2%), diabetes (37.9%). Patients
were largely referred because of previous bleeding requiring
hospitalization (93.3%). The median CHA<inf>2</inf>DS<inf>2</inf>-VASc and
HAS-BLED scores were 4, indicating high risk of both thromboembolism and
bleeding. Post-procedural antithrombotic regimens varied: 61.8% received
dual antiplatelet therapy (DAPT), 21.4% single antiplatelet therapy
(SAPT), 15.1% anticoagulation, and 1.8% no therapy. At the time of
follow-up transoesophageal assessment (median 113 days), most patients
transitioned to SAPT (72.8%), with 12.0% on DAPT, 14.1% no therapy and
only 1.1% on anticoagulation. Procedural complications occurred in 14% of
cases: 6.7% vascular, 6.7% pericardial effusions requiring drainage, and <
1% device embolization, stroke and death. The complication rate declined
over time, likely reflecting improved operator proficiency with increased
procedural experience and better patient selection. All-cause one-year
mortality was 11.3%, largely driven by the no therapy subgroup (30.0%).
The rate of readmissions for thromboembolism at one year was 3.5% and
similar across groups (p = 0.952). The bleeding rate at one year was 2.1%,
driven by the anticoagulation group (33.3% vs SAPT 2.4%, DAPT 0% and no
treatment 0%, p = 0.001). CONCLUSION(S): In a real-world setting,
pLAAO was most used in frail, high-risk patients. Outcomes reflect this
population's vulnerability, with higher complication and mortality rates
than those in controlled trials. Our data suggest both anticoagulation and
no anticoagulation are potential drivers of bleeding and mortality,
respectively, emphasizing the need for evidence-based guidance. In the
interim, careful patient and antithrombotic regimen selection are
paramount. [Formula presented] [Formula presented] Copyright ©
2025

<98>
Accession Number
2040736050
Title
IMPROVING THE FUNCTIONALITY OF HIPSC-DERIVED CARDIOMYOCYTES AND ASSESSING
THE FULL TRANSCRIPTOME OF HEART FAILURE PATIENTS WITH DILATED
CARDIOMYOPATHY USING PUBLICLY AVAILABLE SCRNA-SEQ DATA.
Source
Canadian Journal of Cardiology. Conference: Canadian Journal of
Cardiology. Quebec Canada. 41(10 Supplement) (pp S191-S192), 2025. Date of
Publication: 01 Oct 2025.
Author
Lung B.; Mouttet L.; Mottahedi M.; Hekmatnia Y.; Kachurina N.; Derish I.;
Cecere R.
Institution
(Lung, Mouttet, Mottahedi, Hekmatnia, Kachurina, Derish, Cecere)
MontrealQuebecCanada
Publisher
Elsevier Inc.
Abstract
BACKGROUND: In Canada, heart failure (HF) is an alarming cause of
cardiovascular mortality. Approximately 2.26% of the Canadian population
or 850,000 individuals suffer from HF. HF is defined as a complex syndrome
that results from functional impairments of ventricular filling or
ejection of blood. Unfortunately, heart transplantation remains the only
treatment option to reverse chronic damage caused by HF. Recent advances
in personalized medicine have identified human induced pluripotent stem
cells (hiPSCs) as a potential treatment for HF. hiPSCs may differentiate
into cardiomyocytes, paving the way for eventual transplantation into
patients with end-stage HF. Due to extensive cardiomyocyte heterogeneity
in HF patients, transplantation of hiPSC-derived cardiomyocytes
(hiPSC-CMs) will likely need to be personally tailored to each HF patient
due to different differentiation patterns. However, the HF cardiac
microenvironment has not been extensively elucidated in the literature.
The investigation of cardiomyocyte heterogeneity also revealed that more
functional hiPSC-CMs (as assessed by contractile function, gene, and
protein expression) are required. This is because hiPSC-CMs tend to
express a fetal-like phenotype when grown in cell culture, hindering the
ability for more robust therapies and biomedical innovations from being
developed. Here, we aim to characterize the HF cardiac microenvironment in
silico and improve the in vitro differentiation process of hiPSC-CMs.
METHODS AND RESULTS: We performed a single-cell sequencing meta-analysis
on relevant publicly available datasets containing information on
hiPSC-CMs, hiPSC-CM derived organoids, and different modes of HF. 10
datasets were analyzed. Expression matrices containing gene counts in each
sample were matched with their corresponding metadata and analysis was
performed following Seurat 5.1.0. A negative binomial linear model was
created to analyze differentially expressed genes across different iPSC-CM
and HF conditions to elucidate cell-type, sex, and patient-specific
changes. Heterogeneous cell types were revealed between patients-specific
hiPSC-CMs lines and different HF conditions based on differentially
expressed transcriptomic signals. Indeed, immature hiPSC-CMs primarily
contained PTMA+ cardiomyocytes, indicating an embryonic-like,
proliferative state when compared to mature adult human cardiomyocytes.
Transcriptomically as a whole, hiPSC-CM are significantly different from
HF and normal cardiomyocytes based on expression of PDK4 and KCNMB2.
 CONCLUSION(S): In this meta-analysis, we present the existence of
novel, heterogeneous cell types within patient-specific hiPSC-CM and HF
populations. We intend on using these findings to compare them to our
patient population here in the Heart-in-a-Dish project. Ultimately, we
hope our research can improve the functionality and maturity of hiPSC-CMs
within the in vitro differentiation process. Copyright © 2025

<99>
Accession Number
2040742623
Title
The Impact of Prothrombin Complex Concentrate Versus Fresh Frozen Plasma
for Hemorrhage Management in Cardiac Surgery: A Systematic Review and
Meta-analysis of Randomized Clinical Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Grillo I.T.C.; Katsuyama E.; Aguiar C.C.; Passos F.S.; Costa B.S.; Treml
R.E.; Ehler J.; Kirov H.; Doenst T.; Caldonazo T.
Institution
(Grillo, Aguiar) Department of Medicine, University of Buenos Aires,
Buenos Aires, Argentina
(Katsuyama) Department of Medicine, ABC School of Medicine University
Center, Sao Paulo, Brazil
(Passos) Department of Thoracic Surgery, Mater Dei Hospital, Salvador,
Brazil
(Costa) Department of Medicine, Nove de Julho University, Bauru, Brazil
(Treml) Department of Anesthesiology, Perioperative and Pain Medicine,
Stanford University School of Medicine, CA, United States
(Ehler) Department of Anesthesiology and Intensive Care Medicine, Jena
University Hospital, Jena, Germany
(Kirov, Doenst, Caldonazo) Department of Cardiothoracic Surgery, Jena
University Hospital, Jena, Germany
(Caldonazo) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
Publisher
W.B. Saunders
Abstract
Objective: To clarify the efficacy and safety endpoints, comparing
prothrombin complex concentrate (PCC) versus fresh frozen plasma (FFP) for
hemorrhage management in cardiac surgery. Design(s): Systematic
review and meta-analysis of randomized clinical trials (RCTs).
 Setting(s): Tertiary care. Participant(s): Adult patients who
developed hemorrhage related to coagulation factor deficiency during
cardiac surgery. Intervention(s): PCC or FFP for hemorrhage
management in cardiac surgery. Measurements and Main Results: A
systematic search was conducted in PubMed, Embase, and Cochrane Library
and identified RCTs comparing PCC with FFP for hemorrhage management in
cardiac surgery. The primary outcome was postintervention hemoglobin
levels. Secondary outcomes included 30-day mortality, transfusion
requirements, adverse events, postintervention international normalized
ratio, and reoperation rates. Categorical values were analyzed using risk
ratios with 95% confidence intervals (CIs), whereas continuous values were
compared using the mean difference and standardized mean difference with
95% CIs. Statistical analyses were conducted using R software, version
4.4.2. Four RCTs (671 patients) were included, with 343 (51.1%) patients
receiving PCC. PCC was associated with higher postintervention hemoglobin
levels (mean difference 1.17 g/dL, 95% CI 0.93-1.41, p < 0.01). Compared
with FFP, the PCC group required fewer red blood cell transfusions at 24
hours, had reduced use of recombinant factor VII, and demonstrated
improved postintervention international normalized ratio.
 Conclusion(s): In patients undergoing cardiac surgery with
significant bleeding, PCC was associated with higher postintervention
hemoglobin levels and reduced transfusion needs compared with FFP, without
an increase in adverse events. Copyright © 2025 The Authors

<100>
Accession Number
2040736334
Title
THE RISK OF TRANEXAMIC ACID-ASSOCIATED SEIZURE: A META-ANALYSIS OF LARGE
RANDOMIZED TRIALS.
Source
Canadian Journal of Cardiology. Conference: Canadian Journal of
Cardiology. Quebec Canada. 41(10 Supplement) (pp S20-S21), 2025. Date of
Publication: 01 Oct 2025.
Author
Lamy A.; Sirota D.; Jacques F.; Poostizadeh A.; Noiseux N.; Efremov S.;
Demers P.; Browne A.; Devereaux P.
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Intravenous tranexamic acid (TxA) is widely recommended for
use as a blood-conservation strategy during cardiac surgery. However,
post-operative seizures remain a concern, generating an avoidance of high
doses and leading to different practices in Canada. It has been previously
demonstrated that oxygen bubbles activated by focused ultrasound could
"pop" and temporarily disrupt the blood brain barrier (BBB), allowing
complex molecules to enter the BBB despite being normally impervious to
these molecules. We hypothesize that open-chamber surgeries with air
bubbles to the brain could facilitate the entry of tranexamic acid by
disturbing the BBB and increase the risk of seizures. Therefore, we aimed
to investigate seizures in patients undergoing open-chamber versus
closed-chamber cardiac surgery, using pooled data from the large
DEPOSITION and OPTIMAL trials. METHODS AND RESULTS: We conducted a
meta-analysis of the 2 largest randomized controlled trials of tranexamic
acid use that documented post-operative seizures in patients undergoing
cardiac surgery with cardiopulmonary bypass. Of the 6,191 patients
included in the meta-analysis, 3,458 (56%) underwent open-chamber surgery
and 2,733 (44%) underwent closed-chamber surgery. The primary outcome was
post-operative seizure within 30 days. Summary statistics from each trial
were pooled using an inverse variance-weighted random effects model.
Open-chamber compared with closed-chamber cardiac surgery increased the
risk of seizures within 30 days based on high quality evidence (risk
ratio, 3.13; 95% CI, 1.35-7.25; P=0.008). Heterogeneity across included
studies was minimal (I2 = 0%). The dose of intravenous TxA used was left
to the discretion of the anesthesiologist in DEPOSITION, whereas a fixed
dose of either 1.0 mg/kg or 10.0 mg/kg was used according to the
randomization in OPTIMAL. The risk of seizure was not different between
doses of TxA received in these 2 trials (P=0.35). CONCLUSION(S): In
this meta-analysis of 6,191 patients from the DEPOSITION and OPTIMAL
trials, we found evidence that open-chamber surgery is associated with an
increased risk of seizures after cardiac surgery. These findings suggest
that TxA dosing could be tailored to the type of surgery. [Formula
presented] [Formula presented] Copyright © 2025

<101>
[Use Link to view the full text]
Accession Number
648729517
Title
Combined Pecto-intercostal Fascial Plane and Rectus Sheath Blocks Versus
Local Infiltration for Pain Management Following Pediatric Cardiac
Surgery: A Randomized Clinical Trial.
Source
Anesthesia and analgesia. (no pagination), 2025. Date of Publication: 01
Oct 2025.
Author
Einhorn L.M.; Kharasch E.D.; Lim J.; Fuller M.; Turi J.L.; Jooste E.H.;
Andrew B.Y.; Ames W.A.
Institution
(Einhorn, Jooste, Andrew, Ames) From the Division of Pediatrics,
Department of Anesthesiology
(Kharasch, Lim, Fuller) Department of Anesthesiology
(Turi) Department of Pediatrics, Pediatric and Congenital Heart Center,
Duke University School of Medicine, Durham, NC, United States
Abstract
BACKGROUND: Previous studies have shown that regional anesthesia (RA) use
versus placebo control is associated with less postsurgical opioid
requirements and improved pain scores. This trial compared a novel
combination of bilateral pecto-intercostal fascial plane and unilateral
rectus sheath blocks to an active comparator of surgeon-administered local
anesthetic wound infiltration in children undergoing septal defect repair.
The study tested the hypothesis that RA use would result in less opioid
use and lower pain intensity compared to wound infiltration.
 METHOD(S): This double-blind, randomized, parallel group,
single-center trial included children (<18 years) undergoing primary
atrial septal defect (ASD) or ventricular septal defect (VSD) repair.
Participants were randomized to RA consisting of ultrasound-guided
pecto-intercostal fascial plane and rectus sheath blocks or no-block,
consisting of local anesthetic wound infiltration. Both groups received
1.5 mL/kg of ropivacaine 0.2% for the intervention. The primary outcome
was opioid use (oral morphine milligram equivalents [MME]/kg) 0-12 hours
after surgery. Secondary outcomes were opioid use at additional time
points, pain (0-10 scale) between 0 and 48 hours (area under the curve
[AUC]), and hospital length of stay (LOS). RESULT(S): Data analysis
included 42 children (24 RA, 18 infiltration), age 3.3 +/- 2.7 years (mean
+/- standard deviation [SD]; median, 3; range, 4 months-10 years). Opioid
use (MME/kg mean +/- SD) 0-12 hours after surgery was 0.44 +/- 0.19 in the
RA group compared to 0.83 +/- 0.39 in the infiltration group (mean
difference -0.39; 95% confidence interval [CI], -0.59 to -0.18; P = .001).
Total postoperative opioid use from 0 to 48 hours after surgery was 0.95
+/- 0.40 in the RA group compared to 1.57 +/- 0.75 in the infiltration
group (mean difference -0.64; 95% CI, -1.02 to -0.22, P = .004). Pain
intensity AUC (0-48 hours) was 45.0 +/- 26.8 in the RA group compared to
94.5 +/- 55.7 in the infiltration group (mean difference -49.5 [-78.9 to
-20.1]; P = .002). Opioid use between 12 and 48 hours and hospital LOS was
not different between groups. CONCLUSION(S): This single-center study
showed that the combined pecto-intercostal fascial plane and rectus sheath
blocks were opioid-sparing and provided superior pain control compared to
contemporary practice of local anesthetic infiltration in children
following septal defect repair. This investigation strengthens the
evidence to support RA use to improve postoperative pain in this
population. Copyright © 2025 International Anesthesia Research
Society.

<102>
Accession Number
2040827539
Title
Prolonged duration of pharmacological thromboprophylaxis following
oncologic surgery: A systematic review and meta-analysis of RCTs.
Source
Thrombosis Research. 255 (no pagination), 2025. Article Number: 109500.
Date of Publication: 01 Nov 2025.
Author
Wang Z.; Yu Z.; Niu T.
Institution
(Wang, Yu, Niu) Department of Hematology, West China Hospital, Sichuan
University, Chengdu, China
(Niu) State Key Laboratory of Biotherapy, Collaborative Innovation Center
of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
(Niu) National Facility for Translational Medicine (Sichuan), West China
Hospital, Sichuan University, Chengdu, China
Publisher
Elsevier Ltd
Abstract
Background: Venous thromboembolism (VTE) is the leading cause of 30-day
postoperative mortality, with current guidelines recommending
extended-duration thromboprophylaxis despite limited evidence on its
impact on clinically meaningful benefits. Objective(s): To evaluate
the efficacy and safety of prolonged anticoagulant prophylaxis versus
in-hospital only prophylaxis in cancer surgery patients using a
meta-analysis of randomized controlled trials (RCTs). Method(s): We
conducted a systematic review and meta-analysis of 10 RCTs. The primary
outcomes included overall VTE, symptomatic VTE, pulmonary embolism (PE),
major bleeding, and all-cause mortality. Results were summarized using
relative ratios (RR) and 95 % confidence intervals (CIs). Result(s):
Prolonged prophylaxis significantly reduced the 30-day incidence of
overall VTE (4.0 % vs. 10.0 %; RR 0.40, 95 %CI 0.22-0.76). No significant
differences were observed in the 30-day incidence of symptomatic VTE (0.7
% vs. 1.1 %; RR 0.66, 95 %CI 0.29-1.48), PE (0.5 % vs. 0.5 %), or 90-day
mortality (1.4 % vs. 1.6 %). A non-significant increase in major bleeding
occurred (0.9 % vs. 0.2 %; RR 2.37, 95 %CI 0.79-7.11). Subgroup analyses
indicated heterogeneity in primary outcomes based on surgical site
(abdominopelvic vs. thoracic surgery). Conclusion(s): While prolonged
duration of pharmacological thromboprophylaxis reduces the incidence of
overall VTE, it does not demonstrate clinically meaningful benefits for
symptomatic events or survival. Current risk-stratification tools may
overestimate thrombotic risk in cancer surgery patients receiving standard
in-hospital prophylaxis. Our findings support a selective, rather than
universal, approach to prolonged prophylaxis, emphasizing individualized
risk assessment. Copyright © 2025 Elsevier Ltd. All rights are
reserved, including those for text and data mining, AI training, and
similar technologies.

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